In several previous blogs, I've identified the availability of free vocabulary codesets/valuesets as a key enabler of interoperability.
The National Library of Medicine has produced the SNOMED-CT Core subset for problem lists, RxNorm for medication terms, and a LOINC subset for ordering labs.
To ensure the right subsets are available and maintained, we need governance - who decides what goes into the vocabularies, what mappings are created, and how disputes/redundancies are resolved? We need a place to store vocabularies that makes them easily accessible to all. We need a roadmap for future work.
The HIT Standards Committee's Vocabulary Task Force is holding three hearings. The first hearing on February 23 will focus on governance "rules of the road" for vocabularies. The second hearing, in March, will consider vocabulary infrastructure requirements. The next hearing will focus on end user needs for specific vocabularies included in meaningful use as well as future requirements. Additional hearings and meetings will be scheduled to address priority issues as they are identified.
The February 23 meeting will include three panels: (1) EHR vendors; (2) vocabulary service providers; and (3) vocabulary standards organizations.
Jamie Ferguson, who chairs the task force, has prepared useful background information for the hearing.
If you'd like to send advance comments about vocabulary governance as part of the hearing process, please send them to Judy Sparrow (judy.sparrow@hhs.gov)
The idea of public hearings is good! Will the task force also invite healthcare PROVIDERS of various settings and sizes to testify? They are the ones who need to implement these vocabularies: it's not just a matter of whether SDOs and vendors provide standards and capabilities. Providers also need to manage the transition from their current (local) vocabularies to the new standards.
ReplyDeleteDavid--I sit on the task force--do you draw a distinction between the end users participating in the second public meeting and providers? If so, perhaps we can accommodate your concern.
ReplyDeleteAndy, thanks for your reply. By "providers" I mean not just the "end users" (people who use the EHRs like physicians and nurses) but also those in IT who have to implement the changes, which involves more than implementer vendor products, but also managing the transition and translation from locally-defined terms to standard vocabularies, changing existing interfaces, minimizing disruption to users, managing vocab updates, training on new user interfaces, changing coding processes, etc. CIOs and those who have managed such projects would help inform the task force of the challenges, and what could help them do this. (Sorry if this is redundant -- not sure if my previous post worked)
ReplyDeleteDavid Tao