2025-02-26 Vocabulary Working Group Meeting Notes

Agenda for today’s call

• Intros / reconvening of Working Group

• Discussion of high-priority initiatives for Vocab Working Group

• Capture Action Items

JS - challenges in mapping and aggregating lab data in outpatient medicine

• no terminology services

• proprietary data, etc.

Opportunity - to align upstream and make things better

Russ - working on constructs to manage different terminologies / knowledge in the same model, LIDR device extensions to include specimens, methods, etc.

RH Challenges:

• would receive specimens for different tests / different test results - it could be the same test and result but the data are different. get specimens to process and lab results to interpret. it would take time to understand what are we looking for. variation in data / lack of standards

MN

• interest in molecular pathology

• interest in genomics / genetics - we don’t use much coding (e.g., LOINC / SCT) as they don’t have granularity re genomics

UDI - in claims

DRG bundles don’t always fully capture additional tests / work-up that are provided to patients - capturing complexity is needed to find that one patient may have had 10 more procedures done than someone else

it is worth talking about how the failure of UDI in claims is a barrier to providing care, avoiding duplicates, in addition to price transparency.

at Mayo - lots of complex cases, how do you find a common denominator in routine vs complex cases. Costs may be higher than places that see less complex.

What is level of granularity acceptable to the clinician? Current state imposes current state imposes character limits of the test ordered.

Nomenclature of tests before it gets into CPOE for the purpose of standardizing the CPOE itself.

Whatever interface terminology / syntax should point orders to LOINC. In 90% of cases , the method is immaterial.  But in 10% of cases it is critical

Current LIS/EHR aggregate based on how the tests have been mapped by reference labs.  If the test is mapped incorrectly  to a different methodology it could be critical to patient care.  If you start a glucose test from an inpatient perspective where inpatient lab performs the test, then an outpatient facility orders a glucose test, those results cannot be aggregated, compared as they are different methods. Terminology for common understanding e.g., CBC vs CBC differential - how do you describe the actual test. No standard for the ordering.

If patient goes to 2 places using same exact lab test methodology / analyzer etc can we validate the data come out the same.

Action items:

• SE to contact ila singh at TRU-LAAB to see how they are approaching variance in mapping of lab tests into CPOE

• MN to provide a few examples of molecular assay (e.g., braf) that could be used as the basis for a study