2024-05-16 Meeting notes

Date

16 May 2024

Attendees

esent	Name	Organization
X	Nancy Cornish	CDC
	Manjula Gama-Ralalage	CDC
X	Riki Merrick	APHL
X	Christina Gallegos	APHL
X	Amy Liu	Inductive Health / APHL
regrets	Raj Dash	Duke / CAP
X	John Snyder	National Library of Medicine (SNOMED CT)
	Andrea Pitkus	UW
	Kathy Walsh	Labcorp
	Rob Hausam	Hausam Consulting
	Doug York	APHL
	Pam Banning	3M
X	Sandy Jones	CDC

Discussion topics

Upcoming OOO		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
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against the Anne/Nancy list (compare with ARUP) Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists Raj: I found this at a phlebotomy certification course website: What Color Tubes Are Used for Which Tests in Phlebotomy –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 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 Scott’s response: “When the SNOMED representative referred to the existence of “donor codes,” they might be referring to the ISBT-128 coding standard that’s managed by ICCBBA. Please see their website: ISBT 128 \| ICCBBA, and navigate to view their technical documents: ISBT 128 \| ICCBBA \| Technical DocumentsFDA’s regulations for human cells, tissues, and cellular and tissue-based products (HCT/Ps) in 21 CFR part 1271 require assignment of a “distinct identification code” to facilitate tracking HCT/Ps (see 21 CFR 1271.290(c)) but I don’t believe this is relevant to your question.” 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.) Amy follow up - check if she has all of these nasal sinus fluid definition surgical insertion site peritonealDialysisTunnelSite surgical insertion site peritonealDialysisSite 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 John: 460621000124104 \|Superficial surgical incision wound (morphologic abnormality)\| - created in US extension in 2019. Is this needed? If so, then LabMCoP/APHL should promote it to SNOMED International to retain US SNOMED identifier. John submitted this to be promoted: https://request.ihtsdotools.org/#/requests/edit/959920?fromList=true SNOMED guidance related to morphological abnormality: Morphologic Abnormalities vs. Findings - SNOMED CT Editorial Guide - SNOMED Confluence
	Sandy Jones
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. 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
Specimen CMT - tracking implementation impact Setting baseline Define metrics
Specimen CMT - Compare to NHS Medical Terminology testing
LOINC to SNOMED CT mapping
Reporting Biomarkers to Cancer registries	Yes	National Program of Cancer Registries (NPCR) \| CDC Onepager - GET FROM SANDY NAACCR IG in V2.5.1 and FHIR IGs support synotpic Cancer protocols, but FHIR iG has not been implemented, V2.5.1 is in production; Neometrics is configured and once they migrate to V5.1 they will start reporting that Working with Epic and CAP to inform their clients that use Beaker - they can turn on modules that produces the NAACR V5 format Currently working on hospital onboarding with DataPult How can we help? Any input on use of FHIR NAACCR V5.1 has not been balloted, but is widely implemented - have done crosswalks with LRI IG (and ELR IG) before, but we should redo the crosswalk against LRI base E5 - APHL can create the comparison once we have the LRI base in IGAMT Association of Pathology informatics - get them involved with implementations, maybe create a checklist for the steps needed for implementation Reach out to LIS vendors for Anatomic Pathology Labs Epic (already working with) Oracle Sunquest Vital Access (smaller specialty labs) - already reporting via AIMS Update from CAP Cancer Summit with ONC and NCBI and CMS CAP has synoptic rpeport - SCT codes for all templates for quesistions and answers (Scott Campbell has modeled all of that ) Dataflow: Cancer Checklist is completed in the template by the pathologist Challenges: available to licensed users only currently labs are storing the synoptic data in a textblob, which means we are loosing the discreete coded data could maybe add in checklists for the gross exam of the specimen?
uture 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.)

Chat:

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