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2026-05-14 LabMCoP Meeting Notes
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2026-05-14 LabMCoP Meeting Notes

Date

May 14, 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

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

X

Jake Bunn

CDC

X

Marissa McMeen

CDC

Upcoming OOO

 

  • Reminder: We are now using https://aphlinformatics.atlassian.net/wiki/spaces/LMCOPL/calendars and everyone can just keep it updated

    NOTE: you will need to use type “Event” if you do not have a confluence account

  • Riki not available May 28, 2026 - what do folks want to do?

Working with DHQP for NHSN reporting

Nancy

Follow up list:

  • Urine culture results for HAI requriements

  • Gather current means to record bottle volume

Discussion today:

  • Review the workflow slide Nancy created

    • 1 set = 2 bottles

    • LOINC for blood volume = 3157-5 is not specific to blood culture bottles - do we want 1 LOINC for that, or do we want LOINCs for ^1st bottle, ^second bottle etc?

      • what if we get more than anticipated, would need new LOINC, might be better to have an element for bottle# in set and link to the more generic LOINC?

  • Looking at data:

    • should get coagulase negative Staphyloccous, but when folks use MALDI, they get all sorts of non-human species listed as well, though all of those are coagulase negative

    • the LOINC for volume is not in the data

    • Finding the CPT code in

      • ServiceRequest.code

        Image20260514111149.png

      • DiagnosticReport.code

        Image20260514111335.png

      • interesting that the descriptions vary so widely

      • some labs might append additional digits to the CPT code to create local code for the differnet more specific orders - maybe search data for CPT+wildcard symbol? if found shoudl double-check that they don’t actually are a code in a different code system (using NLM metathessaurus)

      • have seen more than one accession number per bottle - could happen, if sent to reference lab, so imporatnt to record not just the number, but the assigner of the ID (is part of the FHIR datatype)

      • we should have accession# + Specimen# (or Container#) - 1 accession# per set

        Image20260514113539.png

  • NHSN is taking the data from EHR-s, so need to consider how it gets there - some hospitals will have same vendor for EHR and Lab side, so same dB, they should be able to pull some of these data, but when that is not the case, we need to ensure we can support LIS sharing the data elements with EHR-s in a standard way, so the LIS woul dneed to have all the elements required by the IG

  • NHSN IG: https://measures-ci.nhsnlink.org/artifact-listing.html with these artifacts that cover all modules

  • what about the denominator values - those are not in the LIS per Andrea

  • there are different ways this gets calculated/tored - might be in lab, but not in LIS, could be in infectious disease reporting module in EHR, and not in LIS at all; for current reporting under the different accredidation bodies it is just the conatmination rate that is shared

Next Steps:

  • get input from Biomerieux about volume handling

  • ask SHIELD for input how labs record it now

  • Kristy will share data with Nancy, so she can help review as well

Call adjourned

 

12:00 PM EDT - below not discussed

Specimen CMT - Hosting Options

Riki

Any Updates on FU with:

Clinical Architecture: They could create conceptMap baed on the content model they built, need to follow up about FHIR server usage

ONC: Pull up email from Carmela

Specimen CMT terms

Christina

only NHSN terms left for questions:

 

CMT Governance process

 

 

CMT proposed maintenance process

 

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

 

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

 

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

 

Specimen CMT - education

 

  • 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

 

 

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

Recording:

 

Chat:

Since my computer crashed twice during the call, there is no recording and no chat

 

Action items

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