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First published December 20, 2007 as JAMIA PrePrint; doi:10.1197/jamia.M2498
Journal of the American Medical Informatics Association 2008;15(2):174-183
© 2008 American Medical Informatics Association


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Submitted on May 3, 2007
Accepted on October 21, 2007

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

Omar Bouhaddou PhD1*, Pradnya Warnekar RPh, MS1, Fola Parrish PharmD1, Nhan Do MD1, Jack Mandel1, John Kilbourne MD1, and Michael J. Lincoln MD1

Affiliation of the authors: 1 Department of Veterans Affairs Office of Information, Salt Lake City, UT; Department of Biomedical Informatics, University of Utah, Salt Lake City, UT; Department of Defense, Tricare Management Activity, Falls Church, VA ; National Library of Medicine, Bethesda, MD

* To whom correspondence should be addressed.

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.







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