Case Based Surveillance Implementation Guide - Local Development build (v0.2.1). See the Directory of published versions

Message Mapping Guide to Case Based Surveillance IG Profile Mapping

This mapping is presented as demonstration of how to present data provided through CDC Message Mapping Guides as CBS IG FHIR Profiles and other FHIR Resources. In many cases there is a many to one mapping of MMG data element to CBS IG profiles and FHIR resources, broken down by element as appropriate.

General Guidance

Data Elements and Data Element Identifiers

MMG element uniqueness is primarily determined by the data element identifier, typically provided as standard coding or HL7 message segment identifier. In the majority of cases if a data element identifier is mapped to a profile in one MMG that mapping will also apply in all other MMGs, however judgment on context should be considered as this can not be completely accounted for and there are some minor differences between MMGs in the use of identifiers. For example, Candida Auris and TBLTBI MMGs both include the identifier “INV1109” for “Previously Counted Case” for which Candida Auris overrides the default purpose of the identifier and creates a divergent meaning.

Patient Gender, Gender Identity, and Sex (Assigned at Birth)

Terminology around this topic can be inconsistent and easily misunderstood. For general information discussing common modern terminology, please read the FHIR Patient resource notes on Patient Gender and Sex, which also illustrates how this information is handled in standardized form in base FHIR.

In MMGs, the inconsistency in phrasing is present and should be handled as follows:

• Gen v2’s “Subject’s Sex” element is considered equivalent to FHIR’s AdministrativeGender (Patient.gender) as it is given a description of “Subject’s current sex”, despite the usage of the term sex as opposed to gender.
• TBLTBI’s “Birth Sex” element is considered primarily equivalent to “Sex Assigned at Birth” defined by the FHIR Patient resource notes. However, this may or may not align with sex as specified on a subject’s birth certificate due to some jurisdictions allowing the information to be updated. As the intent of the TBLTBI element is to capture clinically relevant data commonly associated with sex assigned at birth, data may be presented as equivalent to the “Clinical Sex” property as defined by the FHIR Patient resource. While surveillance programs currently look at simplified binary sex bining of the data, this may or may not neccessitate consideration of more granular biological properties when considering this element.
• STD’s “Gender Identity” element is equivalent to gender identity as specified in the FHIR Patient resource.

Gen v2

Individual Data Element Notes

Message Profile Identifiers

Message Profile Identifiers are not required in the CBS FHIR workflow and not included in this mapping.

Comment

Data conveyed through the comment data element should be included as part of profiles and resources to which the comment is relevant as narrative elements allow. For larger comments or inclusion of unstructured documentation, a DocumentReference resource may be included.

