2023-03-09 LabMCoP Meeting notes

x

Nancy Cornish

CDC

x

Manjula Gama-Ralalage

CDC

x

Riki Merrick

APHL

x

Christina Gallegos

APHL

x

Amy Lui

Inductive Health / APHL

x

Raj Dash

Duke / CAP

x

John Snyder

National Library of Medicine (SNOMED CT)

x

Andrea Pitkus

UW

x

Kathy Walsh

Labcorp

x

Rob Hausam

Hausam Consulting

x

Doug Franklin

APHL

x

Pam Banning

3M

Upcoming OOO

• Riki 3/21-3/24

• John 3/31-4/6

• Pam 3/31-4/7

• Rob 3/31-4/6

• Nancy 3/30

Presentation from National Cancer Surveillance Program at CDC to ONC

• Process of updating slide deck and sending to ONC

• Nancy and Manjula were on this presentation last week

  • Goal would be for ONC to understand more of this need and also to bring CMS into the discussion - CDC is working on adding more background to the slide deck to share it

  • CMS is re-organizing, hopefully that will result in more support for interoperabilty - Nancy can share the paper: https://www.nejm.org/doi/full/10.1056/NEJMp2215539

• Presentation idetified the need for data blob data to be turned into discrete data

• includes screening for cervical cancer

• 30% are using the electronic Cancer Checklist (eCCs) in the US, 90% in Canada - now called protocols

  • used to be just pdf

  • now has XML version so vendors can incoporate it into their system

  • and can then send this electronically

• even if labs use eCC, it may not go across the interface into the EHR-s

• CAP does not mandate use of discrete data for clinical care - just requires the data elements be present

• Does this include the AOEs that are required for Pap smears?

  • maybe on the cancer screening - as augmentation - this checklist is for the workflow after the specimen is received

• FHIR representation of the eCC’s being worked on

• specimen tracking is differnt in the EHR-s from the pathology result section - so need to watch for potential discrepancy between what the surgeon enters manually

  • would need to define the source of truth for that

  • could maybe pull this into the eCC from the EHR-s in the future?

• Has the eCC been evaluated for use of the LOINC LHC forms (survey panels)?

  • Canada added the individual discrete readings back in 2006

  • example: 85905-8

  • They are also being represented in SCT models - working on solid tumors

  • at Winter 2018 LOINC meeting this was a discussion item - agreement with CAP to have LOINCs created for the high volume, but then that contract was discontinued due to contractual / licensing restrictions - would be great if that could get resurrected, because MU requires LOINC

• the new LOINC/SNOMED agreement will need to review the interlectual property agreements LOINC has (for use in the SNOMED CT LOINC extension)

• have speicmen in clincial lab and pathology lab

• would be good to harmonize data elements around clinical genomics data as well

• need everything in a single code system?

• support for more code systems will require updates to the underlying EHR-s and LIS codes - often data dictionary an ony be mapped to a single code system

• goal would be to encode the most granular clincial context for the data

• International EHR-s and LIS vendors will have to support multiple code systems based on legislation and jurisdictional regulations

  • Epic

  • Cerner

  • MediTech

  • CliniSys / Mimps

Is there a way we can help?

Could make LOINC Committee aware of this topic

TRUU-Lab follow up

• Support for educational offerings

• SHIELD involvement

Dr. Sing will provide update on TRUU Lab for CLIAC April 12- update to this presentation from 2018

https://www.cdc.gov/cliac/docs/addenda/cliac0919/13_TRUU-LAB_Singh.pdf

Also present to Clinical Lab Partners Forum - not scheduled yet

SHIELD might put up a Test Naming topic call April 11

Some questions from SHIELD:

• Are TRUU Lab calls happening? - the time has changed - need to find out if calls are open

  • Wednesdays

• Also a question on the website?

• Regenstrief re-organized internally (LOINC & Health Data Standards LHDS covers UCUM as well) - invite them for that SHIELD call

Reporting Biomarkers to Cancer registries

No updates

Specimen CMT - Progress

• 44 more terms need to be added

• Many terms have not been finalized yet - discouraged, duplicates (with some differences), fields not finalized, 150 terms will need additional work (missing definition, term not decided, etc.) - may need to assign them

• Schema diagrams - John to request access from Riki to search the database to see what attributes are assigned to different concepts

https://app.smartsheet.com/sheets/h6JWqw5v9pwvrqWMq9r4g85CXjv9M8VvVqvHRwc1?view=grid

Specimen CMT - Hosting Options

• JTG Consulting (Jamel Giuma)- would be willing to host the CMT and TRUU Lab

  • Contact info:

    • Email: jamel@jtg.group

    • Direct #: 1-786-598-2540,

    • Mobile: 1-305-301-5074

Specimen CMT - education

Specimen CMT - potential pilot sites

Goal is to have some implementers lined up by April - so who to reach out to?

• Review where we are: Vendor Connections

• Onepager: https://aphlinformatics.atlassian.net/wiki/download/attachments/1853947928/20200601_CBR_SCM_OnePager_v04_final_cleared.pdf?api=v2

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

Specimen CMT - Compare to NHS Medical Terminology testing

Specimen CMT - review of terms with questions

Future projects for this call after CMT