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Exchange of Computable Patient Data between the Department of Veterans Affairs (VA) and the Department of Defense (DoD): Terminology Mediation Strategy

^a Department of Veterans Affairs Office of Information, Salt Lake City, UT
^b Department of Biomedical Informatics, University of Utah, Salt Lake City, UT
^c Department of Defense, Tricare Management Activity, Falls Church, VA
^d National Library of Medicine, Bethesda, MD.

^_* Correspondence: Dr. Omar Bouhaddou, Veterans Affairs, VA Salt Lake City Office of Information, 550 Foothill Drive, Salt Lake City, Utah 84113 (Email: omar.bouhaddou{at}va.gov).

Received for publication: 05/03/07; accepted for publication: 10/21/07.

Complete patient health information that is available where and when it is needed is essential to providers and patients and improves healthcare quality and patient safety. VA and DoD have built on their previous experience in patient data exchange to establish data standards and terminology services to enable real-time bi-directional computable (i.e., encoded) data exchange and achieve semantic interoperability in compliance with recommended national standards and the eGov initiative. The project uses RxNorm, UMLS, and SNOMED CT terminology standards to mediate codified pharmacy and allergy data with greater than 92 and 60 percent success rates respectively. Implementation of the project has been well received by users and is being expanded to multiple joint care sites. Stable and mature standards, mediation strategies, and a close relationship between healthcare institutions and Standards Development Organizations are recommended to achieve and maintain semantic interoperability in a clinical setting.