VSAC - Value Set Authority Center

November 13, 2012

by

Ivor D’SouzaDirector, Information Systems, NLM

2

Today’s Topics

1PRESENTReview where we

are today

2LESSONS LEARNEDChallenges & how we

dealt with them

3FUTUREPlanned initiatives

Where Are We

Today?

Web user interface – human

consumption

Application programming interface –

machine consumption

https://vsac.nlm.nih.gov

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

The VSAC Journeyand

Lessons Learned

Value Set Curation

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Challenge

Curation

Outcomes94 quality measures

84,228 unique codes

1,558 unique value sets

CLEAN

with

in

within4 months

12

Challenge

Curation

Outcomes

Value Set Curation

Used

UMLS® Terminology Services and RxNORM APIs

Triangulation between code system, code & description

Checks for:- Incorrect/malformed codes- Code System/Code mismatch- Code/description mismatch

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Challenge

Curation

Outcomes

Value Set Curation

EXAMPLES(Code reformatted)

SNOMEDCT93109003 -> 293109003 Diphtheria, tetanus and pertussis vaccine adverse reaction (disorder)

ICD10CMM01x69 -> M01.X69 Direct infection of unspecified knee in infectious and parasitic disease classified elsewhere

LOINC8480-6 á┬ -> 8480-6 Systolic blood pressure

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Challenge

Curation

Outcomes

Value Set Curation

EXAMPLES(Code system changed)

ICD10CM -> ICD10PCS02H732G Insertion of Pressure Sensor into Left Atrium, Percutaneous Approach

ICD10CM -> ICD9CM35.11 OPN AORTIC VALVULOPLASTY

LNC -> CPT80069 Renal function panel

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Challenge

Curation

Outcomes

Value Set Curation

EXAMPLE(code/code system mismatch)

2474318017 (urine screen for chlamydia)code for the term (wrong)

412761009 (urine screen for chlamydia)code for the concept (OK)

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Challenge

Curation

Outcomes

Value Set Curation

EXAMPLE(code/description mismatch)

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)

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Challenge

Curation

Outcomes

Value Set Curation

THIRTEEN grueling rounds of corrections

over a 4-month periodCorrected:- 4100+ codes- 370+ value sets- All 94 measures

Planned Next Steps

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)

(Partial list)

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Thank You!