Public Health Information Network Vocabulary
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1 Public Health Information Network Vocabulary Access Distribution ib i System (PHIN VADS) Public Health Vocabulary Standards Developmen t, Dis tribution and Implemen ds tation Sundak Ganesan Health Scientist NCVHS Hearing on Public Health Data Standards Nov 12 th, 2013 Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) Division of Health Informatics and Surveillance (DHIS)
2 Vocabulary Basics Vocabulary View - Collection of value sets associated with a messaging guide e.g., Tuberculosis Case Notification Messaging g Guide Vocabulary
3 What is PHIN VADS? The first public health value set was published in 1995 using the Health Level 7 (HL7) Version 2.x implementation guide for Immunization by CDC National ImmunizationProgram (NIP). In 2004, CDC developed a Web based enterprise vocabulary system called the Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS) for accessing, searching, and distributing public health value sets. CDC Vocabulary and Messaging team manages the PHIN VADS application and content. Several vocabulary and messaging experts from this team actively participates in various Standard Development Organization (SDO) vocabulary development activities. PHIN VADS Website
4 Purpose and Usage of PHIN VADS Distributes the value sets associated with the public health HL7 messaging (V2.x, V3) & CDA implementation guides. PHIN VADS value set hyperlinks are included in the HL7 message implementation guides. CDC as SDO maintains and distributes the code system such as Vaccine names (CVX), Vaccine manufacturers (MVX), Race & Ethnicity, Healthcare Service Locations and Nationally Notifiable Disease/Conditions (NND) using PHIN VADS. Provides all the vocabulary metadata (e.g. OID) needed for HL7 messaging. Promotes sharing and reusing of the value sets in HL7 messaging guides. Hosts multiple versions of value sets that allow implementers to have access to the current, past and the future versions of value sets and value set collections (Vocabulary View). Provides web services (API) that allows HL7 interface engines, medical and public health applications to obtain the value sets as well as validate the vocabularypresent in HL7 messages.
5 Standards adopted by PHIN VADS
6 PublicHealth Activities Supportedby PHIN VADS
7 Meaningful Use (MU) Testimony about PHINVADS was given to ONC Meaningful Use Vocabulary Task Force: Best Practices and Lessons Learned: Vocabulary Infrastructure March 23 rd, 2010 (Audio) One Stop Shop for Meaningful Use Vocabulary Sept 1 st, 2010 (Audio) Collaboration with National Library of Medicine (NLM): CDC PHIN VADS team shared the experience with NLM regarding the value sets management, PHIN VADS application architecture, VADS web services and content. National Institute of Standards and Technology (NIST) and several implementers of MU are using PHIN VADS web services and web site to obtain the value sets associated with Public Health Meaningful Use Implementation Guides such as Immunization, Electronic Lab Reporting, Syndromic Surveillance and Cancer reporting.
8 Reportable Condition Mapping Table (RCMT) RCMT provides mapping between reportable conditions and its associated lab test and results. RCMT s filter the output of clinicallabs labs and identify the lab tests and results of public health interest. PHIN VADS maintains RCMT.
9 PHIN VADS User s/ Partners within CDC
10 PHIN VADS External Users / Partners
11 List of Current Vocabulary Registries and their scope Centers for Disease Control & Prevention (PHIN VADS) Public health value sets, HL7 Messaging guide value sets distribution, web services NLM Unified Medical Language System (UMLS) SDO vocab ulary (R RNorm, x SNOMED), mapping between bt standard ds, MU Quality Measures,.. National Cancer Institute (NCI) Enterpris evocabulary Services (EVS) Cancer domain, NCI Metathesaurus, FDA vocabulary (SPL, UNII), Gene (HUGO, GO), etc.. Envi ronmen t P ro tection ti Agency (EPA) S ub stance Registry System (SRS) Substance (Chemical, Physical, Biological), Map to CAS #, vocabulary (Air, Water, Soil), etc Agency for Healthcare Research & Quality (AHRQ) Unite dstates Health Information Knowledgebase (USHIK) Metadata registry of healthcare data elements and information models of SDOs, HITSP, Mayo Clinic LexGrid, LexBig, LexWiki Distributed network ofterminologies and ontologies using standard tools, web services(hl7 CTS) Washington Publishing Company (WPC) Taxonomy browser & file server Code lists supporting administrative data X12, NUCC, HIPAA, etc Standard DevelopmentOrganization (SDO) Tools Commercial Terminology Distribution (Vendors)
12 Standardization of Occupational Data in EHRs NIOSH s Primary Objectives Incorporate work information in a useful way in EHRs o Occupational Data for Health (ODH) Information Model o Recommend/Define Codes & Value Sets o o Census Industry and Occupation Codes, Employment Status, Work Schedule LOINC, SNOMED CT Incorporate work information in public health reporting o Interoperability Standards Support and improve care of workers Kick-off of Clinical i l Decision i Support pilot project
13 Needs to advance the adoption of public health data standards Public Health Data Elements need to be mapped to LOINC and distribute the information between question and answer instead of typical Yes No Unknown answer model. Implementation of HL7 Generic and Condition specific Case Notification Message Mapping Guides by public health agencies. Public Health workforce needs to be trained on the messaging and vocabulary standards as well as tools (e.g. RELMA) that facilitate mapping. Public Health Case Reporting Implementation Guide adoption by vendors is critical for getting EHR data to public health. Identifying and mapping the public healthdata elements to EHR would help the implementers. Ambulatory Labs and Hospital Labs need to implement and maintain the mapping of reportable conditions associated laboratory tests and results to LOINC, SNOMED and Reportable Condition Mapping Table (RCMT). Terminology services related standards such as HL7 Common Terminology Services (CTS) and IHE Sharing Value Set (SVS) needs to be harmonized. Collaboration between Federal Agencies and other terminology Collaboration between Federal Agencies and other terminology distribution sources regarding the distribution of public health vocabulary.
14 For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone: CDC INFO ( )/TTY: Visit: Contact CDC at: CDC INFO or PHIN VADS Support E mail: PHINVS@CDC.GOV PHIN VADS forum The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Center for Surveillance, Epidemiology, and Laboratory Services (proposed) Division of Health Informatics and Surveillance (DHIS)
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