1. Public Testimony on Subsets & Value Sets to Taskforce on Vocabulary Clinical Operations Workgroup, Health IT Standards Committee from EHR Vendors, Terminology Service Providers, Message Standard Developers Points heard more than Once on February 23, 2010

2. Government’s Role Single Central Authority to govern (open) processes: – Selection, harmonization, updating controlled vocabularies, key subsets – Standards/Infrastructure for value set creation, maintenance – Clear delegation of authority/responsibility for particular value sets –likely different organizations for different types of value sets, e.g., SDOs, CDC, etc. – Harmonization of value sets across use cases/SDOs –ability to make SDOs abide by decisions – Standards/Infrastructure for Dissemination – both centralized and/or distributed mentioned, multiple preferred formats mentioned – Education, Guidance, FAQs

3. Other Advice Ongoing maintenance essential for vocabularies, subsets, & value sets – Requires commitment & resources Value sets must be bound to context – With direct involvement of those who know the use case, the model, the message Remove licensing barriers for other key resources, as done with SNOMED CT Make things easy for implementers – To find, use, get guidance on everything needed for “meaningful use”

4. Convenience Subsets Government- supported frequency-based subsets are useful ( e.g., SNOMED CT CORE problem subset) Leave any specialty set creation to vendors, societies