For the Vermont Oxford Network (VON), a worldwide registry for Neonatal Intensive Care Units (NICUs) , we are standardizing their patient records databases which collect information on very low birth weight infants, all patients cared for in a NICU, follow-up for extremely low birth weight infants, and infants cared for in resource-limited settings all around the world. This detailed clinical data is now entered manually based on a questionnaire. The goal of our project is to enable automated and internationally standardized data entry so data can be ingested faster. Once standardized, we will be able to design FHIR™ apps which partially automate the workflow by ingesting data directly from vendor EHR systems (e.g. Cerner and Epic). Our data and terminology standardization efforts provide the neonatal community of practice the ability to achieve data-driven quality improvement.
J P Systems performed terminology matching on 1,500 maps for the Office of the Chief Nursing Informatics Officer (OCNIO) Standardized Nursing Documentation Project. This project provided guidance to VA project teams on data standards including the successful launch of the Federal Health Terminology Model initiative with active participation from a dozen federal agencies. We defined standard terminologies for Nursing Flowsheets and a pressure ulcer risk assessment which establishes standardized codes to enable interoperability among healthcare systems including CDS alerts.
We mapped the identified VHA Nursing Domain terms for skin and wound care including nursing assessment, interventions, and patient outcomes
to Clinical Care Classification (CCC) System terminology for skin integrity to include Care Components, Nursing Diagnosis,
Nursing Intervention, Nursing Actions and Outcomes; mapping Clinical Care Classification System terminology for skin integrity to Systematized Nomenclature of Medicine--Clinical Terms (SNOMED CT).
Our architecture team defines and maintains the VHIE Business Architecture. Through these efforts, we assessed and reported on VHIE’s Business and System Architecture current state and made recommendations for the future state.
Each Current State Report describes and translates the Business and System Architecture into business terminology for VHIE Program leadership.
Each Future State Report described architecture improvements for VHIE Health.
We define the As-Is & To-Be End-to-End Data Flow Architecture by analyzing the Business and System architecture business capability, service capability, capability maturity, targets, and gaps linked with VHIE program strategy and investment planning.
For over 12 years at the ONC, we led the modeling efforts of the Federal Health Information Model for (FHIM). This federal healthcare it project developed a comprehensive information model with 39 healthcare domains. The model can be seen on our website FHIMS.org. The model also binds standard reference terminologies for accuracy.
VHA is working with the Centers for Disease Control and Prevention (CDC) and the IZ Gateway to establish immunization data exchange at the national level with state Immunization Information Systems (IIS). IISs are confidential, state computerized databases that record immunization doses administered. For this project, we are establishing automated electronic exchange that will include near real-time reporting of VA-administered vaccinations and querying of immunization data from the state IIS. We support the VA Office of Public Health Business Owner with strategy development, managing state data sharing agreements, policy development, stakeholder communications, and connecting to state registries via the CDC's IZ Gateway for bi-directional exchange of VHA immunization data.
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