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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.

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HIT Standards Committee

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  1. 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

  2. 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?

  3. 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.

  4. 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

  5. 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

  6. 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)

  7. 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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