In 2003, the Department of Veterans Affairs Veterans Health Administration (VHA)
began construction of an Enterprise Reference Terminology (ERT)1. ERT includes a
federated set of vocabulary content; a hybrid commercial off-the-shelf (COTS) and
custom-developed software and technology infrastructure; and supporting business
processes and documentation. Since its inception, VHA ERT assembled one of the
largest terminology repositories in the country.
Controlled medical terminology provides many benefits, and chief among them is
support for the creation and use of comparable patient descriptions. Such data
comparability can help:
Reduce ambiguity while describing medical situations
Improve human productivity
Improve the performance of decision support applications
Improve compliance with existing or emerging VHA and other federal mandates
and standards
Enable the exchange of healthcare information
o between departments in the same VHA medical center or care facility
o between VHA and extra-VHA facilities
o between applications
Manage and leverage information in electronic medical records
Improve the display of patient information
Make CPOE (Computer-based Provider Order Entry) more productive
Enable decision support to reduce errors and improve quality
Support evidence-based medicine
Use of controlled terminology in electronic medical records greatly enhances the ability
of both healthcare professionals and computer applications to collect and leverage
available healthcare data productively. The VHA ERT is designed to provide
terminology and terminology services that support these objectives at national scale. In
this context, the notion of a reference terminology is a resource focused on scalable,
longitudinal terminology reuse by computers, applications, and their human users.