HITSP C80 / C83 Briefing and Update

John S. Carter, Apelon, Inc.

VHA CHIO Standards and Interoperability

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

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Briefing Goals

• Describe – 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

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TN901Definitions

TN902Definitions

T66 Terminology

Services (IHE SVS)

Where do C80 and C83 fit?

Implementation Specification (IS)

Selected Components (healthcare

data)Transactions

Transaction Packages

C83 Content Modules,

ConstraintsC80

Vocabulary, Value Sets

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C48 Referral Summary

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C83 Person(al) Information: Gender

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Controlled Vocabulary Key Principles

• Concept-oriented• Standardized,

agreed-upon• Enduring• Simplifiers

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TN901 – Vocabulary Meta-model

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C80 Administrative Gender

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C80 HL7v2 Administrative Gender

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C80 HL7v3 CDA Administrative Gender

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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???

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Inside C80: OIDs

• Object Identifiers• Hierarchical• Assigned locally by

registered authorities2 Joint ISO / ITU

16 Country assignment

840 USA

1 US companies

113883 HL7

5 v3codeSystems

1 Admin Gender

http://www.alvestrand.no/objectid/top.html

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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

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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

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The Ugly

• Word !!!

• Version-itis (e.g., HL7v2 and HL7v3) may lead to inconsistent, non-interoperable data

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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

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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