Date

​Oct 4, 2023

Present

Name

Organization

X

Nancy Cornish

CDC

X

Manjula Gama-Ralalage

CDC

X

Riki Merrick

APHL

X

Christina Gallegos

APHL

X

Amy Liu

Inductive Health / APHL


Raj Dash

Duke / CAP

X

John Snyder

National Library of Medicine (SNOMED CT)

X

Andrea Pitkus

UW

X

Kathy Walsh

Labcorp

 

Rob Hausam

Hausam Consulting

 

Doug Franklin

APHL

 X

Pam Banning

 3M

Discussion topics

Topic

Discussed?

Notes

Upcoming OOO

Y

  • Riki OOO 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 10/12, 10/19 and 10/26

  • Pam OOO 10/19

  • Andrea OOO 10/19

  • Amy 10/12

  • Nancy 10/12,

  • will cancel 10/12

Previous Action Items

Y

  • Modeling donor organs etc)

    • Have new contact at NMDP - Jane Pollack (Bob Milus retired)

    • Example modeling

  • Nancy Follow up

    • Serum separator tube:

      • Serum-separating tubes, also known as serum separator tubes or SSTs, are test tubes used in clinical chemistry tests requiring blood serum.

        SSTs are sometimes called "marble-top tubes", "tiger-tops", or "gold-topped tubes", referring to the stoppers which are either gold, red with a gold ring on top, or marbled red and grey. The stopper of SPS (sodium polyanethol sulfonate) tubes have a paler yellow colour, sometimes causing confusion; these are known as "yellow tops" not "gold". Trademarked versions of the SST include Covidien "Corvac" tubes.

        The tubes have micronized silica particles which help clot the blood before centrifugation, and a gel at the bottom which separates whole blood cells from serum.[1]  Silica nanoparticles induce coagulation through contact activation of coagulation factor XII (Hageman factor).[2] The silica particles are desiccants, which adsorb and hold water vapor.[3]  This is used in the tubes so the blood adheres to the surface of the tiny silica particles and begins to clot. After the blood sample is centrifuged, the clear serum should be removed for testing.[4][5]

        These tubes should be used with care when measuring drug or hormone levels because the drug or hormone may diffuse from the serum into the gel, causing a reduction in measured level. The gel in SST II tubes (which appears slightly less opaque) is supposed[weasel words] to have less effect on drug levels in serum.[citation needed]

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFormix

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFormixSlide

    • need reference to thin prep (request new term with parent cytology specimen container (physical object) for liquid-based cytology container)

    • More info on retracting pus:

    • Scotchtape prep (scoth tape swab from Mike Miller’s book)

    • nasal sinus fluid definition

  • Riki’s Follow up:

    • modeling exposure (wounds) - check when both Jim and John could join

    • need a new term for pacemaker insertion site sample - work with John

      • in SCT there are only swabs for insertion sites (line, drain, chest tube, vascular catherther) - 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

  • Open homework EDTA Stopper top

USCDI v5 comments

 Y

United States Core Data for Interoperability (USCDI)

  • Had call with Maria Michaels, Nancy and Manjula - working on better coordination within CDC and with partners - will set up recurring calls well prior to next comment period

  • Nancy talked to leadership and we have experienced scientist available (understands lab workflows and what issues exist with LIS and EHR-s)- may pull her into the Data Standardization Lab subgroup; USCDI is one of the topics; currently working on minimum data set for surveillance Desiree is running this there is also the CSTE work: (​https://cste.sharepoint.com/:x:/g/EQdpo_BqId1Ih6EE0C1vKYIB0tkA4elCABwDA8Rn47xluQ?rtime=QO7JLK7F20g )

  • this might re-org as part of the CDC re-organization - so might be a hiatus until all figured out

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

 


Specimen CMT pilot implementers

 

Specimen CMT - Hosting Options

 

  • 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

    • ​ 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

 Y

  • surgical insertion site peritonealDialysisTunnelSite

    • Nancy to review definitions

    • apply the modeling similar to the pacemaker insertion site

    • tunneling should help prevent infection

    • we do have concept for morphologic abnormality = 433861000124108 |Peritoneal dialysis catheter tunnel (morphologic abnormality, will use that

  • surgical insertion site peritonealDialysisSite

    • Nancy to review definitions

    • apply the modeling similar to the pacemaker insertion site

  • Aspirate_Tracheostomy

    • this would be an aspirate from the area around the opening

    • usually this will heal over, but fluid procution is often seen and misinterpreted asinfection and submit for culture, which they shouldn’t be sent, hence the designation of discouraged

    • added defintion - ready to publish

  • Prostatic fluid for stamey test

    • use this SCT code, as it is speicfic for Stamey

    • difference between UTI, Cystitis, Prostatitis

  • post prostatemassage urine

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://drive.google.com/file/d/1KET27i0xqGbVvOHKN7TuzNrecooMKPHK/view?usp=sharing

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