nih-gov/www.nlm.nih.gov/vsac/support/usingvsac/Tips.html
2025-02-26 13:17:41 -05:00

440 lines
26 KiB
HTML
Raw Permalink Blame History

This file contains ambiguous Unicode characters

This file contains Unicode characters that might be confused with other characters. If you think that this is intentional, you can safely ignore this warning. Use the Escape button to reveal them.

<!doctype html>
<html lang="en">
<head>
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/>
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link href="https://fonts.googleapis.com/css2?family=Roboto:wght@100;300;400;500;700&display=swap" rel="stylesheet">
<link rel="stylesheet" href="https://use.fontawesome.com/releases/v5.0.10/css/all.css" integrity="sha384-+d0P83n9kaQMCwj8F4RJB66tzIwOKmrdb46+porD/OvrJ+37WqIM7UoBtwHO6Nlg" crossorigin="anonymous">
<link rel="stylesheet" href="/home_assets/uswds/css/styles.css">
<title>Tips for Your eCQM Annual Update Value Set Work </title>
<link rel="schema.DC" href="http://purl.org/dc/elements/1.1/" title="The Dublin Core metadata Element Set" />
<meta name="DC.Title" content="Tips for Your eCQM Annual Update Value Set Work " />
<meta name="DC.Publisher" content="U.S. National Library of Medicine" />
<meta name="DC.Date.Issued" content="2024-09-24" />
<meta name="DC.Date.Modified" content="2024-10-01" />
<meta name="NLMDC.Date.LastReviewed" content="2024-10-01" />
<meta name="NLM.Contact.Email" content="nlmumlscustserv@mail.nlm.nih.gov" />
<meta name="DC.Type" content="Technical Documentation" />
<meta name="NLM.Permanence.Level" content="Permanence Not Guaranteed" />
<meta name="DC.Rights" content="Public Domain" />
<meta name="DC.Language" content="eng" />
<style type="text/css">
p img {
width: 70%;
height: auto;
}
</style>
<!-- Google Tag Manager --><script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push(
{'gtm.start': new Date().getTime(),event:'gtm.js'}
);var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MT6MLL');</script>
<!-- End Google Tag Manager -->
</head>
<body>
<!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-MT6MLL" height="0" width="0" style="display:none;visibility:hidden" title="googletagmanager"></iframe></noscript>
<!-- End Google Tag Manager -->
<!-- TOP NAV -->
<a class="usa-skipnav" href="#main">Skip to main content</a>
<section class="usa-banner" aria-label="Official website of the United States government">
<div class="usa-accordion">
<header class="usa-banner__header">
<div class="usa-banner__inner">
<div class="grid-col-auto"> <img class="usa-banner__header-flag" src="https://assets.nlm.nih.gov/uswds/img/us_flag_small.png" alt="U.S. flag"/> </div>
<div class="grid-col-fill tablet:grid-col-auto">
<p class="usa-banner__header-text"> An official website of the United States government </p>
<p class="usa-banner__header-action" aria-hidden="true"> Heres how you know </p>
</div>
<button class="usa-accordion__button usa-banner__button" aria-expanded="false" aria-controls="gov-banner"> <span class="usa-banner__button-text">Heres how you know</span> </button>
</div>
</header>
<div class="usa-banner__content usa-accordion__content" id="gov-banner">
<div class="grid-row grid-gap-lg">
<div class="usa-banner__guidance tablet:grid-col-6"> <img class="usa-banner__icon usa-media-block__img" src="https://assets.nlm.nih.gov/uswds/img/icon-dot-gov.svg" role="img" alt="" aria-hidden="true"/>
<div class="usa-media-block__body">
<p> <strong> Official websites use .gov </strong> <br />
A <strong>.gov</strong> website belongs to an official government
organization in the United States. </p>
</div>
</div>
<div class="usa-banner__guidance tablet:grid-col-6"> <img class="usa-banner__icon usa-media-block__img" src="https://assets.nlm.nih.gov/uswds/img/icon-https.svg" role="img" alt="" aria-hidden="true"/>
<div class="usa-media-block__body">
