LRI+Vocab+SWG+Meeting+2011-6-15

include component="page" wikiName="siframework" page="LRI Header" LRI Vocab WG Meeting Minutes Time: 8:30 AM-4:00 PM EDT Dial-in: 1-408-600-3600| Passcode: 668 365 537 Meeting Agenda: LRI CIM Vocab Agenda 06152011
 * Date: ** 06/15/2011

Rob Allen (teleconference), Tom Boal, Donna Carter, Neelima Chennamaraja, Bob Coli, Sarah Imholte, Cindy Johns, Riki Merrick, Nam Nguyen, Bill Ormerod, Virginia Sturmfels, Roniqua Watkins
 * Attendance **

Agenda Items

 * 1) ====Discuss what conditions must be met in order to adopt UCUM. What would be considered success/failure of UCUM pilot testing? ====
 * 2) Discuss LOINC adoption and review the LOINC @In-Scope Test Review document. What would be considered success/failure of LOINC pilot testing? What issues need to be addressed?
 * 3) Discuss recommendations for adopting SNOMED. What would be considered success/failure of SNOMED pilot testing?
 * 4) Consensus vote on the UCUM, LOINC, and SNOMED.

Action Items

 * **# ** || **Date Initiated ** || **Action ** || **Owner ** || **Status ** || **Date Closed ** ||
 * 1 || 06/15/2011 || Determine next steps for UCUM if pilot testing is unsuccessful. || All || Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">2 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || Develop an opening statement, consensus, and a formal recommendation of SNOMED CT as a required vocabulary. || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">All || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">3 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || With regards to OBX.5, we need to further evaluate what hierarchies are appropriate for anatomic pathology. || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">All || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">4 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || Research use of CWE 9 for SPM 4 to return what was originally submitted. || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Virginia Sturmfels || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">5 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || Need to add a reference to LOINC In-Scope Test Reviewintended for testing the appropriateness of requiring the use of the LOINC vocabulary. || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">All || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">6 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || Add opening statement to In-Scope Test Review. Include a consensus statement for formal recommendation of LOINC as a required vocabulary. What happens if testing fails? || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">All || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||
 * <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">7 || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">06/15/2011 || Need to include a statement saying that the In-Scope Test List is an abstract representation taken from the LOINC database. || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">All || <span style="font-family: 'Arial','sans-serif'; font-size: 12px;">Open ||  ||


 * UCUM**
 * The following issues need to be addressed prior to adopting UCUM as a standard vocabulary for inclusion in Meaningful Use Stage 2:
 * Require UCUM pilot testing
 * If testing is successful, UCUM should go forward as the required vocabulary. How many people must adopt for it to be useful? How many tests requiring units in the pilot can be covered by UCUM - all for In-Scope Test List and ?% of tests with known issues?
 * If testing is not successful, these are the next steps… (TBD)
 * There needs to be a table of Regenstrief-approved UCUM codes that anyone can easily access and understand so that they know what codes need to be incorporated into messaging.
 * Some sort of transition period must be included in our roadmap for individuals and organizations to get accustomed to UCUM.
 * For UCUM to be adoptable, CMS needs to develop or modify interpretative guidelines to allow equivalent codes/descriptions of the units of measure between electronic and printed reports to be considered in compliance with CLIA regulation.
 * Ensure example UCUM units that are provided with LOINC codes are correct and updated.
 * Consensus was in favor of UCUM, pending pilot.


 * SNOMED CT**
 * SNOMED CT -The group went over Key Recommendations/Takeaways for SNOMED CT.
 * SNOMED CT is a viable vocabulary that is already widely used in some focused settings (e.g. Public Health); the group recommends pilot testing to determine what issues exist.
 * Ensure CLIA compliance by use of CWE 9 to communicate the laboratory result in printed and displayed text, when using SNOMED CT.
 * Require communication of printed report text within encoded results, i.e. use of CWE.9 for print test/CWE message structure.
 * Sender and receiver application performance for print/display text.
 * Successful pilot testing will be defined as:
 * SNOMED CT is included in the OBX.5 for CWE data types and in SPM 4.
 * SNOMED CT is successfully received, displayed, and incorporated as structured data.
 * Valid SNOMED CT codes are used from the appropriate hierarchies.
 * Sender and receiver application performance for print text match on both sides in content of the laboratory results to qualify report of record.
 * Receiver will provide screen shots of the displayed result and it has to match the communicated content- at minimum that is CWE 9.
 * Identified issues from pilot testing must be resolved. The mechanism of resolution is still to be determined.
 * Must add opening statement. Include a consensus statement that the WG recommends SNOMED CT as a required vocabulary for communicating coded results and specimen source terms.
 * With regards to OBX-5: when data type is CWE (Coded With Exceptions), SNOWMED CT should be used.
 * Identify organisms using codes from the organism hierarchy.
 * We will need further evaluation on what hierarchies are appropriate for anatomic pathology- do you need repeating OBX.5?
 * Consider other CWE test types where other vocab outside of SNOMED CT might apply- check out if genomics or other test uses CWE data type for results.
 * Question regarding ICD (International Statistical Classification of Diseases and Related Health Problems) vs. SNOMED CT.
 * Suggestion- use SNOMED CT as preferred terminology with the understanding that for an interim period HL7 will be allowed, but HL7 will be phased out in the long term (year?) in SPM 4, 5, 7, 8 and 9.
 * Need to use CWE 9 for SPM 4 to return what was originally submitted. Virginia Sturmfels will find out more about this requirement This needs a little more research.
 * Achieved consensus on utilizing Recommendations/Key Takeaways for SNOMED CT moving forward.
 * Pilot should include both printout and screenshot for testing as part of requirement.
 * LOINC**
 * Need to ensure the @In-Scope Test Reviewmeets our intentions,
 * Went throughexisting In-Scope Test Review on the Wiki and made changes and edits.
 * We need to add a reference to this list for testing the appropriateness of requiring the use of LOINC vocabulary. The intent is that a user would have a valid LOINC term for each of these tests based on the property attribute but not restrict or dictate which LOINC term is appropriate.
 * Add opening statement to In-Scope Test Review. Include a consensus statement that the WG recommends LOINC as a required vocabulary for communicating test results. What happens if testing fails (i.e. LOINC will still be required but issues identified by pilot testing need to be resolved)?
 * Recommended In-Scope Test List for LRI Pilot Testing of LOINC vocabulary.
 * LOINC code has to be valid when doing testing.
 * LOINC should be independent of pilot. It should be required regardless if pilot passes/fails. Failure means that there were weaknesses/issues identified and those weaknesses will need to be resolved.
 * Aspects of successful pilot testing:
 * Include content creators and content consumers to test end-to-end functionality.
 * A valid LOINC term for each test will be transmitted by the content creators.
 * Every test on the list must be represented cumulatively across all pilot sites.
 * Must adhere to the format specified in the Implementation Guide.
 * Identified issues from pilot testing must be resolved. The mechanism of resolution is still to be determined.
 * We need to include a statement that this is an abstract representation taken from the LOINC database.

<span style="font-family: 'Calibri','sans-serif'; font-size: 16px;">Reference Materials
<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 12px;">1. @In-Scope Test Review <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 12px;">2. Key Recommendations/Takeaways

include component="page" wikiName="siframework" page="space.template.inc_contentleft_end"