1. IT Infrastructure Planning Committee Use Case Enhanced SVS Nikolay Lipskiy, MD, DrPH, Centers for Disease Control (CDC), USA Sundak Ganesan, MD, Northrop Grumman for CDC Proposal discussion Proposal discussion February 1-4, 2010

2. IT Infrastructure Planning Committee Current SVS: Purpose “This profile describes a mechanism of retrieving a Value Set from a Value Set Repository by a Value Set Consumer. “ “The Sharing Value Sets (SVS) profile provides a means through which healthcare systems producing clinical or administrative data, such as diagnostic imaging equipment, laboratory reporting systems, primary care physician office EMR systems, or national healthcare record systems, can receive a common, uniform nomenclature managed centrally. “

3. IT Infrastructure Planning Committee Current SVS: Existing Use Cases 21.3.2.2 Updating terminology codes for a medical and billing across systems 21.3.2.3 Consistent Encoding Terms for anatomical regions in imaging 21.3.2.4 Modification of a protocol code for a mammogram exam

4. IT Infrastructure Planning Committee Enhanced SVS: Purpose 1)Registering 2)Updating 3)Retrieving Single Value Set Value Set Group/View Specific version (i.e., when a report was created) 1. Enhanced profile will describe a mechanism of from a Value Set Repository by a Value Set Consumer

5. IT Infrastructure Planning Committee Enhanced SVS: Purpose (cont) 2. Adding Value Set’s Group ID (and OID?) for: 2.1. Immunization Domain 2.2. Cancer registries Domain 2.3. Public Health Case Reporting (PHCR)

6. IT Infrastructure Planning Committee *Value Set Grouping VS Consumer VS Repository (PHIN VADS) VS Registry (HL7 OIDs Registry) VS Source (i.e. Cancer Registry Program) Retrieve VS Version Query/ Retrieve VS Version or Grouping Register/Update VS Enhanced SVS: Overview of the Process Flow (cont.) Provide & Register /Update VS Register /Update VS Issues such as multiple registries, etc. need to be determined, as does the issue of whether the update should come from the VS Repository Actor or the VS Source actor. The diagrams show it coming from the Repository Actor. Existing actors Vocabulary Consumer Value Set Repository New actors Value Set registry Value Set Source

7. IT Infrastructure Planning Committee Enhanced SVS: Use Cases Use Case 0. (?-Sondra R. Renly) The Management of Clinical Document Vocabularies. Current SVS: Can we extend existing case for this use case? Use Case 1. The Management of Immunization Vocabularies. See proposed profile Use Case 2. The Management of Cancer Vocabularies See proposed profile

8. IT Infrastructure Planning Committee New Transactions 1. Provide and Register Vocabulary The management of value sets needs to be a distributed process allowing programs and vocabulary specialist the capability to create versions of value sets and groups. When code system updates take place a notification is necessary to see the relationship between the concepts and value sets that might be affected by those updates. An example would be the intrinsic value set of Microorganism that is derived from SNOMED. Situations that may result in creating new value sets include: addition of code to existing value set removal of code from existing value set creation of value set removal of value set creation/update/removal of value set groups

9. IT Infrastructure Planning Committee New Transactions (Cont.) 2. Retrieving Data from Registry and Repository Currently a consumer must know the OID of a value set to retrieve it from the Repository. A query will be specified to obtain OIDs of interest. Possible queries: 2.1. Query for a flat file that depicts a relationship between value set groupings 2.2. Query for a list of VS by subject category 2.3. Query for a list of VS associated with specific template/document ID 2.4. Query for a specific VS 2.5. Query for a specific VS group version (i.e., associated with a time stamp)

10. IT Infrastructure Planning Committee

11. Distributing Consistent Nomenclatures? Current Status: New Tasks Based on Adding new Transactions and Use Cases for Management Immunization and Cancer Vocabularies : 1)Additional nomenclatures for Value Set View and Value Set Group 2)Additional nomenclatures for Use Cases (Example on the next slide)

12. IT Infrastructure Planning Committee