French Work group « Microbiology lab reporting : structuring guideline proposal »

1. French Work group « Microbiology lab reporting : structuring guideline proposal »

2. Objectives & Agenda • Objectives • French Work group : current proposal • Feedback from IHTSDO « Microbiology reporting project » • Agenda • French Context • Work group mission & current proposal • Update on IHTSDO « Microbiology reporting project »

3. French Context • US context • @ R. Merik ‘Update on the US Meaningful Use program’ • EU context • Directive 2011/24/EU : Patients' rights in cross-border healthcare • Project • epSOS, SemanticHealthNet, • eHealth interoperability (‘Horizon 2020’) => SNOMED-CT centric • Fr context • DMP (French national EHR/PHR) • CI-SIS: National interoperabilityframework ; includeslaboratoryresultsreporting • Terminologies • bioLoinc (French translation of the subset of LOINC for lab tests, managed by ASIP Santé, with a consortium AP-HP, SFIL, Mondeca, Vidal) • SNOMED v3.5 publiclyavailable in French • Lab IS accreditation • @F. Macary ‘Update on the French program for labeling hospital applications’

4. French WorkGroup missions • Missions • Guide implementation reporting microbiology • Tests request & results description in LTW, LAW • Structure reporting in XD-LAB • Enrich ASIP CI-SIS (Health IS – Interoperability guidance) • Expected deliverables • Guidance document (in French) • Translation into English • Generalization & contribution to IHE Lab - international

5. French WorkCurrent proposal Automation manager LTW LAW LTW LIS Analyzer HIS / CIS • Observation requests • Analysis • Proposals • Specimen description • Code selection LAW Analyzer

6. French WorkCurrent proposal Automation manager LTW LAW LTW LIS Analyzer HIS / CIS • Observation requests • Analysis LAW Analyzer

7. French WorkCurrent proposal Automation manager LTW LAW LTW LIS Analyzer HIS / CIS • Observation requests • Proposal : specimen description LAW Analyzer

8. French WorkCurrent proposal Automation manager LTW LAW LTW LIS Analyzer HIS / CIS • Observation requests • Proposal : code selection LAW Analyzer

9. French WorkCurrent proposal • Observation Reporting LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

10. French WorkCurrent proposal • Observation Reporting • Included / excluded from standadization • Observation description • Observation results LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

11. French WorkCurrent proposal • Observation Reporting • Included / excluded from standadization LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

12. French WorkCurrent proposal • Observation Reporting • Observation description LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser • WhatElse ?  http://www.lhsc.on.ca/lab/report_examples.htm

13. French WorkCurrent proposal • Observation Reporting • Observation results • Organisms names • Bacteria • Fungi, yeasts • parasites • AST results • MIC / diameter -> Unit • Phenotype interpretation (S, I, R, IE, ‘-’) • Resistance Mechanisms LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

14. French WorkCurrent proposal • Observation Reporting • Understood needs for bacteria naming • Uniq ID • Follow ICSP • Keep track of name history evolution • Exhaustivity for medical needs • Maintenance, sustainability • Standard • Open to collaboration • Licence cost • What ? • DSMZ, WHO, LPSN • SNOMED 3.5, SNOMED-CT • NamesForLife, LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

15. French WorkCurrent proposal • Observation Reporting • Observation results • Organisms names • Bacteria • Fungi, yeasts • parasites • AST results • MIC / diameter -> Unit • Phenotype interpretation (S, I, R, IE, ‘-’) • Resistance Mechanisms LTW XD-LAB Public Health Automation manager XD-LAB LTW LAW CIS LIS Analyser LAW Analyser http://www.lhsc.on.ca/lab/report_examples.htm

16. IHTSDO« Microbiologyreporting » • Manyongoingprojects to maintain the terminology • Organism & Infectious Disease Model Project • Microbiology Reporting Project • «Establish subset(s) to be used for microorganism related results reporting. These subsets will be drawn from SNOMED CT content, and new concepts will be added to the SNOMED CT International Release to meet the requirements.” • Microbiology Reporting project - Whyisit of importance ? • Fix existing microorganism related content issues • Add required content to SNOMED CT hierarchies including • Organism, Clinical Finding, Observation Results, Substance • Identify and categorize concept patterns including : • Organisms classes and patterns for modifying classes • Patterns of reporting of results from microbiological examinations. Most of these are values that would normally be paired with laboratory tests • Identify editorial guidelines for descriptions and relationships for the concept patterns • Develop Value Set(s)

17. IHTSDO« Microbiologyreporting » • Organism & Infectious Disease Model Project • Taxonomymodeling effort • Connections to • laboratory findings • new observables model • Decision support • Better support for bacterial taxonomies

18. IHTSDO« Microbiologyreporting » • Microbiology Reporting project • Fix existing microorganism related content issues • ‘organism X / organism Y’ ?? • organism ‘X species’ ?? • Organisme ‘X like’ ?? • … • Rework / Add required content to SNOMED CT hierarchies including • Organism • Clinical Finding • Observation Procedure • method=evaluation action • Observation Results • Artifacts as output of observation procedures