NSAG · Module M9 · Healthcare & Clinical
Cannabis Healthcare Visibility
Standalone deployment retired
The documentation gap between cannabis use prevalence and EHR documentation is 7:1. It is an institutional design problem rooted in how care systems are built, and it has specific, documentable patient safety consequences.
What this address is
This hostname served a standalone copy of NSAG module M9. That copy was retired on 15 August 2026, and the page you are reading replaced it. The deployment stays online so that links already published against it keep resolving, and so that anyone arriving here is sent to the material that is still maintained.
The module's current scope, its evidence base, and its release status are published on the NSAG hub at nsag-site.vercel.app/m9. Where this page and the hub disagree, the hub is correct.
What the module examines
Lapham et al. (2022) published the verified primary source for the documentation gap: 35.1% of primary care patients reported implicit medical cannabis use; EHR documented rate was 4.8% — from the same patient population, measured simultaneously. Tavabi et al. (2023) found the gap tracks racial and socioeconomic lines independent of use prevalence: the populations most burdened by the gap are already facing the greatest healthcare equity challenges. Beiler et al. (2024) confirmed that documentation completeness depends on whether structured EHR fields exist, independent of patient willingness. The governance response focuses on institutional infrastructure and how systems are designed to document care.
M9 sits in the Healthcare & Clinical group of the framework.
What the assessment measured
The module organised a structured self-assessment across six governance dimensions:
- 1Cannabis Screening Standards
- 2Provider Training Standards
- 3EHR Documentation Architecture
- 4Disclosure Safety Infrastructure
- 5Regulatory Compliance & Legal Review
- 6Quality Improvement Integration
Each dimension was described against tiers running from early stage up to the fully implemented tier the framework calls PIONEERING, with observable criteria written for each level, so that an institution could locate its own arrangements rather than receive a score. It was a self-assessment framework for institutional reflection, and never a validated instrument, an audit, an accreditation, or a compliance determination.
Who it was written for
Primary care practices · Hospitals and health systems · FQHCs · Community health organizations · Native Hawaiian and Pacific Islander health programs · Any institution where the service population includes cannabis users
And any patient whose cannabis use goes undocumented, and the clinician who needs to see it before prescribing.
Why the standalone deployment was retired
The fifteen modules were first published as fifteen separate deployments. Scope, evidence, and release status then had to be maintained in fifteen places, and they drifted apart. The hub now holds one canonical page per module, and these fifteen addresses point at it.
Assessment collection is paused across all fifteen modules. The published operations matrix records the same position for every one of them: the canonical route is reachable, collection is paused, and advisory work is delivered by a person rather than by automated scoring. This page is a static record. It carries no forms and collects nothing.