<p> <strong> Secure .gov websites use HTTPS </strong> <br />
A <strong>lock</strong> ( <span class="icon-lock">
<svg xmlns="http://www.w3.org/2000/svg" width="52" height="64" viewBox="0 0 52 64" class="usa-banner__lock-image" role="img" aria-labelledby="banner-lock-title-default banner-lock-description-default" focusable="false">
<title id="banner-lock-title-default">Lock</title>
<desc id="banner-lock-description-default">A locked padlock</desc>
<path fill="#000000" fill-rule="evenodd" d="M26 0c10.493 0 19 8.507 19 19v9h3a4 4 0 0 1 4 4v28a4 4 0 0 1-4 4H4a4 4 0 0 1-4-4V32a4 4 0 0 1 4-4h3v-9C7 8.507 15.507 0 26 0zm0 8c-5.979 0-10.843 4.77-10.996 10.712L15 19v9h22v-9c0-6.075-4.925-11-11-11z"/>
</svg>
</span> ) or <strong>https://</strong> means youve safely connected to the .gov website. Share sensitive information only on official, secure websites. </p>
</div>
</div>
</div>
</div>
</div>
</section>
<!-- HEADER -->
<header id="siteheader" class="usa-header usa-header--basic">
<div class="usa-nav-container tablet:padding-x-4 mobile-lg:padding-x-2 padding-y-1">
<div class="grid-row padding-y-105">
<div class="grid-col-8 desktop:grid-col-4 tablet-lg:grid-col-4 tablet:grid-col-6"> <a href="https://www.nlm.nih.gov/"> <img src="https://assets.nlm.nih.gov/uswds/img/NLM_White.png" alt="NLM logo" class="logo margin-top-1"> </a> </div>
<div class="desktop:grid-col-4 desktop:grid-offset-4 tablet-lg:grid-col-6 tablet-lg:grid-offset-2 tablet:grid-col-6 grid-col-12">
<form class="usa-search desktop:margin-top-2 tablet:margin-top-2 mobile:margin-top-1" role="search" data-gtm-form-interact-id="0" method="get" action="//vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta" target="_self" name="searchForm" id="searchForm2">
<input class="usa-input ui-autocomplete-input" aria-label="Search" type="search" name="query" data-gtm-form-interact-field-id="0" id="search2" autocomplete="off" placeholder="Search NLM" >
<input type="hidden" name="v:project" value="nlm-main-website">
<button class="usa-button border border-top border-bottom border-right border-white" role="button" aria-label="Search" type="submit"> <span class="usa-search__submit-text"> <i class="fas fa-search"></i> </span> </button>
</form>
</div>
</div>
</div>
</header>
<div class="bg-secondary insertCOOP">
<div class="usa-nav-container">
<div class="usa-navbar ">
<button class="usa-menu-btn">Menu</button>
</div>
<nav aria-label="Primary navigation" class="usa-nav">
<button class="usa-nav__close"><img src="https://assets.nlm.nih.gov/uswds/img/close.svg" alt="close"></button>
<ul class="usa-nav__primary usa-accordion insertNav">
<li class="usa-nav__primary-item desktop-lg:margin-x-5 desktop:margin-x-3 tablet:margin-x-0">
<button type="button" class="usa-accordion__button usa-nav__link usa-current" aria-expanded="false" aria-controls="basic-nav-section-one"> <span>Products and Services <i class="fas fa-caret-down margin-left-05"></i> </span> </button>
<ul id="basic-nav-section-one" class="usa-nav__submenu bg-secondary" hidden="">
<li class="usa-nav__submenu-item"> <a href="//eresources.nlm.nih.gov/nlm_eresources/"><span>All Products and Services</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//clinicaltrials.gov/"><span>ClinicalTrials.gov</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//collections.nlm.nih.gov/"><span>Digital Collections</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//catalog.nlm.nih.gov"><span>LocatorPlus Catalog</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//meshb.nlm.nih.gov/search"><span>Medical Subject Headings (MeSH)</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//medlineplus.gov/"><span>MedlinePlus</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//pubmed.ncbi.nlm.nih.gov/"><span>PubMed/MEDLINE</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//uts.nlm.nih.gov/uts/"><span>Unified Medical Language System (UMLS)</span></a> </li>
