PHIN VADS Webinar Series - #2PHIN VADS Application Integration & Web

Services Overview

Dec 2nd, 2010

(1) Overview of PHIN VADS application(2) PHIN VADS Framework(3) PHIN VADS Web services (HL7 CTS, IHE ESVS)(4) PHIN VADS integration with other public health

applications (5) IHE Connectathon 2011 & HIMSS Interoperability

show case- PHIN VADS registered as value set repository to support

IHE public health profiles

(6) Q & A

Agenda

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Vocabulary Definitions & Examples

Code System Defined As:A collection of codes with its descriptions.

Example:SNOMED-CT,

ICD-9

Terminology, Vocabulary, Thesaurus, Taxonomy

“AKA”

Value Set Defined As:A collection of concepts created for a specific purpose such as in response to a question.

Example:A subset of microorganisms related to “Influenza” from

SNOMED-CT

Answer Lists, Permissible Values, Pick List, Code Set

“AKA”

Concept Defined As:Represents a single idea such as the name of a microorganism.

Example: Influenza A Virus

Vocabulary View (Messaging Guides)

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“Vocabulary View” refers to a collection of value sets associated with a HL7 messaging guide or CDA. View is also versioned and can be downloaded as a zip file. View can also be accessed using web services.

Vocabulary View Metadata

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HL7 Common Terminology Services

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HL7 CTS Wiki Web page

HL7 CTS Benefits

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HL7 CTS Implementations

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IHE Enhanced Sharing Value Set (SVS)

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IHE ESVS Specification download link (August 2010)

IHE ESVS – Value Set retrieval

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• In 2004, CDC developed a web-based enterprise vocabulary system called the Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS) for accessing, searching, and distributing HL7 messaging value sets used within the PHIN and NHIN.

• Provides all the vocabulary metadata needed for HL7 messaging.• Promotes sharing and reusing of the value sets.• Hosts multiple versions of value sets that allow implementers to have access to

the current, past and the future versions of value sets and value set collections• Provides web services (API) that allows HL7 interface engines, medical and public

health applications to obtain the value sets as well as validate the vocabulary present in HL7 messages.

• Provides detailed code system metadata for value set concepts such as context, hierarchy, synonyms and alternate codes. This will facilitate the implementation of value sets and improve the quality of local vocabulary mapping to standards.

• PHIN VADS can be accessed at a public web site - http://phinvads.cdc.gov • CDC Vocabulary and Messaging team manages the PHIN VADS.

What is PHIN VADS?

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• Currently, PHIN VADS has 592 value sets supporting 60 HL7 and CDA message implementation guides. The PHIN VADS hosts both the intrinsic and extrinsic value sets.

• PHIN VADS also hosts 149 SDO code systems that are used by HL7 messaging value sets. Many of the code systems (~ 120) belong to HL7 v2.x or V3.

• PHIN VADS updates the value sets often based upon SDO code system updates.

• PHIN VADS Hyperlinks for Meaningful Use (MU) Stage 1 Vocabulary:

a) MU Stage 1- Immunization HL7 2.5.1 IG Vocabularyb) MU Stage 1- ELR HL7 2.5.1 IG Vocabularyc) MU Stage 1 – Value sets related to Syndromic Surveillance

PHIN VADS Content

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• PHIN VADS can be accessed using one of the following methods :1) PHIN VADS Web Browser - http://phinvads.cdc.gov

2) PHIN VADS Web Service – System to System exchange of vocabulary data.

3) PHIN VADS Lite – Local instance of VADS web services and database

PHIN VADS Content Access

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PHIN VADS Framework

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Web Browser VADS WebApplication VADS Web

Services

•The PHIN VADS web application is built upon the PHIN VADS web services.

•When using the PHIN VADS application, the web services are used indirectly.

•These web services are public and built upon open standards (HL7 CTS2 , IHE SVS).

PHIN VADS Web Services: System-to-System Exchange of vocabulary data

PHIN VADS Web Services

VADS Web Services

Custom Program

•Custom programs, applications, or data extraction scripts can be written to directly use PHIN VADS Web Services.

•The PHIN VADS technical team is available to assist you.

•Sample code and a detailed API are available in the PHIN VADS Developer’s Toolkit - http://phinvads.cdc.gov/vads/developersGuide.action

• Allows any individual or organization to implement a local instance of the VADS service and database.

• The VADS Lite deployment is available for Oracle and Microsoft SQL Server.

• VADS Lite is not deployed with a User Interface• The deployment model requires the users to download, install,

and maintain a local installation on their hardware. Vocabulary Server with Application Programming Interface (API) may allow the vendors or implementers to integrate the vocabulary server with their application. – E.g. NEDSS Messaging Subscription Service application includes PHIN

VADS vocabulary server and Orion Rhapsody that will help validate HL7 messages and assist mapping between local and standard terminology.

PHIN VADS Lite

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• PHIN VADS custom downloader can be used like a shopping cart for downloading the VADS content.

• Useful tool especially for generating custom reports and queries from PHIN VADS database.

• Can be easily executed by non-technical people (Epidemiologist, Clinicians, Quality Measure Developers, Value set creators, etc..)

• Allows to download several value sets into a single file. This helps the implementers to import value set collections into a database (E.g. EpiInfo, State Public Health Surveillance Applications, LIS)

• Uses VADS web services to query the VADS database.• Value set and quality developers can use this tool to develop the

intrinsic value sets using the hierarchical relationships from SDO vocabulary such as SNOMED.

