2026-02-19 LabMCoP Meeting Notes

Date

Feb 19, 2026

Attendees

Present	Name	Organization
X	Nancy Cornish	CDC
	Manjula Dharmawardhana	CDC
X	Riki Merrick	APHL
X	Christina Gallegos	APHL
X	Amy Liu	Inductive Health / APHL
	Raj Dash	Duke / CAP
-	John Snyder	Pragmatic Terminologies, LLC
X	Andrea Pitkus	UW
	Kathy Walsh	Labcorp
	Rob Hausam	Hausam Consulting
	Pam Banning	3M

Upcoming OOO		Reminder: 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
Follow up items		Riki’s Follow up - none of these got done yet Contact United Network for Organ Sharing for input on donor terms (pre-coordinated or not?) = ISBT 128 \| ICCBBA \| Technical Documents https://www.isbt128.org/_files/ugd/1a7593_edfd176861c94dca94c34eff8fa3ad0d.pdf - for organs Riki has some contact now with European bloodbank and biobanks = Home - BBMRI-ERIC working with the folks that define their minimum data set: MIABIS - BBMRI-ERIC - these folks shared the follwoing for the reject reason topic, but it seems they differentiate between source site and the organ: #1 Standard PREanalytical Code Version 4.0 - (version 3.0 is here: https://cdn.ymaws.com/www.isber.org/resource/resmgr/isber_2019/pdf/standard_preanalytical_code_.pdf) and also Robin for US Clinical Archtecture unmapped LOINCs: Riki should check up with Charlie to see, if he knows where the LOINCs using the shorname in the description come from - as that is discouraged Riki to set up her VSAC authoring log in 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
Nancy Update		CDC is working on https://isp.healthit.gov/united-states-core-data-interoperability-uscdi#draft-uscdi-v7 Specimen Collection Date/Time: is covered by Performance Time under the Healthcare Information Attributes looking for use cases to support these othere elements - this was discussed https://aphlinformatics.atlassian.net/wiki/spaces/SC/pages/4030726145 specimen received date/time avoid re-order, or get add-on test understand TAT - see articles referenced below lab test performed date/time understanding relations between tests performed at different institutions Type of cross-match timing (within 72 hours) Needed for scheduling of certain imaging procedures (CT with contrast needs kidney function test results first) Understanding of protocol adherence: Stroke or Heart attack Pharmacy needs to know if current test results (kidney function) are available before administration of certain drugs https://pmc.ncbi.nlm.nih.gov/articles/PMC2282400/#:~:text=Abstract,initial%20goal%20for%20acceptable%20TAT. - see Table 1 for QL project of TAT tracking Ref#24 in Laboratory Turnaround Time shows 1996 CAP Q Probe for ED/ICU https://www.captodayonline.com/lis-ehr-results-transmission/ https://www.captodayonline.com/tag/q-probes/ result report status change date/time it could be covered by: Diagnostic Report Date ? if we think yes, then we need to submit a comment about updating the definition for this this is important for the doc to know, that a new report is available (and of course medicolegal reasons) there are papers about this one https://pmc.ncbi.nlm.nih.gov/articles/PMC3038104/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3038104/ Understanding the management of electronic test result notifications in the outpatient setting Timely follow-up of abnormal diagnostic imaging test results in an outpatient setting: are electronic medical records achieving their potential? https://pmc.ncbi.nlm.nih.gov/articles/PMC3243200/#:~:text=Wahls6%20defined%20missed%20results,(15%E2%80%9354%25)10. 7/19 studies in this article show impact of missed lab tests: Ref #32 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review missed cancer diagnosis: Ref#45 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review Ref#40 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review Ref#31 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review ref#29 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review adverse drug events due to abnormal TSH: Ref #42 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review related to abnormal serum potassium level: Ref#38 in Failure to Follow-Up Test Results for Ambulatory Patients: A Systematic Review SHIELD feedback: https://aphlinformatics.atlassian.net/wiki/spaces/SC/pages/4170186771
Specimen CMT terms review	Christina	no new terms to review
Lab tests as procedures or orderables	not discussed Do we still need this?	Recommendation by SNOMED is that the Observable entity hierarchy be used for both ordering and resulting. As for the technique hierarchy, that in no way is intended to be used for either ordering or resulting laboratory tests. Those concepts are used to model both observables and procedures. SNOMED LOINC extension: https://browser.loincsnomed.org/?perspective=full&conceptId1=363787002&edition=MAIN/LOINC/2025-09-21&release=&languages=en The problem is that major EHR-s vendors have set up CPOE using Procedures for orders to initiate a workflow (that creates the triggering event in the system) - that’s where the push-back comes from. There is a CPT to SNOMED CT mapping (as a paid mapping available from AMA), but no LOINC mapping. Can we reach out to CAP Informatics, ADLM Informatics and ASCLS Informatics to get their take on where Lab tests should live We had said we would work through the Colonoscopy example: Reference links: clinical guidelines: Official journal of the American College of Gastroenterology \| ACG Quality Indicators: Official journal of the American College of Gastroenterology \| ACG For CAP cancer reporting is using SNOMED CT - would be good to look which they chose to represent the performed lab test
Specimen CMT - Hosting Options	not discusse	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 using a script to create this from dB content - - zulip thread review: https://chat.fhir.org/#narrow/channel/179202-terminology/topic/Specimen.20Cross-Mapping.20Table.20in.20FHIR.20ConceptMap.20Feedback/with/542341153 Check if ConceptMap resource in FHIR R6 incorporated the coding datatype for valueset attributes Clinical Architecture has modeled the Specimen CMT in Symedical, though still need to check how to deal with the prototype additional field instructions (for nice to have elements) so can then be shared at least via their subscription, but maybe also arrange sharing via API 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 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 try to get AMA support to get providers to adopt this Reach out to IDSA, too Need to consider long-term curation
European Semantic work	not discusse	Link to the German FHIR IG around suceptibility testing: https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fsimplifier.net%2Fguide%2Fars-implementation-guide%3Fversion%3Dcurrent&data=05%7C02%7Criki.merrick%40aphl.org%7Ce11e8daf7f2d4827d07808ddcac8861c%7C434e0aedef824568a0493b17adc08ddd%7C1%7C0%7C638889684844672822%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=kZJRoBl2tMQzWQoYVkaRnEUaaBxepA9sAIu1myDQMyo%3D&reserved=0 Semantic Example section: https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fsimplifier.net%2Fguide%2FARS-Implementation-Guide%2FHome%2FSemantics%3Fversion%3Dcurrent&data=05%7C02%7Criki.merrick%40aphl.org%7Ce11e8daf7f2d4827d07808ddcac8861c%7C434e0aedef824568a0493b17adc08ddd%7C1%7C0%7C638889684844702198%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=qQH%2Ff5xwG0O8DvNE4rbjZineXBhY%2BiOWmN047DRthNQ%3D&reserved=0 Confluence page: Ask if Rob can keep us updated
Specimen CMT pilot implementers	not discusse	Review where we are: Vendor Connections
Specimen CMT - education	not discusse	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 https://infobeta.cap.org/shield/
Specimen CMT - tracking implementation impact Setting baseline Define metrics	not discusse
Future projects for this call after CMT	not discusse	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

Recording:

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