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<div class="h1">Updating Value Sets</div>
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</div>
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<!-- start row-->
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<!-- start column-->
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<h3>Code Validation, Expansion Profiles, Revisions, and Publication</h3>
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<p>
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The following tutorial supports any Authors and Stewards who need to
|
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update their value sets as well as the measure developers and value set
|
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developers for the annual updates of the electronic Clinical Quality
|
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Measure (eCQM) value sets. This tutorial is useful for other purposes as
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well, beyond the eCQM value set annual updates.
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</p>
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<!-- start accordion-->
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<button
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type="button"
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class="usa-accordion__button"
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aria-expanded="false"
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aria-controls="updatingvaluesets-section-1"
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>
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<!-- <h4 class="margin-bottom-0"> -->
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I. My Value Sets and Search All Value Sets
|
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|
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<!-- </h4>-->
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</button>
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</h4>
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|
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<div
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class="usa-accordion__content usa-prose"
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id="updatingvaluesets-section-1"
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>
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<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets_img1.jpg"
|
||
id="eCQM1"
|
||
alt="Image of the open VSAC Authoring tab, showing the My Value Sets and Search All Value Sets sections."
|
||
/><br /><br />
|
||
|
||
<p>
|
||
My Value Sets contains all value sets, regardless of status, assigned
|
||
to you as an Author and/or as a Steward.
|
||
</p>
|
||
|
||
<p>
|
||
Search All Value Sets contains all value sets, regardless of status.
|
||
Click [Search] to view all.
|
||
</p>
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets_img2.jpg"
|
||
id="eCQM2"
|
||
alt="Image of the open VSAC Authoring tab, showing the expanded Search All Value Sets section. The Search button is highlighted to show the user needs to click on the Search button to obtain the list of all value sets."
|
||
/><br /><br />
|
||
|
||
<p>
|
||
Use the filter boxes to refine your results, and click on any column
|
||
heading to sort your results.
|
||
</p>
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets_img3.jpg"
|
||
id="eCQM3"
|
||
alt="Image of the open VSAC Authoring tab, showing the expanded Search All Value Sets section. The Code System column filter text box contains 'LOINC' and the Author column filter text box contains 'VSAC."
|
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/>
|
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</div>
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<!-- end accordion content-->
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<h4 class="usa-accordion__heading">
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<button
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type="button"
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class="usa-accordion__button"
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aria-expanded="false"
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aria-controls="updatingvaluesets-section-2"
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>
|
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<!-- <h4 class="margin-bottom-0"> -->
|
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II. VSAC Authoring Permissions
|
||
|
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<!-- </h4>-->
|
||
</button>
|
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</h4>
|
||
|
||
<div
|
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class="usa-accordion__content usa-prose"
|
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id="updatingvaluesets-section-2"
|
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>
|
||
<ul>
|
||
<li>
|
||
In addition to UMLS License credentials, you must also obtain VSAC
|
||
authoring/stewarding permissions by contacting the VSAC staff at
|
||
<a href="https://support.nlm.nih.gov/">Customer Support</a>.
|
||
</li>
|
||
|
||
<li>
|
||
A value set must be assigned to an Author and Steward group in order
|
||
for an Author or Steward to have access to the value set for the
|
||
purpose of editing, updating and publishing.
|
||
</li>
|
||
|
||
<li>
|
||
New value sets created by Authors in the VSAC are automatically
|
||
associated to the Author who created it.
|
||
</li>
|
||
|
||
<li>
|
||
If you authored draft value sets in the Measure Authoring Tool prior
|
||
to the MAT-VSAC import on 11/24/2013 then you must contact the VSAC
|
||
staff directly to associate your draft value sets to your Author and
|
||
Steward group.
|
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</li>
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</ul>
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</div>
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<!-- end accordion content-->
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<h4 class="usa-accordion__heading">
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<button
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type="button"
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class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-3"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0">-->
|
||
III. What is an Expansion Profile?
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-3"
|
||
>
|
||
<p>
|
||
<strong>Expansion</strong> refers to the calculation of a value set's
|
||
list of codes according to a defined rule or set of rules, such as
|
||
specific code system versions.
|
||
</p>
|
||
|
||
<p>
|
||
An <strong>expansion profile</strong> is a set of rules defined by a
|
||
particular program, such as the CMS Clinical Quality Measures Value
|
||
Sets Annual Update. For example, the eCQM Update 2020-05-07 expansion
|
||
profile applied a set of allowable code system versions, defined by
|
||
CMS, as well as a set of desired legacy codes, approved by CMS.
|
||
</p>
|
||
|
||
<p>
|
||
The Expansion Profile for the eCQM Update 2020-05-07 validated value
|
||
set code lists against the code system versions and legacy codes
|
||
defined by CMS and ONC.
