Upcoming OOO | | |
CSTE Presentation | Riki - no update | |
LOINC SNOMED Extension Follow up | | Charlie Harp on common uses of generic LOINCs: ) I can take a look at the data as I believe we can extract unique codes from the data. Do you only want codes that have a LOINC pattern or all codes? If I can pull code system, code, description, original text and incidence count would that work? I will check with my team if so. - my answer: We were thinking just the generic LOINCs, but if you can expand to find common non-LOINC concepts that we should request LOINCs for, that would be great! Use cases to support release of LOINC part code to SNOMED CT concept mappings Waiting for input from Keith Campbell (SOLOR/KOMET) - direct outreach to NIH Charlie Harp email response: We have not incorporated the LOINC to SCT relationships into our mapping process yet. We had experimented with the “unofficial” parts model in the past. I would be interested in a discussion on the potential uses of this content including other members of my team. I have considered this model for creating plausibility checking content for validating LOINC code and specimen SCT code in lab result messages. There are other types of Lab plausibility checks (like unit and value checking) that we are also considering for PIQI Input from Labcorp: The LOINC Scale Type of Ordinal, Nominal, Quantitative and Narrative do guide our selection of SNOMEDs for results. I am not aware of any use cases.
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Specimen CMT - review of terms with questions | Christina/Amy | Follow up items: Is there a difference in techinque for the corneal impression vs corneal impression smear? gel separator and clotactivator tube - is a single product - cannot purchase as separated entity, so should not model as separate additives evacuated blood tubes are modeled as physical objects, so would need to use SPM-27 (Specimen container), not sure how many would support that, in LOI this is O, so we should make change request to make RE - if needed often asked as AOE we have used container types in SPM-5 in 2 instances - for Blood_potassium_EDT and for Papsmear_ let’s ask Jen from Arup, who submitted the blood tube types how she is using these (if only in compendium, or expecting to come in as part of order) - Riki to do
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SCT hierarchy for methods | ask John | Observation method the thought was to map to techinque hierarchy - background from email here: A decade ago we didn’t have the LOINC/SNOMED collaboration with a SNOMED Extension, so mapping to the procedure hierarchy made perfect sense. Fast forward to where we are today.The most useful way to handle this would be to map to the “Technique” attribute value range. Right now that attribute is restricted to referencing concepts in << 272394005 |Technique (qualifier value)|, however as we get into the clinical and radiology domain, I can see that range constraint being expanded to include << 129265001 |Evaluation - action (qualifier value)| in order to pick up the imaging method (i.e. MRI, CT, US, etc.) and possibly but unlikely other subhierarchies in the qualifier value hierarchy Specimen collection (SPM-7) should be from procedure hierarchy, correct? - yes. but not all are under specimen collection method; the biopsies and surgical removal are under 118292001|Removal (procedure), so that should be the top level term. |
Creating Value Sets for specimen related attributes | John - no update | US valuesets should be in VSAC for all clinical care Value sets that are used in HL7 should be in International RefSets (and are probalby easier to migrate, if they aplready exist in VSAC (but would need to make sure we promote US extension terms first) Specimen reject reason table review - specimen calls on Mondays 2 PM - started a zulip chat to ask for input: <ADD LINK> Containers (EU review work might have some new content - Reached out to Feijke for update) Additives Riki to set up her VSAC authoring log in
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Previous Action Items | Not discussed | |
Specimen CMT - Hosting Options | | How can we publish the content in the dB? SNOMED CT Extension and use of RefSets (start with VSAC value sets as proof of concept and then migrate over) to indicate: 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
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Specimen CMT pilot implementers | | |
Specimen CMT - education | | Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration -this can be supported / accomplished? with the Implementaiton Guide we could write 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
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Specimen CMT - tracking implementation impact Setting baseline Define metrics
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Specimen CMT - Compare to NHS Medical Terminology testing | | Will get updated vocab at a later date |
Future projects for this call after CMT | | |