NLM Tools for EHR Certification and Meaningful Use
The National Library of Medicine provides free access to vocabulary standards, applications, and related tools that can be used to meet US EHR certification criteria and to achieve Meaningful Use of EHRs. Below are resources either created by or supported by NLM that can be used for providing patient-specific education materials, e-prescribing, and creating, exchanging, and interpreting standardized lists of problems, medications, and test results.
Value Set Authority Center (VSAC)
Per Centers for Medicare and Medicaid Services (CMS), VSAC is the official repository for Value Sets that support 2014 Meaningful Use Clinical Quality Measures (CQMs). VSAC will also host other value sets such as Routes of Administration and Patient Assessment Instruments in the near future. The VSAC provides Certified EHR implementers the ability to search for and retrieve these value sets both through a GUI interface as well as APIs that can be implemented into an automated system. VSAC will also provide authoring tools for value set authors that will leverage NLM expertise in synonymy (UMLS) as well as provide instant code/descriptor validation.
- Publisher: National Library of Medicine
- Access: Free for use
- Value Set Authority Center web application
- 2014 Clinical Quality Measures Data Element Catalog (DEC)
MedlinePlus Connect
MedlinePlus Connect is a free service that allows health organizations and IT providers to link patient portals and electronic health record systems to http://medlineplus.gov, the National Library of Medicine’s consumer health web site. MedlinePlus Connect accepts requests for information on diagnoses (problems), medications, and lab tests, and returns related MedlinePlus information. It is available as a Web application or a Web service.
- Publisher: National Library of Medicine
- Access: Free for use
- MedlinePlus Connect Overview
- MedlinePlus Connect Technical Documentation
RxNorm
2014 EHR certification criteria designate RxNorm as the vocabulary for medications.
RxNorm, a standardized nomenclature for clinical drugs and drug delivery
devices, is produced by the National Library of Medicine (NLM). RxNorm provides
normalized names for clinical drugs and links its names to many of the drug
vocabularies commonly used in pharmacy management and drug interaction software,
including those of First Databank, Micromedex, MediSpan, Gold Standard,
and Multum. By providing links between these vocabularies, RxNorm can mediate
messages between systems not using the same software and vocabulary.
- Publisher: National Library of Medicine
- Access: Free for use*
- RxNorm Files and Documentation
- RxNorm Overview
- Research: PubMed Citations related to RxNorm and Meaningful Use
Helpful Subsets (click to open)
RxNorm Current Prescribable Content
The Current Prescribable Content (CPC) subset of RxNorm provides
content from RxNorm for satisfying this requirement. Each monthly
release of the CPC subset contains the names and codes for those
drugs that the NLM believes to be currently available on the US
market. This includes both National Drug Codes (NDCs) and RxNorm
Concept Unique Identifiers (RxCUIs). The CPC is limited to content
produced or derived by the NLM, eliminating intellectual property
considerations associated with using the full monthly RxNorm dataset.
For information on discontinued/obsolete drugs, or to map RxNorm codes to and from codes from other drug information sources, a user will need to consult the full RxNorm dataset.
For information on discontinued/obsolete drugs, or to map RxNorm codes to and from codes from other drug information sources, a user will need to consult the full RxNorm dataset.
- Publisher: National Library of Medicine
- Access: Free for use
- RxNorm CPC Files and Documentation
Helpful APIs (click to open)
RxNorm API
There are two RxNorm APIs, SOAP/WSDL and RESTful, available to provide
developers with functions for retrieving RxNorm data from the most current
RxNorm data set. Useful for mapping names and codes from RxNorm source
vocabularies (First Databank, Multum, etc.), names from local formularies
and NDC codes to RxNorm identifiers. Can also help find the current
status of RxNorm identifiers (active, retired, remapped).
- Publisher: National Library of Medicine
- Access: Free for use
- RxNorm API (SOAP/WSDL) Documentation
- RxNorm API (RESTful) Documentation
RxMix
RxMix is a programmatic interface to the entire suite of RxNorm products,
allowing users to daisy-chain calls together from RxNorm, RxTerms, and
NDF-RT APIs.
- Publisher: National Library of Medicine
- Access: Free for use
- RxMix web site
SNOMED CT® - Systematized Nomenclature of Medicine - Clinical Terminology ®
2014 EHR certification criteria designate SNOMED CT for problems. SNOMED
CT is a comprehensive clinical terminology that is freely available to US
users through NLM.
- Publisher: International Health Terminology Standards Development Organisation (IHTSDO)
- Access: Free for use in IHTSDO member countries*
- SNOMED CT International Release Files
- US SNOMED CT Content Request System
- Research: See PubMed Citations related to SNOMED CT and Meaningful Use
Helpful Publications (click to open)
US Edition of SNOMED CT
The US Edition of SNOMED CT combines the SNOMED CT International
Release (from IHTSD0) along with concepts that come from the US
Extension.
- Publisher: National Library of Medicine
- Access: Free for use*
- US Edition Files and Documentation
- US SNOMED CT Content Request System
Helpful Subsets (click to open)
CORE Problem List of SNOMED CT
The CORE (Clinical Observations Recording and Encoding) Problem List
Subset identifies important clinical concepts in SNOMED CT that occur
frequently in the problem list. It facilitates the use of SNOMED CT
for clinical documentation at the summary level.
