Meaningful Use and the impending ICD-10 implementation is all the buzz! Understanding terminology management for SNOMED-CT, ICD-9-CM and ICD-10-CM/PCS leaves many folks with their heads spinning. What does this all mean? Is there a one stop shopping to help me (save me)? The good news is that there are resources available. The not so good news is that availability does not necessarily equal ease of use.
A great place to begin educating yourself about the different vocabulary standards required by Meaningful Use is the National Library of Medicine (NLM). The NLM is not some dusty old building located in an obscure area with lots of old books just waiting to be checked out. Located on the campus of the National Institutes of Health (NIH), the NLM is a driving force in informatics and data standards. The NLM’S Value Set Authority (VSAC) will be the official repository for Value Sets that support 2014 Meaningful Use Clinical Quality Measures (CQMs). The NLM offers tools for EHR Certification and Meaningful Use where you can learn about RxNorm, SNOMED-CT, and LOINC and explore their native file formats. There is a link to MedlinePlus Connect, a wonderful consumer health information resource, to help meet Meaningful Use requirements for patient education resources.
While the website and the associated resources are great, they do require a degree of sophisticated understanding and experience. Terminology management issues center on some key challenges:
Locating and understanding file formats
Coordinating and understanding content sources and update cycles
All of the files discussed here are in their native formats and require fairly proficient resources to manipulate and integrate those files. It is important to remember that these vocabularies are not static. Each set (RxNorm, LOINC, and SNOMED-CT) has a different update cycle. Mapping between code sets will become more prevalent and necessary. Since problems lists are now required to use SNOMED-CT and many problem lists are coded in ICD-9-CM codes, mapping and translation between these vocabularies will be needed. You’ll also need to map your lab items to LOINC. Medications will need to be reconciled with RxNorm. Begin to see the complexity?
Most users have found that using these free resources is a good place to start, but more is needed to fully use and maintain these vocabularies. As most organizations have found, building your own EHR is not feasible. Terminology management is just as sophisticated and necessary and requires the right tools to do the job right.
NLM Tools for EHR Certification and Meaningful Use
ICD-10-CM at CDC
CMS ICD-10 Website
CMS Meaningful Use Website