Functional Assessment Data: Current Status of Federal Initiatives to Support Interoperability among Post Acute Care Settings

Abstract

Health information needed along the transitions in care includes functional status such as self-care abilities assessments. Despite current federal efforts to support interoperability of functional status data, gaps still exist. Functional status assessments are included in data collection instruments widely used in four post acute care (PAC) settings, with each type of setting using a different standard instrument. These various instruments lack a shared standard for the content (meaning) of functional assessment items, necessitating mapping to a standard data terminology. Analysis indicates complete LOINC representation and incomplete SNOMED representation among functional status items and instruments. The new U.S. Core Data for Interoperability (USCDI) data standard has not included functional status in the next version to be adopted due in part to insufficiently defined use cases. The Post-Acute Care Interoperability Workgroup (PACIO) produced a FHIR implementation guide for functional status based on a use case. Gaps persist in PAC interoperability adoption.