National Center for Public Health Informatics CSTE & CDC Joint ELR Task Force Standards Workgroup Meeting - NCMT Discussion Jan 7 th 2011

Agenda Background – 5 minutes Tasks: –Establish a panel regarding the maintenance of NCMT (SDO, CSTE, ELR Workgroup, CDC) –Establish a process for maintaining the NCMT (LOINC/SNOMED update, State request, CSTE Position Statement updates) –Update the NCMT Content –Resource for maintaining the NCMT –Provide requirements for enhancing CDC Vocabulary Server (VADS) to support NCMT distribution – Web / Web services –Support for knowledgebase projects using NCMT content Timeline

Notifiable Condition Mapping Table (NCMT) Definition: Notifiable Condition Mapping Table (NCMT) provides a cross-walk between Nationally or State Notifiable Condition, Laboratory Tests (LOINC) and Laboratory Results (SNOMED). CSTE Technical Guide is a subset of NCMT. Notifiable Conditions (National / State) Influenza Lab Test (LOINC) Infuenza A, B,C – Ag, Ab Lab Results – Organism (SNOMED) Influenza Virus - A, B,C, Subtypes Organism List Lab Test List

Original Scope & Purpose of Dwyer NCMT - Jerry Sable Slide 2004 A pplications – Not application or software. Repositories of facts needed by public health applications for filtering B reakable – Dwyer tables have information about all the notifiable condition associated lab tests and results. Users could break this or subset for efficient use (e.g. STD subset of Dwyer Table). C ase definitions – Dwyer tables are not laboratory criteria for diagnosing notifiable conditions and cannot be used to confirm cases. All the tests in the Dwyer table are related to notifiable conditions, but the strength of the relationship varies. (E.g. IgG antibody tests  Past infection). D ecision support – Dwyer tables provide facts but does not contain any rules or criteria for ruling in or ruling out various situations. Dwyer table is not a decision support system but could provide facts for a decision support system E LR – Used for filtering the lab test results and routing the lab results to various public health programs. Dwyer table was designed primarily for ELR. F inished – Dwyer tables are not finished or complete. Changes in notifiable conditions list, new lab tests, organism taxonomy updates, medical knowledge updates, Coding system updates (LOINC and SNOMED). So, keeping the Dwyer Table up-to-date is an ongoing project.

Shaun Grannis – Regenstrief Slide

NCMT Content Source One or more of the following resources / options could be used for future NCMT content: 1)Regenstrief - Shaun Grannis – Notifiable Condition Detector which uses up- to-date NCMT (see AMIA 2010 paper). 2)Regenstrief RELMA Browser – Provides a hierarchy of LOINC Lab tests based upon Micoorganism Hierarchy. 3)CSTE Technical Implementation Guide (TIG) – Provides LOINC and SNOMED codes for each reportable condition. 4)Few State Public Health Departments such as NY PHD have been maintaining NCMT. 5)ELR Knowledgebase work initiated by Utah Public Health Dept / Rocky Mountain CoE. 6)Collecting all the State Public Health Department’s version of NCMT and creating a Master NCMT after harmonization to reduce the variation of each state’s NCMT. 7)Indian Health Services (IHS) Knowledgebase – Public Health Case Reporting