</ul>
</li>
<li class="usa-nav__primary-item desktop-lg:margin-x-5 desktop:margin-x-3 tablet:margin-x-0">
<button type="button" class="usa-accordion__button usa-nav__link usa-current" aria-expanded="false" aria-controls="basic-nav-section-two"> <span> Resources for You <i class="fas fa-caret-down margin-left-05"></i></span> </button>
<ul id="basic-nav-section-two" class="usa-nav__submenu bg-secondary" hidden="">
<li class="usa-nav__submenu-item"> <a href="/portals/researchers.html"><span>For Researchers</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/portals/publishers.html "><span>For Publishers</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/portals/librarians.html"><span>For Librarians</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/training.html "><span>For Educators/Trainers </span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/portals/healthcare.html"><span>For Health care Professionals</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/portals/public.html "><span>For the Public</span></a> </li>
</ul>
</li>
<li class="usa-nav__primary-item desktop-lg:margin-x-5 desktop:margin-x-3 tablet:margin-x-0">
<button type="button" class="usa-accordion__button usa-nav__link usa-current" aria-expanded="false" aria-controls="basic-nav-section-three"> <span>Explore NLM <i class="fas fa-caret-down margin-left-05"></i> </span> </button>
<ul id="basic-nav-section-three" class="usa-nav__submenu bg-secondary" hidden="">
<li class="usa-nav__submenu-item"> <a href="/about/index.html"><span>About the Library</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/about/visitor.html"><span>Visit the Library</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/hmd/index.html"><span>History of Medicine</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/about/org.html"><span>NLM by Organization</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/news/newsandevents.html"><span>News, Events, and Updates</span></a> </li>
</ul>
</li>
<li class="usa-nav__primary-item desktop-lg:margin-x-5 desktop:margin-x-3 tablet:margin-x-0">
<button type="button" class="usa-accordion__button usa-nav__link usa-current" aria-expanded="false" aria-controls="basic-nav-section-four"> <span> Grants and Research <i class="fas fa-caret-down margin-left-05"></i> </span> </button>
<ul id="basic-nav-section-four" class="usa-nav__submenu bg-secondary" hidden="">
<li class="usa-nav__submenu-item"> <a href="/ep/index.html"><span>NLM Extramural Programs</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="/research/index.html"><span>NLM Intramural Research Program</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="https://www.ncbi.nlm.nih.gov/"><span>National Center for Biotechnology Information</span></a> </li>
<li class="usa-nav__submenu-item"> <a href="//lhncbc.nlm.nih.gov/"><span>Lister Hill National Center for Biomedical Communications</span></a> </li>
</ul>
</li>
</ul>
</nav>
</div>
</div>
<!-- End of TOP NAV -->
<!-- DIVISIONAL BANNER -->
<div class="bg-gray-70">
<div class="grid-container">
<div class="grid-row divisional">
<div class="grid-col text-white">
<div class="float-left">
<h4 class="margin-bottom-0"> VSAC Support Center</h4>
</div>
<div class="float-right margin-top-05">
<p>
<a class="text-white" href="/vsac/support/index.html">VSAC Support Center Home</a>
</p>
</div>
</div>
</div>
</div>
</div>
<!--END DIVISIONAL BANNER -->
<!-- Breadcrumbs -->
<div class="grid-container">
<nav class="usa-breadcrumb usa-breadcrumb--wrap padding-top-1" aria-label="Breadcrumbs">
<ol class="usa-breadcrumb__list">
<li class="usa-breadcrumb__list-item"> <a href="/index.html" class="usa-breadcrumb__link"><span>Home</span></a> </li>
<li class="usa-breadcrumb__list-item"> <a href="/vsac/support/index.html" class="usa-breadcrumb__link"><span>VSAC Support Center Home</span></a> </li>
</ol>
</nav>
</div>
