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National Library of Medicine Sets Meaningful Use Standards

NLM, in collaboration with the Office of National Coordinator for Health Information Technology, will provide vocabulary sets for clinical measures found in MU Stage 2.

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The National Library of Medicine (NLM) announced it will launch the NLM Value Set Authority Center (VSAC) in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and the Center for Medicare & Medicaid Services. VSAC will provide downloadable access to all official versions of vocabulary value sets contained in clinical quality measures that support Meaningful Use Stage 2.

The value sets provide lists of numerical values and individual names from standard vocabularies. These vocabularies are used to define clinical concepts like diabetes or "clinical visit" used in the quality measures. According to The National Library of Medicine website, the content of the VSAC "will gradually expand to incorporate value sets for other use cases, as well as for new measures and updates to replace existing measures." Access to the VSAC requires a unified medical language system metathesaurus license. The library encourages organizations that don't have one to apply for one as soon as possible.

"The industry has been pushing ONC for this sort of objective standard-setting body," said Stacey Empson, managing director of healthcare solutions at technology and business solution firm CTG Health Solutions, in an interview with InformationWeek Healthcare. "I think it makes a lot of sense that [NLM is] an organization … that has developed standards before and is the terminology business."

[ For the latest development on Meaningful Use, see Meaningful Use Stage 2 Rules Finalized. ]

Empson said the VSAC will do a couple of things, beginning with defining an official vocabulary for Meaningful Use Stage 2 quality measures in particular. "There are a lot of standardized terminology services out there, but what this does in terms of value is it recognizes those standards already in place and [puts it in] one common vocabulary," she said. "It standardizes a process for not only the common vocabulary, but [also] how frequently it will be updated."

The VSAC, she said, requires a twice-a-year update, which includes testing, a review, and "almost an objective evaluation, if you will, of the common vocabulary sets. I sense it'll always be in flux, but it will be willing to be evolved and developed, with things like ICD-10, for instance."

Additionally, she said, prospective users shouldn't overlook the fact that the service is free, easily downloadable, and publicly available. "It's good for providers because it takes it out of the hands of a privatized organization that may try to charge for these things," she said. The service also forces vendors to collaborate more with the ONC, according to Empson.

The one red flag Empson identified is the tighter control over specific value sets. Although it's early on, "it may, however, be too tightly controlled and not leave enough room for flexibility, which I think has been inherent in a lot of MU requirements," she said.

"I get the impression ONC wants providers to meet the requirements and achieve their dollars, although Stage 2 is more stringent than Stage 1," she said. "But I think what we'll need to watch is not if it's too restrictive, but does it allow for enough flexibility for the provider to define their own value sets and their own quality measures."

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)

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