The Veterans Health Administration (VHA) Data and Terminology Standardization Office examines the way the mobile application (App) presents data to the patient to ensure that the definitions and clinical terms conform to the national health industry standards the VA follows. We guard against ambiguous terms and measures, and against collecting data that cannot be understood and correctly interpreted in VA records.
We evaluate the App according to the types of data it handles. For example, if your App cites immunizations, we ensure the App follows the Center of Disease Control's National Center of Immunization and Respiratory Diseases Vaccine Administered (CVX) code. As early as possible, you would provide us with a list of immunization data handled by your App. We would map (match to a code) these immunizations to the corresponding CVX codes.
There are other standards besides elements like immunizations. For example, if your App references a pain scale, we make sure the scale is accurate and verifiable, and that it does not violate existing pain-scale guidelines.
Our office follows the VA/DoD Target Health Standards Profile (HSP) for terminology standards. The DoD and the VA Health Architecture Review Board (HARB) in support of the DoD/VA Joint Executive Council (JEC) Joint Strategic Plan (JSP) have approved the HSP. You can view the HSP here: https://www.voa.va.gov/DocumentView.aspx?DocumentID=1089.
JEC and Strategic Council http://www1.va.gov/op3/docs/StrategicPlanning/VA_DoD_JEC_JSP_FY_2013_2015.pdf
This profile includes standards established under the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Records Final Rule (28 July 2010) for Meaningful Use, eHealth Exchange [formerly the Nationwide Health Information Network (NwHIN)], the DoD Information Technology Standards Registry (DISR), and the VA Technical Reference Model (TRM). The HSP also reflects technical and data standards in support of the Virtual Lifetime Electronic Record (VLER) and the Integrated Electronic Healthcare Record (iEHR) initiatives.
- eHealth Exchange http://www.healthit.gov/providers-professionals/faqs/what-ehealth-exchange
- DoD Information Technology Standards Registry https://acc.dau.mil/CommunityBrowser.aspx?id=148577
- VA Technical Reference Model (TMR) http://www.va.gov/TRM/TRMHomePage.asp
- VLER http://www.va.gov/vler/
The review will also follow Health Level 7 (HL7) Standards. HL7 recommends that different standards be used for specific elements (i.e., SNOMED for clinical terms, LOINC for laboratory terms, and Rx Norm for pharmacy terms). Upon the submission of the spreadsheet, the certifier will find and interpret the values or “mapping” of the terms with standardized terms.
- Health Level 7 (HL7) www.hl7.org
- Logical Observation and Identifiers Numeric Codes (LOINC) http://loinc.org/
- Systematic NoMenclature of Medicine Clinical Terms (SNOMED-CT) browser http://www.cliniclue.com/cliniclue_xplore
- Rx Norm Navigator (RxNav) http://rxnav.nlm.nih.gov/
- Meaningful Use (Stage 2) http://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2
These references are current as of November 21, 2013. Note: Some versions are not finalized.
C32 2.5 Recognized copy
C80 2.0.1 Review copy
C154 1.0.1 Review copy
C-CDA 2.0 Final Implementation Guide
NIST C32 FAQ (non-normative)
CDA Tools (non-normative)
|Meaningful Use (Stage 2)||http://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2|
MU test guide
Blue button C-CDA analysis
Health App Certification Program
|Food & Drug Admin. App standards||http://www.fda.gov/medicaldevices/digitalhealth/mobilemedicalapplications/default.htm|
|Food & Drug Admin. App standards||http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM263366.pdf|
|Veterans Health Information Model||http://enterprise.metadata.va.gov/pls/apex/f?p=VHIM:1:3391517879721404|
|Veterans Health Information Model||http://enterprise.metadata.va.gov/pls/apex/f?p=2600:500:0|
|Health Standards Profile||https://www.voa.va.gov/DocumentView.aspx?DocumentID=1089. Also, 2013 Target DoD-VA Health Standards Profile - September2012.doc|
VA/DoD Joint Execute Council &
DoD Information Technology Standards
|VA Technical Reference Model (TMR)|
Vertual Lifetime Electronic Record
|Logical Observation and |
Identifiers Numeric Codes (LOINC)
|Systematic NoMenclature |
of Medicine Clinical Terms
|Rx Norm Navigator (RxNav)|
|Health Level 7 (HL7)||www.hl7.org|
|Centers of Disease Control on vaccines||http://www.cdc.gov/vaccines/programs/iis/code-sets.html|