HIT Standards Committee

1
HIT Standards Committee

• Clinical Operations Workgroup
• Update on Vocabulary Task Force
• Jamie Ferguson
• Kaiser Permanente
• Betsy Humphreys
• National Library of Medicine
• December 18, 2009

2
Vocabulary Task Force

• Kick-offThe Vocabulary TF held its first meeting
  11/19/2009 to begin consideration of the gaps
  and issues identified by the HIT Standards
  Committee.
• Task Force ChargeIdentify gaps, issues and
  needs for clinical and administrative vocabulary
  solutions within the scope of the HIT Standards
  Committee. Develop recommendations to ONC for
  methods, actions, standards and/or programs to
  mitigate, manage or solve these vocabulary
  concerns.
• Task Force ScopeVocabulary needed for
  Meaningful Use and other purposes under ARRA
  within the scope of the Standards Committee.

2
3
Vocabulary Task Force Membership

• Chair Jamie Ferguson Kaiser Permanente
• Co-Chair Betsy Humphreys National Library of
  Medicine
• Members
• Clem McDonald National Library of Medicine
• John Halamka Harvard Medical School
• Stan Huff Intermountain Healthcare
• Christopher Chute Mayo Clinic
• Marc Overhage Regenstrief Institute
• Dan Vreeman Regenstrief Institute
• Andy Wiesenthal IHTSDO
• Stuart Nelson RxNorm/NLM
• John Klimek NCPDP
• Floyd Eisenberg National Quality Forum
• Amy Gruber CMS
• Donald Bechtel ASC X12
• Patricia Greim Veterans Affairs
• Jim Walker Geisinger
• Greg Downing HHS

3
4
Input from Standards Committee

• Implementation Workgroup
• Create publicly available vocabularies and code
  sets
• Ensure they are easily accessible with
  straightforward updates
• Noted licensing issues, e.g., for CPT and
  medication cross-maps
• Clinical Operations Workgroup
• Noted gaps in cross-maps, subsets and value sets
• Noted gaps in governance, management and
  maintenance
• Noted gaps in value set binding to content
  exchange standards
• Quality Workgroup
• Noted needs for value set determination and
  processes
• Coordination with quality measure stewards

4
5
Vocabulary Process Gaps Issues for Task Force

• Governance requirements and recommendations
• Infrastructure requirements and recommendations
• Licensing requirements and recommendations
• Education/communications requirements and
  recommendations
• Specific value set and subset processes
• Requirements determination and definition process
  for value sets
• Coordination of releases, e.g. RxNorm and SPL
• Dissemination and publication of value sets
• Maintenance of value sets

5
6
Vocabulary Standards Gaps Issues for Task Force

• Cross-maps
• SNOMED CT frequently used to ICD and CPT
• RxNorm and proprietary medication codesets
• Testing and Implementation guidance
• UCUM, RxNorm
• Tooling for implementers
• SNOMED CT
• Subsets and value sets
• SNOMED CT, LOINC, RxNorm
• Binding value sets to content exchange standards
• CDA
• Regulatory
• FDA requirements for UCUM in devices and labs

6
7
Task Force Approach and Priorities

• Goals and guidelines for discussion
• TF Approach should include public input and
  invited expert testimony
• TF Approach should result in recommendations to
  ONC on identified gaps and issues
• TF Approach should address all identified issues
  in 2010
• Group discussion to identify TF approach
  alternatives
• Group discussion to identify priorities and
  immediate next steps

7
8
Schedule and Structure of Task Force Meetings

• Monthly meetings proposed, the day before each
  meeting of the HIT Standards Committee
• In-person in Washington DC with teleconference
  capability
• Likely meeting structure
• Background Paper with Issues, Questions to be
  addressed
• One vocabulary process topic, plus,
• One vocabulary standards gap or issue
• Invited testimony as appropriate
• Workgroup discussion
• At least one task force phone call between
  meetings

8