2026-04-16 LabMCoP Meeting Notes

2026-04-16 LabMCoP Meeting Notes

Date

Apr 16, 2026

Attendees

Present

Name

Organization

Present

Name

Organization

X

Nancy Cornish

CDC

X

Manjula Dharmawardhana

CDC

X

Riki Merrick

APHL

X

Christina Gallegos

APHL

X

Amy Liu

Inductive Health / APHL

 

Raj Dash

Duke / CAP

-

John Snyder

Pragmatic Terminologies, LLC

X

Andrea Pitkus

UW

X

Kathy Walsh

Labcorp

 

Rob Hausam

Hausam Consulting

 

Pam Banning

 3M

 

Elissa Passiment

 

X

Kristina Betz

CDC - NHSN

X

Diego Arambula

CDC

Upcoming OOO

 

Working with DHQP for NHSN reporting

Nancy

Brief introduction to the Specimen CMT

NHSN Digital Quality Measures using FHIR - single data stream once a month from hospital with ER or in-patient encounter for CMS requirements

calculate glucose drop after insulin medication, sepsis mortality, HAI bacteremia, C diff treatement - see https://www.cdc.gov/nhsn/fhirportal/index.html and subpages

using LaboratoryObservation (QI Core) 6.0.0, DiagnosticReport (QI Core), Specimen (USCore)

Narrative section in FHIR resources - not sure that is correct - that applies to CDA

note that CLIA requires the test name, which US Core does not support until 8.0.0

NHSN requires standard codes to be used for this - LOINC valueset for each measure

assume acute care hospitals will have to start reporting in 2028 - so that is the scope for the FHIR servers (assume EHR-s), but they will have to have coded lab results from reference labs in their system (which will need to be in V2 for now)

LOINC list for blood culture - consider reviewing for any others available in LOINC

Value set for specimen for each of the tests in the quality measure

would it be helpful to identiy the preferred/acceptable SCT for the specimentype

will continue the conversation next week

Call adjourned

 

12:03 PM EDT

Specimen CMT - Hosting Options

Riki

Any Updates on FU with:

Clinical Architecture:

ONC:

Specimen CMT terms

not today

 

 

 

CMT Governance process

not today

 

CMT proposed maintenance process

not today

Start writing this up on this confluence page: Specimen CMT Update Process

Questions from Zulip thread that should be covered by the process we come up with here:

  1. Requests for terms used in practice that are not yet in the Cross Map Table?

  2. Requests for any corrections or needed updates to terms?

  3. What type of version control will be leveraged for releases and major/minor updates?

  4. How do you plan to incorporate SNOMED CT Release Updates into Cross Map updates/releases?

  5. At what frequency will updates occur? For example, will you process SCT updates once yearly and have a subsequent Cross Map release yearly with changes or more or less often?

  6. How do you communicate differential changes between releases? Is a differential file produced or is it expected that users will be able to find changes on their own?

  7. What type of customer support for downloads is expected? Will the release entity provide or is it expected of the site hosting the content for download? Both need to work colLABoratively to ensure no blockers arise for users/consumers.

User Guide starter Specimen Cross-Mapping-Table (Specimen CMT)

Follow up items

not today

Lab tests as procedures or orderables

Do we still need this?

Recommendation by SNOMED is that the Observable entity hierarchy be used for both ordering and resulting. 

As for the technique hierarchy, that in no way is intended to be used for either ordering or resulting laboratory tests.  Those concepts are used to model both observables and procedures.  

SNOMED LOINC extension: https://browser.loincsnomed.org/?perspective=full&conceptId1=363787002&edition=MAIN/LOINC/2025-09-21&release=&languages=en

The problem is that major EHR-s vendors have set up CPOE using Procedures for orders to initiate a workflow (that creates the triggering event in the system) - that’s where the push-back comes from.

There is a CPT to SNOMED CT mapping (as a paid mapping available from AMA), but no LOINC mapping.

Can we reach out to CAP Informatics, ADLM Informatics and ASCLS Informatics to get their take on where Lab tests should live

We had said we would work through the Colonoscopy example:

Reference links:

clinical guidelines: Official journal of the American College of Gastroenterology | ACG

Quality Indicators: Official journal of the American College of Gastroenterology | ACG

  • For CAP cancer reporting is using SNOMED CT - would be good to look which they chose to represent the performed lab test

There is this question in the LOINC Community: https://forum.loinc.org/t/assistance-creating-a-value-set-for-all-loinc-procedure-concepts/2993

it is related to this US Core FHIR Change request: https://jira.hl7.org/browse/FHIR-54415

Answer to this one is that in USCDI Procedure (https://isp.healthit.gov/taxonomy/term/781/uscdi-v6) does not list LOINC as applicable Vocab standard in any verion, so remove it.

Often folks think of lab tests as procedures, because they can be ordered in CPOE (and outsidde the US, in the UK for example that’s how folks have modeled those, which is why LOINC was adding more of the high level order codes in 2.81 release, so we still should tackle the LOINC community question.

John was working on creatign an intesnional valueset definition based on class + type and maybe a few other attributes

European Semantic work

not today

Link to the German FHIR IG around suceptibility testing:

https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fsimplifier.net%2Fguide%2Fars-implementation-guide%3Fversion%3Dcurrent&data=05%7C02%7Criki.merrick%40aphl.org%7Ce11e8daf7f2d4827d07808ddcac8861c%7C434e0aedef824568a0493b17adc08ddd%7C1%7C0%7C638889684844672822%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=kZJRoBl2tMQzWQoYVkaRnEUaaBxepA9sAIu1myDQMyo%3D&reserved=0

Semantic Example section: https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fsimplifier.net%2Fguide%2FARS-Implementation-Guide%2FHome%2FSemantics%3Fversion%3Dcurrent&data=05%7C02%7Criki.merrick%40aphl.org%7Ce11e8daf7f2d4827d07808ddcac8861c%7C434e0aedef824568a0493b17adc08ddd%7C1%7C0%7C638889684844702198%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=qQH%2Ff5xwG0O8DvNE4rbjZineXBhY%2BiOWmN047DRthNQ%3D&reserved=0

Confluence page:

Ask if Rob can keep us updated

Specimen CMT pilot implementers

not today

Specimen CMT - education

not today

  • 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 today

 

Future projects for this call after CMT

not today

  • 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

Recording:

If you are interested in the recording, please email riki.merrick@aphl.org

Chat:

11:16:06 From Andrea Pitkus : Also these details could be exchanged in messaging across different parts of workflow (eg orders, results reporting, ph)
11:24:58 From Andrea Pitkus : I presented to ASCLS national mtg a few years ago.
11:54:58 From Andrea Pitkus : If folks are not familiar, this is what we've been discussing: https://semver.org/#:~:text=The%20version%20format%20for%20Semantic%20Versioning%20is,version**%20Indicates%20that%20the%20version%20is%20unstable
12:00:41 From Andrea Pitkus : Is there a user guide describing terms, usage, details. we've been discussing?
12:02:23 From Manjula Dharmawardhana (CDC) : Reacted to "describing terms, us..." with 👍
12:04:00 From Andrea Pitkus : sacher torte

Action items

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