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Specimen CMT - review of terms with questions
Yes
Send a reminder for concept map to Shaun - Riki to do this
ear wax - review domain - change to molceular
Aspirate_Nasal is post-coordinated, while NasalAspirate is pre-coordinated - ideally we would like folks to use prototype + source site, but when a lab supports only a single entry, then
Usage is for clinical domain, so for pre and post-coordinated terms the usage should be the same
NHSN terms are outdated, so do not import at this time - Riki to check with Sheila on progress to get updated list(s)
Nodule could be a specimen for both micro and pathology - will need to write up comments for each domain as to what kind of tests this specimen is submitted for
pathology = for histologic evaluation
micro = for culture evaluation (bacterial, fungal, mycobacterium)
OralSwab - is discouraged has 2 preferred alternatives: Saliva (we have), OralSwab_Buccal - leave as is
PapSmear - currently mapped to a collection from 3 sites
mapping to Source site will be problematic, as SPM-8 cannot repeat and we cannot get a single term in SCT for these disparate sites
for HPV molecular testing will have to follow what the company recommends to collect - may need a different entry here under molecular
Previous Action Items
Nancy Follow up:
EDTA Stopper top
EDTA sufficient or do we need to specify K2 or K3?
Nancy can review the list in SNOMED from John
Need to check on completeness against the Anne/Nancy list (compare with ARUP)
Nancy/Anne’s list is 10 years old - may not want to compare with this outdated list and use ARUP and Labcorp lists
in SCT there are only swabs for insertion sites (line, drain, chest tube, vascular catheter) - this should be fixed
we should model it after 435971000124108 | Body fluid specimen from peritoneal dialysis insertion site (specimen) and require method, which should be aspirate
How do we decide what format to share this in - get input from EHR-s and LIS vendors.
Write letter of mulitple stakeholders to request EHR-s and LIS vendors to implement
indicating that this is a patient safety issue, as incorrect Abx treatment will contribute to multi-drug resistance (use CTSI findings to provide background)
focus on blood, urine, wound cultures (get data from NHSN, too)
Nancy is talking to DHQP about the linkage with specimen collection
While we have HIT certification that is for the EHR-s there is currently no enforcement for implementation at the organizations
need C-suite buy-in
Professional organizations - like CAP and ACOS and AJCC get them to write the synoptic reports (better structuring of data) - for surgical aspects - similar to what CAP has done for Cancer (though they do not have the SCT codes included in the past - may be including SNOMED CT starting in 2025, but they are also using the SCT codes for observables) https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2021/12/synoptic-reporting-for-cancer-surgery-current-requirements-and-future-state/: The four CoC accreditation standards that include synoptic operative reporting requirements apply to sentinel lymph node biopsy for breast cancer (Standard 5.3), axillary lymph node dissection for breast cancer (Standard 5.4), wide local excision for primary cutaneous melanoma (Standard 5.5), and colonic resection for colon cancer (Standard 5.6). These accreditation standards were developed from the evidence-based recommendations for cancer surgery detailed in the Operative Standards for Cancer Surgery manuals.7,8
try to get AMA support to get providers to adopt this
Reach out to IDSA, too
Specimen CMT - education
No
Need education for providers and IT folks that helps with set up of the EHR-S / LIS configuration
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 https://infobeta.cap.org/shield/
Specimen CMT - tracking implementation impact
Setting baseline
Define metrics
No
Specimen CMT - Compare to NHS Medical Terminology testing
No
Will get updated vocab at a later date
LOINC to SNOMED CT mapping
No
Future projects for this call after CMT
No
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 (i.e., Specimen Condition table, etc.)
Kathy Walsh - Labcorp to Everyone 11:12 AM A laboratory test on ear wax can be a sample of ear wax that is sent to a lab for analysis. This test may be recommended if you have: Ear pain or discomfort, A persistent discharge from your ears, Hearing loss, and A suspected infection. The sample can be collected using a sterile swab, a sterilized metal scoop, a plastic curette, a wooden spatula, or a Jobson-Horne probe. You can collect a sample at home by gently rotating a sterile swab in your ear canal a few times. However, a health professional is usually better able to collect the sample without damaging your ear or causing an infection. Ear wax can contain many diagnostic biomarkers, including genetic material, proteins, lipids, and chemical elements. The composition of ear wax can reflect the physiology and pathophysiology of the body, and can even indicate exposure to environmental pollutants.
John Snyder (NLM) to Everyone 11:27 AM 630941000124109 |Evacuated blood collection tube with spray-dried dipotassium ethylene diamine tetraacetic acid for trace element testing (physical object)| Tube with K2EDTA (spray-dried) for trace element. Tubes for trace elements are labeled specifically for these purposes on the shelf package and case label. Use only appropriately labeled tubes for these tests.
Amy Liu 11:30 AM 1256100007 |Edetate dipotassium (substance)|
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