Stream: united states
Topic: Mapping SSA race codes to USCore
Karl M. Davis (Jun 30 2020 at 17:29):
I'm wondering how folks would approach mapping a USCore Patient record, when handed a "RACE" field that looks like this (I believe this is how the Social Security Administration codes things):
RACE
LABEL: Beneficiary Race Code
DESCRIPTION: The race of the beneficiary.
SHORT NAME: RACE
LONG NAME: BENE_RACE_CD
TYPE: CHAR
LENGTH: 1
SOURCE: CMS Common Medicare Environment (CME)
VALUES: 0 = Unknown
1 = White
2 = Black
3 = Other
4 = Asian
5 = Hispanic
6 = North American Native
COMMENT: -
Karl M. Davis (Jun 30 2020 at 17:30):
It doesn't really map cleanly to https://www.hl7.org/fhir/us/core/ValueSet-omb-race-category.html, which is a USCore required field. The "5 = Hispanic" code, in particular.
Karl M. Davis (Jun 30 2020 at 17:31):
Any best practices here?
Karl M. Davis (Jun 30 2020 at 17:32):
I'm inclined to recommend we just map it to UNK, and either include this SSA value set as a separate Coding or in a separate ethnicity field/extension/whatever.
Karl M. Davis (Jun 30 2020 at 17:33):
I'm also curious, though, why https://www.hl7.org/fhir/us/core/ValueSet-omb-race-category.html doesn't include other "null" flavors, such as "UNC (un-encoded)". Per the spec, us using "UNK" here isn't strictly correct.
Lloyd McKenzie (Jun 30 2020 at 18:27):
@Brett Marquard @Eric Haas
Robert McClure (Jun 30 2020 at 18:36):
@Karl M. Davis Regarding the mapping, I agree it seems that these CMS codes do not align with what OMB has decided is a "Race." What you have is what OMB would call a combination of Race and Ethnicity. Believe me when I tell you this is a loaded issue - try googling "OMB race and ethnicity." There was lots of discussion on how to ask the two questions and for the 2020 census they decided to stay with two answers, so your essentially combined set does not map well.
One solution is to build a mapping table that records either an Ethnicity if the response is #5, or a Race if it is anything else. When you record one of those profiles, you could consider creating a default instance of the other profile with something like UNK but I see that is not available in the Ethnicity value set which is surprising. I think this is worth discussing at the USRSC or Cross-WG to come up with a solution. Likely USRSC as this would be a US Core conformance issue. @Brett Marquard @Eric Haas @Floyd Eisenberg
Karl M. Davis (Jun 30 2020 at 18:49):
@Robert McClure Thanks, I hate it. All of it. :laughter_tears:
Where, when, etc. would I find the USRSC and Cross-WG schedules, invites, etc.?
Karl M. Davis (Jun 30 2020 at 18:50):
(To be clear: your detailed response is very much appreciated. I hate the problem and solution space.)
Eric Haas (Jun 30 2020 at 19:06):
I personally have never seen this set of codes -every time I fill out form it is the omb race choices and the hispanic and non-hispanic choice and I don't want to touch it with a ten foot pole.
creating a default instance of the other profile
Unclear what the "other profile" is and why you need and unknown code @Robert McClure
Robert McClure (Jun 30 2020 at 23:48):
@Eric Haas I was saying that since his list maps to two profiles, a single answer would make an instance of one of those profiles and the other could be an instance of "UNK" as the value. Just a thought.
Karl M. Davis (Jul 21 2020 at 16:33):
@Robert McClure or anyone else: how would I raise this issue (as suggested) with the USRSC and Cross-WG?
Robert McClure (Jul 21 2020 at 19:03):
@Karl M. Davis I think this might best be discussed at Cross Project WG (CPG) but it means crafting an example to indicate if the approach makes sense. Did you understand my suggestion, which btw, I'm not sure is possible or how you would specify it in an IG. I'd assume that if you just put it into a specifica implementation, you'd do this all behind the scenes. @Floyd Eisenberg - do you agree about going to CPG?
Karl M. Davis (Sep 01 2020 at 14:15):
@Robert McClure Is the right process for me to just show up at the next https://confluence.hl7.org/display/CGP/Cross-Group+Projects+Home meeting I can attend? Or is there somewhere that I should submit this, first?
Robert McClure (Sep 09 2020 at 21:46):
@Karl M. Davis @Floyd Eisenberg Did this get addressed while I was on PTO? Flying home now...
Floyd Eisenberg (Sep 10 2020 at 13:27):
Did not get addressed to my knowledge. Sorry for the delay in responding
Last updated: Apr 12 2022 at 19:14 UTC
