A Milestone for Vocabulary Resources

The Vocabulary Task Force of the HIT Standards Committee is hard at work specifying the vocabularies and codesets that should be publicly available to accelerate certification and meaningful use efforts.

Today, Kaiser Permanente announced the donation of its Convergent Medical Terminology (CMT) to the International Healthcare Terminology Standards Development Organisation (IHTSDO©) for U.S. distribution through the U.S. Department of Health and Human Services (HHS) so that all health care providers—large and small—can benefit from the translation-enabling technology.

This donation makes the results of years of work at Kaiser Permanente available to help U.S. health professionals and hospitals achieve key meaningful use standards set forth by the Office of the National Coordinator of Health IT and the Center for Medicare and Medicaid Services.

The donation includes:

1.  Over 75,000 extensions to existing vocabularies (new concepts, natural language descriptions for clinicians and patient friendly terms)

2.  Derivative works (crossmaps of vocabularies to each other)

3.  Toolkits for collaborative editing

In addition to the Kaiser donation, below is a guide to other freely available resources, such as crossmaps from SNOMED CT to ICD-9-CM and ICD-10-CM.

The CM versions used in the US (produced by the National Center for Health Statistics, CDC)  are different from the basic ICD-9 and ICD-10 as released by the World Health Organization.  There is a project to map SNOMED CT to the basic ICD-10 that is being undertaken by the International Health Terminology Standards Development Organisation (IHTSDO), which is the owner of SNOMED CT.

SNOMED CT to ICD-9-CM  - There are two free mappings from SNOMED CT to ICD-10-CM, a basic "conceptual" mapping which is released with SNOMED CT (free to all US users under the UMLS license) and a draft rule-based mapping for the reimbursement use case.  The rule-based map includes IF-THEN rules for selecting the appropriate ICD-9-CM code for a condition in those cases when a SNOMED CT concept could map to more than one ICD-9-CM entry.  For example, in order to select the appropriate ICD-9-CM code for infertility, you must look elsewhere in the patient's record to determine whether the patient is male or female.  Having received modest feedback on the draft mapping, the next step is to produce a current rule-based map that covers all entries in the SNOMED CT CORE problem list subset, which we hope to complete by early 2011.

SNOMED CT to ICD-10-CM - NLM is currently inserting ICD-10-CM into the UMLS Metathesaurus, which will create the synonymous mappings between SNOMED CT and ICD-10-CM.  When this step has been completed (by November 2010), we will work on a rule-based mapping between the SNOMED CT CORE Problem list subset and ICD-10-CM.  This should become available in later in 2011.

All of the above information refers to mappings of diagnoses and conditions - not procedures.

For completeness, access to DRG and Medicare/Medicaid data resources is described below.

The “GROUPER” program, used by Medicare associates ICD-9-CM codes with specific “diagnosis-related” codes.  These codes, previously called “DRGs” (“diagnosis-related groups”) are now properly called Medicare Severity Diagnosis Related Groups (MS-DRGs).   The GROUPER logic, which was developed and is maintained by 3M/Health Information Systems, is updated annually as part of the regulatory update process required for Medicare Inpatient Prospective Payment System.

The software for the GROUPER is distributed for a fee from NTIS.  The complete documentation of the GROUPER logic/Definitions Manual is distributed for a fee from 3M.

Medicare or Medicaid data is available for research from CMS’s Research Data Assistance Center (“ResDAC”), which is a CMS contractor that provides free assistance to academic, government and non-profit researchers interested in using Medicare and/or Medicaid data for their research. ResDAC is staffed by a consortium of epidemiologists, public health specialists, health services researchers, biostatisticians, and health informatics specialists from the University of Minnesota.  Please see the ResDAC website for more information.