2023-03-02 Meeting notes

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Nancy Cornish

CDC

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Manjula Gama-Ralalage

CDC

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Riki Merrick

APHL

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Christina Gallegos

APHL

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Amy Lui

Inductive Health / APHL

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Raj Dash

Duke / CAP

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John Snyder

National Library of Medicine (SNOMED CT)

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Andrea Pitkus

UW

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Kathy Walsh

Labcorp

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Rob Hausam

Hausam Consulting

Doug Franklin

APHL

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Pam Banning

3M

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

• need for data blob data to be turned into discrete data

• includes screening for cervical cancer

• 30% are using the electronic Cancer Checklist (eCCs) - 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

Specimen CMT - education

NOT DISCUSSED

Specimen CMT - potential pilot sites

• IA PHL - would like to ensure that envrionmental is covered in the long-term, but open to review the content

• 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

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?

Specimen CMT - Compare to NHS Medical Terminology testing

Specimen CMT - review of terms with questions

Future projects for this call after CMT