Atlassian uses cookies to improve your browsing experience, perform analytics and research, and conduct advertising. Accept all cookies to indicate that you agree to our use of cookies on your device. Atlassian cookies and tracking notice, (opens new window)
NOTE: you will need to use type “Event” if you do not have a confluence account
CSTE Presentation
Riki
CSTE ELR call presentation on wound cultures and Specimen CMT (modeled for ELR) by Nancy, Riki, and Manjula has been postponed to a TBD date later
European Lab related Vocab
Riki
European Lab Terminology group working on finalizing their list of containers and asking for review - no update
Specimen CMT - review of terms with questions
Christina/Amy
Revisit remapping SPM-8 for the woundfluid from ileostoma
is the wound on abdominal cavity vs the ileostoma?
most common: at juncture of abdominal wall and intestine
skin wound
intenstinal wound
Lymphfluid drainage
need to request synonym for lymph fluid sample for 168145009
Serum sample
decided to use the generic SCT term - in clinical practice the most common would be to have the patient, so will NOT use SCT specific to “from patient”, where available
LOINC has the system ^Donor, so we might want to have donor specific
serum, ser/pl, marrow, blood, XXX (so that would be the problem)
those are probably used to map to the Donor crossmatch testing for example
use of SPM-5 to indicate donor or pre-ccordinate terms?
Most systems already have a way to track that specimen is from a donor, for example in the patient demographics or by using specific identifiers on the spamples indicating it is from donors
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
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 (though they do not have the SCT codes included in the past - may be including SNOMED CT starting in 2025, but they are also using the SCT codes for observables) Synoptic reporting for cancer surgery: Current requirements and future state: The four CoC accreditation standards that include synoptic operative reporting requirements apply to sentinel lymph 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), and colonic resection for colon cancer (Standard 5.6). These accreditation standards were developed from the evidence-based recommendations for cancer surgery detailed in the Operative Standards for Cancer Surgery manuals.7,8
try to get AMA support to get providers to adopt this
Reach out to IDSA, too
Specimen CMT - education
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
Specimen CMT - tracking implementation impact
Setting baseline
Define metrics
Specimen CMT - Compare to NHS Medical Terminology testing
Will get updated vocab at a later date
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.)
Recording:
Per APHL policy we are not currently allowed to record any meetings
From Chat
Action items
Quick decisions not requiring context or tracking
For quick, smaller decisions that do not require extra context or formal tracking, use the “Add a decision…” function here.
Decisions requiring context or tracking
For decisions that require more context (e.g., documentation of discussion, options considered) and/or tracking, use the decision template to capture more information.
