2024-01-04 LabMCoP Meeting Notes

Jim Case

Snomed International

X

Nancy Cornish

CDC

X

Manjula Gama-Ralalage

CDC

X

Riki Merrick

APHL

X

Christina Gallegos

APHL

X

Amy Liu

Inductive Health / APHL

X

Raj Dash

Duke / CAP

-

John Snyder

National Library of Medicine (SNOMED CT)

Andrea Pitkus

UW

Kathy Walsh

Labcorp

Rob Hausam

Hausam Consulting

Doug Franklin

APHL

Pam Banning

 3M

Upcoming OOO

Y

• Riki 1/16-1/18 FHIR Connectathon, Travel/vacation days: 1/15, 1/19, 1/22

• 1/15 MLK Day

• Feb 1 Continuing resolution money runs out 😮

Previous Action Items

Y

• Nancy Follow up

  • Can only have 1 bodysite in HL7, but these are from different sites - find out how often cervix + Fornix are collected together

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFornix

    • ComboCytologicalMaterialfromEndocervixEctocervixVaginalFornixSlide

    • Labcorp allows multi-select - they use AOE question for this, so add as comment with specific

  • need reference to thin prep (request new term with parent cytology specimen container (physical object) for liquid-based cytology container) - need to look up what the liquid is

  • nasal sinus fluid definition

  • surgical insertion site peritonealDialysisTunnelSite

  • surgical insertion site peritonealDialysisSite

  • defintion for deep wound

  • definition for superficial wound

• Riki’s Follow up:

  • submit a code for formalin10

  • work with John

    • new term for pacemaker insertion site sample

      • 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

    • For wound modeling (see 2023-11-30 LabMCoP Meeting Notes ) create a few pre-coordinated specimen terms

      • to cover the wound causes as children under: 119365002 | Specimen from wound (specimen)

      • another child term for aspirate under 445611000124106 | Specimen from bite wound (specimen), since that is preferred over the existing swab

• Open homework EDTA Stopper top

  • https://phlebotomygeeks.yolasite.com/resources/PRINT OUT COMMON TUBES.pdf

    • but color is manufacturer dependent, whihc is why we named the tubes by the additives

    • there are container types in SNOMED under 706049005 |Blood tube (physical object)|

    • Need to check on completeness against the Anne/Nancy list

    • Have a start here: https://aphlinformatics.atlassian.net/wiki/download/attachments/2018312270/ContainertypesListRikiEmailed20171013.xlsx?api=v2

    • K1 or K2 might be important to differentiate

Modeling donor organs / parts

Y

• Outreach out to Jane Pollack (jpollack@nmdp.org) at NMDP. was successful - schedule call for this topic - waiting for answer on what date will work

• Should we make pre-coordinated terms, or support use of type modifiers?

Specimen CMT - review of terms with questions

 Y

 Wound terms - Cat bite as example:

• Specimen from bite

• AOE for Cat bite - use https://loinc.org/11373-8/ - their example answer list is https://loinc.org/LL4936-2/ - but we can use SCT from event hierarchy for more detail - for this one use:

• For description of cat scratch wound aspirate - PHLIPPreferred does not include cat - add description to use AOE to indicate wound etiology

Toe joint synovial fluid - use pre-coordinated existing term

Vaginal and rectal swab combo - SPM-8 does not repeat, so unsure how to represent that in the table - add a note that in this case SPM-8 is NOT included in the CMT - add a similar note to any term with mulitple body sites

Deep wound and superficial wound need definitions (superficial = Raj thinks limited to cuntaneous layers)

superficial wound is discouraged term, because often can have contamination from skin flora

AbcessAspirate

• copy definition from other entry - description is wound abscess - thsi mapping does not take wound into account, but adds the aspirate, since that is the preferred collection method

• we have both the pre-coordinated and the post-coordinated mapping listed as preferred - leave this way for now - long term we want to encourage use of post-coorinated approach

• updated collection method reference: https://www.aruplab.com/Specimen-Handling/resources/pdf/InfectiousDisease.pdf

fistula_swab needs definition: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/fistula

fully coordinated for spermaticCord and VasDeference, SpermaticCordBiopsy, SpermaticCordFineNeedleBiopsy

Pipel specimen - same as EndometriumTissueByBiopsy - no need to be so detailed on what type of biopsy

Angio catheter - is a venous catheter used for individuals needing multiple IV deliveries and can be used for angiogram - map to peripheralVenousCatheterTip - refernece for catherters: https://www.ciamedical.com/angiocatheters#How%20Does%20An%20Angiocatheter%20Work?

HL7 table terms for Hickman and CVT - don’t use the more specific mappings to the common access veins and map as partial, add note that MUST have SPM-10 to denote the vessel it is placed in: https://www.ncbi.nlm.nih.gov/books/NBK557614/

Specimen CMT pilot implementers

 N

• Review where we are: Vendor Connections

Specimen CMT - Hosting Options

 N

• How can we publish the content in the dB?

  • Allow access somehow to query the dB

  • as access or excel or csv

  • Using FHIR conceptMap similar to Conceptmap-example-specimen-type - FHIR v6.0.0-cibuild - based on this profile: ConceptMap - FHIR v6.0.0-cibuild

  • riki.merrick to ask Eric if he still has that or how he built it:

  • ANSWER FROM ERIC:

    • if you look in the xml source Conceptmap-example-specimen-type.xml - FHIR v6.0.0-cibuild . you can see how it is mapped. 

    • I am not sure if you mean the table rendering or creating the concept map from a spreadsheet or CSV file.  The FHIR build tool did the table rendering for that mapping, I think I entered the data by hand, or Grahame did it. It would not be hard to create a script to create a concept map from an excel or csv file if needed.  The table needs to be large enough to make it worthwhile though. you could even create formula cells in the spreadsheet to generate the XML or json for each item. and then copy to a text editor and append to the Metadata fields.

Specimen CMT - education

N

Specimen CMT - tracking implementation impact

• Setting baseline

• Define metrics

N

Specimen CMT - Compare to NHS Medical Terminology testing

N

USCDI v5 comments

N

United States Core Data for Interoperability (USCDI)

LOINC to SNOMED CT mapping

N

Reporting Biomarkers to Cancer registries

N

National Program of Cancer Registries (NPCR) | CDC

Sandy will put together a one-pager

Future projects for this call after CMT

 N

• 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