Identifying pregnant Persons

MPhilofsky · December 16, 2021, 3:28pm

Here at Colorado we need to identify Persons who are pregnant at the time of a Visit and the estimated date of delivery.

Our source Epic EHR data have a Pregnancy table. I know Epic customers have a bit of variation in how their data are stored in Epic, but I am wondering if anyone has done gap analysis between the source Diagnoses tables and Pregnancy tables? What about pregnancy as an episode? Has anyone identified the source of truth (or 98% truth) for pregnancy data? @burrowse has PEDSnet tackled this?

Besides linking pregnancy Conditions to Visits, how have others identified pregnant persons? Has anyone used the Episode and/or Episode Event tables to create pregnancy episodes?

@clairblacketer I see a standard concept_id for estimated date of delivery in the Observation domain, yet, CDM v5.4 doesn’t have the value_as_datetime field in the Observation table, but it is present in v6.0. Why was it decided to not include it in v5.4? Any suggestion on how to store the date for estimated date of delivery concept_id?

@SELVA_MUTHU_KUMARAN Did you receive any replies offline from your forum post here?

David_Dorr · December 16, 2021, 4:29pm

If it helps, I asked our Obs here to define for me all the ways pregnancy could be identified in Epic.
If it were obvious, it would not be a question….

if they get prenatal care here at OHSU, then they have a “pregnancy episode” and you can tell by the open pregnancy episode with an EDD (estimated delivery date). This would have to be mapped into the Observation table by each site and you note the problems above.
if they get routine prenatal care outside the system, it can be impossible to know.
in the “vitals” section - there may be a little check box for "pregnant?” (i.e., when the MAs are rooming a patient) - I have to look in Epic to be sure. I know there is one of these discrete Y/N sections for breastfeeding in the rooming/vitals. This also will not be mapped automatically.
So my sense is the gap is large