This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

U.S. Data Access Framework (DAF) Smoking Status Profile (Profile)

Scope and Usage

This profile sets expectations for use of the Observation resource to record Smoking Status of a patient within the Data Access Framework (DAF) Implementation Guide. This profile identifies which core elements,extensions,vocabularies and value sets must be Supported by DAF actors. For the definition of Supported please refer to DAF FHIR IG. The data elements identified by the profile are based on ONC 2014 Edition S&CC and DAF use cases. The mappings between the ONC 2014 Edition S&CC data elements and DAF data elements are captured in the table below, where the first column identifies the ONC 2014 Edition S&CC data element name, the second column maps the ONC 2014 Edition S&CC data elements to DAF data elements which are derived from ONC 2014 Edition S&CC standards and DAF use cases and lastly the third column identifies the mapping to FHIR resources and attributes.

Meaningful Use Data Element Mapping

The DAF Smoking Status profile mapping to Meaningful Use data elements and FHIR Resources are as shown below.

Meaningful Use Data Element Name	Mapping to Priority DAF Data Elements	FHIR Resource Mapping
Smoking Status
	Patient for whom smoking status is being captured	Observation.subject
	Smoking Status Value	Observation.valueCodeableConcept
	Smoking Status Value Applicability (Time Period when the Smoking Status value is/was applicable)	Observation.appliesPeriod

Meaningful Use Data Element Name

Mapping to Priority DAF Data Elements

FHIR Resource Mapping

Smoking Status

Patient for whom smoking status is being captured

Observation.subject

Smoking Status Value

Observation.valueCodeableConcept

Smoking Status Value Applicability (Time Period when the Smoking Status value is/was applicable)

Observation.appliesPeriod

Boundaries and Relationships

This profile relies on the following other profiles:

DAFPatient which defines DAF Patient profile is used by DAFSmokingStatus profile to refer to patients.
FHIR Extensibility defines how extensions can be applied to FHIR resources and data types. Specifically the data-absent-reason extension can be used to code data elements with missing information when appropriate. See DAF FHIR IG for additional guidance.

Profile Details

Profiles:
DAFSmokingStatus	Smoking Status Observation

Search Parameters

The full list of supported search parameters are can be accessed at DAF Requestor conformance expectations and DAF Responder conformance expectations.

Example Usage Scenarios

The following are example usage scenarios for the DAF Smoking Status profile:

Query for Smoking Status of a particular patient
Query for all patients who have had a history of smoking
Query for all patients who have never had tobacco
Query for all patients who have smoked during a time period of interest
Query for all patients who have a smoking history and are in an age group

Profile specific implementation guidance

Implementers need to be mindful of the following during their implementation

Smoking Status Applicability: The Smoking Status values describe point-in-time smoking status, and implementers have to be mindful of the semantic meaning while using these codes to describe smoking behavior. For example, if I want to say that a patient used to smoke heavily between 2000 and 2010, it does not make sense to use the code for Former smoker', along with an appliesPeriod representing 2000-2010. This is because 'Former smoker' did not apply during that time range. Instead implementers should use a 'current smoker' along with a time range representing 2000-2010.

See DAF FHIR IG for implementation guidance common to all profiles.