2026-04-23 LabMCoP Meeting Notes

Date

Apr 23, 2026

Attendees

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

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
Working with DHQP for NHSN reporting	Nancy	discussing lab data flows for lab data when coming into the EHR-s; sometimes often? EHR-s will re-map LOINCs that come in, or also remapping organism names when there is a post-cooridnated expression is expected in report outs (like HAI, for drug-resistant organisms) NHSN has some real world data - most are reporting blood cultures as Observations, which they should, most were using LOINC in Observation.code and in Observation.valueCodeableConcept with associated SCT code in results (would be interested how these are codified - as pre-coordinated organism or with multiple Observations one for organism + susceptibility result) - it may be both, as they can take more than one Observation per specimen. they are getting Resistance testing related LOINCs, for example: NHSN would also like to get information about volume collected - that is not in a standard place in the HIT system; the lab records the volume they get - they could also get this in via the order, but it would not be the preferred method; it should originate in the lab; there are some instruments that provide it = Observations rather than part of the Specimen resource, where we have a place for it. BD and Biomerieux are the main players in this space; current LOINC could be: - wonder if we want to have a Blood culture specific LOINC (this is really on the container, so should that we kept out of the volume concept? SNOMED Observable is less granular What is the preferred place? = Specimen.Collection.Quantity - this does not support methodology of gathering the volume (estimate vs measured?) need to look where this would be in the V2 - especially if not yet using SPM segment where are vendors currenlty storing specimen volume? Ask in SHIELD one stick that gets then aliquoted into 2 bottles - in the lab those are considered a set Does Biomerieux combine the volume result from both bottles, or a single bottle? Container question for specimen call: include a blood culture bottle for the example of Specimen + SpecimenDefinition there are CLSI recommendations about differentiating pediatric vs adult containers (based on weight), but there should not be an issue with using adult containers; Nancy’s group is focusing on 18 & older for now Follow up list: Which lab test is NHSN getting results for? Any lab test that is in the EHR-s for qualifying encounter during that calendar month (emergency, inpatient at acute care hospital) Urine culture results for HAI
Call Adjourned		12:04 PM EDT
Specimen CMT - Hosting Options	not today	Any Updates on FU with: Clinical Architecture: ONC:
Specimen CMT terms	not today
CMT Governance process	not today
CMT proposed maintenance process	not today	Start writing this up on this confluence page: Questions from Zulip thread that should be covered by the process we come up with here: Requests for terms used in practice that are not yet in the Cross Map Table? Requests for any corrections or needed updates to terms? What type of version control will be leveraged for releases and major/minor updates? How do you plan to incorporate SNOMED CT Release Updates into Cross Map updates/releases? At what frequency will updates occur? For example, will you process SCT updates once yearly and have a subsequent Cross Map release yearly with changes or more or less often? How do you communicate differential changes between releases? Is a differential file produced or is it expected that users will be able to find changes on their own? What type of customer support for downloads is expected? Will the release entity provide or is it expected of the site hosting the content for download? Both need to work colLABoratively to ensure no blockers arise for users/consumers. User Guide starter
Follow up items	not today	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
Lab tests as procedures or orderables	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: 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 There is this question in the LOINC Community: it is related to this US Core FHIR Change request: https://jira.hl7.org/browse/FHIR-54415 Answer to this one is that in USCDI Procedure (https://isp.healthit.gov/taxonomy/term/781/uscdi-v6) does not list LOINC as applicable Vocab standard in any verion, so remove it. Often folks think of lab tests as procedures, because they can be ordered in CPOE (and outsidde the US, in the UK for example that’s how folks have modeled those, which is why LOINC was adding more of the high level order codes in 2.81 release, so we still should tackle the LOINC community question. John was working on creatign an intesnional valueset definition based on class + type and maybe a few other attributes
European Semantic work	not today	Link to the German FHIR IG around suceptibility testing: Semantic Example section: Confluence page: Ask if Rob can keep us updated
Specimen CMT pilot implementers	not today	Review where we are: Vendor Connections
Specimen CMT - education	not today	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
Specimen CMT - tracking implementation impact Setting baseline Define metrics	not today
Future projects for this call after CMT	not today	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:

Not recorded

Chat:

Postcall email: Regarding the recent blood culture discussion, I came across this from an Epic Beaker user: https://github.com/hendersonsa793-healthcare/epic-beaker-lab-portfolio/blob/main/05_beaker-lis-case-studies/blood-culture-reflex-workflow-design.md

Basically, their Beaker LIS workflow/build did not match laboratory practice in that it required culture plate details prior to detection of a positive blood culture bottle (which doesn't make sense.) If a bottle isn't positive, it is signed out as no growth without further testing. The reflex orders for the gram stain, culture plates, and organism identification/workup are added to the positive bottles.

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