Lab Meeting Minutes Oct 2013

Attendees:

Nobuyuki Chiba – A&T

Jim Harrison – University of Virginia / CAP

Yoshimi Hirasawa – Techno Medica

Genichi Kato – Saiseikai Shiga Hospital

Tsuyoshi Kawata – Itec Hankyu-Hanshin Co.Ldt.

Laurent Lardin – bioMérieux

François Macary – ASIP Santé

Kimiko Matsuoka – Osaka General Medical Center

Riki Merrick – APHL

Filip Migom – MIPS

Ishii Naomi – Hitachi high-tech

Hiroyoshi Okada - Itec Hankyu-Hanshin Co.Ldt.

"Salt" Yasunari Shiokawa – AJS Inc.

Shinishi Watanabe – A&T

Osamu Yamada – Okasaka City Hospital

Shigeki Yokoyama – KD-ICONS Co.Ldt.

Results of the cochair elections

announced by Jim Harrison on behalf of Mary Kennedy the IHE LAB secretary

Two cochairs elected:

• Riki Merrick – Planning
• François Macary – Technical

Osamu Yamada and Sondra Renly having expressed the will of not taking a new term as cochair, the IHE LAB committee current governance team is as follows:

• Planning cochair: Riki Merrick
• Technical cochairs: François Macary, Yoshimi Hirasawa
• Secretary: Mary Kennedy

Those 4 people are the ones associated with the email box lab@ihe.net

The committee members are grateful to Sondra Renly and Osamu Yamada for their fruitful two terms [2009-2013] served as cochairs.

LAB Technical Framework – scope, current publications

See presentation: LAB Tokyo meeting opening

Publications expected end of October on www.ihe.net, that will be the basis for 2014 connectathons:

• LAB TF R5.0 (5 CPs integrated),
• LAW R2 (19 CPs integrated),
• ILW R2 (1 CP integrated).

Controlled coded vocabularies for microbiology

Study on Standardization of Various Masters in Microbiology

Study contributed by:

• Kimiko Matsuoka– Osaka General Medical Center
• Shigeki Yokoyama – KD-ICONS Co.Ltd.
• Takashi Noguchi – Tokyo University
• Genichi Kato – Saiseikai Shigaken Hospital
• Kazuyuki Nakayasu – Ministry of Health, Labour and Welfare

Slides presented by Kimiko Matsuoka: Masters for microbio]

4 level classification of microorganisms

4 level classification of anti-microbial agents

Discussion:

• The classification of microorganisms presented goes as far as the species of the microbe (the last 3 digits of the identifier). It does not distinguish strains nor genetic mutations on a species.
• LOINC. IHE LAB Volume 4 (LOINC subset) has been deprecated in 2010. The number of active LOINC codes available for microbiology in the current release 2.44 of LOINC is:
  • 1,682 codes for Antibiotic susceptibility testing (class = ABXBACT), in general 4 LOINC codes available for each antibiotic tested, one for each of the 4 methods:
    • MIC (Minimum Inhibitory Concentration)
    • MLC (Minimum Lethal Concentration) synonym to MLC (minimum bactericidal concentration)
    • Agar diffusion
    • Gradient Strip
  • 10,236 codes for the rest of microbiology (bacteriology + parasitology + mycology)
• The SNOMED codes studied are extracted from an old release SNOMED 3.5 or SNOMED RT. The current release, SNOMED CT (Clinical Terms) uses pure numeric and non significant identifiers. And the microbiology part of it is produced by microbiologists. There is no particular order in the SNOMED CT concept, since the identifiers are non-significant. Each concept is determined by its relationships to other concepts. See http://www.ihtsdo.org/snomed-ct/
• IHTSDO is re-working the organism hierarchy in SNOMED CT, to include organism’s attributes but keeping the Linneean hierarchy clean – from class to subspecies and subtype.
• The interest of using non-significant identifiers, like in LOINC and SNOMED CT, is that it eases the maintenance over time of the terminology:
• A class of concepts (e.g.; staphylococci) is not limited by a pre-reserved series of codes (what would happen in the Japan Master microbe classification if there were more than 999 species under one genus?)
• The codes are independent of the sorting order of concepts (what would happen in the Japan Master microbe classification if a particular species were reclassified under another genus?)
• The master classifications presented are used in several hospitals in Japan. They are maintained over time.
• These master classifications will be presented to the American Society for Microbiology (ASM) next year.

Progress of the coded vocabularies for microbiology in France

Slides presented by François Macary: Vocabularies for microbio French WG

• New CP needed to allow the usage of field SPM-5 (specimen type modifier), necessary in microbiology
• Next meeting of this work group is in November. The major issue left to be solved is what coding system for microorganisms.
• Notification from Riki : Specimen cross mapping table is posted here: http://www.phconnect.org/group/laboratorymessagingcommunityofpractice/forum/topics/labm-cop-notes-files-and-link-to-recordings-starting-8-8-2013 Scroll to the last reply for the latest version – happy to have more folks participate in reviewing the definitions etc – call are 2nd and 4th Thursday 10 AM – 12 PM EST. Email Riki for call information.
• Riki: In US for ordering will use local codes as the master, if there is a LOINC that is acceptable, then it should also be sent – CPT codes in the US are used on the re-imbursement side, not granular enough for ordering – if single test, LOINC is very usable, but not for batteries – not well defined components and not resolved how to represent reflex testing
• Message structures: Using specimen centric message structures in France (OML^O33, OUL^R22). The US for certification are using the order centric messages (OML^O21 and ORU^R01).