Vocabulary Task Force

1. HIT Standards CommitteeClinical Quality Workgroup and Vocabulary Task Force Friday, July 29, 2011 Jim Walker and Jamie Ferguson, Chairs Karen Kmetik and Betsy Humphreys, Co-Chairs

2. Vocabulary Task Force Chair: Jamie Ferguson Kaiser Permanente Co-Chair: Betsy Humphreys National Library of Medicine Members Donald Bechtel Accredited Standards Organization X12 Lisa Carnehan NIST Christopher Chute Mayo Clinic Bob Dolin HL7 Floyd Eisenberg National Quality Forum Patricia Greim Veterans Affairs John Halamka Harvard Medical School Stan Huff Intermountain Healthcare John Klimek NCPDP Clem McDonald National Library of Medicine Stuart Nelson National Library of Medicine Marc Overhage Regenstrief Institute Marjorie Rallins American Medical Association Dan Vreeman Regenstrief Institute Jim Walker Geisinger Andrew Wiesenthal IHTSDO (SNOMED) Federal Ex Officio Chris Brancato HHS/ONC Greg Downing HHS Doug Fridsma HHS/ONC Marjorie Greenberg HHS/CDC Amy Gruber CMS 2

3. Clinical Quality Measures Workgroup Chair: Jim Walker Geisinger Health System Co-Chair: Karen Kmetik American Medical Association Members David Baker Northwestern University Anne Castro BlueCross BlueShield of South Carolina Christopher Chute Mayo Clinic John Derr Golden Living, LLC Bob Dolin HL7 Floyd Eisenberg NQF Rosemary Kennedy Thomas Jefferson University David Lansky Pacific Business Group on Health Gene Nelson Dartmouth University Eva Powell National Partnership Philip Renner Kaiser Permanente Danny Rosenthal Inova Health System Joachim Roski Brookings Institution Federal Ex Officio Jon White, AHRQ Aneel Advani, Indian Health Service, HHS Patrice Holtz, CMS, HHS TBD, CDC, HHS 3

4. Assign vocabularies to the fundamental concepts in the NQF�s Quality Data Model v.3 (QDM) Final report to Standards Committee, August 17. Scope: Reporting of clinical-quality measures. Standardized information exchange (for MU-2)? Out of Scope: Intra-organization information management Reporting to other external entities Project Scope 4

5. Desiderata for Standard Vocabularies Interdisciplinary relevance Minimum necessary Maturity Logical (hierarchical data model vs. flat structure) Technical (vocabulary is fully specified for proposed use) Implementation (current implementation experience supports the usability of the vocabulary) Maximum expected useful Life Expectancy Quality of current and ongoing duration Maximum ability to accommodate Innovation Serves the maximum number of needs Intra-organizational clinical and administrative needs Quality reporting Reporting to public health agencies Safety reporting 5

6. Patient Characteristics Socio-economic Status - referred to CMS for clarification of request (in the absence of widely accepted typologies) Payer typology � ANSI ASC X12 and the Payer Typology? (Will ACOs be considered payers in this context?) 6 Questions for the Joint Work Group

7. Patient-Professional Interaction (�Encounter�) SNOMED-CT CPT acceptable for MU-2 (but not MU-3)? Functional status ICF (International Classification of Functioning, Disability, and Health) for categories of function Does ICF serve a necessary function not served better by LOINC or another vocabulary? LOINC for assessment tools and individual functions 7 RECOMMENDED CODE SETS 

8. Medication RxNorm Vaccines CVX? Risk Assessment LOINC Is SNOMED-CT not needed for appropriate responses? System resources LOINC for __________ HL7 for ____________ 8 RECOMMENDED CODE SETS