1. November 13, 2012

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

3. Web user interface – human consumption Application programming interface – machine consumption

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

9. 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

11. 11 Challenge Curation Outcomes 94 94 quality measures 84,228 84,228 unique codes 1,558 1,558 unique value sets CLEAN with in within 4 4 months

12. 12 Challenge Curation Outcomes Used UMLS® Terminology Services and RxNORM APIs 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

13. 13 Challenge Curation Outcomes EXAMPLES (Code reformatted) SNOMEDCT 93109003 -> 293109003 Diphtheria, tetanus and pertussis vaccine adverse reaction (disorder) ICD10CM M01x69 -> M01.X69Direct infection of unspecified knee in infectious and parasitic disease classified elsewhere LOINC 8480-6 ┬ á -> 8480-6 Systolic blood pressure

14. 14 Challenge Curation Outcomes EXAMPLES (Code system changed) ICD10CM -> ICD10PCS 02H732G Insertion of Pressure Sensor into Left Atrium, Percutaneous Approach ICD10CM -> ICD9CM 35.11 OPN AORTIC VALVULOPLASTY LNC -> CPT 80069 Renal function panel

15. 15 Challenge Curation Outcomes 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)

16. 16 Challenge Curation Outcomes EXAMPLE (code/description mismatch) 99411Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) 96411Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure)

17. 17 Challenge Curation Outcomes THIRTEEN grueling rounds of corrections over a 4-month period Corrected: -4100+ codes -370+ value sets -All 94 measures

18. 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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