The 2014 Edition preferred language standard (45 CFR 170.207(g)) requires EHR technology to be capable of representing a patient’s preferred language in accordance with ISO 639-2 “limited” by ISO 639-1. What does “limited” or “constrained” by ISO-639-1 mean? Additionally, in some instances, there are ISO 639-2 languages that have both a (B) bibliographic code and (T) terminology code. In these instances, what code must be used?
“Limited” or “constrained” by ISO 639-1 means that the languages in ISO 639-2 that an EHR technology must be capable of representing are limited or constrained to those languages that have a corresponding alpha-2 code in ISO 639-1. EHR technology must be capable of representing these languages in the alpha-3 codes of ISO 639-2 for the purposes of certification. In instances where both a bibliographic code and terminology code are present for a required ISO 639-2 language, EHR technology is expected to be capable of representing the language in accordance with the (T) terminology codes (ISO 639-2/T) for the purposes of certification. For example, Albanian is the first language in ISO 639-2 where two codes [alb (B), sqi (T)] are present and, thus, “sqi” should be used to represent this language for certification. The bibliographic codes are for bibliographic applications and exist for historical reasons.
For further discussion of the differences between the bibliographic and terminology codes within ISO 639-2, please see the frequently asked question published by the Library of Congress at http://www.loc.gov/standards/iso639-2/faq.html#3.