2024-10-24 LabMCoP Meeting Notes

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

regrets

John Snyder

National Library of Medicine (SNOMED CT)

X

Andrea Pitkus

UW

 X

Kathy Walsh

Labcorp

 regrets

Rob Hausam

Hausam Consulting

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

specimen condition and reject reason work

 No

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

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

• 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.

Presentation to CSTE ELR call - first Tuesday of the month 1 PM ET

Nancy

Nancy Barrett from CT requested a presentation on specimen collection - will add specimen CMT information - for 11/5 or 12/3 - aim for December

Was also asked by Cody McNeese (OR) to talk more about how to send these codes electronically - ideally we would like deliverables to share with ELR informatics folks; requested slides ahead of time - collection instructions and the current state of specimen CMT

CDC eClearance also will be updated

Nancy will share the email threads

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      • Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists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?) =

    • 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 - these folks shared the follwoing for the reject reason topic, but it seems they differentiate between source site and the organ: #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)

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

  • Connect with CAP Informatics Committee (Riki can email Kevin Schap) and ASCP (does anyne have a connection?)

  • 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

Specimen CMT - review of terms with questions

 Manjula created mappings between the SCT column headers and elements in FHIR conceptmap resource:

Specimen CMT pilot implementers

• Review where we are: Vendor Connections

  • no update

Specimen CMT - Hosting Options

 Yes

• 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

• How do we decide what format to share this in - get input from EHR-s and LIS vendors.

• Write letter of mulitple stakeholders to request EHR-s and LIS vendors to implement

  • indicating that this is a patient safety issue, as incorrect Abx treatment will contribute to multi-drug resistance (use CTSI findings to provide background)

    • focus on blood, urine, wound cultures (get data from NHSN, too)

  • Nancy is talking to DHQP about the linkage with specimen collection

  • While we have HIT certification that is for the EHR-s there is currently no enforcement for implementation at the organizations

  • need C-suite buy-in

  • Professional organizations - like CAP and ACOS and AJCC get them to write the synoptic reports (better structuring of data) - for surgical aspects - similar to what CAP has done for Cancer

  • try to get AMA support to get providers to adopt this

  • Reach out to IDSA, too

Specimen CMT - education

 Yes

•  Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration

• if we have a use case of how a patient is impacted on their journey through the healthcare system - CAP created a nice video that showed how patient care was affected by incorrect data SHIELD FDA BAA Year 2 (cap.org)

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

No

Specimen CMT - Compare to NHS Medical Terminology testing

 No

 Will get updated vocab at a later date

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.)