Next, Doug Fridsma began a discussion of our Summer Camp items, noting the many projects of the S&I framework are proceeding according to plan. Thus, the HIT Standards Committee will not specify the vocabularies used within enterprise applications, just those vocabularies that are needed for specific purposes when data is transmitted between entities. When BIDMC sends immunization records to public health, it uses CVX codes. However, when BIDMC sends clinical summaries, it maps FDB to RxNorm for all drug names. We clarified this with an example from Beth Israel Deaconess Medical Center:īIDMC uses First Data Bank as the medication vocabulary for its internal systems. *Using RxNorm for all medications including vaccines, even though CVX is the required vaccine vocabulary for Meaningful Use stage 1. Non-lab Diagnostic study - LOINC for name, SNOMED-CT for appropriate findings, UCUM for UnitsĪ rich discussion followed. Patient characteristics - ISO 639-2 for preferred language, HL7 for administrative gender, PHIN-VADS (Centers for Disease Control) for Race/Ethnicity Examples of their selections includeĪdverse Drug effect - RxNorm for medications, SNOMED-CT for non-medication substances, SNOMED-CT for severity of reaction The workgroup used SNOMED-CT and LOINC wherever possible and tried to select one vocabulary per domain (allergies, labs, medications etc). Reducing the number of standards makes mapping between different vocabularies much easier. The charter for the group was to select the minimum number of vocabulary standards with the minimum number of values to meet the requirements of meaningful use stages 2 and 3. Jim Walker, chair of the Clinical Quality workgroup, presented an overview of the vocabulary work done to support all our clinical coordination and quality measurement activities. Per the Standards Summer Camp schedule, the July HIT Standards Committee meeting focused onĮPrescribing of discharged medications recommendations Bottom up adoption of standards that are implemented and improved by stakeholders is a better approach. It's clear that at times we'll have to consider new standards that seem very reasonable for the purpose intended and test them in real world scenarios before forcing top down adoption through regulation. We want to encourage innovation and use market adoption as a measure of our success.
However, many standards are mature but not widely adopted or novel but not well tested. Standards that are widely adopted by the marketplace and are well tested make harmonization easy. Farzad Mostashari, national coordinator for healthcare IT, began the meeting with a discussion of the issues we have always faced while harmonizing standards.
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