|
||
</p>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-4"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0">-->
|
||
IV. Validate a Previously Published Value Set against an Expansion
|
||
Profile
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-4"
|
||
>
|
||
<p>
|
||
Value sets that were previously published have likely undergone code
|
||
changes due to periodic updates by the code systems on which the value
|
||
sets were based. Some codes may now be invalid or inactive (retired by
|
||
the code system), and some code systems may have remapped existing
|
||
codes to new codes.
|
||
</p>
|
||
|
||
<p>
|
||
Authors need to review all value sets they wish to republish (for
|
||
example, for the eCQM Annual Updates).
|
||
</p>
|
||
|
||
<ol>
|
||
<li>
|
||
Find your value sets in Authoring -> My Value Sets, if they have
|
||
been assigned to an Author or Steward group to which you belong. If
|
||
you do not see a value set listed in My Value Sets, search for it in
|
||
Search All Value Set Definitions, click on its OID, then click
|
||
<strong>Contact Steward</strong> in the left sidebar to send a
|
||
request to the Steward to add you to the value set's Authoring group
|
||
using the
|
||
<a
|
||
href="https://www.nlm.nih.gov/vsac/support/authorguidelines/groupmanage.html"
|
||
>Group Management</a
|
||
>
|
||
function.
|
||
</li>
|
||
|
||
<li>Click on the value set OID to review your value set.</li>
|
||
|
||
<li>
|
||
In the left sidebar of the authoring window, click the
|
||
<strong>Validate</strong> link and then choose the appropriate
|
||
Expansion Profile calculation from the drop down. Check with your
|
||
program or sponsoring agency to determine which Expansion Profile
|
||
you should use. In the Code Validation pop-up box, click [Validate]
|
||
to view the expansion results.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM4.jpg"
|
||
id="eCQM4"
|
||
alt="eCQM4"
|
||
/><br /><br />
|
||
</li>
|
||
|
||
<li>
|
||
You can click the [View] button to see exactly which code system
|
||
versions and expansion rules are being applied to your value set
|
||
codes. Here, you see an example of the eCQM Update 2019-05-10
|
||
Expansion Profile being applied to this value set.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM5.jpg"
|
||
id="eCQM5"
|
||
alt="eCQM5"
|
||
/><br /><br />
|
||
</li>
|
||
|
||
<li>
|
||
Review the Validated Code List. Determine if any inactive/invalid
|
||
codes should remain in your updated value set expansion. You can
|
||
include inactive/invalid codes in your updated value set expansion
|
||
if the Expansion Rules in your Expansion Profile Details display
|
||
this rule: "Legacy/Retired Codes: VSAC applied the most recent code
|
||
system version that includes the code in an active status."
|
||
Sometimes there will be a code-system-supplied remapped code
|
||
available for you to use in place of an inactive/invalid code. There
|
||
will be very few cases of remapped codes.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM6.jpg"
|
||
id="eCQM6"
|
||
alt="eCQM6"
|
||
/><br />
|
||
</li>
|
||
</ol>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-5"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0"> -->
|
||
V. View Remap Info (for RxNorm, LOINC, and SNOMED CT value sets only)
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-5"
|
||
>
|
||
<ol>
|
||
<li>
|
||
Use the column headings to sort your view of validation and
|
||
remapping information to facilitate reviewing the validation table.
|
||
</li>
|
||
|
||
<li>
|
||
If Remapping codes exist for any of your inactive/invalid codes, you
|
||
will see a [View Remap Info] button at the top right of the table.
|
||
When you click on this [View Remap Info], you will see a new window
|
||
providing a table with remapping information. You should review the
|
||
remapped codes and decide if they are appropriate for your value
|
||
set.
|
||
</li>
|
||
</ol>
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM7.png"
|
||
id="eCQM7"
|
||
alt="eCQM7"
|
||
/>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-6"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0">-->
|
||
VI. Invalid or Inactive?
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-6"
|
||
>
|
||
<p>
|
||
The terms <strong>invalid</strong> and <strong>inactive</strong> are
|
||
confusingly similar because they both mean the code should be removed
|
||
from the value set, but for different reasons.
|
||
</p>
|
||
|
||
<p>
|
||
<strong>Invalid</strong>: The code never existed in the code system or
|
||
it could be a typo. You should remove invalid codes from your value
|
||
sets.
|
||
</p>
|
||
|
||
<p>
|
||
<strong>Inactive</strong>: The code system has decided to suppress
|
||
this code for reasons particular to the code system. You should remove
|
||
inactive codes from your value sets.