- Publisher: National Library of Medicine
- Access: Free for use*
- CORE Subset Files and Documentation
Convergent Medical Terminology Subsets
In September 2010, Kaiser Permanente donated their CMT content and tooling
to the IHTSDO. The CMT subset is a set of over 75,000 clinician and
patient-friendly medical concepts that are linked to US and international
interoperability standards.
- Publisher: Kaiser Permanente
- Access: Free for use*
- CMT Files and Documentation
Nursing Problem List Subset of SNOMED CT
The main purpose of the Nursing Problem List Subset of SNOMED CT is
to facilitate the use of SNOMED CT as the primary coding terminology
for nursing problems used in care planning, problem lists or other summary
level clinical documentation.
- Publisher: National Library of Medicine
- Access: Free for use*
- Nursing Problem List Files and Documentation
SNOMED CT Route of Administration Subset
The Route of Administration subset of SNOMED CT is a listing of the
current set of terms related to the location of administration for clinical
therapeutics.
- Publisher: National Library of Medicine
- Access: Free for use*
- Route of Administration Files and Documentation
Helpful Mappings (click to open)
ICD-9-CM Procedure Codes to SNOMED CT Map
ICD-9-CM codes used in-patient claims data, as reported by the Centers
for Medicare and Medicaid Services (CMS) for the year 2011. Map published
January 2013.
- Publisher: National Library of Medicine
- Access: Free for use*
- ICD-9-CMv3 -> SNOMED CT Mapping Files and Documentation
ICD-9-CM Diagnostic Codes to SNOMED CT Map
ICD-9-CM codes used in short-stay and outpatient hospitals, as reported
by the Centers for Medicare and Medicaid Services (CMS) for the year
2009. Map published May 2012.
- Publisher: National Library of Medicine
- Access: Free for use*
- ICD-9-CM -> SNOMED CT Mapping Files and Documentation
SNOMED CT to ICD10-CM Map
A rule-based map to support semi-automatic generation of ICD-10-CM codes
from clinical data encoded in SNOMED CT.
- Publisher: National Library of Medicine
- Access: Free for use*
- SNOMED CT -> ICD-10-CM Mapping Files and Documentation
SNOMED CT to ICD9-CM Reimbursement Map
This draft map consists of the 5,000 most commonly used SNOMED CT concepts
from Kaiser Permanente and the University of Nebraska. A more recent
version of the map is also available out of the UMLS Metathesaurus (MAPSETCUI
C3165219 in MRMAP/MRSMAP).
- Publisher: National Library of Medicine
- Access: Free for use*
- SNOMED CT -> ICD-9-CM Mapping Files and Documentation
LOINC® - Logical Observation Identifiers Names and Codes
2014 EHR certification criteria designate LOINC as the vocabulary for reporting lab test results. LOINC provides a universal set of codes in the domain of laboratory and other clinical observations. LOINC can simplify integrating lab test results into an EHR system as structured data.
- Publisher: Regenstrief Institute
- Access: Free for use.
- Research: PubMed Citations related to LOINC and Meaningful Use
Helpful Subsets (click to open)
LOINC Top 300+ Lab Orders
This is a collection of the top 300+ most common universal laboratory order codes for use by developers of order entry systems that deliver them in HL7 messages to laboratories, where they could be understood and fulfilled. This value set is designed to cover greater than 95% of the test ordering volume in the US, and was developed with both empirical and consensus-driven approaches. This list is referenced by the HITSP C80 Clinical Document and Messaging Terminology Construct in Table 2-96 "Laboratory Order Value Set" where it states that it "should be considered a minimum “starter” set" and "does not attempt to include all possible LOINC codes" or all possible lab orders.
- Publisher: Regenstrief Institute
- Access: Free for use
- Top 300 Lab Orders (PDF, XLSX, XLS)
LOINC Top 2000+ Lab Observations and Mapper's Guide
This is an empirically-based list of the most common LOINC result codes for laboratories, practices, researchers, and others who wish to map their laboratory test codes to universal LOINC codes. Knowing that relatively few codes account for much of the result volume, we think that the Top 2000+ list will be an excellent starter set. This list contains 2017 most commonly reported LOINC codes that represent about 98% of the test volume carried by three large organizations that mapped all of their laboratory tests to LOINC codes. To jump start your mapping effort, check out the Mapper's Guide to the Top 2000+ Lab Tests. It contains a wealth of advice and guidance about which codes to choose for a given purpose.
- Publisher: Regenstrief Institute
- Access: Free for use †
- Top 2000+ Lab Observations (PDF, XLSX, CSV)
LOINC Panels and Forms file
This file is an export of a key subset of the Panels and Forms represented in LOINC. The entire package of this key subset is currently available at http://loinc.org/downloads/accessory-files, in addition to separate packages for Laboratory panels, Clinical panels, Consumer Health panels, HEDIS panels, the HL7 Clinical Genetics panels, Newborn Screening panels, PhenX panels, US Government panels (including the CMS survey instruments MDSv2, MDSv3, OASIS, and CARE), and Other Survey Instruments. The hierarchical structure is represented in the file by the PARENT_ID, ID and SEQUENCE fields. The root, or top level, records in the file are those records where the PARENT_ID = ID. The records are in a Microsoft Excel spreadsheet (compressed as a zip file) with separate worksheets (tabs) for the form structure, LOINC code details, and answer lists.
- Publisher: Regenstrief Institute
- Access: Free for use †
- Panels and Forms Files/Documentation