HHS panel considers central authority for health IT vocabulary

A central authority may be needed to oversee common vocabulary terms for health data exchange and electronic health records.

A federal advisory task force is considering whether a central authority is needed to define and enforce medical vocabulary terms to be used in health care messaging, records and data exchange.

The Health and Human Services Department’s Vocabulary Task Force heard testimony from the National Library of Medicine, Centers for Disease Control and Prevention, National Cancer Institute, Joint Commission, and several other organizations March 23. The goal was to review options for creating and updating a common vocabulary for health information systems.

Experts say free and standardized terminology is needed for interoperability between health record systems. Currently, there are vocabularies for clinicians who identify patient problems, for medication terms and for lab orders, among others. Issues that haven't been resolved include governance, such as who decides what goes into the vocabularies, and how disputes are resolved.

Dr. Theresa Cullen, chief information officer of the Indian Health Service, testified that the National Library of Medicine would be an appropriate central authority for putting together a common vocabulary.

“A United States central authority needs to be established,” Cullen said. “The National Library of Medicine would be a logical location for such an effort. The entity should be as independent as possible and insulated from both political and vendor influences.”

Decisions on additional terms must include input from multiple clinical end users as well as terminology experts, she added.

The vocabulary task force was established by HHS’ Health Information Technology Standards Committee’s Clinical Operations Workgroup.