Proposed changes to HealthcareProviderRoleType subset

Hi Fariba,

Thank you for your feedback. The two concerns you’ve described (appropriate subset & use of SNOMED CT values) will be taken into consideration. Any updates to our proposal will be provided in the forum once we have completed our community engagement period.

Regards,
Marie Tran

Hi Anne,

Thank you for your feedback. We appreciate your concerns about interoperability and we will be taking your suggestion about the SNOMED code list into consideration. Any updates will be provided in the forum once we have completed our community engagement period.

Regards,
Marie Tran

Hello,

We recommend that there needs to be a distinction and clear boundaries between in the concepts of a role and a specialty in data modeling. When developing standards for health information exchange we have 2 distinct elements to define a provider’s role in health care. Role Type for example to define a medical doctor as distinct from a pharmacist , and that of a specialty that a medical doctor has e.g. Pediatrics. These proposed additional values are Specialty and we are concerned that by adding these to the role type subset this further conflates these concepts which complicates data exchange modeling.

Note that in HL7 FHIR there are two distinct relevant elements in use in interoperability standards:
PractitionerRole.code and PractitionerRole.specialty

In assessing the 3 available subsets we do not see HealthCareProviderRoletype as best fit for these new additions. We recommend including these in a more fit for purpose subset such as ProviderRoleCode. Furthemore the use of aThe subset set using SNOMED CT coding system, which promotes best standards practice and interoperability.

1- `HealthCareProviderRoletype` - SCPTYPE - sets boundary between role type and specialty (e.g. Medical Doctor)

2- `PractitionerSpecialty` - SNOMED CT that contains the SNOMED specialty (qualifier) values (e.g. Pediatrics)

3- `ProviderRoleCode` - SNOMED CT that contains all the SNOMED occupations (e.g. Pediatrician)- and is the one that should be used by the users that now want to add these new roles to #1

Thank you,
Fariba

Our team at TELUS has reviewed this code set and the proposed additions. Our EMRs will also benefit from these concepts being added, so thank you for bringing these forward. We have some others as well that we will post separately over the next few days.

One concern that we have is that the proposed codes are not SNOMED and if we are looking at interoperability outside of Canada this will be important. Wondering if there is a good reason for this? We understand that systems may have to change to accommodate which is sometimes difficult but necessary. This particular code set is very widely used.

Thanks for your consideration,

Anne

CIHI is proposing the addition of medical specialists to the ‘HealthcareProviderRoleType’ subset, which is associated with the Provider Type data element in the Pan-Canadian Primary Health Care EMR Minimum Data Set, version 1.1 .

The proposed changes include the addition of approximately 40 medical specialist concepts such as Pediatrician, Dermatologist and others. The additions are in alignment with medical specialties defined by the Royal College of Physicians and Surgeons of Canada and the Canadian Medical Association. The purpose of this update is to have a more inclusive subset to identify who is providing care using the existing implementation of the HealthcareProviderRoleType subset and to improve alignment with other standards.

Before moving ahead with the proposed additions, we would like to confirm whether there are any questions or concerns from the HTC community. Please reply to this post or contact CIHI’s Primary Health Care Information team at This email address is being protected from spambots. You need JavaScript enabled to view it. if you have any questions or concerns. We would appreciate feedback from the community before May 6th.

List of proposed codes and concepts to be added to HealthcareProviderRoleType

ANES - Anesthesiologist
CRSG - Cardiac surgeon
CARD - Cardiologist
CRCM - Critical Care medicine specialist
DERM - Dermatologist
EMSP - Emergency medicine specialist
ENDO - Endocrinologist
FAM - Family physician
GAST - Gastroenterologist
GNSG - General surgeon
GEMD - Geriatric medicine specialist
HEM - Hematologist
IDIS - Infectious disease specialist
IMSP - Internal medicine specialist
MDBI - Medical biochemist
MDGN - Medical geneticist
MDMI - Medical microbiologist
NEPH - Nephrologist
NEUR - Neurologist
NUSG - Neurosurgeon
NMSP - Nuclear medicine specialist
OBGY - Obstetrician-Gynecologist
OMSP - Occupational medicine specialist
ONCO - Oncologist
OPHTGST - Ophthalmologist
ORTHSG - Orthopedic surgeon
OTOL - Otolaryngologist
PMSP - Palliative medicine specialist
PATH - Pathologist
PED - Pediatrician
PHMD - Physical medicine and rehabilitation specialist
PLAS - Plastic surgeon
PSYCHTST - Psychiatrist
PHPH - Public health physician
RAD - Radiologist
RESP - Respirologist
RHEUM - Rheumatologist
THOR - Thoracic surgeon
UROL - Urologist
VSSG - Vascular surgeon