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2025-05-08 LabMCoP Meeting Notes

Date

​May 8, 2025

Attendees

Present

Name

Organization

-

Nancy Cornish

CDC

-

Manjula Gama-Ralalage

CDC

X

Riki Merrick

APHL

X

Christina Gallegos

APHL

-

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

 

Pam Banning

 3M

Discussion topics

Upcoming OOO

 

CSTE Presentation

Riki - no update

  • 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

Specimen CMT - review of terms with questions

Christina/Amy

  • Follow up items:

    • stool with 10% formalin - would this work for SPM 6? 464601000124100 | Modified polyvinyl alcohol with copper sulfate and ten percent formalin (product) - Nancy said she will take a look

    • Serum_Thrombin_Gel - need more info about the gel - SCT has 702281005 | Evacuated blood collection tube with thrombin and clot activator and gel separator (physical object) | - Christina email follow up with John when she sends the list of

    • Ask Jen from Arup, who submitted the blood tube types, how she is using these (if only in compendium, or expecting to come in as part of order): ANSWER: It can be helpful to have the container, for example when it is protecting the sample from light, it contains additives (urine), uses a specific collection kit (aptima), or is phlebotomy. This (the submission of container types) was in preparation for using them within our compendium. I would like to get to a point where we communicate to our clients what we would expect in the SPM segment, but we aren't there yet and many of our clients are still sending 2.3.1.

      • often times the lab will create collection kits, where they add the additives to containers and provide those to customers, or it is part of the described collection procedure, especially for lab developed tests

      • for blood tubes, they are usually commercial products

      • SPM-27 for container type we don't currently have in the CMT, but it is O in LOI and LRI

      • SPM-6 is RE in ELR, but O in LOI and LRI - currently have deconstructed commercial containers into additives in the CMT - will have to revist, if we add container type

      • for breast cancer testing knowing all the additives is important, currently covered by AOEs, as often also need to know duration of additive exposure (usually at time of collection) - here are some https://arup.utah.edu/media/breast_cancer_guidelines/Hammond GR Jan 21 11.pdf

      • sometime the additives are added at later point in time

  • NHSN term - Riki to ask Nancy if we have the latest yet

Creating 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 RefSets (and are probably easier to migrate, if they already exist in VSAC (but would need to make sure we promote US extension terms first)

  • Specimen reject reason table review - OO decided that when the reject reason is a specimen condition, we should use the SAME concepts, so review with that in mind

    • review the “unsatisfactory for evaluation due to …” concepts

  • Containers (EU review work might have some new content - Reached out to Feijke for update - here is the latest file

  • Additives (Nancy reviewing the stool preservatives)

LOINC common maps


Call Adjourned


11:56 AM ET

Next call is May 29th

Previous Action Items

 Not discussed

Specimen CMT - Hosting Options

 Not discussed

  • How can we publish the content in the dB?

  • SNOMED CT Extension and use of RefSets (start with VSAC value sets as proof of concept and then migrate over) to indicate:

    • preferred specimen types by domain

    • maybe also terms that need additional attributes (by kind of attribute) if we also write an implementation guide for it

  • 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 pilot implementers

 Not discussed

Specimen CMT - education

 Not discussed

  • 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 ​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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