1. NCVHS Subcommittee on Standards and Security James J. Cimino, M.D. Co-Chair, HL7 Vocabulary Technical Committee Department of Medical Informatics Columbia University

2. Selection Criteria for Message Standards Is there loss of information? Does it employ high-quality terminologies? How can the government support the standard?

3. Questions for SDOs - General Is there active participation by all interested parties? What evaluations have been done?

4. Questions for SDOs - Data Quality Does it alleviate duplication of data capture? Is there a data model that considers all users?

5. Patient ambulatory_status_cd birth_order_amt living_arrangement_cd living_dependency_cd multiple_birth_ind newborn_baby_ind organ_donor_ind preferred_pharmacy_id has1 1 participates_in1 has 1 is_requested_by 1 is_scheduled_by 1 has 1 1 1 has_a_primary_provider 0..* is_a_role_of 0..1 has_as_primary_facility 0..* is_target_of 0..1 is_source_for0..1 a_contact has_as_0..1 is_involved_in 1 Reference Information Model

6. 11 11 11 11 11 11 11 11 11 11 11 11 11 effective_dt return_to_work_auth_dt termination_dt unable_to_work_effective_dt 11 1111 11 11 Patient ambulatory_status_cd birth_order_amt living_arrangement_cd living_dependency_cd multiple_birth_ind newborn_baby_ind organ_donor_ind preferred_pharmacy_id1has1 1 1 1participates_in1 0..* 1 pertains_to 0..* has 1 1 is_requested_by 1 1 is_scheduled_by 1 1 has 1 11 1 1 0..* has_a_primary_provider 0..* 0..1 is_a_role_of 0..1 1has1 0..* has_as_primary_facility 0..* 0..1 is_target_of 0..1 is_source_for0..1 has_as_ a_contact 0..1 11 11 11 11 11 11

7. Reference Information Model

8. Questions for SDOs - Data Quality Does it alleviate duplication of data capture? Is there a data model that considers all users? What criteria are used for selecting terminologies?

9. Principles for Adoption of HL7- Compliant Terminologies 1. The terminology must be compliant with the semantics of the HL7 structures 2. The terminology provider must be willing to participate in HL7- sanctioned interoperability efforts 3. There must be an organization committed to the timely maintenance and update of the terminology 4. Appropriateness of cost will be a consideration. (see “Principles for HL7- sanctioned Terminology Integration Efforts) 5. The terminology must be free from excessive license fees, yet HL7- sanctioned interoperability efforts must not jeopardize the business model of the terminology provider (see “Principles for HL7-sanctioned Terminology Integration Efforts) 6. The terminology should be comprehensive for the intended domain of use 7. Regulatory circumstances may require the adoption of specific terminologies. The use of such terminologies, provided that they are consistent with principle #1 above, shall not be considered a deviation from the HL7 standard

10. Transactions Alerts and Reminders Exchange of Logic and Guidelines

11. Additional Comments Should there be criteria for terminologies? Keep your eye on the doughnut