2024-09-19 LabMCoP Meeting Notes

 X

Nancy Cornish

CDC

 regrets

Manjula Gama-Ralalage

CDC

regrets

Riki Merrick

APHL

 X

Christina Gallegos

APHL

 X

Amy Liu

Inductive Health / APHL

 X

Raj Dash

Duke / CAP

John Snyder

National Library of Medicine (SNOMED CT)

 regrets

Andrea Pitkus

UW

Kathy Walsh

Labcorp

Rob Hausam

Hausam Consulting

Doug York

APHL

Pam Banning

 3M

Sandy Jones

CDC

Upcoming OOO

• Reminder: We are now using https://aphlinformatics.atlassian.net/wiki/spaces/LMCOPL/calendars and everyone can just keep it updated

  NOTE: you will need to use type “Event” if you do not have a confluence account

• Cancel 9/26 call next week

Specimen CMT presentation for SHIELD

Presentation on September 10, 2024 went welll - here is the link to the recording: 2024-09-10 SHIELD Topic#2 Call Meeting Notes

May need new time for this call?

Riki will have overlapping call for the next 4 -6 months - may be able to join late, if that call ends early

Would any of these times work on Thursdays in Eastern timezone:

10-11 AM, 11AM-noon, or 2-3 PM

Raj - 2pm can work for some Thursdays (conflict 1 Thurs/month)

Nancy - all should work

specimen condition and reject reason work

Here is the confluence page where OO is tracking this project: https://confluence.hl7.org/display/OO/Specimen+Condition+and+Specimen+Reject+Reason+Vocabulary

Next step is to review against the concepts in

#1 Standard PREanalytical Code Version 4.0 - (version 3.0 is here: https://cdn.ymaws.com/www.isber.org/resource/resmgr/isber_2019/pdf/standard_preanalytical_code_.pdf) maybe consider using this (if so, HL7 would need joint copyright or something) and also

#2 international standard for biobanking: the ISO 20387:2018 - is anyone member and has access?

• CAP may be a member and may be able to grab ISO doc- Raj send email to ask CAP

• Annex A lists some requirements regarding documented information during sample acquisition (see A.2 Acquisition)

• Annex B gives a list of examples for the respective requirements mentioned in Annex A (see B.2 Acquisition). Based on the acceptance criteria 'reject reasons' can be deduced.

#3 ISBER BP5 for information regarding 'Specimen Reject Reason'

Bite wound terms

• Manjula received request from CT DPH asking about bite wound terms in specimen CMT

  • Why terms were preferred vs discouraged

  • Seeing more wound specimens coming on swabs

• CT DPH asking for presentation on these terms in the future

• Nancy to send IDSA guidelines to include in specimen CMT for bite wound terms

• Andrea has questions regarding wounds - discuss on 10/10 call

Previous Action Items

• 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

      • Raj: I found this at a phlebotomy certification course website: What Color Tubes Are Used for Which Tests in Phlebotomy – PhlebotomyU

        • Here's a nice one-pager (University of Colorado Health): https://www.testmenu.com/universityhospital/TestDirectory/SiteFile?fileName=sidebar\CLNLAB-2020-03-13-Blood-Tube-Color-Chart.pdf

        • Cleveland Clinic: Blood Collection Tubes - Collection | Cleveland Clinic Laboratories

    • https://phlebotomygeeks.yolasite.com/resources/PRINT OUT COMMON TUBES.pdf

      • but color is manufacturer dependent, which is why we named the tubes by the additives

      • there are container types in SNOMED under 706049005 |Blood tube (physical object)|

      • Have a start here: https://aphlinformatics.atlassian.net/wiki/download/attachments/2018312270/ContainertypesListRikiEmailed20171013.xlsx?api=v2

      • K1 or K2 might be important to differentiate

    • We should leave the top color out of it, since that is manufacturer specific

    • Nancy will see, if their fellow has time to review and complete the list for us (she is a phlebotomist )

  • Contact United Network for Organ Sharing for input on donor terms (pre-coordinated or not?) = Contact - UNOS

    • Riki filled out the form - No repsonse

    • ISBT 128 | ICCBBA | Technical Documents

      • https://www.isbt128.org/_files/ugd/1a7593_edfd176861c94dca94c34eff8fa3ad0d.pdf - for organs

    • Might be a topic for SNOMED International

      • We may need to reach out to laboratories/industry to see if the donor codes are needed (we need to show that these codes are needed.)

    • Riki has some contact now with European bloodbank and biobanks = Home - BBMRI-ERIC working with the folks that define their minimum data set: MIABIS - BBMRI-ERIC

• Riki’s Follow up - none of these got done yet 😞

  • liquid-based cytology specimen vial = https://us-request.ihtsdotools.org/#/requests/preview/354843?fromList=truehttps://request.ihtsdotools.org/#/requests/edit/786429

  • submit a code for formalin10

  • work with John

    • new term for pacemaker insertion site sample

      • 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

    • For wound modeling (see 2023-11-30 LabMCoP Meeting Notes ) create a few pre-coordinated specimen terms

      • to cover the wound causes as children under: 119365002 | Specimen from wound (specimen)

      • another child term for aspirate under 445611000124106 | Specimen from bite wound (specimen), since that is preferred over the existing swab

    • IDSA has a guidelines for wound cultures (deep and superficial - related to surgical wounds) - link sent to Amy

Specimen CMT - review of terms with questions

Specimen CMT pilot implementers

• Review where we are: Vendor Connections

  • no update

Specimen CMT - Hosting Options

• How can we publish the content in the dB?

  • Allow access somehow to query the dB

  • as access or excel or csv

  • Using FHIR conceptMap similar to Conceptmap-example-specimen-type - FHIR v6.0.0-cibuild - based on this profile: ConceptMap - FHIR v6.0.0-cibuild

  • riki.merrick to ask Eric if he still has that or how he built it:

  • ANSWER FROM ERIC:

    • if you look in the xml source Conceptmap-example-specimen-type.xml - FHIR v6.0.0-cibuild . you can see how it is mapped. 

    • I am not sure if you mean the table rendering or creating the concept map from a spreadsheet or CSV file.  The FHIR build tool did the table rendering for that mapping, I think I entered the data by hand, or Grahame did it. It would not be hard to create a script to create a concept map from an excel or csv file if needed.  The table needs to be large enough to make it worthwhile though. you could even create formula cells in the spreadsheet to generate the XML or json for each item. and then copy to a text editor and append to the Metadata fields.

    • Manjula will take a look at the concept map

Specimen CMT - education

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

Specimen CMT - Compare to NHS Medical Terminology testing

LOINC to SNOMED CT mapping

Future projects for this call after CMT

• 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.)