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VSAC Support Center

VSAC Users' Forum Agenda: July 17, 2014

  • Welcome and Introduction (3 minutes)

  • Review of Last Month's Discussion (10 minutes)

    • UMLS Concept Unique Identifiers (CUIs) in VSAC: We have heard from some value set creators that they would like to use UMLS CUIs as value set code members. We discussed this on the VSAC Users' Forum Call last month, and in the meantime we are considering requirements for implementing this. Although it would be redundant to recreate the UMLS Terminology Services (UTS) within VSAC, we are exploring importing the UMLS concept unique identifiers (CUIs) with their concept term and corresponding Semantic Types. We anticipate VSAC users would need access to the rich amount of information contained in the UMLS Metathesaurus for each concept so we will hyperlink each UMLS CUI to the UTS, which would allow you to browse the context, atoms and relationships of that concept within the UMLS Metathesaurus.
    • Additional Download Formats (text): When the NLM first launched VSAC two years ago, we provided value set downloads in two formats that served the immediate needs of the user community for the CMS Clinical Quality Measure value sets. We provided Excel spreadsheets as well as SVS XML. Since then, we have heard from several users that they need a text format for value set downloads. We discussed this on the VSAC Users' Forum Call last month, and in the meantime we are considering requirements for implementing a text format for value set downloads. We produced a prototype pipe-delimited text file and asked a few external people to review. We are also developing templates for XSLT style sheets to help users more easily transform SVS XML download files.
  • Today's User-Requested Agenda Items (30 minutes)

    • HL7 Code Systems in VSAC: Additional code systems: VSAC was originally populated with standard terminologies required by federal regulation in support of the CMS Clinical Quality Measure value set program. There are currently 15 terminologies within VSAC: SCT, RxNorm, LNC, ICD9CM, ICD10CM, CPT, CDT, etc. Other projects that require value sets have needs for additional terminologies, such as the HL7 code systems. For example: allowing users to author value sets used to generate CCD documents through C-CDA. For example HL7 Version 3 RoleCode used to define the relationship to patient for family history and emergency contact information.
      • HL7v3.0
      • ActStatus 2.16.840.1.113883.5.14
      • LanguageAbilityProficiency 2.16.840.1.113883.5.61
      • LivingArrangement 2.16.840.1.113883.5.63
      • RoleStatus 2.16.840.1.113883.5.1068
      • Observation Interpretation 2.16.840.1.113883.5.83
      • RoleCode 2.16.840.1.113883.5.111
      • HL7v2.5
      • Extended Priority Codes 2.16.840.1.113883.12.485
      • Specimen Risk Code 2.16.840.1.113883.12.489
      • Observation Result Status 2.16.840.1.113883.12.85
      • Result Status 2.16.840.1.113883.12.123
    • Capturing Clinical Data over Time: Value sets would need to allow for the inclusion of inactive records but using an effective and expiration date range. This way when pulling clinical data from a patient's chart using a published value set, we would get all the data we need. We do not go back into the EHR and update a LOINC code on a lab result that was active when it was added, but may have been deprecated in the current version of the code set.
    • Types of Data Changes Related to Value Sets:
      • Do updates typically include changes to the list of codes in a value set? Not necessarily.
      • What about the list of measures that use a value set? This depends on the measure developer's intent.
      • What other things can change? Any metadata can change.
      • What is the relationship between value set name and OID? The OID is the identifier, the name is the description.
      • Can the name change and the OID remain the same? Yes. The OID will always remain the same.
      • Does the combination of OID and version date uniquely identify a value set? If not, is there a unique identifier?
      • When I compare the June 14, 2013 and the May 30, 2014 July 1, 2014 versions of the value set "Above Normal Follow-up" (OID=2.16.840.1.113883.3.600.1.1525), as near as I can tell, the only difference is the version date. If that is correct, what was the reason for the update? Is this typical? Yes. The SVS XML download contains the package release date for the MU2 value sets. We are working on providing a way to help users understand content changes. The XSLT template we are developing, and we can distribute, can help you understand content changes.
      • The July 2014 release contains a smaller number of value sets than the June 2013 release, what happened to the value sets that are not in the July 2014 release? These are measure developer decisions.
  • What is VSAC Working on Now?

    • Updating VSAC with the July version of RxNorm (next week)
    • Updating VSAC with LOINC 2.48 (next month)
    • Investigating ways to include additional code systems in VSAC (HL7 and UMLS)
    • Creating a downloadable pipe-delimited text format and XSLT templates for SVS
    • Intensional Value Set Authoring Capability (long term)
    • VSAC Share (long term)
  • Webinar Questions (10 minutes)

  • Summary (1 minute)

  • Next Webinar August 28: Submit your questions, suggestions, training requests.