Custom Downloader Example

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CDC Interoperability Tools (Case Notification)

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• PHIN Message Subscription Service (VADS Lite Web Services)

• PHIN Message Quality Framework (MQF) , CDS (Web Services)

• NEDSS Based System - NBS (Web Services)

• EpiInfo (Custom downloader Web services)

• National Healthcare Safety Network – NHSN (VADS Lite Web services)

• Environmental Public Health Track Network – EPHTN (Web services)

• IHE Connectathon - EMR Vendors (Web services – IHE ESVS)

• Quality Measure Developers authoring value sets (Custom Downloader)

• PHIN VADS interaction with other vocabulary & Messaging tools (Web services) – Work in progress– LexGrid, IHTSDO SNOMED Workbench, Messaging Workbench, UMLS UTS, Virginia

Tech SNOMED Browser, USHIK, USGS, EPA SRS, RELMA, HL7 interface Engines, etc..– RELMA – Bookmarking feature of VADS to link VADS value sets to LOINC questions

(data elements) and also used in HL7 Msg IG.

PHIN VADS Application Integration

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IHE Connectathon

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• PHIN VADS participating as value set repository supporting the following IHE public health profiles:1) Physician Reporting to a Public Health Repository – Cancer

Registry (PRPH)2) Maternal & Child Health - CDC NCHS Vital records: Birth

Certificate & Fetal Death Report3) Early Hearing Detection & Intervention (EHDI)

IHE Connectathon Event – Public Health profiles

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• Value set consumer downloading all the value sets associated with each IHE profile (e.g. Download views - MCH, Cancer, EHDI)

• Value set consumer sending a value set identifier (OID) to retrieve the value set concepts (e.g. To populate the drop down in a form or to see if the concept is found in EMR repository – data mining such as MCH)

• Value set consumer sending a concept code and code system OID to value set repository (VADS) in order to find out if the concept is part of the value set (e.g. Trigger for cancer reporting)

• Value set consumer (State Cancer Registry) validates the codes being sent in the report by making a quick web service call to PHIN VADS. If it was an invalid code or not part of the value set, it would give a warning or error message.

Value Set Consumer interaction with PHIN VADS (IHE Connectathon)

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PHIN VADS Support - phConnect

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PHIN VADS online forum URL: http://www.phconnect.org/group/phinvads

E-mail:phinvs@cdc.gov

Demonstration- PHIN VADS Developers Guide

Questions

Value Set Authoring Tool Webinar

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Webinar Invitation link

Sundak Ganesan – Lead Vocabulary Specialist Sheila Abner – Vocabulary Specialist Steve Eady – Tech Lead Prosenjit Dutta – Developer Scott Keller – Database Analyst Cathy Lester – Quality Assurance/Tester Vanessa Fernandez – Business Analyst Michael Pray – Project Manager Mark Winarsky & Gautam Kesarinath

– CDC FTE Program Managers Nikolay Lipskiy – CDC FTE lead for SDO standards

Acknowledgments

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Appendix

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• NLM Unified Medical Language System (UMLS)– SDO vocabulary (RxNorm, SNOMED), mapping between standards, subsets, etc..

• Centers for Disease Control & Prevention (PHIN VADS)– Public health & clinical care value sets, HL7 Messaging IG value sets distribution, web services, ..

• National Cancer Institute (NCI) – Enterprise Vocabulary Services (EVS)– Cancer domain, NCI Metathesaurus, FDA vocabulary (SPL, UNII), Gene (HUGO, GO), etc..

• Environment Protection Agency (EPA) – Substance Registry System (SRS)– Substance (Chemical, Physical, Biological), Map to CAS #, vocabulary (Air, Water, Soil), etc…

• Agency for Healthcare Research & Quality – United States Health Information Knowledgebase (USHIK)

– Metadata registry of healthcare data elements and information models of SDOs, HITSP, …

• Mayo Clinic - LexGrid , LexBig, LexWiki – Distributed network of terminologies and ontologies using std. tools, web services (HL7 CTS), …

• Washington Publishing Company (WPC) – Taxonomy browser & file server – Code lists supporting administrative data – X12, NUCC, HIPAA, etc…

• Commercial Terminology Distribution (Vendors)

Vocabulary Distribution Portals

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PHIN VADS Information Model

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ValueSetConcept

CodeSystem

VocabularySourceReferenceVocabularyViewVersion

VocabularyView

ViewValueSetVersion

ValueSetVersion

GroupCodeSystem

CodeSystemConceptAltDesignation

CodeSystemConceptProperty

VocabularyAuthorityReference

ConceptRelationship

ValueSet

PHINVocabularyGroup

CodeSystemPropertyReference

CodeSystemConcept

ValueSetGroup

PHINVADS Information Model

Value Set Maintenance (Versioning)

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Change Event Model: PHIN VADS maintains the past, current and future versions of a value set.Used for capturing the complicated versioning process. Allows for locking of vocabulary objects during vocabulary authoring.Provides a historical record of all changes made to an object over time.Each change is stored as a delta from prior version to proposed version.Supports collaborative authoring managed through governance.

• Allows locking of a subset of the data model to be edited.• Change Control Model provides a mechanism for governance

of edits to VADS data.• Organizes edits to subsets of the data structure, such as Code

System, Value Set, Vocabulary Views, etc.• Edits to VADS are checked against business rules, then applied

as a group to the actual tables• Completed edits are moved via XML as a Change Control

Package to the Review and Production environments. • Each change control package contains the original vocabulary

item as well as its changes. This can be used for reports later.• The Change Control Package provides an audit trail.

PHIN VADS Change Control Model

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Change Control Model

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• Please contact PHIN VADS team at phinvs@cdc.gov for PHIN VADS data dictionary.

PHIN VADS Data Dictionary

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