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Next call is July 17th, 2025? - APHL week - no Christina or Riki
Specimen CMT - SCT submission terms
John
Substance term for fibrocartilage tissue to support speicmen type of cartilage
Sodium-polyeathanol sulfanate (SPS) susbstance - it is an additive
specimen from cardiac device insertion site:
have term one for tissue and one for body fluid
is pocket the same as insertion site (or is insertion site a larger concept?
or could we leave the specimen term as insertion site and just use the morphological abnormality to indicate the pocket (1162882002)?
but if we don’t have that populated, what does that mean then, just the insertion site (when close to the surgery) = maybe use surgical insicsion wound (609343002) as morphologic abnormality
cardiac implanatable device includes pacemaker, defibrilator, maybe some others
corneal impression specimen
smear is a procedure where the sample gets squashed / smeared between 2 slides, while the touch-prep = tissue impression just touches the tissue to the slide to preserve the anatomical structure
current term 708285007 - inactivate this concepts and add 2 new concepts
one would be a tissue smear
one would be the touch-prep / impression
Nancy will ask her cytopathologist friend about how many procedures are out there
do we want to create a more generic term that we then indicate the body site for - so “CornealImpression” would become tissue touchprep_Cornea
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
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:
Chat:
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