Specific tasks include supporting the VHA Clinical Health Data Repository (CHDR), support of InterSystems HealthShare and FHIR implementation Support. Additionally, we provide data standards development services for the creation and maintenance of HL7 data standards for messages.

Furthermore, representing our client’s requirements to international Standards Development Organizations, we participated in the HL7 Vocabulary Workgroup (WG) which required engagement in the Unified Terminology Governance efforts.  Specifically, this WG is establishing a standards repository for FHIR and related terminology code systems. Also, in coordination with major internal and external stakeholders such as DoD, FEHRM, Cerner, HealthShare, terminology SDOs, and VA is of primary importance.

We offer a wide range of clinical terminology services for the VHA: 
  • Clinical Terminology Authoring
  • VHA's MED-RT Releases
  • Updates to VistA reference clinical terminologies for Allergies, Documents and Medications
  • Add new terms to VistA
  • Clinical Terminology matching to align terms to international standards
  • Analysis of CHDR data between DoD and VA

Moreover, our work for this project provides ongoing clinical terminology engagement which supports matching of VistA data extracted via the Virtual Patient Record (VPR) to FHIR objects in HealthShare Enterprise (HSE). In fact, HSE allows the VA to transition from legacy and non-standard VistA-integration methods to a single VistA integration platform. This supports implementation of a Longitudinal Patient Record, improve patient health record interoperability with DoD and external care providers. Additionally, it improves VA patient records by enabling standardization of clinical terminology content. 

Also, in support of the HealthShare initiative, we supported matching of a broad range of VistA data to HealthShare structures called the “Summary Data Architecture” (SDA). Then we aligned them with remaining VistA data (extending SDA), and finally completed the SDA extensions. As FHIR migrates to R4, terminology content will need to be updated to the appropriate FHIR resources. Harmonization of FHIR resources across VA projects is needed and was stored in a master list of FHIR resources to support the FHIR Community of Practice (CoP). We focused on aligning FHIR resources with VA terminology and external clinical terminology standards that were leveraged as program needs indicated.