1. HITSP C80 / C83 Briefing and Update
John S. Carter, Apelon, Inc.
VHA CHIO Standards and Interoperability

2. http://www. xml. com/pub/a/2007/04/11/a-smoother-change-to-version-20

3. Describe Briefing Goals the role these constructs play in HITSP
the role of controlled vocabulary in practical HIT implementations
the current state of these constructs during public comment period
process challenges and future goals
opportunities for further work

4. Where do C80 and C83 fit? Implementation Specification (IS)
Selected Components (healthcare data)
Transaction Packages
Transactions
T66
Terminology Services
(IHE SVS)
C83 Content Modules, Constraints
TN902
Definitions
C80 Vocabulary, Value Sets
TN901
Definitions

5. C48 Referral Summary

6. C83 Person(al) Information: Gender

7. Controlled Vocabulary Key Principles
Concept-oriented
Standardized, agreed-upon
Enduring
Simplifiers

8. TN901 – Vocabulary Meta-model

9. C80 Administrative Gender

10. C80 HL7v2 Administrative Gender

11. C80 HL7v3 CDA Administrative Gender

13. Inside C80: Vocabulary Source
SNOMED CT
Owned by IHTSDO
Produced by CAP
Distributed by NLM
Problem List Subset
Developed by Kaiser and VA experts
Distributed by NCI
So who’s in charge???

14. Inside C80: OIDs Object Identifiers Hierarchical
Assigned locally by registered authorities 2
Joint ISO / ITU 16
Country assignment
840
USA 1
US companies
113883
HL7 5
v3codeSystems
Admin Gender

15. Vocabulary versioning is tricky
Inside C80: Versions
Vocabulary versioning is tricky
Numbered (LOINC 2.24)
Dated (SNOMED Jan. 2008, ICD-9-CM 2008)
Parent document (HL7 v2.5.1)
??? Zip codes
Value set versioning is an unsolved question
As far as that goes, value set definition is an unsolved question

16. Current State C83 includes ~50 Content Module sections
C80 includes ~100 Value Set definitions
Maybe this is 20% of all HITSP value sets
Many technical details remain to iron out

18. The Ugly
Word !!!
Version-itis (e.g., HL7v2 and HL7v3) may lead to inconsistent, non-interoperable data

19. SDOs themselves often are a little fuzzy on vocabulary
The Bad
SDOs themselves often are a little fuzzy on vocabulary
Different HITSP work groups may be working in parallel, possibly reinventing the wheel
No repository available

20. C80 and C83 provide a great start
The Good
C80 and C83 provide a great start
Make HITSP constructs more implementable
Improve the underlying standards
Offer a path to a more rigorous construct development process in the future
Keith Boone, Don Van Syckle, Sarah Ryan
VHA
HITSP Community