1. Lisa A. Lang, MPP Assistant Director for Health Services Research Information Head, National Information Center on Health Services Research and Health Care Technology National Library of Medicine National Institutes of Health U.S. Department of Health and Human Services United States National Library of Medicine National Institutes of Health, Health and Human Services

2. World’s largest biomedical library Maintains vast print collection Produces electronic information resources Supports and conducts research, development, and training in biomedical informatics and health IT United States National Library of Medicine National Institutes of Health, Health and Human Services 2

3. NLM is responsible as the central coordinating body for clinical terminology standards within HHS. The NLM role is to assure the on-going validity and accuracy of the value sets. VSAC is provided by NLM in collaboration with the ONC and CMS. United States National Library of Medicine National Institutes of Health, Health and Human Services 3

4. Provides downloadable access to all official versions of vocabulary value sets contained in the 2014 CMS Clinical Quality Measures (CQMs). Because many of the clinical terminologies used by value sets have copyright restrictions, VSAC users are required to agree to the terms of the UMLS License. United States National Library of Medicine National Institutes of Health, Health and Human Services 4

5. PHASE 1 Create a validation authority and central repository for all value sets. Provide quality assurance through validation of value set terms with code sets. PHASE 2 Provide authoring capabilities for organizations and individuals to create value sets for their specific needs. United States National Library of Medicine National Institutes of Health, Health and Human Services 5

6. United States National Library of Medicine National Institutes of Health, Health and Human Services 6

7. A value set is a list of terms and their codes derived from single or multiple standard vocabularies used to unambiguously define clinical concepts (such as patients with diabetes, clinical visit, reportable diseases) used in clinical quality measures and to support effective health information exchange, as well as other specific business purposes. United States National Library of Medicine National Institutes of Health, Health and Human Services 7

8. Initial: “Meaningful Use” 2014 Clinical Quality Measures Contribute to the unambiguous definition of the numerator and the denominator for a quality measure. Example: #diabetes patients/specific population Future/Phase 2: In collaboration with the field, s upport exchange and analysis of data within and between such diverse contexts as clinical and comparative effectiveness research, clinical decision support, performance measurement and public health United States National Library of Medicine National Institutes of Health, Health and Human Services 8

9. As currently represented in the VSAC, value sets are closely tied to specific measures (CQM). Value set developers currently include such organizations as National Committee for Quality Assurance AMA (Physician Consortium for Performance Improvement) CDC CMS United States National Library of Medicine National Institutes of Health, Health and Human Services 9

10. [This CQM has 40 Value Sets, one of which we show here]: Value Set OID: 2.16.840.1.113883.3.117.1.7.1.247 Value Set Name: Ischemic Stroke United States National Library of Medicine National Institutes of Health, Health and Human Services 2.16.840.1.113883.3.117.1.7.1.250Ischemic Stroke ICD9 value set 2.16.840.1.113883.3.117.1.7.1.251Ischemic Stroke ICD-10 value set 2.16.840.1.113883.3.117.1.7.1.252Ischemic Stroke SNOMEDCT value set Ischemic Stroke Grouping 10

11. United States National Library of Medicine National Institutes of Health, Health and Human Services 11

12. United States National Library of Medicine National Institutes of Health, Health and Human Services 12

13. 93 CQMs 3008 Value Sets 196,467 Codes/Terms United States National Library of Medicine National Institutes of Health, Health and Human Services 13

14. United States National Library of Medicine National Institutes of Health, Health and Human Services 14

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27. United States National Library of Medicine National Institutes of Health, Health and Human Services 27 Work Sheet 1

28. United States National Library of Medicine National Institutes of Health, Health and Human Services 28 Work Sheet 2

29. United States National Library of Medicine National Institutes of Health, Health and Human Services 29

30. United States National Library of Medicine National Institutes of Health, Health and Human Services 30

31. United States National Library of Medicine National Institutes of Health, Health and Human Services 31 INPUTOUTPUT RetrieveValueSet OID (id) expanded value set (XML) no metadata RetrieveMultipleValueSets OID, CMS eMeasureID, NQF# expanded value set (XML) all metadata

32. T Integration with Authoring Tool(s) to support value set authorship Free-standing, web- based value set authoring tool(s) Web page population for human consumption Web download / web services for machine consumption Phase 2 Controlled Value Set Repository & Validation Engine API Phase 1 Value Set / Measure Authors Consensus Organization(s) NLM ONC Consensus Org(s) NLM Curation Delivery API Future of VSAC

33. VSAC Web site: http://vsac.nlm.nih.gov Contact NLM: (888) FIND-NLM Contact Lisa Lang at NLM: langl@nlm.nih.gov United States National Library of Medicine National Institutes of Health, Health and Human Services 33