Care sites and specialty, specialty code clean-up

[Gowtham_Rao]

Referencing prior discussions on this topic

@Gowtham_Rao

Vocabulary Place of Service belongs to the domain Place of Service and is used to populate place_of_service_concept_id in the care_site table.
Vocabulary Visit belongs to the domain Visit and is used to populate Visit_concept_id.
Vocabulary Place of Service is mapped to Visit in both concept_relationship and concept_ancestor table (I dont know how complete this is @Dymshyts ?) Place of Service is a child of Visit

There is a n:1 relationship between visit_occurrence table and care_site table - so there may not be more than one care_site_id per visit_occurrence_id record. As an extension, there may not be more than one place_of_service_concept_id per visit_occurrence_id.

Would it then be reasonable to add all the concept’s in Place of Service vocabulary from Place of Service domain into Visit domain, as a standard_concept and maintain hierarchical relationship?

I wanted to ask - of the 59 standard and about 487 total concept’s in the Place of Service domain, can we change their domain to visit - so that they may be used in the visit_occurrence table as either visit_concept_id and visit_source_concept_id?

The classification of visit’s into inpatient and outpatient is then natural using the concept ancestor table

@Gowtham_Rao

I think we need to answer the question: why do we need the domain_id “Place of Service”. Why can’t it be “Visit”.

I don’t think we need “Place of Service” domain_id, because we are mapping the standard Concept’s in that domain to standard concepts in “Visit” domain.

@Christian_Reich

@Gowtham_Rao:

Because Place of Service doesn’t denote something that further qualifies a Visit, but a Care Site where the visit happened. And for that we have the table CARE_SITE.

@Gowtham_Rao

Yes, if we change the field name from place_of_service_concept_id to caresite_source_concept_id and caresite_concept_id. This is obviously not backwards compatible, but will be consistent with Omop CDM conventions. Maybe done for CDM 6.x

@Gowtham_Rao

In US health care, care-site is not a ‘credentialing’ information, but a ‘claim’. e.g. place of service information comes in every claim on CMS 1500 form.

@Gowtham_Rao

We (@Christian_Reich @Dymshyts @Dave_Kern @Gowtham_Rao) worked on cleaning up these concepts, and would like the communities input. See document. We propose to change the domain for the vocabulary ‘Place of Service’ (standard concept) to ‘Visit’, because we found that ‘Place of Service’ is an attribute of the Visit and not attribute of ‘Care Site’ as discussed here.

@Gowtham_Rao

In the US health Care claims system, HIPAA place of service is an attribute of the visit and not caresite. Why - because it is information that is provided at the claim level.

Place of Service Code Set | CMS

Mapping that into higher order visits are done using omop generated vocabulary. That mapping was done by the OHDSI community in past one month and information was shared on this forum. Active roles were played by