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HIT Standards Committee. Clinical Operations Workgroup, Vocabulary Task Force (VTF) Update on Vocabulary For Stage 2 Jamie Ferguson, Kaiser Permanente Betsy Humphreys, National Library of Medicine 22 June 2011. Current VTF Priorities & Process.

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HIT Standards Committee

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Hit standards committee

HIT Standards Committee

Clinical Operations Workgroup, Vocabulary Task Force (VTF)

Update on Vocabulary For Stage 2

Jamie Ferguson, Kaiser Permanente

Betsy Humphreys, National Library of Medicine

22 June 2011


Current vtf priorities process

Current VTF Priorities & Process

  • ONC Requested Vocabulary Standards for Stage II/III

    • Medications for e-prescribing and medication allergies

    • Lab tests for results reporting and test orders

    • Problems for problem list documentation

    • Standards required to specify quality measures

  • Process:

    • Assess/Revise as necessary Previous HITSC Vocabulary Recommendations for key EHR segments

    • Series of teleconference meetings, next 6/24

    • Work with Clinical Quality WG on Vocabulary Recommendations to support Quality Measures

      • 1st joint CQWG-VTF meeting 6/20; another 6/29?


General issues

General Issues

Can an EHR certification requirement precede a meaningful use requirement in order to facilitate adoption? (Discussed in HITSC meeting 5/18/11)

How will an EHR’s use of vocabulary standards be tested and certified?

VTF has scheduled presentation/discussion with NIST (6/24)

Requirements for subsets used in certification testing could differ from those used to facilitate adoption/use.

EHR products must be able to accommodate (i.e., not reject) any valid value from a required standard vocabulary.


Recent relevant developments

Recent relevant developments

May 31 – LOINC Top 2000+ Lab Observations and Mapper's Guidereleased

June 6 – RxNorm Prescribable Drugs subset (1st draft) released

May 26 – IHTSDO and Global Medical Device Nomenclature (GMDN) in formal negotiation re: inclusion of GMDN content in SNOMED CT


Allergens allergic reactions

Allergens & Allergic Reactions

Quality Measures require:

medication allergies, non-medication allergens, severity of reaction

Medications/active ingredients - RxNorm (specific named components)

Vaccinations

Still under discussion: CVX/MVX, RxNorm

Inactive ingredients, non-medication allergens

Still under discussion: UNII, SNOMED CT

Recent (5/24) recommendations from NCPDP re: allergies suggest incorporation in RxNorm

Severity of reaction - SNOMED CT

Reaction itself – SNOMED CT


Medical devices

Medical Devices

For initial (limited) quality measure requirements: SNOMED CT

VTF to monitor developments and make later recommendation re: more detailed device terminology (GMDN, UMDNS)


For action by vtf after joint cqwg vtf meeting 6 20

For Action by VTF (after joint CQWG-VTF meeting 6/20)

Patient characteristics

Conditions/Diagnoses/Problems

Non-laboratory Diagnostic Studies

Face-to-face, telemedicine, other communications (e.g., mail, e-mail)

?? Requirements for terminology vs other EHR attributes

For Joint CQWG-VTF discussion (6/29?)

Experience, Family History, Functional Status, Health Record Component, Lab Test Orders, Interventions, Physical Exam, Preferences, Symptoms/Adverse Effects, System Resources


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