2021-07-14

Chat History:

00:09:59 Andrea Pitkus PhD, MLS(ASCP)CM: Implementation Plan Brainstorm and Feedback (7/26/21)
00:15:12 Andrea Pitkus PhD, MLS(ASCP)CM: I'd agree that a lab order and a lab result should be discretely captured, encoded and then flow up/downstream smoothly from an interoperability perspective.
00:26:30 Andrew Northup: Yes, lab order and results data. We have to be clear that these systems are not interpreting any of that data however. Again, practice of medicine belongs to licensed practitioners of medicine
00:27:55 Andrea Pitkus PhD, MLS(ASCP)CM: Concur. With the knee deep fax paper files sitting on the floor that need manual interventation is not a great approach. Hopefully COVID funding earmarked for PH will aid this too.
00:29:58 Andrea Pitkus PhD, MLS(ASCP)CM: Higher vol institutions are impacted too.
00:31:09 Andrea Pitkus PhD, MLS(ASCP)CM: Some have only LOINC encoded their top 100 tests to meet vol MU requirements, but not the rest needed for transfers of Care docs, etc. So gaps remain even at top medical centers. Some have also reported sending to PH ELR with HL7 2.31 messages so they lack capability to use SPM segment as in MU ELR requirements.
00:31:13 Andrew Northup: true. ideally our work impacts those providers and institutions by making it easier and more intuitive to interpret those results
00:31:36 Andrew Northup: and yes no more paper! haha
00:41:49 Andrea Pitkus PhD, MLS(ASCP)CM: IT's understanding the data (it's meaning/type), how it should be built in LIS/EHRs, encoded correctly and then messaged
00:42:45 Andrea Pitkus PhD, MLS(ASCP)CM: SPM 4 i(in HL7 v 2.51 messaging as HL7 2.31 messaging doesn't support this field) s for specimen type mapped to SCT specimen type codes; SPM 8 is for specimen source mapped to anatomic body site SCT codes.
00:43:30 Andrea Pitkus PhD, MLS(ASCP)CM: Each is usually built in different data dictionaries mapped to different SCT codes so the meaning/context is realized and not lost
00:44:21 Andrea Pitkus PhD, MLS(ASCP)CM: Regarding LOINC codes. Wound culture LOINCs do not specify a specimen type/source/system as it's XXX so it must be included in these other fields, mapped to SCT correctly
00:45:42 Andrea Pitkus PhD, MLS(ASCP)CM: FOr COVID, an example of one of these specimenless LOINCs is LOINC 94309-2 SARS-CoV-2 (COVID-19) RNA [Presence] in Specimen by NAA with probe detection
00:46:11 Andrea Pitkus PhD, MLS(ASCP)CM: SARS-CoV-2 (COVID-19) RNA [Presence] in Specimen by NAA with probe detection (So the specimen and source info needs to be available elsewhere)
00:48:46 Andrea Pitkus PhD, MLS(ASCP)CM: Regarding the endocrine use case, stimulation, suppression, and challenge cases may be comingled without clarity via the test naming or coding as to what the stimulant, depressant, challenge, dosing, timing ec is
01:02:45 Andrea Pitkus PhD, MLS(ASCP)CM: May wish to focus on automated chem/hem/micro where there are not timed, specimenless, calculated tests initially.
01:03:00 Andrea Pitkus PhD, MLS(ASCP)CM: Then work our way up to the most complex scenarios/types of tests.
01:03:43 Andrea Pitkus PhD, MLS(ASCP)CM: This would exclude a number POCT test kits and other manual tests /kits like some COVID ag/ab tests too