Data Element Library (DEL) Mission and Goals: The mission of the DEL is to serve as a comprehensive, electronic, distributable, and centralized resource of CMS patient assessment instrument content for the public.
Goals of the DEL:
- Serve as a resource for CMS assessment data elements
- Promote the sharing of electronic CMS assessment data sets and information standards
- Influence and support industry efforts to promote electronic health record (EHR)/health IT interoperability
DEL Overview: The DEL is a new CMS resource that moves toward enabling the availability of electronic health information when and where it’s needed. The DEL is a public resource for use by providers, vendors, researchers, and the general public, and will help facilitate health information exchange and EHR interoperability. Building on CMS Administrator Seema Verma’s interoperability efforts, and in coordination with interoperability efforts of the Office of the National Coordinator for Health Information Technology (ONC), the DEL will represent a centralized resource for CMS’ required long-term and post-acute care (LTPAC) assessment instrument data elements (e.g., assessment questions and response options) and their related health information technology (health IT) standards.
Aligning with CMS’ strategic goals to improve customer experiences, to enhance provider and clinician experiences, and as part of the governmentwide MyHealthEData initiative, the DEL provides a unique opportunity to advance interoperable health information exchange. Interoperable health information exchange has the potential to improve care coordination, patient outcomes, and healthcare efficiencies, and reduce provider burden and costs through the use and exchange of data. The DEL also supports CMS’ Patients Over Paperwork initiative aimed at reducing the administrative burden on providers so they can focus on their patients, and patients can be better informed partners in their own care.
The DEL furthers CMS’ goal of data standardization and interoperability, which is also a goal of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.
The DEL will initially contain data elements from the patient assessment instruments for the following PAC settings:
|
PAC Setting |
CMS Assessment Instrument |
|
Long-term Care Hospitals (LTCHs) |
LTCH Continuity Assessment Record & Evaluation (CARE) Data Set (LCDS) |
|
Skilled Nursing Facilities (SNFs) |
Resident Assessment Instrument (RAI) Minimum Data Set (MDS) |
|
Home Health Agencies (HHAs) |
Outcome and Assessment Information Set (OASIS) |
|
Inpatient Rehabilitation Facilities (IRFs) |
IRF patient assessment instrument (IRF-PAI) |
|
Hospices |
Hospice Item Set |
Through the DEL application, providers, vendors, researchers, and other stakeholders will be able search the database and generate reports on CMS assessment contents, including questions, response options, relevant details, and their associated health IT standards, in one location. In addition to the CMS assessment instruments referenced in the IMPACT Act, it is envisioned that the future DEL could expand to include other CMS assessment content, such as the assessment instrument currently under development for hospice, as well as the Functional Assessment Standardized Items (FASI), which are currently under development for use in long-term services and supports (LTSS).
The DEL does not contain any patient-level data. The DEL is limited to CMS assessment questions and response options, as well as their associated attributes including the assessment version, item labels, item status, copyright information, CMS item usage, skip pattern information, look-back periods, and related health IT standards.
CMS anticipates that the DEL will make it easier for IT vendors to incorporate data elements adopted by CMS into provider EHRs, thereby reducing burden, improving interoperable data exchange, and facilitating care coordination. ONC has recognized health IT standards such as Logical Observation Identifiers Names and Codes (LOINC), Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED), Consolidated Clinical Document Architecture (CCDA), and Fast Healthcare Interoperability Resources (FHIR) to support interoperable exchange of health information. In the initial version of the DEL, assessment items are mapped to LOINC and SNOMED standards, when feasible.
In addition, the DEL provides a centralized location for providers, states, researchers, or others to obtain the most up to date information on CMS assessment content.
The CMS Data Element Library may be viewed here: https://DEL.cms.gov
Resources
- For more information on the IMPACT Act, visit the IMPACT Act webpage
- To keep up to date on the Data Element Library, sign up for the listserv here.
- For more information on Post-Acute Care Quality Reporting Programs, visit:
If you have any questions, please contact DELHelp@cms.hhs.gov.