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
Next calls: Jun 19, 2025 cancel call; Riki is out Jun 26, 2025, Nancy out 6/19- 6/30, Amy is out 7/3
Specimen CMT - SCT submission terms
John
bodyfluid from insertion site resolution - did Nancy’s answer from last week resolve this? Hold until next week
can get fluid or tissue from the pacemaker pocket
will create a pacemaker specific term for body fluid and one for tissue from pacemaker insertion site or pacemaker pocket? - a pocket concept does not exist in SCT, would be modeled using
SNOMED also has pacemaker and pacemaker lead (would probably also have tissue on it (will be put in broth culture) as specimen (which when taken out, received at pathology lab and then forwarded to the manufacturer)
What about the medication port (bubble under the skin to administer recurring medication for example for cancer patients) - do we have a term for that?
Looking at the references provided, one reference identified a group of devices as “Cardiac implantable electronic devices” and this caught my eye. The following concept was added to SNOMED in 2021:
Touch prep (add as a synonym)- under PHLIP pref name “tissue impression smear”
Descriptions “touch prep” and “tissue impression smear” have the same PHLIP pref name of “smear_tissueimpression” - not sure if synonym should be for tissue impression smear since they are different
“tissue impression smear” is different from “touch preparation smear sample”
Hold until next week - John will create a request a new concept “touch preparation specimen”
fibrocartilage component of connective tissue (for term Cartilage)
add as a child of “connective tissue”
specimen substance does not recognize body structure - cartilage term request into substance hierarchy, but do we need to specify component of connective tissue or fibrocartilage tissue?
Hold unto next week
Cellsave Formula (product) “submit for new term in product hierarchy”
do we need additional synonym that will look like “cytology tube with Na2EDTA and polyethylene glycol” - yes
new term to be added: “Antigen of Mycobacterium tuberculosis (substance)” and added under parent concept “microbial antigen”
may need to map to substance and physical object device
Creating Value Sets for specimen related attributes
Not discussed
Specimen reject reason table review - review the “unsatisfactory for evaluation due to …” concepts
Call Adjourned
12:05pm
Next call is July 3rd, 2025
LOINC common maps
Not discussed
Previous Action Items
Not discussed
Andrea follow up:
Ask Stacy Robinson at ASCLS for clarification about Touch prep, vs squash prep vs smear
Nancy Follow up:
Pulling together the wound specimen presentation for CSTE ELR call on Sep 2, 2025 with Riki and Manjula
Additives (Nancy reviewing the stool preservatives)
EDTA Stopper top
EDTA sufficient or do we need to specify K2 or K3? - yes!
Nancy can review the list in SNOMED from John
Need to check on completeness against the Anne/Nancy list (compare with ARUP)
Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists
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
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) https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2021/12/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
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 https://infobeta.cap.org/shield/
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:
not currently done
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.