|
||
</p>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-7"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0"> -->
|
||
VII. Making Changes to Your Value Set
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-7"
|
||
>
|
||
<ol>
|
||
<li>
|
||
<!--<strong>Before you modify your code list, it is important to first change the code system version to the appropriate code system version for your program release</strong>, as defined by your sponsoring agency or program. For example, the appropriate code system version for RxNorm is 2015-01 for the eCQM Annual Updates in 2015. -->You
|
||
will need to manually remove retired(inactive/invalid) codes from
|
||
your value set and add remapped codes, if appropriate, to your value
|
||
set.
|
||
</li>
|
||
|
||
<li>
|
||
<strong>Editing/Updating Your Value Set:</strong><br />
|
||
|
||
<p>
|
||
If your value set is in Draft status and was not previously
|
||
published, click the [Edit] button at the top of the tab.
|
||
</p>
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="/vsac/support/authorguidelines/eCQM8.png"
|
||
id="eCQM8"
|
||
alt="eCQM8"
|
||
/><br /><br />
|
||
|
||
<p>
|
||
If your value set is in Published status, and was previously
|
||
published, click the [New Version] button at the top of the tab.
|
||
</p>
|
||
<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="/vsac/support/authorguidelines/eCQM9.png"
|
||
id="eCQM9"
|
||
alt="eCQM9"
|
||
/>
|
||
</li>
|
||
|
||
<li>
|
||
Check the check boxes beside codes you wish to remove from your
|
||
value set, and then click the trashcan icon at the top of the Value
|
||
Set Code List table.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM10.png"
|
||
id="eCQM10"
|
||
alt="eCQM10"
|
||
/>
|
||
</li>
|
||
|
||
<li>
|
||
To add individual codes to your value set, click the plus
|
||
<strong>(+)</strong> icon at the top of the Value Set Code List
|
||
table. This creates a new empty row at the top of the Value Set Code
|
||
List table. Paste in the code field the code you wish to add, for
|
||
example, a code that was mapped to an inactive or invalid code.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM11.png"
|
||
id="eCQM11"
|
||
alt="eCQM11"
|
||
/>
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/eCQM12.png"
|
||
id="eCQM12"
|
||
alt="eCQM12"
|
||
/>
|
||
</li>
|
||
</ol>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-8"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0"> -->
|
||
VIII. Importing Codes into Your Value Set
|
||
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-8"
|
||
>
|
||
<p>
|
||
In many cases, you may have a long list of codes that you wish to add
|
||
to your value set and then <strong>Validate</strong>. You may have
|
||
this list of codes stored in a local spreadsheet or in a
|
||
non-spreadsheet formatted text file. You can copy the column of codes
|
||
from your spreadsheet or import the codes from the text file and add
|
||
them to your value set by using the <strong>Import</strong> link at
|
||
the top of the Value Set Code List table.
|
||
</p>
|
||
|
||
<ol>
|
||
<li>
|
||
In the VSAC Authoring Tool, in a value set you are modifying,
|
||
confirm you are in <strong>Edit</strong> mode by clicking the
|
||
<strong>[Edit]</strong> or <strong>[New Version]</strong> button at
|
||
the bottom of the Value Set Code List table. If you do not see the
|
||
<strong>[Edit]</strong> or <strong>[New Version]</strong> button,
|
||
you may not be the Value Set Author for this value set, or the value
|
||
set may need to be withdrawn from a more advanced state (Proposed,
|
||
Approved, Ready to Publish).
|
||
<strong
|
||
>Before importing your list of codes, you need to select a Code
|
||
System and Code System Version for your value set.</strong
|
||
>
|
||
The codes you are about to import will be validated against your
|
||
selected Code System and Code System Version.
|
||
</li>
|
||
|
||
<li>
|
||
Locate and click the <strong>Import</strong> link at the top of the
|
||
Value Set Code List table.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/importcodes.jpg"
|
||
id="ImportCodes"
|
||
alt="Import Codes into a Value Set"
|
||
/>
|
||
</li>
|
||
</ol>
|
||
|
||
<br />
|
||
|
||
<h4>Copy-Paste Codes into the Text Box</h4>
|
||
|
||
<ol>
|
||
<li>
|
||
If your codes are in an Excel spreadsheet, select and copy the
|
||
spreadsheet column that contains the codes (do not include the
|
||
column heading). In the Import Codes dialog pop-up box, select the
|
||
<strong>From Text Box</strong> option from the Import Methods list
|
||
to be able to simply copy and paste your codes, and then click the
|
||
<strong>[Import]</strong> button. You will need to select the
|
||
appropriate text separator: space, semicolon(;), or vertical bar(|).
