2024-08-15 LabMCoP Meeting Notes

Date

15 Aug 2024

Attendees

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

Discussion topics

Upcoming OOO	Yes	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
NHSN Specimen terms
Previous Action Items		USCDI question from Andrea Andrea - Cancer data sharing guide Home Page - Cancer Pathology Data Sharing v1.0.1 is going to be required in HTI-2 in FHIR - current methods/procedures for specimen collection on pre-analytical side flowing into LIS - is that information getting through? HTI-2 - including FHIR cancer pathology sharing guide - it should make the capability of checklist items easy in FHIR - not a lot of labs have FHIR capability Home Page - Cancer Pathology Data Sharing v1.0.1 American College of Surgeons have a checklist which includes communicating to pathology https://www.facs.org/media/xe2kafyv/quickreferenceguide.pdf https://www.facs.org/media/gowlicmx/letter-to-surgeons-for-coc-operative-standards-final.pdf - These are the initial ACOS Synoptic Checklist areas: There are four target areas that require documentation by the operative surgeon: • Sentinel node biopsy for breast cancer (Standard 5.3) • Axillary lymph node dissection for breast cancer (Standard 5.4) • Wide local excision for primary cutaneous melanoma (Standard 5.5) • Colon resection (Standard 5.6) CAP has cancer checklists many of them are SNOMED CT (and other code system) coded, but for USCDI need to have LOINC codes for these (as described in mCODE Home - minimal Common Oncology Data Elements (mCODE) Implementation Guide v3.0.0), will have to translate between the two, hopefully once the LOINC extension in SNOMED CT is done, that translation can be included in the CAP checklist (by mapping to the CKUs) ONC had a few workshops around cancer data exchange Andrea please ADD THE DETAILS HERE Having different standards in use in clinical labs vs pathology labs is problematic Anatomic Pathology is covered now, but was not part of MU certifications in the beginning, but is covered here Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) Proposed Rule \| HealthIT.gov uscdi United States Core Data for Interoperability (USCDI) Nancy - In the past, paper requisition was used for specimen collection and entered in computer manually. Not much has changed - there really is no way to communicate with surgical pathology and surgeons performing specimen collection. CAP has developed a guidance document (i.e., CAP cancer checklist, etc.) on how to collect specimen and analyze specimen, etc. 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 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 = https://www.bbmri-eric.eu/ working with the folks that define their minimum data set: https://www.bbmri-eric.eu/howtomiabis/ 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. There will be a call Clinical Architecture on August 16th 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
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.)

Chat:

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