2026-04-23 LabMCoP Meeting Notes
Date
Apr 23, 2026
Attendees
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 |
X | 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 |
| Diego Arambula | CDC |
Upcoming OOO |
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Working with DHQP for NHSN reporting | Nancy | discussing lab data flows for lab data when coming into the EHR-s; sometimes often? EHR-s will re-map LOINCs that come in, or also remapping organism names when there is a post-cooridnated expression is expected in report outs (like HAI, for drug-resistant organisms) NHSN has some real world data - most are reporting blood cultures as Observations, which they should, most were using LOINC in Observation.code and in Observation.valueCodeableConcept with associated SCT code in results (would be interested how these are codified - as pre-coordinated organism or with multiple Observations one for organism + susceptibility result) - it may be both, as they can take more than one Observation per specimen. they are getting Resistance testing related LOINCs, for example: https://loinc.org/49617-4 NHSN would also like to get information about volume collected - that is not in a standard place in the HIT system; the lab records the volume they get - they could also get this in via the order, but it would not be the preferred method; it should originate in the lab; there are some instruments that provide it = Observations rather than part of the Specimen resource, where we have a place for it. BD and Biomerieux are the main players in this space; current LOINC could be: https://loinc.org/3157-5 - wonder if we want to have a Blood culture specific LOINC (this is really on the container, so should that we kept out of the volume concept? SNOMED Observable is less granular What is the preferred place? = Specimen.Collection.Quantity - this does not support methodology of gathering the volume (estimate vs measured?) need to look where this would be in the V2 - especially if not yet using SPM segment where are vendors currenlty storing specimen volume? Ask in SHIELD one stick that gets then aliquoted into 2 bottles - in the lab those are considered a set Does Biomerieux combine the volume result from both bottles, or a single bottle? Container question for specimen call: include a blood culture bottle for the example of Specimen + SpecimenDefinition there are CLSI recommendations about differentiating pediatric vs adult containers (based on weight), but there should not be an issue with using adult containers; Nancy’s group is focusing on 18 & older for now Follow up list: Which lab test is NHSN getting results for? Any lab test that is in the EHR-s for qualifying encounter during that calendar month (emergency, inpatient at acute care hospital) Urine culture results for HAI |
Call Adjourned |
| 12:04 PM EDT |
Specimen CMT - Hosting Options | not today | Any Updates on FU with: Clinical Architecture: ONC: |
Specimen CMT terms | not today |
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CMT Governance process | not today |
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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:
User Guide starter Specimen Cross-Mapping-Table (Specimen CMT) |
Follow up items | not today |
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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
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: Confluence page: Ask if Rob can keep us updated |
Specimen CMT pilot implementers | not today |
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Specimen CMT - education | not today |
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Specimen CMT - tracking implementation impact
| not today |
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Future projects for this call after CMT | not today |
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Recording:
Not recorded
Chat:
Postcall email: Regarding the recent blood culture discussion, I came across this from an Epic Beaker user: https://github.com/hendersonsa793-healthcare/epic-beaker-lab-portfolio/blob/main/05_beaker-lis-case-studies/blood-culture-reflex-workflow-design.md
Basically, their Beaker LIS workflow/build did not match laboratory practice in that it required culture plate details prior to detection of a positive blood culture bottle (which doesn't make sense.) If a bottle isn't positive, it is signed out as no growth without further testing. The reflex orders for the gram stain, culture plates, and organism identification/workup are added to the positive bottles.
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