Issue # and location

Issue summary

If a care site has multiple types of visits or care associated with it, it is unclear which place of service concept should be used to appropriately represent the setting of care.

Convention type

Table

CDM table

CARE_SITE

CDM field

place_of_service_concept_id

Provenance of data

General, any database with care site information

The ratified convention

Choose the concept in the visit domain that best represents the setting in which healthcare is provided in the Care Site. If most visits in a Care Site are Inpatient, then the place_of_service_concept_id should represent Inpatient. If information is present about a unique Care Site (e.g. Pharmacy) then a Care Site record should be created.

It is also possible to set a specific visit_concept_id in the VISIT_OCCURRENCE table that represents the exact setting of care for that visit, which may differ from the place_of_service_concept_id in the CARE_SITE table. For example, a patient may go to an inpatient hospital for an outpatient procedure. In this case, the hospital entry in the care_site table should identify it as an inpatient hospital but the specific visit_concept_id for the outpatient procedure should identify that it was an outpatient encounter.

In an EHR system the care site can represent a department rather than the institution as a whole.

Date of ratification/published

Nov 27, 2018

Downstream implications

No

No. The isPrimaryKey check will make sure the care site ids are not duplicated in the CARE_SITE table but there is no explicit check for the same care_site_source_value and different place_of_service_concept_ids.

Interesting to note that there is an open issue about retaining this field and the place_of_service_source_value in the model: Remove place_of_service_concept_id and source_value from CARE_SITE CommonDataModel #273