LRI+Validation+Suite+WG+2011-10-25

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 * LRI Validation Suite Meeting Minutes**
 * Date:** 10/25/2011
 * Time:** 1:00-2:00 pm EDT

Robert Allen, Neeli Bajaj, Tom Boal, Joan DuHaime, Freida Hall, Cynthia Levy, James Littlejohn, Scott Robertson, Rob Snelick, Virginia Sturmfels, Sheryl Taylor
 * Attendance**

Note: If you attended this meeting and are not listed above, please contact Amanda Mari (Diamanta.Mari@lmco.com) or (443-348-2773) to be added to the list.


 * Agenda **
 * **Introduction **
 * **F2F Documentation and Related Discussion **
 * **LOINC and Local code testing **
 * **Next Steps **
 * **Q and A **

A speaker from the division of Laboratory Services with the Center of Disease Control (CDC) joined the call. She advised that her team has expertise in verifying clear compliance with CLIA and would like to support this validation effort.
 * Introduction of newest support participant **

Robert Snelick referred her to the S&I framework wiki page for the LRI validation work group to review the several slide decks that are available that were presented and the recent F2F event which shows the overview of this workgroup as well as the charter and the scope. There is also information available on the wiki pertaining to various sub projects that are typically are not discussed in these meetings. This information will be very helpful in bringing any new comers up to speed. An anticipated timeline has been added to the wiki page. This timeline will not be finalized until after the second printing of the implementation guide. It is too difficult at this time to be firm in dates as a lot of things are changing.
 * F2F Documentation and Related discussions **

Another set of slides that is currently available for view is regarding the question of how to test vocabulary. This document captures most of the most recent discussion on this topic. It does not, however, include the feedback that was received at the F2F. In regards to the feedback from the F2F, it has been determined that the workgroup would like to begin putting together a more concrete policy on how to conduct this testing. Some of the other requests from attendees of the F2F including the request to send local codes as part of the test message. Significant progress was made but, there are still some foggy areas that need to be revisited for clarification.

One area where the workgroup is still not clear on the requirements is the use of LOINC and Local codes. It has been determined that a LOINC code will almost always be sent but, a local code may or may not be included. Clarification needs to be made in regards to whether a LOINC code can be used by itself or does a local code need to be associated as well. The testing tool will be able to test the ability to add a local code.
 * LOINC and Local code Testing **

Another item that needs to be considered is if a LOINC code is not sent, either because it is not applicable or not yet assigned, the Electronic Health Record (EHR) should still be able to function. A test needs to be created that will check to see how the EHR will react to a LOINC code being blank.

<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">The speaker from the CDC suggested that it may make sense to display both the LOINC and local code descriptor. The local code will be more specific and customized to the setting as there are only a limited number of LOINC codes. Rob Snelick advised that it is expected that the text will be posted on the screen as CLIA requires that the name of the test is stated. An additional consideration is that the CLIA inspectors are going to want to ensure that the report shown on the screen is the same text as the lab results.

<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Vocabulary needs to be a consideration as well. There are a significant number of tests where the description is very scientific and will not equate to common terminology. This is something that should be considered as well in regards to posting descriptions of tests. <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">In regards to validation in the past, the test name that the lab uses is what is used for validation. Using what the labs test name is which is linked to the local code. The vocabulary team has recently attempted to get clarification from KLEA to see if the lab description does not match the LOINC link would cause problems with the KLEA inspectors.

<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">A suggestion from the workgroup is to send multiple tests from multiple sources that have the same LOINC code but different local code. Once EHR test is complete, attempt to pull a report that will then display or group the similar tests together. In order to consider this option, the quality measures from meaningful use need to be investigated further in order to assume that the users will all have the reporting functionality available to them. <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Another suggestion is to inspect the current database to review linage for LOINC and to leverage meaningful use with other quality measures.

<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">The next steps that need to occur is that the workgroup needs to continue to build the test cases and investigate some of the other requirements and try to put them together for an example test in order to determine an approach.
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Next Steps **

<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">None at this time
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Questions **

Next Meeting ** WebEx link: [|siframework2.webex.com] ** ** Dial-in: 1-408-600-3600 Passcode: 661 974 427 **
 * Date: Tuesday, 11/01/2011**
 * Time: 1****:00 p.m. EDT**

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