Seeking expertise on addiction medicine...

Heather Leslie heather.leslie at oceaninformatics.com
Thu Feb 18 23:05:25 EST 2016


Hi Joseph,

Ooooh dear! I feel their pain.

Is this what you had in mind? https://www.healthit.gov/providers-professionals/achieve-meaningful-use/core-measures/record-smoking-status


And the valueset for smoking status are these SNOMED codes:
(1) Current every day smoker. 449868002
(2) Current some day smoker. 428041000124106
(3) Former smoker. 8517006
(4) Never smoker. 266919005
(5) Smoker, current status unknown. 77176002
(6) Unknown if ever smoked. 266927001
(7) Heavy tobacco smoker. 428071000124103
(8) Light tobacco smoker. 428061000124105

Mixing frequency and consumption levels with whether they are currently smoking or not - sends shivers down my spine... Can two values be recorded concurrently? What if they fit both (1) 'current every day smokers (I assume of tobacco) AND (2) heavy tobacco smoker. What if they are former heavy smokers but only on some days...?

>From what I understand these concepts reflect the way that many systems capture smoking status, or map to these values from the clinical system. 

And from https://www.healthit.gov/sites/default/files/standards-certification/2014-edition-draft-test-procedures/170-314-a-11-smoking-status-2014-test-procedure-draft-v1.0.pdf ".
 we understand that a "current every day smoker" or "current some day smoker" is an individual who has smoked at least 100 cigarettes during his/her lifetime and still regularly smokes every day or periodically, yet consistently; a "former smoker" would be an individual who has smoked at least 100 cigarettes during his/her lifetime but does not currently smoke; and a "never smoker" would be an individual who has not smoked 100 or more cigarettes during his/her lifetime. The other two statuses (smoker, current status unknown; and unknown if ever smoked) would be available if an individual's smoking status is ambiguous. The status "smoker, current status unknown" would apply to individuals who were known to have smoked at least 100 cigarettes in the past, but their whether they currently still smoke is unknown. The last status of
"unknown if ever smoked" is self-explanatory."

And this is just for one of the data elements we need

It was the other data point that I thought was going to be hard... :)

Anything else you can point me to?

Regards

Heather

> -----Original Message-----
> From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On
> Behalf Of Joseph Dal Molin
> Sent: Friday, 19 February 2016 10:18 AM
> To: openehr-clinical at lists.openehr.org
> Subject: Re: Seeking expertise on addiction medicine...
> 
> Have a look at the US Meaningful Use 1 & 2 quality measure smoking criteria...
> having said that, the smoking measures were/are so convoluted they probably
> encouraged substance abuse among the poor souls that had to figure out how
> to implement them.
> 
> Joseph
> 
> On 16-02-18 06:04 PM, Marcus Baw wrote:
> > Hi Heather,
> >
> > I have a couple of years' experience dealing with and prescribing for
> > substance misuse in a British prison environment. The main drugs in
> > question were opioids, cocaine, amphetamines, benzodiazepines,
> > alcohol, and commonly abused prescription drugs such as pregabalin and
> > gabapentin.
> >
> > I'm not sure if this stuff is helpful from a 'modelling' point of view
> > but I'm happy to help out if it's in any way useful.
> >
> > M
> >
> > On 18 February 2016 at 06:55, Rikard Lövström
> > <rikard.lovstrom at gmail.com <mailto:rikard.lovstrom at gmail.com>> wrote:
> >
> >     Hi Heather,
> >
> >     I did a Powerpoint presentation in 2011 looken at 30 key figures
> >     from quality registers on tobacco use, compared it to the 10 put
> >     forward by an expert group and finally concluded on the two (!) I
> >     thought was sufficient.
> >
> >     I can try to find it. By the weekend.
> >
> >     Kind regards,
> >     Rikard
> >
> >     Rikard Lövström
> >
> >     Den 18 feb 2016 07:50 skrev "Heather Leslie"
> >     <heather.leslie at oceaninformatics.com
> >     <mailto:heather.leslie at oceaninformatics.com>>:
> >
> >         Hi everyone,
> >
> >         The CKM Editorial teams in Norway and the international
> >         openEHR CKM are seeking expertise for development of our
> >         tobacco, drug and alcohol archetypes - all of which follow a
> >         similar pattern around addition and its management.
> >
> >         The tobacco archetype in particular is causing some difficulty
> >         in cracking the best pattern - the multitude of ways that this
> >         data is represented in current systems is compounded by the
> >         multitude of different forms of tobacco use (non-smoking and
> >         smoking) and forms of tobacco used in smoking. There has been
> >         a lot of discussion and various iterations over the past few
> >         years - it is now time to try to pin it down and publish.
> >
> >         We think that consultation with an expert or two in this area
> >         will help us establish the best approach for a robust
> >         candidate archetype, which will then go out to the community
> >         for further review and collaboration.
> >
> >         If you'd like to volunteer your services, please let me know.
> >
> >         If you can refer me to someone else who could assist, please
> >         do so.
> >
> >         Many thanks in anticipation,
> >
> >         Heather
> >
> >         *Dr Heather Leslie *MBBS FRACGP FACHI
> >         *Informatics Lead*, Ocean Informatics
> >         <http://www.oceaninformatics.com/>
> >
> >         *Clinical Programme Lead, *openEHR Foundation
> >         <http://www.openehr.org/>
> >         p: +61 418 966 670 <tel:%2B61%20418%20966%20670>   skype:
> >         heatherleslie twitter: @omowizard
> >
> >
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