2024-03-21 LabMCoP Meeting Notes

Date

Mar 21, 2024

Attendees

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
X	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 York	APHL
	Pam Banning	3M

Discussion topics

Topic	Discussed?	Notes
Upcoming OOO	Yes	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
Previous Action Items	Yes	Nancy Follow up: EDTA Stopper top EDTA sufficient or do we need to specify K2 or K3? Nancy can review the list in SNOMED from John Need to check on completeness against the Anne/Nancy list (compare with ARUP) Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists Raj: I found this at a phlebotomy certification course website: What Color Tubes Are Used for Which Tests in Phlebotomy – PhlebotomyU Here's a nice one-pager (University of Colorado Health): https://www.testmenu.com/universityhospital/TestDirectory/SiteFile?fileName=sidebar\CLNLAB-2020-03-13-Blood-Tube-Color-Chart.pdf Cleveland Clinic: Blood Collection Tubes - Collection \| Cleveland Clinic Laboratories https://phlebotomygeeks.yolasite.com/resources/PRINT OUT COMMON TUBES.pdf but color is manufacturer dependent, which is why we named the tubes by the additives there are container types in SNOMED under 706049005 \|Blood tube (physical object)\| Have a start here: https://aphlinformatics.atlassian.net/wiki/download/attachments/2018312270/ContainertypesListRikiEmailed20171013.xlsx?api=v2 K1 or K2 might be important to differentiate We should leave the top color out of it, since that is manufacturer specific Contact United Network for Organ Sharing for input on donor terms (pre-coordinated or not?) = Contact - UNOS Amy follow up - check if she has all of these nasal sinus fluid definition surgical insertion site peritonealDialysisTunnelSite surgical insertion site peritonealDialysisSite Riki’s Follow up: liquid-based cytology specimen vial = https://us-request.ihtsdotools.org/#/requests/preview/354843?fromList=truehttps://request.ihtsdotools.org/#/requests/edit/786429 submit a code for formalin10 work with John new term for pacemaker insertion site sample in SCT there are only swabs for insertion sites (line, drain, chest tube, vascular catheter) - 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 For wound modeling (see 2023-11-30 LabMCoP Meeting Notes ) create a few pre-coordinated specimen terms to cover the wound causes as children under: 119365002 \| Specimen from wound (specimen) another child term for aspirate under 445611000124106 \| Specimen from bite wound (specimen), since that is preferred over the existing swab IDSA has a guidelines for wound cultures (deep and superficial - related to surgical wounds) - link sent to Amy 460621000124104 \|Superficial surgical incision wound (morphologic abnormality)\| - created in US extension in 2019. Is this needed? If so, then LabMCoP/APHL should promote it to SNOMED International to retain US SNOMED identifier. John will submit this to be promoted. SNOMED guidance related to morphological abnormality: Morphologic Abnormalities vs. Findings - SNOMED CT Editorial Guide - SNOMED Confluence
CDC and ONC meeting Update		Carmela is detailed from ONC to the new CDC Standards Devision supporting CDC comments on USCDI V5 draft specifically talking about specimen collection date/time, performed test date/time, lab received date/time and specimen collection method Lab related date/timestamps - vs specific triggers for collecting those, that are clincially important - specimen collection date/time is different from generic procedure time (since specimen collection, while techincally a procedure, is not specifically captured as such in HIT systems) specialization of generic elements - example medical record number vs patient identifier (in 2019 congress was having a discussion around a national unique patient identifier) test kit unique identifier (model = device level), lot number (may be harder than the device level id) and instance level identifier (serial number) = production identifier - these things are recorded in the lab, but not currently in the LIS = https://www.fda.gov/medical-devices/unique-device-identification-system-udi-system/udi-basics currently all FDA 510k devices have to have a device level identifier UDI - it would be great if you could just scan the test kit / reagent / instrument barcode when the lab gets the testkit/reagent/instrument
Specimen CMT - review of terms with questions		cathetertips Swan-Gantz = pulmonary artery catheter VAS HL70487 - do not use - be more specific - preferred would be venous catherters we have the central lines as genreic AND also pre-coordinated terms can make VENT - not clear what for, so do not use Catheter tip - too generic - so do not use Groshog - single lumen venous central catherter type - can be bothtunneled and not tunneled - create 2 entries and map to either - mark as dsicouraged Porta - implanted under skin for application of chemotherapy - preferred - partial - must include skin access location (SPM-10) catheter - too generic - do not use Triple Lumen Catheter tip = typically central lines, but with mulitple lumen, each of them is labeled cell culture medium terms need to be submitted to SCT - but this an example term Will pick up at choronic membrane
CALL ADJOURNED		12:57 PM ET
Specimen CMT pilot implementers	No	Review where we are: Vendor Connections no update
Specimen CMT - Hosting Options	No	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	No
Specimen CMT - tracking implementation impact Setting baseline Define metrics	No
Specimen CMT - Compare to NHS Medical Terminology testing	No
LOINC to SNOMED CT mapping	No
Reporting Biomarkers to Cancer registries	No	National Program of Cancer Registries (NPCR) \| CDC Sandy will put together a one-pager
Future projects for this call after CMT	No	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

From Chat:

You 12:00 PM
https://aphlinformatics.atlassian.net/wiki/spaces/LMCOPL/pages/2325151824

Rajesh Dash to Everyone 12:15 PM
Production Identifier
https://www.fda.gov/medical-devices/unique-device-identification-system-udi-system/udi-basics

vgh5@cdc.gov 12:25 PM
I will be out of office April 25

John Snyder (NLM) 12:33 PM
Groshong catheters are a type of central venous catheter, which are placed under direct fluoroscopic visualization in an angiography suite.

Recording:

https://youtu.be/bb5qp-bUndk

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