Participants for today’s call:

 

Membership:

Name

Organization

Role

Raj Dash

College of American Pathologists (CAP)

Chair

Steering Committee member

Scott Campbell

UNMC

Steering Committee member

Dan Rutz

Epic

Steering Committee member

Muktha Natrajan

CDC

 

Sandy Jones (Secondary)

CDC Cancer Surveillance

 

Anne Peruski (Secondary)

CDC

 

Andrea Pitkus

University of Wisconsin-Madison

Steering Committee member

Xavier Gansel

bioMérieux

Steering Committee member

Stan Huff

Graphite Health

Steering Committee member

John Snyder

NLM

Steering Committee member

Rob Hausam

Hausam Consulting

 

Marjorie Rollins

Regenstrief

Steering Committee member

Amy McCormick (secondary)

Epic

 

Nanguneri Nirmala

Tufts Medical Center

Steering Committee member

Mehdi Nassiri

Indiana University/Indiana University Health/Association for Molecular Pathology

Steering Committee member

Eza Hafeza

Regenstrief

Steering Committee member

Jim Case

Snomed International

Steering Committee member

Kevin Schap

CAP

 

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Discussion topics

Item

Notes

 

Item

Notes

Item

Notes

Review: Identify tangible activities for this working group

  1. Find a co-chair for this group!

  2. This workgroup is slated to comment on the roadmap’s approach to addressing educational / training gaps in the use of standards such as LOINC. Will address at next meeting!

    1. Concepts around Healthcare IT (HIT) standards needs to be conveyed earlier in training for healthcare providers as use and application of standards in vended applications is the major gap.

    2. IT folks are less susceptible because they have a script that is more rigidly followed through implementation guidance. A vendor may not support functionality for standards or only partially support.

    3. Regulatory requirements (such as CLIA) may pose a hurdle to implementation of data standards.

    4. Implementation guidance is often not well read. Training resources may not be well publicized or readily available. Perhaps conformance testing tools need to be made more widely available?

    5. What might be helpful is to look at standards implementation from a data lifecycle standpoint across all users (end to end across ecosystem), rather than just training on a single standard for a single use case.

    6. Last paragraph on page 4 of the road map final version could be augmented with these points.

Use case review

D-Dimer (qualitative) 

AST (quantitative)

LRI review


Observation Result Status Codes Interpretation - Final, prelim, etc OBX-11, significant overlap with Result Status, OBR-25. These are transactional and more focused on implemented configuration and not required for semantic interoperability. No data standard recommended beyond the HL7 valueset.

Result Status - Final, prelim, etc., significant overlap with Observation Result Status Codes. These are transactional and more focused on implemented configuration and not required for semantic interoperability. No data standard recommended beyond the HL7 valueset.

Value Type - Data type of the result. Recommend continue to use the HL7 valueset (table 0125)

Examples:

Encapsulated Data Formatted Text (Display) Multiplexed array Numeric array Numeric Numeric range Reference Pointer Structured Numeric String Data Time Text Data (Display) Value range Extended Address


Specimen Type

Specimen Reject Reason

Specimen Condition

Relevant Clinical Information

Device Type

LOINC

SNOMED CT

UCUM

Next steps

  1.  Raj Dash has a conflict next week, so next call will be April 8th at 1:30-2:30 pm eastern

  2.  

Cloud recording: https://duke.zoom.us/rec/share/9ZJc-QAGiwPgo_R_in1WcmRM8oah8xWqg6D8KKIlGQ9BR56z-azlKygBOTTzV5I.nA8hcNRDiegpr2Un?startTime=1710782966000

From Chat:

 I agree with both Jim and Xavier – we should recommend what we feel is correct and then make adjustments:

Personally I like interpretations always in OBX-8 to have a consistent place where to find them – OBX-8 can repeat, in case you need more than one aspect of interpretation – for example detected and abnormal.

HL70078 values are drawn from the observationInterpretation code system – it is harmonized across all HL7 product families (one of the only ones!), so any changes to use SCT instead (rather than in addition) should be done across all HL7 products.

 

FYI – there is a vocabulary group in Europe working on these issues, too – we should take a look at what they are doing: https://confluence.hl7.org/display/HEU/2024-03-08+Lab+-+Semantic+WG and provide input there, so we don’t have a US way and a European way!

 

Riki