2023-09-28 LabMCoP Meeting Notes

Date

Sep 28, 2023

Attendees

Present	Name	Organization
X	Nancy Cornish	CDC
X	Manjula Gama-Ralalage	CDC
X	Riki Merrick	APHL
regrets	Christina Gallegos	APHL
X	Amy Liu	Inductive Health / APHL
	Raj Dash	Duke / CAP
X	John Snyder	National Library of Medicine (SNOMED CT)
	Andrea Pitkus	UW
X	Kathy Walsh	Labcorp
	Rob Hausam	Hausam Consulting
	Doug Franklin	APHL
	Pam Banning	3M

Discussion topics

Topic	Discussed?	Notes
Upcoming OOO	Y	Riki OOO 9/29; 10/6; 10/20-11/5 LOINC conference: 10/17-10/20 = 10/19 - leave on calendar for Amy and Nancy SNOMED Business meeting 10/21-10/25 and Expo 10/26-10/27 = cancel call on 10/26 - leave on calendar for Amy and whoever can make it John OOO 10/19 and 10/26 Pam OOO 10/19 Andrea OOO 10/19 Nancy - government shutdown
Previous Action Items	Y	Modeling exposures on ~~wounds~~ (organ donors) Nancy reached out to Bob Milius and Joel Schneider - no answer also reached out to UNOS - Maya Webber - have sent explanatory email - Nancy will forward email to Riki and Andrea - she mentions “we collect laboratory data per OPTN specifications” Nancy to follow-up one more time with Bob and Joel Need SCT for liver, kidney potential transplant biopsies - sometimes it is wedge biopsy Do we need SCT code that delineates donor before transplant is in the recipient? There is allowance for donor in pre-coordinated concept in SNOMED Identify donor organs that are transplanted (identify the donor organ before it is transplanted) “Organs that have been successfully transplanted include the heart, kidneys, liver, lungs, pancreas, intestine, thymus and uterus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, nerves and veins” including bone marrow will need additional information, reference material, use case, etc. 105455006 \| Donor for medical or surgical procedure (person) - or a descendant that is more appropriate for the speicmen type could be used in SPM-5 as a specimen type modifier when creating a prototype, since we cannot account for every possible organ or tissue type (would have to figure out how to represent that in the CMT) or use specimen hierarchy term that is for the type of donated material - blood / organ / tissue and then require SPM-8? Riki to write up a few examples and bring back next week CMT one-pager was shared with Sandy Jones - also have them for SNOMED Expo ComboCytologicalMaterialfromEndocervixEctocervixVaginalFormix specimen with two different body structure/site - how to handle this because only one is supported in HL7 v2? Which body site do we choose? depends on whether you are collecting a biopsy, brush, etc. may need guidelines for where you collect the specimen Nancy to follow up with OB/GYN ComboCytologicalMaterialfromEndocervixEctocervixVaginalFormixSlide pap smear sample for SPM-5 should we be using cervical cytology microscopy slide or microscope slide? use the microscope slide - since that doesn’t really change or is there something special about the slide? - Nancy to review come back to review body site Pap Testing Liquid Sample need reference to thin prep need to request new term with parent cytology specimen container (physical object) for liquid-based cytology container --Nancy to look this up and ask the new cytologist at CDC Pericardium tissue_biopsy this has a different definition than the term above added definition micro domain check to see if it is in the path domain submit as tissue from pericardium, for specimen type comment Need more info on retracting pus - most of the articles around pus are patient information -so far have not found articles that indicate that you cannot discern pus from necrosis without microscopy
USCDI v5 comments	Y	United States Core Data for Interoperability (USCDI) Have call set up with Maria for Monday at noon - reuqest to include Manjula
Reporting Biomarkers to Cancer registries	N	National Program of Cancer Registries (NPCR) \| CDC Sandy will put together a one-pager
Specimen CMT - review of terms with questions		Plasma emove the comment about biologic product - we are not yet addressing that yet Heparin_gel tube thsi si the container term: 767390000 \|Evacuated blood collection tube with heparin lithium and gel separator (physical object)\| - is not modeling the substances of the physical object, so we still need to submit for separatror gel (need to get a link to the manufacturer info) - inert acrylic gel; polymer gel = Nancy to email to Riki Scotchtape prep Nancy to get the definition for scoth tape swab from Mike Miller’s book Scratchwound exposure type solution - Riki to check with Jim, if he can join a LabMCoP call Serum in silicone coated tube chemistry silicone is helping with clotting; could also be on the stopper Serum_Clotactivator use the same as the gel for heparin_gel tube need substance for clotactivator, which seems to be silicone particles applies to 2 domains nasal sinus fluid definition Nancy to provide surgicalInsertionSite_Pacemaker need to digest the other referenced articles for any more text needed for the definition or the comments we also need a new term in SCT there are only swabs for insertion sites (line, drain, chest tube, vascular catherther) we should model it after 435971000124108 \| Body fluid specimen from peritoneal dialysis insertion site (specimen) Open homework EDTA Stopper top https://phlebotomygeeks.yolasite.com/resources/PRINT OUT COMMON TUBES.pdf but color is manufacturer dependent, whihc is why we named the tubes by the additives there are container types in SNOMED under 706049005 \|Blood tube (physical object)\| Need to check on completeness against the Anne/Nancy list Have a start here: https://aphlinformatics.atlassian.net/wiki/download/attachments/2018312270/ContainertypesListRikiEmailed20171013.xlsx?api=v2 K1 or K2 might be important to differentiate
Specimen CMT pilot implementers	N	Review where we are: Vendor Connections
Specimen CMT - Hosting Options	N	How can we publish the content in the dB? Allow access somehow to query the dB as access or excel or csv Using FHIR conceptMap similar to Conceptmap-example-specimen-type - FHIR v6.0.0-cibuild - based on this profile: ConceptMap - FHIR v6.0.0-cibuild @riki.merrick to ask Eric if he still has that or how he built it: ANSWER FROM ERIC: if you look in the xml source Conceptmap-example-specimen-type.xml - FHIR v6.0.0-cibuild . you can see how it is mapped. I am not sure if you mean the table rendering or creating the concept map from a spreadsheet or CSV file. The FHIR build tool did the table rendering for that mapping, I think I entered the data by hand, or Grahame did it. It would not be hard to create a script to create a concept map from an excel or csv file if needed. The table needs to be large enough to make it worthwhile though. you could even create formula cells in the spreadsheet to generate the XML or json for each item. and then copy to a text editor and append to the Metadata fields.
Specimen CMT - education	N
Specimen CMT - tracking implementation impact Setting baseline Define metrics	N
Specimen CMT - Compare to NHS Medical Terminology testing	N
Future projects for this call after CMT	N	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

Recording:

https://youtu.be/juMWSYHXQt0

Action items

Type your action, use '@' to assign to someone.

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.

Add a decision…

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.

Create from Template