<!-- End Breadcrumbs -->
<main class="padding-bottom-5" id="main">
<div class="grid-container">
<div class="grid-row">
<div class="grid-col">
<div class="h1">Tips for Your eCQM Annual Update Value Set Work </div>
</div>
</div>
<p> A. Study your value sets and <a href =" https://www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets.html">validate your value sets </a> by selecting the appropriate expansion profile for the upcoming eCQM Annual Update; e.g., eCQM Update YYYY-MM-DD-QA Analysis. Upon validation, analyze whether you need to <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets.html">make changes to your value sets</a>. If you need to make changes to listed codes or members of grouping value sets, create a new definition version.</p>
<p>B. View inactive/invalid codes on the value set trial expansion spreadsheet for each eCQM Measure in VSAC Collaboration during the time that eCQM Authors are updating their value sets before CMS submits the final measure packages to the VSAC Team. At the various times that CMS submits draft measure packages to the VSAC Team, the VSAC Team populates every CMS eCQM collaboration site with a value set trial expansion spreadsheet of a measures value set expansions based on the most recently published value set definitions expanded/calculated with the expansion profile created for the CMS eCQM Update, such as the 2024-05-02 QA Analysis expansion profile. These value set trial expansion spreadsheets in VSAC Collaboration include code QA analysis based on the agreed-upon code system versions for the eCQM Annual Update. </p>
<u> Access the Value Set Trial Expansion Spreadsheets for each eCQM Measure on VSAC Collaboration</u> <br>
<p>If you are a member of the eCQM Value Set Steward groups such as “MU2 Management”, “Mathematica” and “HRSA-HAB”, you can access each measures collaboration site in the <a href="https://vsac.nlm.nih.gov/collab">VSAC Collaboration Management tab</a>.</p>
<p>To access the spreadsheets, filter the column headers by the following:</p>
Last Document Update: 20240501 (YYYYMMDD) <br>
(Note that the VSAC Team will provide this date to the eCQM Managers at the various times that the VSAC Team delivers the QA information to CMS during the eCQM Annual Update season.)<br>
<p><img src="tips-images/measuresinrelease.png" alt="Find measures in VSAC Collaboration by searching in the Last Document Update Column"></p>
You can search directly in the <a href= "https://vsaccollab.nlm.nih.gov/collab">VSAC Collaboration Tool</a> by measure ID (e.g., CMS104). Refer to the <a href="https://www.nlm.nih.gov/vsac/support/vsaccollaboration/index.html">VSAC Collaboration Tool Users Guide</a> for more information.<br>
<p><img src="tips-images/findmeasure.png" alt="Find measure collaboration site in VSAC Collaboration by typing eCQM ID in the Collaboration Site Name field"></p>
<p>Analyze the value set trial expansion spreadsheet for each eCQM Measure in VSAC Collaboration. Study the codes in the “Validated Code List” in the spreadsheet. The Validated Code List shows the author-defined codes (value set definition) and their validated status (active or inactive or invalid). The validated code status is based on the code system version in the expansion profile. </p>
<p><img src="tips-images/validatedcodelist.png" alt="Validated Code List on the value set trial expansion in VSAC Collaboration"></p>
<p>The inactive/invalid codes are displayed in the Validated Code List because the value sets are expanded with the eCQM expansion profile named “eCQM Update YYYY-MM-DD - QA Analysis.” This is an expansion profile requested by the eCQM Managers for this purpose during the time that eCQM Value Set Authors are working on <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets.html"> updating their value sets</a> before CMS sends the VSAC Team the final measure package.
