1. United States Health Information Knowledgebase (USHIK) Metadata Registry Project Glenn M. Sperle Health Care Financing Administration 410 786-4610 25 May 2000 Health Level Seven

2. 25 May 2000 2 Purpose of Briefing Provide Status of Metadata Registry Project –United States Health Information Knowledge Review –Goal –Today’s Situation –Approach –Metadata Registry Overview –Some Examples –Point of Contact

3. 25 May 2000 3 Metadata Registry Project Goal Build, populate, demonstrate, and make available for general use a metadata registry to assist in cataloging and harmonizing data elements across multi- organizations. Utilize selected Health Insurance Portability and Accountability Act (HIPAA) data elements for demonstration.

4. 25 May 2000 4 Today’s Situation (i) HCFA and DoD have developed the USHIK to demonstrate the use of a metadata registry that: –Focuses on Health Insurance Portability and Accountability Act (HIPAA) data. –Contains data definitions from X12, HL7, and NCPDP. –Functions based on ISO/IEC 11179 metadata standard –Utilizes the Australian National Health Information Model (NHIM) high level information model to facilitate grouping of data definitions. USHIK is available for review at: http://hmrha.hirs.osd.mil/registry/

5. 25 May 2000 5 Today’s Situation (ii) HCFA has offered to support operation of the USHIK by Health Informatics Standards Board (HISB) for one year in order for HISB and Standards Development Organizations to utilize and evaluate metadata registry benefits.

6. 25 May 2000 6 HISB and seven SDOs have accepted HCFA’s offer to utilize the USHIK metadata registry to evaluate metadata registry capabilities –Accredited Standards Committee - Healthcare (X12N) –American Dental Association (ADA) –American Society for Testing and Materials Committee E31 on Healthcare Informatics (ASTM E31) –Health Industry Business Communications Council (HIBCC) –Health Level (HL7) –Medical Device Communications Industry Group (IEEE 1073) –National Council for Prescription Drug Programs (NCPDP) Today’s Situation (iii)

7. 25 May 2000 7 Five additional organizations are interested in providing input or observing –Center for Disease Control (CDC) –Department of Defense, Health Affairs (DoD HA) –National Committee on Vital and Health Statistics (NCVHS) –Government Computer-Based Patient Record (G-CPR - Joint Department of Defense, Health Affairs (DoD HA), Department of Veteran Affairs (VA), and Indian Health Service (IHS) Project) –Health Care Financing Administration, End Stage Renal Disease Program (HCFA ESRD) Today’s Situation (iv)

8. 25 May 2000 8 Approach Two phase approach –Initial startup to provide access to current SDO data dictionary content and basic metadata registry operations Load “As-Is” information Minimize impact on SDO Map data elements to Australian National Health Information Model (NHIM) –Establish procedures for achieving metadata registry content consistency Incorporating into SDO operations Versioning of data elements Required metadata and quality metrics Enhance capabilities of metadata registry

9. Methods of Finding Data Elements Metadata Registry Overview … Birth Date Hair Color Eye Color Sex... Data Elements ABCDEFGH.. Initiatives Health Insurance Portability and Accountability Act... Data Collections HCFA Long Term Care BRFSS Data Agreements X12 NCVHS Core Data NCPDP Organizations CDC AHCPR NCVHS Models HL7-RIM DoD HA FAM-D AIHW What data elements are used? Data elements are described in common format. References to Authoritative Sources NCPDP (National Council for Prescription Drug Program) Data Element X12 (American Standards Committee) Transaction Set -Data Element -Composite Data Element HL7 (Health Level Seven) Reference Information Model -Subject Area -Class -Attributes NHIM (Australian National Health Information Model ) Model -Model Subtype -Information Model Subtype -Data Element -Data Concept -Composite Data Element -Derived Data Element … Person_Sex Gender Sex_Category Code... Where are data elements defined? Codes can be downloaded for use in applications. A metadata registry is a place to keep facts about characteristics of data that are necessary to clearly describe, inventory, analyze, and classify data. A metadata registry supports data sharing with cross-system and cross-organization descriptions of common units of data. A metadata registry assists users of shared data to have a common understanding of a unit of data’s meaning, representation, and identification. Identifying and Definitional Attributes: Data Element ID : 07-329-4837.00000692.v1 Name : Gender Code Context : X12 Data Dictionary Definition : Code indicating the sex of the individual Status : Received as of 01/19/1999 Example : Synonyms/Keywords : Comment : Data Collection Methods : Relational and Representational Attributes: Data Type : ID Representational Form : Representational Layout : Minimum Size : 1 Maximum Size : 1 Unit Of Measure : Precision : Minimum Range : Maximum Range : Data Domain: Permissible value Domain Meaning Name Domain Meaning Definition Text A Not Provided B Not Applicable F Female M Male N Non-sexed U Unknown X Unsexable Related Data References: Object Relationship Related Item Type Gender Code is composite part of X12 Data Dictionary Standards Alternate Names and Contexts: Name Context Gender Code X12 Data Dictionary 1068 X12 Data Element Number

10. 25 May 2000 10 Data elements are described in common format. (i)

11. 25 May 2000 11 Data elements are described in common format. (ii)

12. 25 May 2000 12 Data elements are described in common format. (iii)

13. 25 May 2000 13 High Level Information Model Assists in Grouping Data Elements

14. 25 May 2000 14 Data Elements are Linked to Model Views Model Views Data Elements

15. 25 May 2000 15 Data Elements Linked by Different Organizations Appear Together NCPDP Data Element (0060-02-166-0014 Registration Authority) X12 Data Element (0060-07-329-4837 Registration Authority)

16. 25 May 2000 16 Comparison Matrix Aids in Harmonizing Data Elements

17. 25 May 2000 17 Data Element Usage Shows Linkages Between Data Elements

18. 25 May 2000 18 Future HISB will manage the release of the new USHIK HCFA will utilize an internalized version of USHIK for managing End Stage Renal Disease and Peer Review Program metadata

19. 25 May 2000 19 Point of Contacts and Example Metadata Registry Sites Health Care Financing Administration –Bob Mayes Director, Information Systems Group Office of Clinical Standards and Quality Health Care Financing Administration 7500 Security Blvd., Bldg S3-02-01 Baltimore, MD 21244-1850 410.786.6872 / 410.786.8532 Fax rmayes@hcfa.gov Department of Defense - Health Affairs –Marco Johnson Chief, Operational Architecture Information Management Information Management, Technology & Reengineering TRICARE Management Activity Office of Assistant Secretary of Defense ‑ Health Affairs 5111 Leesburg Pike, Suite 810 Falls Church, VA 22041-3206 703.681.5611 / 703.681.8845 Fax marco.johnson@tma.osd.mil http://www.hirs.osd.mil/hdp/index.html National Health Information Knowledgebase (NHIK) from Australian Institute of Health and Welfare (AIHW) –http://www.aihw.gov.au Environmental Data Registry (EDR) from the U.S. Environmental Protection Agency (EPA) – http://www.epa.gov/edr United States Health Information Knowledgebase (USHIK) on DoD Health Information Service (HIRS) – http://hmrha.hirs.osd.mil/registry/

20. 25 May 2000 20 USHIK - HL7 Information Model