CHICAGO – The American Health Information Management Association (AHIMA) says it’s time for the ONC to address the governance of standard vocabularies and terminology for the meaningful use program.

“AHIMA believes that it is time for ONC and the HIT Committees to address the governance of standard vocabularies including terminology and classification that are or should be requirements for the ARRA-HITECH Meaningful Use program as well as other HHS regulations including HIPAA and various uses such as quality measurement, public health, research, reimbursement, and policy making,” Dan Rode, AHIMA’s vice president, policy and government relations, wrote in a Feb. 25 letter to the ONC.

Rode noted that AHIMA, a nonprofit professional association made up of more than 61,000 health information management (HIM) related professionals, had responded separately to the ONC’s request for comment on Stage 2 meaningful use.

[See also: Feds at work on Stages 2 and 3 of meaningful use requirements.]

“However,” wrote Rode, “this letter speaks to a specific concern that we believe is not raised in the solicitation and we believe must be considered by the ONC and its HIT Committees as recommendations are formed for Meaningful Use Stage 2 requirements."

“Appropriate requirements for Meaningful Use Stage 2 must include clear guidance concerning the adoption of recognized clinical terminologies and classifications for information exchange and quality measurement in electronic health record systems,” the letter concluded. “AHIMA stands ready to assist the federal government and the healthcare industry in seeing the establishment of a governance mechanism similar to most other industrial nations.”

Rode also asked the ONC to "keep in mind the healthcare industry’s work to achieve implementation of ICD-10-CM/PCS as well as the need for more widespread use of a standardized clinical terminology which supports information exchange."

[See also: Preparing for ICD-10.]

To encourage and expedite healthcare information use, exchange and data integrity, it is mandatory that there be recognizable governance of acquisition and use of vocabularies in national programs industrywide, said Rode.

AHIMA made the recommendation for such governance based on the following observations:

• Health data sharing requires a common language for meaningful information exchange. Using recognized terminologies and classifications limits confusion and misunderstanding of facts.
• Measurement of quality and value of information are difficult and expensive without vocabulary standards.
• There are compelling demands for using a combination of nomenclature standards such as SNOMED CT and LOINC for clinical use and recognized classification standards such as ICD-10-CM/PCS and ICF1 for statistical and administrative/business requirements.
• Recognized standards for encoding natural language used by health care providers must be specified for inclusion in EHR systems standards, products and certification requirements so that both primary and secondary users of health information have a common reference to support information sharing.
• Standardized data elements and established value sets employing standard terms for data elements (often entire code sets) are useful in introducing standard terminology in systems so database fields can employ a “collect once use many times” approach to ensure the ability to share and compare data with others.
• The current environment for U.S. healthcare providers and health plans requires a clear path for administrative simplification.
• In the U.S., the National Institute of Medicine’s National Library of Medicine (NLM) has been the organization to facilitate map development but this has not yet occurred between SNOMED CT and ICD-10-CM/PCS – therefore, raising the potential for some MU-2 requirements facilitated by SNOMED-CT to not have access to valid mapping tools for linking EHR systems’ data with the contemporary coding systems that will be in place Oct. 1, 2013.
• Global interoperability for information exchange is facilitated by use of internationally recognized terminologies and classifications.