Study the inactive and invalid codes to determine the codes that you would like to remove and study <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets.html">any remapped codes</a> that you may want to add for the eCQM Annual Update by<a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/expansions.html"> validating the OID </a>in VSAC Authoring. </p>
<p><img src="tips-images/expansprofile.png" alt="Validate OID in VSAC Authoring with the eCQM Expansion Profile"></p>
<p>For any remaining inactive/invalid codes that you do not remove, VSAC will automatically retain the inactive/invalid codes and apply the code system version in which the codes were last active for the final eCQM publication these codes will appear in the Expansion List of the value set trial expansion spreadsheet for each eCQM Measure in VSAC Collaboration at the time of the final publication.</p>
<p> At the interim stages when Measure Developers are working on updating and finalizing value sets using the “eCQM Update YYYY-MM-DD - QA Analysis” expansion profile and the VSAC Team delivers the measures value set trial expansion spreadsheets, the inactive/invalid codes are dropped and will not appear in the Expansion List. To view the inactive/invalid codes in the expansion, <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/expansions.html">do a trial expansion</a> in VSAC with the expansion profile that was created for the eCQM Annual Update, e.g., eCQM Update 2024-05-02. In the trial expansion, the inactive and invalid codes will appear in the Expansion List and show as active status for the code system in which the codes were last active. This is also true for the final eCQM Annual Update publication.</p>
<p>C. <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/updatingvaluesets.html">Validate, update, save, submit, and approve</a> your value sets by the deadline established by the CMS-created eCQM Annual Update Timeline.</p>
<p>D. Confirm that all eCQM value set authors value sets are published and are not a draft version by the time that CMS submits the final measure packages to the VSAC Team in the Spring. The eCQM Program Managers can go to My Program Releases, Program Release Items, Export Program Release Results, and Consolidated Release Results. View column E Latest Published Definition Version or Draft Status. To view member value sets, go to column P Grouping Value Set Member Latest Published Definition Version or Draft Status. If Draft or Proposed status is noted in either column, value set authors need to submit the value set to the steward for approval and then VSAC will publish the value set. </p>
<p>You may also select the Itemized Release Results (organized by measure) option under Export Program Release Results. View Column F, Latest Published Definition Version or Draft Status. To view member value sets, go to column R Grouping Value Set Member Latest Published Definition Version or Draft Status. If Draft or Proposed status is noted in either column, value set authors need to submit the value set to the steward for approval and then VSAC will publish the value set. </p>
<p>E. Download Your Value Set Purpose Statements within a Release, Edit, and Bulk Update Options</p>
<p>In Authoring, My Value Set Definitions, select the program, “CMS eCQM and Hybrid Measure.” Select last years eCQM Update 2024-05-02 in the Release dropdown menu and then click Export Search Results, Purpose Statement Results to download a spreadsheet of all existing value set purpose statements for the value sets for which you have author or steward permissions. Edit your purpose statements as desired, using this downloaded spreadsheet, and save this spreadsheet to your local environment. Once you have updated your purpose statements, upload your updated spreadsheet by clicking on the Update Purpose Statements button. For more information on the purpose statement bulk upload, please see the <a href="https://www.nlm.nih.gov/vsac/support/authorguidelines/purpose-statement-bulk-edit.html">documentation</a> on how to download and upload edited purpose statement field information. </p>
<p><img src="tips-images/updatepurpose.png" alt="Update purpose statements function in Authoring My Value Set Definitions"></p>
<p> To make changes to purpose statements for individual value sets, edit the value set metadata screen within the VSAC Authoring Tool and save your changes before CMS sends the final measure package to the VSAC Team.</p>
<p>eCQM Managers can view all the purpose statements for an entire release in My Program Releases, Program Release Items, and Purpose Statements Results. </p>
<p> F. Check to see if all your value sets have an “Active” review status.</p>
<p>All value sets definitions must have an “Active” review status by the time CMS submits the final measure packages to the VSAC Team. Use these tools to assist with identifying value sets that are due for review and to be able to “Mark as Reviewed” several value sets at once. </p>
1. Go to My Value Set Review Status in Authoring.<br>
2. Click the value set “Due for Review” checkbox.<br>
<p><img src="tips-images/forreview.png" alt="Value Sets Due for Review in Authoring My Value Set Review Status"></p>
