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Date

Attendees

Present

Name

Organization

X

Nancy Cornish

CDC

X

Manjula Gama-Ralalage

CDC

X

Riki Merrick

APHL

X

Christina Gallegos

APHL

X

Amy Liu

Inductive Health / APHL

-

Raj Dash

Duke / CAP

X

John Snyder

National Library of Medicine (SNOMED CT)

Andrea Pitkus

UW

X

Kathy Walsh

Labcorp

Rob Hausam

Hausam Consulting

 

Doug York

APHL

 

Pam Banning

 3M

Discussion topics

Topic

Discussed?

Notes

Updates

 Yes

No topics or updates.

  1. Review specimen cross mapping table

  2. Discuss reporting Biomarkers to Cancer registries with Sandy Jones - we will send another meeting invite for May 16th.

Upcoming OOO

Yes

Previous Action Items

 

Specimen CMT - review of terms with questions

 Yes

 5/2/2024:

  • Gastric Tube - do not use term (not appropriate for culture)

    • Broad term. There are different types of gastric tubes (i.e., nasogastric tube, tube that goes through the abdominal wall, etc.)

    • you do not want to culture them or the site

    • culture stomach secretions for babies with TB (constantly coughing and swallowing sputum)

    • Use gastricfluid_gastronomytube or gastricfluid_nastogastricdrainage terms

    • Preferred term would be GastricFluid_Drainage

  • TubingTip (IV catheter) - do not use term

    • generic term - we have other related terms

    • must be collected sterile

    • is this a device sample (before being used)? (i.e., environmental sample)

  • UrineCatheter

    • generic term - is it referring to indwelling catheter?

    • pull in same fields as catheterTip_IndwellingCatheter

  • Wound_PostSurgical

    • encourage aspirates, discourage swabs

    • collect only if there is cardinal signs of infection: redness, swelling, heat, and pain

    • use surgical wound SCT code: (112633009 |Surgical wound (morphologic abnormality)| - it implies surgery had taken place

  • ArterialBlood_PeripheralArterialCatheter_PosteriorTibialArtery

    • Do we include source site and spatial orientation or specimen?

    • drawing blood from arterial catheter is not encouraged

    • It should be fully coordinated.

    • SPM-10: 13363002 |Structure of posterior tibial artery (body structure)|

CALL ADJOURNED

Yes

@ 1:00pm ET

Specimen CMT pilot implementers

No

Specimen CMT - Hosting Options

 No

  • 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.

      • There will be a call Clinical Architecture on May 3rd to discuss moving specimen CMT to Symedical

      • Manjula will take a look at the concept map

Specimen CMT - education

 No

 

Specimen CMT - tracking implementation impact

  • Setting baseline

  • Define metrics

 No

 

Specimen CMT - Compare to NHS Medical Terminology testing

 No

 

LOINC to SNOMED CT mapping

 No

 

Reporting Biomarkers to Cancer registries

 No

National Program of Cancer Registries (NPCR) | CDC

Sandy Jones will put together a one-pager - Nancy will reach out

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.)

Chat:

Nancy @ 12:22pm: What is Gastric Fluid Analysis? –Purpose, Procedure, Result (http://anavara.com )

Kathy @ 12:23pm : Definition: Gastric culture is a test to check a child's stomach contents for the bacteria that cause tuberculosis (TB).How the Test is Performed: A flexible tube is gently placed through the child's nose and into the stomach. The child may be given a glass of water and asked to swallow while the tube is inserted. Once the tube is in the stomach, the health care provider uses a syringe to remove a sample of the stomach contents. The tube is then gently removed through the nose. The sample is sent to a lab. There, it is placed in a special dish called a culture medium and watched for the growth of bacteria. https://www.ucsfbenioffchildrens.org/medical-tests/gastric-culture

Nancy @ 12:38pm: Clinical Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by IDSA (http://idsociety.org )

John @ 12:42pm: 112633009 |Surgical wound (morphologic abnormality)|

Nancy @ 12:47 (email): Clinical Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by IDSA
VII. What Is the Preferred Management of Surgical Site Infections?

  1. Suture removal plus incision and drainage should be performed for surgical site infections (strong, low).

  2. Adjunctive systemic antimicrobial therapy is not routinely indicated, but in conjunction with incision and drainage may be beneficial for surgical site infections associated with a significant systemic response (Figure 2), such as erythema and induration extending >5 cm from the wound edge, temperature >38.5°C, heart rate >110 beats/minute, or white blood cell (WBC) count >12 000/µL (weak, low).

  3. A brief course of systemic antimicrobial therapy is indicated in patients with surgical site infections following clean operations on the trunk, head and neck, or extremities that also have systemic signs of infection (strong, low).

  4. A first-generation cephalosporin or an antistaphylococcal penicillin for MSSA, or vancomycin, linezolid, daptomycin, telavancin, or ceftaroline where risk factors for MRSA are high (nasal colonization, prior MRSA infection, recent hospitalization, recent antibiotics), is recommended (strong, low). See also Tables 2 and 3.

  5. Agents active against gram-negative bacteria and anaerobes, such as a cephalosporin or fluoroquinolone in combination with metronidazole, are recommended for infections following operations on the axilla, gastrointestinal tract, perineum, or female genital tract (strong, low). See also Table 3.

John @ 12:55pm: 13363002 |Structure of posterior tibial artery (body structure)|

Recording:

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