IHE ITI by liuhongmei


									                              IHE Profile Proposal (Short)
   1. Proposed Profile: Public Health Metadata Registry Management
       Proposal Editor:
       Nikolay Lipskiy, CDC
       Gautam Kesarinath, CDC
       Sundak Ganesan, Northrop Grumman Consultant for CDC
       Alean Kirnak, Software Partners LLC
       Michael Nusbaum (for Canada Health Infoway)
       Vassil Peytchev, Epic
       Charles Parisot, GE Medical
       Date: October 12, 2009
       Version: 2.0
       Domain: ITI. Also related to QRPH.

   2. The Problem
Value set registries have critical importance for transactions of Electronic Health Records (EHR) and
population health data management. There are several gaps in a description of Management of Value
Sets Registries. As it was published in IHE SVS Future Considerations (at:
1. The SVS Profile does not contain a Value Set Registry. The existence of a Registry would help
refining the search and the use in general of the SVS profile (versioning, text searching, etc).
2. This profile is not addressing mapping a Value Set onto an existing or internal Value Set or Code
System at this time and may be addressed in future text.
3. The language will not be a parameter in the Value Set retrieve transaction. The language hence
forth will be referred to locale specific name. In a bilingual country, for example, the locale specific
name can be a very useful feature. Since the name of the description will have to be pushed to a
separate layer and the language will have to be bound to another layer, this is considered a separate
look-up process, and it is not part of the XML binding. This functionality can be addressed via the
Registry, and the Registry is not part of this year’s profile’s scope. The locale specific name cannot
be part of the Value Set.
Existing CTS2 has just general descriptions of terminology registry (see the workflow from attached
below CTS2 figure 21.3-2). Management of value set registry also has just the high level description
in CTS 2.0.
Transactions related to versioning of value sets are not well described.
Both, SVS and CTS2 do not cover the following Value Sets Registries Management transactions:
      Aggregation and categorization of value sets by Value Sets Registry owners for specific
       topics (i.e. Immunization, TB, STD etc.)
      Functional grouping of value sets defined as “Views” in HL7 Implementation Guides.
                Many HL7 Implementation Guides (e.g. Tuberculosis, H1N1 Flu) have at least 25
                to 30 value sets that are associated with coded data elements. Value set registries
                allows to group the value sets associated with a HL7 Implementation Guide. This
                functional grouping of value set is defined as “View”. View allows implementers to
                download the value sets associated with a particular HL7 implementation guide.
                Several implementation guides may be implementing various versions of the value
                sets. Value set registry has a need to maintain the various versions of the value sets
                and views. Currently, CTS or SVS do not have a mechanism to access or query
                views and its versions.

      Management of preferred and alternate codes (e.g. SNOMED alphanumeric and numeric
       codes, ISO Country 2 & 3 character codes)
Key Use Case
Several public health profiles (Cancer Registry, Public Health Case Reporting) are currently being
proposed with QRPH utilizing a value set registry such as PHIN VADS for accessing the value sets
associated with each IHE profile. Implementers of these IHE profiles and various HL7
implementation guides require a way to access the various versions of the value sets and views
associated with them.Users and implementers need to get access to a group of value sets. For
example, implementers of TB surveillance want to see aggregated and categorized value sets related
to Tuberculosis.
Owners of the value set registry should provide services regarding aggregation and categorization of
value sets.

   3. Standards & Systems
       IHE Sharing Value Sets (SVS)
       HL7 CTS 2.0 specification
       Value sets based on IHE, HITSP and Consolidated Health Informatics (CHI)
       CDC Vocabulary Server – PHIN VADS as Value Set Registry hosting value sets associated
       with IHE profiles and various HL7 implementation guide.

   4. Discussion
       IHE is a stakeholder in the trend toward shared vocabulary service specifications. It should
       continue to explore what approaches work with IHE profiles, and what strategy to take in
       approaching shared vocabulary services and vocabulary registries. The profile will be a
       vehicle for IHE to monitor and participate in the “Service-Aware Enterprise Architecture
       Framework” of HL7, DICOM efforts, and in HITSP architectural framework efforts.
       Development of a profile that describes transactions related to the Value Sets Registry will
       foster further improvement of IT architectural solutions for public health, and population
       health monitoring and quality of care management.

       PHIN VADS value set registry has implemented various web services that are related to value
       sets especially the views which allows implementers to download all the value set concepts
       associated with a particular IHE profile or HL7 implementation guide. PHIN VADS team will
       assist IHE ITI to enhance the existing SVS specification as well as work with HL7 to enhance
       HL7 CTS 2. PHIN VADS team will also work with QRPH content profile editors and
       integrate the above mentioned use case in the QRPH profile for Cancer Reporting, Public
       Health Case Reporting and Immunization.


              Comparison of SVS and CTS 2, Version 1.1 Specifications

SVS contains the Retrieve Value Set transaction, which consists of:

      Retrieve Value Set Request
      Retrieve Value Set Response

CTS 2 includes three profiles:

   1. CTS 2 Query Profile
   2. Terminology Administration Profile
   3. Terminology Authoring Profile

We proposing to work on adding to SVS technical specifications from CTS 2 related to the first
described above CTS2 profiles:

Administrative Scenarios
      Import Content
Associated Functional Models: Import Code System , Import Code System Revision

      Export Content
Associated Functional Models: Export Code System

      Remove Content
Associated Functional Models: Change_Code_System_Status

      Change Content Status
Associated Functional Models: Change Code System Status

        Update Notification
Associated Functional Models: Register for Notification

        Update Notification Management
Associated Functional Models: Update Notification Registration, Update Notification Registration

        Content Dependency Notification
Functional Models: Register for Notification, Update Notification Registration, Update Notification
Registration Status

Code System Search / Query
        Retrieve Available Code Systems
Associated Functional Models: List Code Systems, Return Code System Details

        Retrieve Coded Concepts from Code System
Associated Functional Models: List Code System Concepts, Return Concept Details

        Validate Concept in Code System
Associated Functional Models: Return Concept Details

        Identify Concept Language Translations
Associated Functional Models: Return Concept Details

        Retrieve Concept Representations
Associated Functional Models: Return Concept Details

        Compare Code System Versions
Associated Functional Models: Return Code System Details, List Code System Concepts

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