2025-06-05 LabMCoP Meeting Notes

2025-06-05 LabMCoP Meeting Notes

Date

Jun 5, 2025

Attendees

 

Present

Name

Organization

Present

Name

Organization

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 - regrets

UW

X

Kathy Walsh

Labcorp

 

Rob Hausam

Hausam Consulting

 

Pam Banning

 3M

Discussion topics

Upcoming OOO

 

Specimen CMT - SCT submission terms

John

  • can link all specimen to cytopathology procedure via the procedure attribute, but since speicmen can be used for more than just this

  • how could we look up based on collection method - only using value set constrained searches are possible, rather than relying on SCT modeling constraints

  • bodyfluid from insertion site - wanted a generic term, where we would then use the SPM-5 to identify the type of inserted thing

    • have morphologic abnormality for “insertion site”, which has children that all are drains or catheters, but all are non-tunneled - John would not want to have pacemaker in there, because a pacemaker insertion site is surgical, creating a pouch, which can get infected

    • could we differentiate between tunneled and non-tunneled here?

    • collection is via aspirate or swab after cleaning the surface

    • tunneled are usually created for long-term care for repeated medicine administration to reduce the risk of infection

    • SNOMED CT currently does cover the tunnel / non-tunneled in the physical device hierarchy, which would mean they are different products (tunneled catheters have a cuff (small ring around the catheter) that allows skin to grow around it)

Creating Value Sets for specimen related attributes

John

  • in VSAC we can create a grouping value set, that can group all indiviudal value sets that will fall under anatomic pathology; each indivdual value set can have an intestional definition, so that new concepts in the defined hierarchies will be added with new updates to SCT

  • PHIN-VADS can also be used for creating value sets

  • Specimen reject reason table review - review the “unsatisfactory for evaluation due to …” concepts

Call Adjourned

 

Next call is June 12th, 2025

LOINC common maps

 Not discussed

 

Previous Action Items

 Not discussed

Specimen CMT - Hosting Options

 Not discussed

  • 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

  • SNOMED CT Extension and use of RefSets (start with VSAC value sets as proof of concept and then migrate over) to indicate:

    • preferred specimen types by domain

    • maybe also terms that need additional attributes (by kind of attribute) if we also write an implementation guide for it

  • 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 pilot implementers

 Not discussed

Specimen CMT - education

 Not discussed

  • 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

Specimen CMT - tracking implementation impact

  • Setting baseline

  • Define metrics

 Not discussed

 

Specimen CMT - Compare to NHS Medical Terminology testing

 Not discussed

 Will get updated vocab at a later date

Future projects for this call after CMT

 Not discussed

  • 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:

  • @riki.merrick

Goals

  •  

Discussion topics

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Presenter

Notes

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