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Specimen CMT - review of terms with questions
Christina / Amy
PapSmear- more needed?
cannot populate SPM-8 here, as these are disparate strucutres and no overarching concept can be assigned
Pap in liquid transport container
cannot populate SPM-8 here, as these are disparate strucutres and no overarching concept can be assigned
started off as manufacturer’s proprietary test - brand-name preservative, that is added to the contianer, but very common - this is still only Hologic
we have 1331905008 | Cytology specimen vial containing preservative fluid (physical object)| - we can add the synonym of Liquid-based cytology specimen vial (physical object), if we think this is needed - there are different preservative based thin-prep products, so using the brand name, we don’t need it
different types of collecting choices brush-spatula combination or broom can be used with the collection kit
add the references into the collection
Do we need to mention regulation around Pap testing? Like the extra questions that need to be asked prior to collection? - will leave out, should be covered elsewhere
Plasma_HeparinLithium_gel - looking for modeling of the container = no way to link physical object to substance, so not modeled in SCT
have SCT concept for HeparinLithium, but hard to model the gel (since we do not know the composition) - leave that out of additives?
you cannot buy the gel separator separately, so should be considered part of the container
in Denmark they are modeling the separator as a separate attribute, not as an additive
clotting accelerator can be spray-dried or non-spray-dried may aslo be important
maybe we can create a compendium of containers (Jen Rychert has been submitting for container concepts, so we have a fairly complete list in the US extension) with mappings
random is a temporal aspect, but it would match the tempral concept of spot urine
ToeJointSynovialFluid
usually collected via syringe aspiration - usually from the big toe
definition has mention of ganglion cyst - need to remove that from this definition and find out, where that should go
ganglion cyst = this can be removed by aspiration, but it is not submitted to pathologists or excision, which would be sent in - add one for the ganglion cyst excision under pathology related
discouraged - SynovialFluid and indicate which toe joint is being aspirated from
Call Adjourned
11:?? AM 12:02 PM ET
Previous Action Items
No
Nancy Follow up:
EDTA Stopper top
EDTA sufficient or do we need to specify K2 or K3?
Nancy can review the list in SNOMED from John
Need to check on completeness against the Anne/Nancy list (compare with ARUP)
Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists
in SCT there are only swabs for insertion sites (line, drain, chest tube, vascular catheter) - this should be fixed
we should model it after 435971000124108 | Body fluid specimen from peritoneal dialysis insertion site (specimen) and require method, which should be aspirate
Mapping Specimen Cross Mapping Table to FHIR Concept Map.docx
How do we decide what format to share this in - get input from EHR-s and LIS vendors.
Write letter of mulitple stakeholders to request EHR-s and LIS vendors to implement
indicating that this is a patient safety issue, as incorrect Abx treatment will contribute to multi-drug resistance (use CTSI findings to provide background)
focus on blood, urine, wound cultures (get data from NHSN, too)
Nancy is talking to DHQP about the linkage with specimen collection
While we have HIT certification that is for the EHR-s there is currently no enforcement for implementation at the organizations
need C-suite buy-in
Professional organizations - like CAP and ACOS and AJCC get them to write the synoptic reports (better structuring of data) - for surgical aspects - similar to what CAP has done for Cancer (though they do not have the SCT codes included in the past - may be including SNOMED CT starting in 2025, but they are also using the SCT codes for observables) https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2021/12/synoptic-reporting-for-cancer-surgery-current-requirements-and-future-state/: The four CoC accreditation standards that include synoptic operative reporting requirements apply to sentinel lymph node biopsy for breast cancer (Standard 5.3), axillary lymph node dissection for breast cancer (Standard 5.4), wide local excision for primary cutaneous melanoma (Standard 5.5), and colonic resection for colon cancer (Standard 5.6). These accreditation standards were developed from the evidence-based recommendations for cancer surgery detailed in the Operative Standards for Cancer Surgery manuals.7,8
try to get AMA support to get providers to adopt this
Reach out to IDSA, too
Specimen CMT - education
No
Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration
if we have a use case of how a patient is impacted on their journey through the healthcare system - CAP created a nice video that showed how patient care was affected by incorrect data https://infobeta.cap.org/shield/
Specimen CMT - tracking implementation impact
Setting baseline
Define metrics
No
Specimen CMT - Compare to NHS Medical Terminology testing
No
Will get updated vocab at a later date
LOINC to SNOMED CT mapping
No
Future projects for this call after CMT
No
In general the call is intended as a forum for ANY messaging related issues to work out.
In the past we have
reviewed containers re-vive that - and how does that interact with devices (UDI identification?)
review code systems around additives (HL70371 and SCT substance and product hierarchies)
started work on cross-mapping between HL7 method codes and SNOMED CT procedure / technique concepts
American College of Surgeons is working on procedure protocol and synoptic data elements / surgical synoptic reports - we could work with them together on that
Look at other HL7 tables that we would want to migrate SCT (i.e., Specimen Condition table, etc.)
Kathy Walsh - Labcorp to Everyone 11:13 AM ThinPrep® PreservCyt® solution container
Andrea Pitkus to Everyone 11:13 AM Note: Certain molecular tests, such as CT/GC, TV, M.gen, can be performed from the same material collected for the Cervical Screening Test from the ThinPrep vial. Contact your laboratory for more information.
John Snyder (NLM) 11:19 AM 706057008 |Cytology specimen container (physical object)|
Andrea Pitkus 11:19 AM I was just trying to confirm how the modeling of the separate fields would be expected and if they are modeled similarly to the traditional PAP specimen/collection
clinician collects the Cervical Screening Test sample using either a broom-like device or the brush/spatula combination.
You may want to take the exact text from the package insert as I just grabbed from the website which is usually marketing
Kathy Walsh - Labcorp 11:25 AM CytoRich™ preservative fluid in the TriPath SurePath™ collection vial
Amy Liu 11:30 AM Sorry, I have to drop for another call
Manjula Dharmawardhana 11:31 AM Sorry. I have to drop
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