2023-08-10 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

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

Doug Franklin

APHL

Pam Banning

3M

Upcoming OOO

Y

• John OOO at HL7 WGM 9/10-9/14

• Riki & Christina OOO at HL7 WGM 9/8-9/15

• Rob at HL7 WGM 9/8-9/15

• Raj OOO 9/14-10/5

Previous Action Items

Y

• Submitted on the August 3rd -pus swab specimen requested for inactivation with swab and body fluid and pus specimen was requested for inactivation with relation to body fluid

• Request SNOMED CT to deprecate 119323008 | Pus specimen (specimen) and 258502009 | Pus swab (specimen) - we understand Swab, not sure about pus - can we discuss

  • pus can’t be identified by gross examination - it could also be necrosis - you must use microscope to differentiate it

    • pus from abscess in a breast turned out to be necrotic tumor - which couldn’t be identified until looking at the tissue, so it is misleading

  • pus (substance) will still be there

  • recommend to use instead:

    • abscess aspirate

    • drainage fluid - change from do not use to needs collection method

      • by incision (presumed to be sterile)

      • no-incision

Open

• Created the 2 requests:

  • drafted submission for synonym “anterior nasal cavity swab“ to 697989009^Anterior nares swab - need the pdf, as the link no longer works -COMPLETED - PDF sent to Riki & John, tickets have been submitted to SNOMED International for review

  • requested to deprecate 871810001 and then create a new term, that retains the synonym “Mid-turbinate nasal swab” - this one will be hard, as there is no body structure name for the space (below the inferior turbinate)- submitted and in the review process (possibly need to add another body structure concept)

• Riki forgot about the submission for Swab from donor bronchus specimen - John needs the reference URLs for these; Nancy is working on that now

• Modeling exposures on wounds - see when we can have Jim on our call (group with discussion about mid-turbinate swab) - Riki to see when works for him - Ask Riki for contact information for the person from a national marrow donor program- reach out to him for more information on this. Research on donor bronchus is limited. (Bob Milius bmilius@nmdp.org; He is retired so use personal email: bob@milius.com) - Nancy to reach out

  • Joel Schneider - NMDP/CIBMTR - jschneid@nmdp.org (Joel was Bob’s colleague)

  • Need to determine which concepts need to be requested

  • May need to reach out to someone from a national organ donor society - UNOS | United Network for Organ Sharing | US Organ Transplantation

• Updates on Specimen CMT pilot implementers

  • Review where we are: Vendor Connections - nothing new since last week --no updates

• COMPLETED: Nancy homework - terms that need definitions: - separate list with definitions sent to Amy

  • bloody liquid stool

  • Bronchial aspirate

  • BodyFluid

  • BronchusDonorSwab

  • PericardialFluid

Reporting Biomarkers to Cancer registries

 Y

 This is a future topic.

Nancy worked with Sandy Jones works for Division of Cancer National Program for Reporting Cancer Registry (NPCR) who would be interested in this. She will be at the CAP’s annual summit in Chicago

National Program of Cancer Registries

works on synoptic reporting

Lab Test Naming Conventions

 Y

• SHIELD call topics - planning call is set for Aug 9 from 4-5 PM ET

  • TRUU Lab

  • LOINC

  • Dr. Singh will give a presentation to SHIELD on August 29

    • discuss naming for physicians vs. laboratories

    • will have follow up calls

Specimen CMT - review of terms with questions

 N

• STOPPED HERE 8/10

• EDTA Stopper top - Riki to look for the table we made (check sharepoint - Anne and Nancy made this)

  • https://phlebotomygeeks.yolasite.com/resources/PRINT OUT COMMON TUBES.pdf

    • but color is manufacturer dependent, whihc is why we named the tubes by the additives

    • there are container types in SNOMED under 706049005 |Blood tube (physical object)|

    • Need to check on completeness against the Anne/Nancy list

    • Have a start here: https://aphlinformatics.atlassian.net/wiki/download/attachments/2018312270/ContainertypesListRikiEmailed20171013.xlsx?api=v2

• GraftTissue vs graft site

  • updated the definitions for both

  • the way we are modeling is the way we want folks to model

  • in SCT there are 2 terms

    • specimen from graft - example a clot from a graft

    • graft tissue from patient - that’s what we use for the poplieteal graft

Specimen CMT - Hosting Options

• How can we publish the content in the dB?

  • Allow access somehow to query the dB

  • as access or excel

  • Using FHIR conceptMap similar to Conceptmap-example-specimen-type - FHIR v6.0.0-ballot2 - based on this profile: ConceptMap - FHIR v6.0.0-ballot2

  • @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-ballot2 . 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.

Specimen CMT - education

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

Specimen CMT - Compare to NHS Medical Terminology testing

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