|
||
</li>
|
||
|
||
<li>
|
||
If any of your codes are invalid, the import tool will not allow
|
||
them to be imported.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/copypastecodes.jpg"
|
||
id="CopyPasteCodes"
|
||
alt="Copy and Paste Codes into Text Box"
|
||
/>
|
||
</li>
|
||
</ol>
|
||
|
||
<h4>Import Codes from a File</h4>
|
||
|
||
<ol>
|
||
<li>
|
||
Alternatively, if you have codes in a non-spreadsheet formatted
|
||
file, such as a text (.txt) file, you can upload the file by
|
||
selecting the <strong>From File</strong> option from the Import
|
||
Methods list and then click on the
|
||
<strong>[Select File]</strong> button. Locate the file on your
|
||
computer and click the <strong>[OK]</strong> button. Be sure to
|
||
select the appropriate text separator: space, semicolon(;), or
|
||
vertical bar(|). The sample codes will be imported in the Codes text
|
||
box. Click the <strong>[Import]</strong> button once you are done.
|
||
</li>
|
||
|
||
<li>
|
||
You can import codes from an Excel spreadsheet using the From File
|
||
option, but you will first need to save the spreadsheet as a text
|
||
file. Once you have converted the spreadsheet to a text file you can
|
||
import the codes using the From File option as previously
|
||
mentioned.<br />
|
||
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/importfromfile.jpg"
|
||
id="ImportCodesFile"
|
||
alt="Import Codes from a File"
|
||
/>
|
||
</li>
|
||
</ol>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
<h4 class="usa-accordion__heading">
|
||
<button
|
||
type="button"
|
||
class="usa-accordion__button"
|
||
aria-expanded="false"
|
||
aria-controls="updatingvaluesets-section-9"
|
||
>
|
||
<!-- <h4 class="margin-bottom-0"> -->
|
||
|
||
IX. Submitting, Approving, and Publishing Your Value Set
|
||
<!-- </h4>-->
|
||
</button>
|
||
</h4>
|
||
|
||
<div
|
||
class="usa-accordion__content usa-prose"
|
||
id="updatingvaluesets-section-9"
|
||
>
|
||
<p>
|
||
You must save your value set definition and submit it to your steward
|
||
for approval. The steward will review the value set definition and
|
||
decide to approve or reject your value set definition.
|
||
</p>
|
||
<ol type="1">
|
||
<li>
|
||
Save changes to your value set by clicking the
|
||
<strong>Save</strong> button.<br />
|
||
|
||
<img
|
||
src="/vsac/support/authorguidelines/UpdateVSsave.png"
|
||
alt="Save Value Set"
|
||
style="width: 950px"
|
||
/>
|
||
</li>
|
||
|
||
<li>
|
||
Submit your updated value set for the steward to approve by clicking
|
||
the <strong> Submit </strong> button.<br />
|
||
<img
|
||
src="/vsac/support/authorguidelines/UpdateVSsubmit.png"
|
||
alt="Submit Value Set"
|
||
style="width: 950px"
|
||
/>
|
||
</li>
|
||
|
||
<li>
|
||
The Steward will review the value set definition and decide to
|
||
approve or reject your value set definition.
|
||
</li>
|
||
<li>
|
||
To approve the value set definition and to enable public access of
|
||
the value set's expansion, the Steward should click the
|
||
<strong> Approve </strong>button.
|
||
<br />
|
||
|
||
<img
|
||
src="/vsac/support/authorguidelines/UpdateVSapprove.png"
|
||
alt="Approve Value Set"
|
||
style="width: 950px"
|
||
/><br />
|
||
|
||
You will see a message that confirms your approval to publish the
|
||
value set changes to the public repository. The updated value set
|
||
will be available to VSAC users from the Search Value Set tabs.
|
||
<br />
|
||
<img
|
||
class="figure-img img-fluid img-thumbnail"
|
||
src="//www.nlm.nih.gov/vsac/support/authorguidelines/approvesuccess.jpg"
|
||
id="ApproveSuccess"
|
||
alt="ApproveSuccess"
|
||
/>
|
||
<br />
|
||
To reject the changes, click the<strong> Reject </strong> button.
|
||
The value set returns to its draft state for the author to make
|
||
further changes. The author must make the necessary changes and
|
||
submit the updated value set for steward approval again. <br />
|
||
<img
|
||
src="/vsac/support/authorguidelines/UpdateVSreject.png"
|
||
alt="Reject Value Set"
|
||
style="width: 950px"
|
||
/>
|
||
</li>
|
||
</ol>
|
||
</div>
|
||
<!-- end accordion content-->
|
||
</div>
|
||
<!-- end accordion-->
|
||
</div>
|
||
<!-- end column-->
|
||
</div>
|
||
<!-- end row-->
|
||
|
||
|
||
|
||
|
||
|
||
<p class=”margin-top-5”><small>Last Reviewed: April 19, 2022</small></p>
|
||
|
||
</div>
|
||
</main>
|
||
|
||
<!-- FOOTER -->
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