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Upcoming OOO

• Riki 3/21-3/24

Review call notes from last week

Briefly done

Presentation from National Cancer Surveillance Program at CDC to ONC

• Nancy and Manjula were on this presentation last week

  • Goal would be for ONC to understand more of this need and also to bring CMS into the discussion - CDC is working on adding more background to the slide deck to share it

  • CMS is re-organizing, hopefully that will result in more support for interoperabilty - Nancy can share the paper:

• Presentation idetified the need for data blob data to be turned into discrete data

• includes screening for cervical cancer

• 30% are using the electronic Cancer Checklist (eCCs) in the US, 90% in Canada - now called protocols

  • used to be just pdf

  • now has XML version so vendors can incoporate it into their system

  • and can then send this electronically

• even if labs use eCC, it may not go across the interface into the EHR-s

• CAP does not mandate use of discrete data for clinical care - just requires the data elements be present

• Does this include the AOEs that are required for Pap smears?

  • maybe on the cancer screening - as augmentation - this checklist is for the workflow after the specimen is received

• FHIR representation of the eCC’s being worked on

• specimen tracking is differnt in the EHR-s from the pathology result section - so need to watch for potential discrepancy between what the surgeon enters manually

  • would need to define the source of truth for that

  • could maybe pull this into the eCC from the EHR-s in the future?

• Has the eCC been evaluated for use of the LOINC LHC forms (survey panels)?

  • Canada added the individual discrete readings back in 2006

  • example: 85905-8

  • They are also being represented in SCT models - working on solid tumors

  • at Winter 2018 LOINC meeting this was a discussion item - agreement with CAP to have LOINCs created for the high volume, but then that contract was discontinued due to contractual / licensing restrictions 😞 - would be great if that could get resurrected, because MU requires LOINC

• the new LOINC/SNOMED agreement will need to review the interlectual property agreements LOINC has (for use in the SNOMED CT LOINC extension)

• have speicmen in clincial lab and pathology lab

• would be good to harmonize data elements around clinical genomics data as well

• need everything in a single code system?

• support for more code systems will require updates to the underlying EHR-s and LIS codes - often data dictionary an ony be mapped to a single code system

• goal would be to encode the most granular clincial context for the data

• International EHR-s and LIS vendors will have to support multiple code systems based on legislation and jurisdictional regulations

  • Epic

  • Cerner

  • MediTech

  • CliniSys / Mimps

Goal would be for ONC to understand more of this need and also to bring CMS into the discussion - CDC is working on adding more background to the slide deck to share it

CMS is re-organizing, hopefully that will result in more support for interoperabilty - Nancy can share the paper:

Is there a way we can help?

Could make LOINC Committee aware of this topic

Review LabMCoP confluence space

• Quick overview

TRUU-Lab follow up

• Support for educational offerings

• SHIELD involvement

Dr. Sing will provide update on TRUU Lab for CLIAC April - update to this presentation from 2018

https://www.cdc.gov/cliac/docs/addenda/cliac0919/13_TRUU-LAB_Singh.pdf

Also present to Clinical Lab Partners Forum

SHIELD might put up a Test Naming topic call April 11

Some questions from SHIELD:

• Are TRUU Lab calls happening? - the time has changed - need to find out if calls are open

• Also a question on the website?

•  Riki to Follow up with Dr. Singh on getting this information out there

• Regenstrief re-organized internally (LOINC & Health Data Standards LHDS covers UCUM as well) - invite them for that SHIELD call

Reporting Biomarkers to Cancer registries

NOT DISCUSSED

Specimen CMT - Progress

NOT DISCUSSED

https://app.smartsheet.com/sheets/h6JWqw5v9pwvrqWMq9r4g85CXjv9M8VvVqvHRwc1?view=grid

Christina completed her terms, Manjula still working on his terms

there are several that need review - next week

Specimen CMT - Hosting Options

NOT DISCUSSED

email update from John: I talked to SNOMED International and I am going to be setting up a special area in the US Extension where I can do some test modeling and create new attribute relationships. Once I have that setup, I will try doing some test models off the existing content and see what I can come up with

Specimen CMT - education

NOT DISCUSSED

Specimen CMT - potential pilot sites

Goal is to have some implementers lined up by April - so who to reach out to?

• LIS vendors

  • Epic, Cerner, OpenELIS, Orchard, StarLIMS, CliniSys,

• EHR-s vendors

  • Epic, Cerner

• Terminology Services

  • Clincial Architecture, IMO, 3M, Wolter Kluvers, Optum

  IVD vendors to help promote the use?

• CAP for eCC?

• Onepager: https://aphlinformatics.atlassian.net/wiki/download/attachments/1853947928/20200601_CBR_SCM_OnePager_v04_final_cleared.pdf?api=v2

•  Andrea will see, if she can use the Specimen CMT content in their cancer project and report back
•  Raj to reach out to CAP to get contacts at vendors that we don’t have contact for - see here: Vendor Connections

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

  Setting baseline

  Some ideas:

• Like the idea of ONC survey:

  • of physicians / surgeons / other providers that collect specimen - focus on collection procedure, speicmen type, source site

  • of labs to see what they can receive AND what they can send out to PH / cancer registries etc

  • Maybe ask APHL to ensure coverage of PHLs

  • Maybe ask ASCP / CAP specifically for pathology labs

• Check on coverage of specimen terms in EPIC system during connectathon for Cancer Reporting FHIR IG?

Could the CAP cancer protocol for specimen use the CMT to populate their drop down?

NOT DISCUSSED

Specimen CMT - Compare to NHS Medical Terminology testing

NOT DISCUSSED

Specimen CMT - review of terms with questions

NOT DISCUSSED

Future projects for this call after CMT

NOT DISCUSSED