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2025-03-27 LabMCoP Meeting Notes

Date

​Mar 27, 2025

Attendees

Present

Name

Organization

 -

Nancy Cornish

CDC

 -

Manjula Gama-Ralalage

CDC

X

Riki Merrick

APHL

-

Christina Gallegos

APHL

X

Amy Liu

Inductive Health / APHL

X

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

 

Pam Banning

 3M

 

Sandy Jones

CDC

 

 

Carmen Pugh

 

Discussion topics

Upcoming OOO

 

LOINC SNOMED Ontology

Riki/Andrea/John

​LOINC Ontology

Seems like there are some issues, as this is still a work in progress

need to make a clear intention between order items (procedure?) vs performed test (orderable) - need to find out how they implemented the order/obs flag

Recording of the intro presentation: ​Webinar to introduce Version 1.0 of the LOINC Ontology

Clinical LOINC Committee will be working on document hierarchy (make sure they finish lab concepts)

Overall this is a good step for supporting grouping of LOINCs

CSTE Presentation

Riki

  • CSTE ELR call presentation on wound cultures and Specimen CMT (modeled for ELR) by Nancy, Riki, and Manjula has been postponed to a TBD date later

European Lab related Vocab

Riki

European Lab Terminology group working on finalizing their list of containers and asking for review - no update

Specimen CMT - review of terms with questions

Christina/Amy

  • nothing for today to review

  • Discussing option to use a SNOMED extension

    • How would we indicate the additional attributes that define the specimen?

    • We may not want these classfied as “AOEs”, as they would then not be reported in the specimen specific spots

      • Like currently happens with specimen collection date/time

    • there are other AOEs outside of specimen specific attributes like last menstrual period

      • Have LOINCs for some, but not for all of them

    • some of the AOEs are reported back with the result, when the lab used them in the interpretation of the result (as a statement of what was used)

    • Review existing data sets for commonly uses of generic LOINCs that could give us insights into how folks use these (and find ones we should make LOINCs for)

      • Ask Charlie to look at their data set

      • Raj could look at Cosmos (Epic de-identified dataset, but might include non-US metric units - might require LOINC mapping updates based on the unit of measure received for each result) - hard to get access to this

      • We often have folks map to the “wrong LOINC”, because they need to meet specific reporting requirements (quality measures or reporting to PHs) - would be good to capture reason for mapping to help adjudicate these

  • LOINC part code to SNOMED CT concept mappings - are folks wanting these released?

    • Geisinger uses these for the query quality improvement

    • some folks may be using the LOINC part code for component searches

      • the new release might make this harder, as several have been renamed to “observation” - where the prior component moved to a different attribute - and currently this was not applied consistently

        • the longname and shortname didn’t change

    • Ask Keith about SOLOR/KOMET

    • Also ask Charlie Harp

Value Sets for specimen related attributes

John

  • US valuesets should be in VSAC for all clinical care

  • Value sets that are used in HL7 should be in International ref sets

  • Also need to get back to the specimen reject reason table review - specimen calls on Mondays 2 PM

  • we also have containers (EU review work might have some new content - reach out to Feijke for update) and additives started

Previous Action Items

 Not discussed

Specimen CMT pilot implementers

 Not discussed

Specimen CMT - Hosting Options

 Not discussed

  • How can we publish the content in the dB?

  • How do we decide what format to share this in - get input from EHR-s and LIS vendors.

  • Write letter of mulitple stakeholders to request EHR-s and LIS vendors to implement

    • indicating that this is a patient safety issue, as incorrect Abx treatment will contribute to multi-drug resistance (use CTSI findings to provide background)

      • focus on blood, urine, wound cultures (get data from NHSN, too)

    • Nancy is talking to DHQP about the linkage with specimen collection

    • While we have HIT certification that is for the EHR-s there is currently no enforcement for implementation at the organizations

    • need C-suite buy-in

    • Professional organizations - like CAP and ACOS and AJCC get them to write the synoptic reports (better structuring of data) - for surgical aspects - similar to what CAP has done for Cancer (though they do not have the SCT codes included in the past - may be including SNOMED CT starting in 2025, but they are also using the SCT codes for observables) ​Synoptic reporting for cancer surgery: Current requirements and future state: The four CoC accreditation standards that include synoptic operative reporting requirements apply to sentinel lymph node biopsy for breast cancer (Standard 5.3), axillary lymph node dissection for breast cancer (Standard 5.4), wide local excision for primary cutaneous melanoma (Standard 5.5), and colonic resection for colon cancer (Standard 5.6). These accreditation standards were developed from the evidence-based recommendations for cancer surgery detailed in the Operative Standards for Cancer Surgery manuals.7,8

    • try to get AMA support to get providers to adopt this

    • Reach out to IDSA, too

Specimen CMT - education

 Not discussed

  •  Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration

  • 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 ​SHIELD FDA BAA Year 2

Specimen CMT - tracking implementation impact

  • Setting baseline

  • Define metrics

 Not discussed

 

Specimen CMT - Compare to NHS Medical Terminology testing

 Not discussed

 Will get updated vocab at a later date

Future projects for this call after CMT

 Not discussed

  • 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 (i.e., Specimen Condition table, etc.)

Recording:

 Per APHL policy we are not currently allowed to record any meetings

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