Hi all (@Christian_Reich and @Tom_Galia in particular) -
I wanted to provide an update regarding the care site specialty that we were discussing on Thursday. I can share with you what we do -
At PEDSnet, we have a specialty_concept_id for our care_site table. This value set is the same value set as the value set for provider.specialty_concept_id (concepts where domain_id='Provider Specialty' and vocabulary_id in ('Specialty', 'ABMS','NUCC')). The ABMS mappings are the preferred mappings and contributing sites can provide NUCC codes if there is not an adequate ABMS mapping.
We ask that if care site specialty information is unavailable, it just gets mapped to one of our flavors of null. If a care site has multiple specialties, we ask that sites extract the most general specialty that encompasses the multiple specialties available within that care site. If multiple specialties are contained within a particular care site and there is not a way to assign a general specialty, then it gets mapped to a the non-specific concept 'Pediatric Medicine' (38004477).
We decided to include care site specialty because it provides information about the specialty practices a patient requires. Additionally, if a patient is seen by a provider that has multiple specialties, care site specialty can provide more accurate information about the purpose of a particular visit. Also, care site specialty information can be useful for sites that have poor provider specialty mappings or do not assign specialties well. I can speak from experience in using the database that having a specialty_concept_id contains very useful information about services rendered and is informative for phenotyping patients. It is often the case that a provider specialty can not be assigned to a particular visit (e.g., if a patient was seen by multiple providers or if provider specialty is unavailable), so having the care site specialty is informative. It also provides useful metadata about the setting in which a patient was seen that is not readily available elsewhere.