| Interoperability Standards Platform (ISP)

Analysis of clinical specimens to obtain information about the health of a patient.

Data Element

Specimen Type

Description (*Please confirm or update this field for the new USCDI version*)

Substance being sampled or tested.

Examples include but are not limited to nasopharyngeal swab, whole blood, serum, urine, and wound swab.

Applicable Vocabulary Standard(s)

Applicable Standards (*Please confirm or update this field for the new USCDI version*)

SNOMED Clinical Terms (SNOMED CT®) U.S. Edition, September 2024 Release

Submitted By: Nedra Garrett / Centers for Disease Control and Prevention
Data Element Information
Use Case Description(s)
Use Case Description	Disease reporting to public health relies on data from the EHR for identification of reportable events and to provide critical information used in confirming a diagnosis, understanding severity and classifying a case of disease that requires public health intervention for prevention, treatment, control, and outbreak identification and response. The specimen collection date is of particular importance for public health in understanding when laboratory confirmable evidence of a disease process was present in the patient. Specimen type and specimen site provides information useful in interpreting laboratory findings to determine severity and transmissibility.
Estimate the breadth of applicability of the use case(s) for this data element	Over 3000 public health agencies in the US would use these data elements for disease surveillance and control activities.
Link to use case project page	https://www.cdc.gov/elr/index.html
Healthcare Aims	Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	LOINC https://phinvads.cdc.gov/vads/SearchVocab.action
Additional Specifications	N/A
Current Use	Extensively used in production environments
Supporting Artifacts	These are standard elements in HL7 laboratory messaging https://www.cdc.gov/elr/index.html
Extent of exchange	5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Supporting Artifacts	These data elements are standard components of HL7 electronic test order and reporting (ETOR) messages between clinical setting and clinical laboratorories and of HL7 electronic laboratory reporting (ELR) messages sent from clinical laboratories to public health. https://www.cdc.gov/elr/index.html
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	None
Restrictions on Use (e.g. licensing, user fees)	None
Privacy and Security Concerns	None
Estimate of Overall Burden	N/A
Other Implementation Challenges	N/A

Comment

Submitted by Riki Merrick on 2023-09-19

Further specify SNOMED CT hierarchy for this element

APHL suggest to further clarify the hierarchy in SNOMED CT to be used here: SNOMED CT concepts drawn from the specimen hierarchy.

Submitted by nedragarrett_CDC on 2022-09-28

CDC's Consolidated Comment for USCDI v4

CDC continues to recommend inclusion of this high priority data element in USCDI v4

Submitted by Lantana Consul… on 2022-04-29

Lantana Consulting Group Comment

Along with inclusion of Specimen Type, Lantana suggests including Specimen Collection DateTime. A DateTime element is necessary to track and create useful context when exchanging pathology information. Without it, the progress made by including Specimen Type in USCDI V3 will be limited.

Submitted by RUy on 2022-04-29

Standard leads to PHINVADS, not specific value sets

Specimen type is a critical component to understanding and validating laboratory tests and results for both clinical care and public health. However, the submission here points to a website that discusses the electronic laboratory reporting program and not to a standard. The link to PHINVADS here similarly does not reference any specific value sets. NACHC believes this data element should reference one or more value sets (with or without relevant standards/profiles) that consist of implemented and validated concepts used in the existing laboratory standards.

Please see attached NACHC letter, documenting this comment and other feedback for v3 accepted draft data elements.

2022-04-30 NACHC USCDIv3 Letter of Support.pdf

Submitted by aphillips@imoh… on 2022-04-28

Level 2 Data Element: Specimen type

IMO supports the inclusion of the Laboratory Data Class in USCDI V3 to include the Draft data elements for Tests and Values/Results.

While valuable, IMO questions the capability of ONC certified HIT to store and exchange the Level 2 Data Elements detailed in this submission While many of these data elements are implemented in CLIA for routine exchange between labs and state, tribal, local, or territorial (STLT) public health agencies, we request that this submission be reviewed thoroughly for implementation in ONC certified HIT.

Submitted by nedragarrett_CDC on 2021-09-29

Unified Comment from CDC

Additional Use Case: This is a standard data item used by central cancer registries in all states. Data received through data exchange from laboratories to central cancer registries for CDC and NCI’s national cancer surveillance systems, as required by law.
CSTE supports inclusion of this measure into USCDI v3: very useful for laboratory related fields context.

Submitted by Riki Merrick APHL on 2021-04-15

APHL comment to add into USCDIV2

This data element is critical in understanding what a laboratory result may mean - for example a positive culture result from a blood culture has different implications than from a urine culture. In many cases the specimen type can be expressed as part of the LOINC of the test being performed, but if that is not the case (because a less specific LOINC was chosen, or no LOINC was used) then this supports the test result. It has been part of v2 messages for a long time (OBR-15.1) and is required element in ELR R1 (SPM-4).