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2025-04-15 Vocabulary Working Group Meeting Notes

2025-04-15 Vocabulary Working Group Meeting Notes

Agenda

Goals:

  • evaluate the degree to which lab data standards are sufficient in providing interoperable and comprehensive data to stakeholders across the lab data value chain for molecular and non-molecular tests.

    • address gaps and fragmentation of the lab data chain of molecular tests

    • leverage standards improve provider ability to effectively order and interpret test results.

  • Assess impact (e.g., patient safety, accurate ordering / results interpretation) where standards are not implemented or where gaps exist

Discussion

  • lab data workflow…

    • Lab test ordering

    • Lab test rendering

    • Lab test results reported

    • Lab test results interpreted

    • Lab data re-use for

      • reimbursment

      • post-market surveillance

      • RWE / research / new product development

  • Degree to which vocabulary and messaging standards (e.g., FHIR IGs etc.) support interoperable exchange of data along the workflow

  • Evaluate molecular / non-molecular lab test example - to what degree does what is in place today support both of these - what if any tailoring is needed?

  • Action items / next steps

 

Meeting notes

 

  • if it is a serum plasma tests there is a loinc code that distinguishes sample type (e.g., serum only plasma ) LIDR would represent them as 2 different rows

  • historically the policy of LOINC - the use of serum / plasma is intended for where there is no difference in the reference ranges between the serum or plasma - if there is a difference between those 2 there should be a different LOINC code for the serum or plasma. there could be nuances in the plasma or serum - people calibrate instruments so that even though the raw measurement may be difference it is calibrated to capture clinical differences. also came up with continuous glucose monitors - measuring interstitial glucose but mfrs calibrate so it corresponds to fingerstick or venous glucose. So in actual use you complicate life if you use CGM and the purpose is to manage insulin

  • can we obtain the LIVD maps from Roche?

  • most systems have a downloadable data dictionary - this is where they would LOINC encode - what happens in the backend they are mapping to test 1234 to the actual ordered test and then that goes to whichever insurance you are contracted with - they could interface with many different labs.

  • EHR vendors may use a generic name - if there is a difference in the methodology the single order term would be put in the message - a single term may not be able to support different LOINC maps.

 

  • can we name the cases where we do care about the method - e.g., I want a serum sodium from Siemens or Roche it is useless.

  • besides the method - cutoff points for determining detected or not detected for drug screening

 

  • could be using the EHR as educational tools. there is no way currently to get information e.g., for a panel

 

next steps

group agrees to further examine the ordering of tests where test method matters.

  • collect tests from the group where test methods matter (molecular and non-molecular) (e.g., proBPN for suspected congestive heart failure) to discuss what is needed at the time of ordering (nomenclature, additional instructions etc)

  • Chairs to reach back out to group to gather a few examples to go through during May meeting