20 Messaging and Vocabulary Standards for Government Health IT

Tim’s got a good story about the federal government’s choice of health IT messaging and vocabulary standards selection over at Medical Connectivity Consulting. Worth reading, especially since he did the legwork to find the correct link for the standards list. I know a couple of the guys who worked on creating this list (on the Feds side) and although the list looks like it was pretty easy to put together, I can assure you that it was not as simple as it looks. While we’re not going to agree with everything they selected (like IEEE 1073 which seemed still-born) I commend the Feds for picking something.

Now we have something to throw darts at :-). Here’s the list, which is lifted from here verbatim but is easier to read:

1. Laboratory Results Names. Standard: Logical Observation Identifiers Names and Codes (LOINC[supreg]).
2. Messaging Standards. Includes: Scheduling, medical record/image management, patient administration, observation reporting, financial management, public health notification, and patient care. Standard: Health Level Seven[supreg] (HL7[supreg]) Version 2.3 and greater.
3. Messaging Standards. Includes: Retail pharmacy transactions. Standard: National Council for Prescription Drug Programs (NCPDP) SCRIPT[supreg].
4. Messaging Standards. Includes: Device-device connectivity. Standard: Institute of Electrical and Electronics Engineers, Inc. TM 1073.
5. Messaging Standards. Includes: Image information to workstations. Standard: Digital Imaging and Communications in Medicine[supreg] (DICOM[supreg]).
6. Demographics. Standard: HL7[supreg] Version 2.4 and greater.
7. Lab Result Contents. Standard: Systematized Nomenclature of Medicine Clinical Terms[supreg] (SNOMED CT[supreg]).
8. Units of Measure. Standard: HL7[supreg] Version 2.X+.
9. Immunizations. Standard: HL7[supreg] Version 2.3.1, specifically the Vaccines Administered (CVX) and Manufacturers of Vaccines (MVX) external code sets maintained by the Centers for Disease Control and Prevention’s (CDC) National Immunization Program (NIP).
10. Medications. Standards: Federal Drug Terminologies: (Sub- domain: Standard Adopted):
    • Active Ingredient: FDA Established Names & Unique Ingredient Identifier (UNII) codes.
    • Manufactured Dosage Form: FDA/CDER Data Standards Manual.
    • Drug Product: FDA’s National Drug Codes (NDC).
    • Medication Package: FDA Standards Manual.
    • Label Section Headers: LOINC[supreg] Clinical Structured Product Labeling (SPL).
    • Special Populations: HL7 Version 2.4 and greater.
    • Drug Classifications: The Department of Veterans Affairs’ National Drug File Reference Terminology (NDF-RT) for mechanism of action and physiologic effect.
    • Clinical Drug: the National Library of Medicine’s RxNorm.
11. Interventions/Procedures (Part A): Lab Test Order Names. Standard: LOINC[supreg].
12. Interventions/Procedures (Part B): Non-laboratory. Standard: SNOMED CT[supreg].
13. Anatomy. Standards: SNOMED CT[supreg] and the National Cancer Institute’s (NCI) Thesaurus.
14. Diagnosis/Problem Lists. Standard: SNOMED CT[supreg].
15. Nursing. Standard: SNOMED CT[supreg].
16. Financial/Payment. Standard: HIPAA Transactions and Code Sets.
17. Genes. Standard: Human Genome Nomenclature.
18. Clinical Encounters. Standard: HL7[supreg] Version 2.4 and greater.
19. Text-Based Reports. Standards: HL7[supreg] and Clinical Document Architecture (CDA) Version 1.0-2000 Chemicals.
20. Chemicals. Standard: Environmental Protection Agency’s Substance Registry System.

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