Card Tech Minutes 2017.10.11-13

Attendees

Chris Melo, Co-Chair, Philips Healthcare

Nick Gawrit, Co-Chair, heartbase

Paul Dow, Secretary, ACC

Rebecca Baker, ACC

Nakano Shinichi, Toshiba, IHE Japan

Takeshi Oozeki, Toshiba, IHE Japan

Ann Pollard, HCA

Sophia Chaidez, HCA

Birgit Roy, ACC

Ganesan Srinivasan, ACC

Antje Schroeder, Siemens Healthineers

Beth Stokes, ACC Accreditation Services

Alex Kraus, Biotronik [WebEx]

Andrea Price, Indiana University [WebEx]

Dan Murphy, Epic [WebEx]

Charles Thomas, University of Washington[WebEx]

Day 1 Minutes

Planning Committee Discussion

General discussion regarding the IHE process.

What do we want to achieve with

CPN Extensions - Charles Thomas

Review of possible additions to the CPN including: indications, disease states, and clinical per-procedure evaluation, e.g. CHADS-2 Vasc score. The challenge is How do you code a process? We may create a checkbox, along the lines of Was this process completed? There may be difficulties with documenting how an Acceptable Use Criteria or Clinical Decision Support tool was used.

There are gaps in the underlying specifications for the LAAO Registry regarding data dictionaries, for aborting a procedure, as well other items for deploying devices. There are some issues that need to be resolved and include normative vs. extensible value sets. The methodology recommendations are complex and beyond the scope of the IHE Tech Committee. The coding challenges will be addressed by Charles off line. By Wednesday, we hope to have the milestones for public comment and trial implementation publication.

CPN Companion Guide - Rebecca Baker

The goal is create a bridge from the technical documents to the implementer at a clinical facility. This will help communicate value and return on investment to the implementation team. There can be confusion from sites who say they already have a structured report. There are many poorly written structured reports around the country. This is an opportunity to allow data to flow downstream to other uses. The clinical guide could provide structure through a common set of discrete data points as a recommendation.

IHE Japan Update - Nakano Shinichi

2017 Cardiology Connectathon: 44 vendors 70 systems tested at the September event. CATH, ECHO, ECG, and IVI were tested. IVI was first tested in 2013 and has seen updates and improvements since that time. Open Issues: 1. Hard to catch up to recent technical standards. Last year, some items were required. This year they are optional. Possible collaboration with Radiology Group? 2. No multi modality systems. Possible collaboration with US and/or EU? We may reach out to the larger Cardiology membership about possible solutions.

Standards Update - Takeshi Oozeki

ISO/TR 215 - This is regarding the secondary use of clinical data for cardiology data. Imaging data, as represented by measured values from ECG, and cardiac echo are not standardized. The Japanese Circulation Society [JCS] established guidelines to register the measured value data in 2015. LOINC may be the preferred coding system. Chris will follow up on the question regarding the use of SNOMED codes in IHE profiles that are implemented in Japan. Are further fees associated with use?

Day 2 Minutes

EBIW Workflow - Antje Schroeder

The clinical situation is when a patient needs to add camera based.JPG images, e.g. from dermatology, or point-of-care ultrasound DICOM images from a diagnostic study. The RAD Domain has chosen to develop the ultrasound use case. There is still some debate about what demographic data will be required to document the encounter and the transactions. This will be released for public comment in Feb 2018. As we get closer to the release date, the CARD domain can provide some feedback on the technical details. There may be an opportunity to work with IHE Japan regarding this update. There may be further discussions regarding national extensions and coordinated efforts to use this profile across domains and national regions. Antje will keep the IHE CARD TC updated with new details as they occur.

CPN Companion Guide and White Paper: Scope and Purpose - All

The discussion revolved around balancing the needs to understand the use cases for operational vs. patient care aspects of the profiles. [Add notes from Rebecca]

Chippenham and HCA Cath Lab Structured Report project overview - Sophia Chaidez and Ann Pollard

Review of the historical background of the project

IVI Update - Nakano Shinichi

Review of the background development of the profile. Discussion of modification of procedure steps for clarification of Modality Procedure Steps in Progress [MPPS] for intermittently connected modalities, such as ultrasound. Additionally, the workflow process and its verbiage was discussed with extensive examples from clinical scenarios.

CPN Extesions - Charles Thomas

Review of CPN within Art Decor. This lead to a conversation of Edits to Be Done work list to determine what codes need to be added to the profile for the LAAO Report. The code list is dynamic and terms will be added. The substantial challenge is the ongoing maintenance of a controlled CV terminology. There are complex factors that prevent a centralized governance process for the data elements. There are several groups outside of IHE that are working on this topics. This sort of maintenance is out of scope of IHE charter, but we can provide insights and guidance. It may be helpful to have other societies with registries, such as STS, to participate to contribute insights as well as codes for their procedures and submission.

Day 3 Minutes

CPN Companion Guide - Rebeca Baker

Rebecca reviewed the projected a timeline for completion of the guide in approximately 14 weeks, and ready for public comment on April 4, 2018. One goal is walk through a rendered EP Report. Though the text will focus on the rendered document, and not on the XML. Though a certain amount of comfort navigating the XML as well as the Art Decor tool, could be beneficial. There may be more flexibility with our timelines as the text is developed. The general plan will be to review the profile off line and save the T-cons for specific questions.

Next Steps

1. Team Members - Rebecca, Dan, Andrea, Sophia, Ann

2. Walk through Profile - 12/20/2017

3. Other Steps TBD

IVI - Nakano Shinichi

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Next Steps

1. Nakano will post questions to the Google group for feedback regarding the national extensions for procedures.

2. We will schedule T-cons in the near future on this topic.

CPN Extensions - Charles Thomas

Much of the coding dictionary for the LAAO Registry is still under development by the ACC and will not be ready until 2018 Q4. AFA and other groups will use CHADS Vasc score which could explain why some SNOMED codes are available. These codes should be in the EP profile as well.

Next Steps

1. Paul will send Charles Traci Connolly's e-mail.

2. Charles will complete a draft by April 1, 2018.

Domain Planning - All

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