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VSAC - Value Set Authority Center

VSAC - Value Set Authority Center . b y Ivor D’Souza Director, Information Systems, NLM. November 13, 2012. Today’s Topics. 1. 3. PRESENT. Review where we are today. FUTURE. 2. Planned initiatives. LESSONS LEARNED. Challenges & how we dealt with them. Where Are We T oday?.

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VSAC - Value Set Authority Center

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  1. VSAC - Value Set Authority Center by Ivor D’Souza Director, Information Systems, NLM November 13, 2012

  2. Today’s Topics 1 3 PRESENT Review where we are today FUTURE 2 Planned initiatives LESSONS LEARNED Challenges & how we dealt with them

  3. Where Are We Today? • Web user interface – human consumption • Application programming interface – machine consumption

  4. https://vsac.nlm.nih.gov

  5. VSAC API • Based on IHE Sharing Value Sets (SVS) Profile • XML-based • In use by USHIK, Mayo & Mitre • Returns value sets by: • OID • OID & version • Measure ID

  6. The VSAC JourneyandLessons Learned

  7. Value Set Curation CLEAN Challenge 1,558 unique value sets with Curation 84,228 unique codes in Outcomes 94 quality measures within 4 months

  8. Value Set Curation Used UMLS® Terminology Services and RxNORM APIs Challenge Curation • Triangulation between • code system, code & description • Checks for: • Incorrect/malformed codes • Code System/Code mismatch • Code/description mismatch Outcomes

  9. Value Set Curation EXAMPLES (Code reformatted) Challenge • SNOMEDCT93109003 -> 293109003Diphtheria, tetanus and pertussis vaccine adverse reaction (disorder) • ICD10CMM01x69 -> M01.X69Direct infection of unspecified knee in infectious and parasitic disease classified elsewhere • LOINC8480-6┬á -> 8480-6Systolic blood pressure Curation Outcomes

  10. Value Set Curation EXAMPLES (Code system changed) Challenge • ICD10CM -> ICD10PCS02H732G Insertion of Pressure Sensor into Left Atrium, Percutaneous Approach • ICD10CM-> ICD9CM35.11 OPN AORTIC VALVULOPLASTY • LNC-> CPT80069 Renal function panel Curation Outcomes

  11. Value Set Curation EXAMPLE (code/code system mismatch) Challenge Curation • 2474318017 (urine screen for chlamydia) • code for the term (wrong) • 412761009 (urine screen for chlamydia) • code for the concept (OK) Outcomes

  12. Value Set Curation EXAMPLE (code/description mismatch) Challenge • 99411 Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) • 96411 Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) Curation Outcomes

  13. Value Set Curation Challenge THIRTEEN grueling rounds of corrections over a 4-month period Curation • Corrected: • 4100+ codes • 370+ value sets • All 94 measures Outcomes

  14. Planned Next Steps (Partial list) • Process Initiatives (in collaboration with HHS partners) • Governance process for value set editing, approval and publishing • Value set review to validate against purpose of measure • Tooling for VS maintenance and authoring • Direct access to online code systems (should eliminate errors encountered) • Access to UMLS synonymy, hierarchy and relationships • Built-in quality checks to alert on potential errors • Automated alerts when new code system releases require value set refresh • Evaluate CTS2 suitability for use with VSAC • Opportunities to improve value set consumption • Integration with Measure Authoring Tool (MAT)

  15. Thank You!

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