2023-11-30 LabMCoP Meeting Notes

X

Jim Case

Snomed International

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

X

John Snyder

National Library of Medicine (SNOMED CT)

Andrea Pitkus

UW

 X

Kathy Walsh

Labcorp

Rob Hausam

Hausam Consulting

Doug Franklin

APHL

Pam Banning

 3M

Upcoming OOO

Y

• Riki 12/6, 12/20 - 12/22

• Raj 12/13-12/15?, 12/19-12/31?

• Amy 12/15-12/20 and 12/25-12/29

• Nancy 12/18 - 1/1

• Manjula 12/14

• APHL Closed 12/27 - 1/1 - will cancel the call for 12/28

Previous Action Items

Y

• Nancy Follow up

  • Can only have 1 bodysite in HL7, but these are from different sites - find out how often cervix + Fornix are collected together

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFornix

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFornixSlide

    • Labcorp allows multi-select - they use AOE question for this, so add as comment with specific

  • need reference to thin prep (request new term with parent cytology specimen container (physical object) for liquid-based cytology container) - need ot look up what the liquid is

  • adhesive tape prep (from Mike Miller’s book):

    • gummed surface pressed against the perianal region of the patient (after separating the buttocks)

    • procedure: currently transparent tape method for fungal identification - need to update that mapping; test is for pinworm eggs

  • nasal sinus fluid definition

  • surgical insertion site peritonealDialysisTunnelSite

  • surgical insertion site peritonealDialysisSite

• Riki’s Follow up:

  • 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

  • submit a code for formalin10

• Open homework EDTA Stopper top

  • 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

    • K1 or K2 might be important to differentiate

Modeling wound causation

Y

• In SNOMED bites are modeled as disorders

• the specimen model does not include disorders, propose to send elsewhere in the message

• specimen source identity can be physical object / physical force / morphologic abnormality / organism

• in SNOMED disorder ‘due to’ is modeled as event for bites

• outside of animals other causess for wounds are physical (heat, stabbing) or chemical

• other aspects of wound already using SPM-5 to describe morphiology like deep or superficial wound, but it repeats, so could still use

• All wound terms will be partial, as location of wound must be documented by the lab (even if it doesn’t neccessarily affect result interpretation, it can affect properly attribution of result, if more than one wound is being sampled at the same time)

• sending elsewhere in the message = OBX under the Order = Ask at Order Entry (AOE) - is really at collection

  • AOEs are often defined by individual orgnaizations

  • for some tests there are stnadardized AOEs available (like pap smear) - we could provide these here along with the appropriate suggested extensible value set

  • we would need to find or request LOINC to encode cause of wound

• We might want to 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

Modeling donor organs / parts

Y

• Outreach out to Jane Pollack (jpollack@nmdp.org) at NMDP. was successful - schedule call for this topic - waiting for answer on what date will work

• Should we make pre-coordinated terms, or support use of type modifiers?

Specimen CMT - review of terms with questions

 N

Specimen CMT pilot implementers

 N

• Review where we are: Vendor Connections

Specimen CMT - Hosting Options

 N

• 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.

Specimen CMT - education

N

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

N

Specimen CMT - Compare to NHS Medical Terminology testing

N

USCDI v5 comments

N

United States Core Data for Interoperability (USCDI)

LOINC to SNOMED CT mapping

N

Reporting Biomarkers to Cancer registries

N

National Program of Cancer Registries (NPCR) | CDC

Sandy will put together a one-pager

Future projects for this call after CMT

 N

• 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