3. Select all of the value sets at once by clicking the checkbox on the left above the list of value sets.<br>
4. Click the “Mark as Reviewed” button.
<p><img src="tips-images/markall.png" alt="Mark all value sets by checking the box above the field"></p>
<p>eCQM Managers can view all the value set definitions that are due for review in an entire release in My Program Releases. Go to My Program Releases, select a program release, and click the Value Set Review Status Report button. </p>
<p><img src="tips-images/reviewstatus.png" alt="Select Value Set Review Status Report in My Program Releases"></p>
<p class=”margin-top-5”><small>Last Reviewed: October 1, 2024</small></p>
</div>
</main>
<!-- FOOTER -->
<footer class="usa-footer__primary-section padding-top-5 padding-bottom-3 insertfooter">
<div class="grid-container">
<div class="grid-row">
<div class="desktop:grid-col-3 grid-col-6"> <a href="https://www.nlm.nih.gov/socialmedia/index.html">
<p class="text-white margin-bottom-1">Connect with NLM</p>
</a>
<ul class="social_media add-list-reset">
<li class="margin-right-05"><a href="https://www.facebook.com/nationallibraryofmedicine"><img class="bg-secondary" src="https://www.nlm.nih.gov/images/facebook.svg" alt="Facebook"></a></li>
<li class="margin-right-05"><a title="External link: please review our privacy policy." href="https://www.linkedin.com/company/national-library-of-medicine-nlm/"><img class="bg-secondary" src="//www.nlm.nih.gov/images/linkedin.svg" alt="LinkedIn"></a></li>
<li class="margin-right-05"><a title="External link: please review our privacy policy." href="https://twitter.com/NLM_NIH"><img src="https://www.nlm.nih.gov/images/twitter.svg" class="padding-1 bg-secondary" alt="Twitter"></a></li>
<li class="margin-right-05"><a title="External link: please review our privacy policy." href="https://www.youtube.com/user/NLMNIH"><img src="//www.nlm.nih.gov/images/youtube.svg" class="bg-secondary" alt="You Tube"></a></li>
<li class="margin-right-05"><a title="External link: please review our privacy policy." href="https://public.govdelivery.com/accounts/USNLMOCPL/subscriber/new?preferences=true"><img src="//www.nlm.nih.gov/images/mail.svg" class=" bg-secondary" alt="Government Delivery"></a></li>
</ul>
</div>
<div class="desktop:grid-col-3 grid-col-6">
<p class="address_footer text-white"> National Library of Medicine <br>
<a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white"> 8600 Rockville Pike <br>
Bethesda, MD 20894 </a></p>
</div>
<div class="desktop:grid-col-3 grid-col-6">
<p><a href="/web_policies.html" class="text-white"> Web Policies </a><br>
<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white"> FOIA </a><br>
<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white">HHS Vulnerability Disclosure</a> </p>
</div>
<div class="desktop:grid-col-3 grid-col-6">
<p><a class="supportLink text-white" href="//support.nlm.nih.gov?from="> NLM Support Center </a> <br>
<a href="/accessibility.html" class="text-white"> Accessibility </a><br>
<a href="/careers/careers.html" class="text-white"> Careers </a></p>
</div>
</div>
<div class="grid-row">
<div class="grid-col-12">
<p class="text-center text-white"> <a class="text-white" href="//www.nlm.nih.gov/">NLM</a> | <a class="text-white" href="https://www.nih.gov/">NIH</a> | <a class="text-white" href="https://www.hhs.gov/">HHS</a> | <a class="text-white" href="https://www.usa.gov/">USA.gov</a></p>
</div>
</div>
</div>
</footer>
<script src="//assets.nlm.nih.gov/uswds/js/uswds.min.js"></script>
<script src="//assets.nlm.nih.gov/jquery/jquery-latest.min.js"></script>
<script src="//assets.nlm.nih.gov/jquery/jquery-migrate-latest.min.js"></script>
<script src="/scripts/nlm_autocomplete.js"></script>
<script src="/scripts/nlm_uswds.js"></script>
</body>
</html>