Full Table

MMG Data Element	DE Identifier	CBS Profile	FHIR Resource	Element/Extension
Local Subject ID	N/A: PID-3	US CBS Patient	Patient	identifier
Birth Date	N/A: PID-7	US CBS Patient	Patient	birthdate
Subject’s Sex	N/A: PID-8	US CBS Patient	Patient	gender
Race Category	N/A: PID-10	US CBS Patient	Patient	extension[us-core-race]
Other Race Text	32624-9	US CBS Patient	Patient	extension[us-core-race]
Ethnic Group	N/A: PID-22	US CBS Patient	Patient	extension[us-core-ethnicity]
Country of Birth	78746-5	US CBS Patient	Patient	extension[birthPlace]
Other Birth Place	21842-0	US CBS Patient	Patient	extension[birthPlace]
Country of Usual Residence	77983-5	US CBS Patient	Patient	address:Usual-Residence
Subject Address County	N/A: PID-11.9	US CBS Patient	Patient	address
Subject Address State	N/A: PID-11.4	US CBS Patient	Patient	address
Subject Address ZIP Code	N/A: PID-11.5	US CBS Patient	Patient	address
Date of Illness Onset	11368-8	US CBS Condition of Interest	Condition	onsetDateTime
Illness End Date	77976-9	US CBS Condition of Interest	Condition	abatementDateTime
Illness Duration	77977-7	US CBS Condition of Interest	Condition	onsetDateTime & abatementDateTime
Illness Duration Units	N/A: OBX-6	US CBS Condition of Interest	Condition	onsetDateTime & abatementDateTime
Pregnancy Status	77996-7	CBS Pregnancy Status	Observation
Diagnosis Date	77975-1	US CBS Condition of Interest	Condition	extension[assertedDate]
Hospitalized	77974-4	US CBS Hospitalization	Encounter
Admission Date	8656-1	US CBS Hospitalization	Encounter	period.start
Discharge Date	8649-6	US CBS Hospitalization	Encounter	period.end
Duration of Hospital Stay in Days	78033-8	US CBS Hospitalization	Encounter	length
Subject Died	77978-5	CBS Cause of Death	Observation
Deceased Date	N/A: PID-29	US CBS Patient	Patient	deceased[x]
Condition Code	N/A: OBR-31	US CBS Condition of Interest	Condition	code
Local Record ID	N/A: OBR-3	US CBS Patient	Patient	identifier
State Case Identifier	77993-4	US CBS Patient	Patient	identifier
Legacy Case Identifier	77997-5	US CBS Patient	Patient	identifier
Age at Case Investigation	77998-3	CBS Age at Case Investigation	Observation
Age Unit at Case Investigation	N/A: OBX-6	CBS Age at Case Investigation	Observation
Case Disease Imported Code	77982-7	CBS Exposure Observation	Observation	valueCodeableConcept
Imported Country	INV153	CBS Exposure Observation	Observation	component
Imported State	INV154	CBS Exposure Observation	Observation	component
Imported City	INV155	CBS Exposure Observation	Observation	component
Imported County	INV156	CBS Exposure Observation	Observation	component
Country of Exposure	77984-3	CBS Exposure Observation	Observation	component
State or Province of Exposure	77985-0	CBS Exposure Observation	Observation	component
City of Exposure	77986-8	CBS Exposure Observation	Observation	component
County of Exposure	77987-6	CBS Exposure Observation	Observation	component
Transmission Mode	77989-2	CBS Transmission Mode	Observation
Case Class Status Code	77990-0	US CBS Condition of Interest	Condition	extension[cbs-case-class-status]
Immediate National Notifiable Condition	77965-2	CBS Immediate National Notificable Condition	Observation
Case Outbreak Indicator	77980-1	CBS Case Outbreak	Observation	component
Case Outbreak Name	77981-9	CBS Case Outbreak	Observation	component
Notification Result Status	N/A: OBR-25	N/A
Jurisdiction Code	77969-4	CBS Jurisdiction Code	Observation
Reporting Source Type Code	48766-0	US CBS Reporting Source Organization	Organization
Reporting Source ZIP Code	52831-5	US CBS Reporting Source Organization	Organization
Binational Reporting Criteria	77988-4	CBS Binational Reporting Criteria	Observation
Person Reporting to CDC - Name	74549-7	US CBS Reporting Source Organization	Organization	contact.name
Person Reporting to CDC - Phone Number	74548-9	US CBS Reporting Source Organization	Organization	contact.telecom:phone
Person Reporting to CDC - Email	74547-1	US CBS Reporting Source Organization	Organization	contact.telecom:email
Case Investigation Start Date	77979-3	CBS Case Investigation Start Date	Observation
Date First Electronically Submitted	N/A: OBR-7	1
Date of Electronic Case Notification to CDC	N/A: OBR-22	1
Date Reported	77995-9 2	CBS Date of Initial Report	Observation
Earliest Date Reported to County	77972-8	CBS Earliest Date Reported to County	Observation
Earliest Date Reported to State	77973-6	CBS Earliest Date Reported to State	Observation
MMWR Week	77991-8	CBS MMWR	Observation	component
MMWR Year	77992-6	CBS MMWR	Observation	component
Date CDC Was First Verbally Notified of This Case	77994-2	3
Date First Reported to PHD	77970-2 2	CBS Date Reported to Public Health Department	Observation
Reporting State	77966-0	CBS Reporting State	Observation
Reporting County	77967-8	CBS Reporting County	Observation
National Reporting Jurisdiction	77968-6	CBS National Reporting Jurisdiction	Observation

Footnotes

Mumps Vaccination History

This table is provided as an example of mapping vaccination related fields using the Mumps Message Mapping Guide as a base case. Only the “Epidemiology Questions about Vaccine History” group, including the “Preferred Vaccination History” repeating sub-group, are included.

Individual Data Element Notes

Vaccine History Comments

Data conveyed through the vaccine history comments element should be included as annotations provided in the note element of the relevant profile, typically the US CBS Immunization profile itself.

Full Table

MMG Data Element	DE Identifier	CBS Profile	FHIR Resource	Element/Extension
Did the Subject Ever Receive a Vaccine Against This Disease	VAC126	US CBS Immunization	Observation
Number of Doses Received On or After 1st Birthday	VAC129	US CBS Immunization	Immunization	4 5
Date of Last Dose Prior to Illness Onset	VAC142	US CBS Immunization	Immunization	4
Vaccination Doses Prior to Onset	82745-1	US CBS Immunization	Immunization	4 5
Vaccinated per ACIP Recommendations	VAC148	CBS Subject Vaccinated per ACIP Recommendations	Observation
Reason Not Vaccinated Per ACIP Recommendations	VAC149	CBS Subject Vaccinated per ACIP Recommendations	Observation	component
Vaccine History Comments	VAC133	(See Individual Data Element Notes)	N/A	N/A
Vaccine Type	30956-7	US CBS Immunization	Immunization	vaccineCode 6
Vaccine Administered Date	30952-6	US CBS Immunization	Immunization	occurrence 7
Vaccine Dose Number	30973-2	US CBS Immunization	Immunization	protocolApplied.doseNumber
Vaccine Manufacturer	30957-5	US CBS Immunization	Immunization	manufacturer 8
Vaccine Lot Number	30959-1	US CBS Immunization	Immunization	lotNumber
Vaccine Expiration Date	VAC109	US CBS Immunization	Immunization	expirationDate
National Drug Code (NDC)	VAC153	US CBS Immunization	Immunization	vaccineCode 6
Vaccination Record Identifier	VAC102	US CBS Immunization	Immunization	identifier
Vaccine Event Information Source	VAC147	US CBS Immunization	Immunization	reportOrigin

Footnotes