PaLM Conf Minutes 2017-Sept-20

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The recording for this meeting can be downloaded:


Riki Merrick, Co-Chair Vernetzt, LLC
Raj Dash, Co-Chair CAP
Carolyn Knapik CAP, secretariat
Mary Kennedy CAP, secretariat
Alessandro Sulis CRS4
Daniel Moncusi Systelab
Dan Rutz Epic
David de Mena SAS
Filip Migom MIPS
Francesca Frexia CRS4
Francesca Vanzo Arsenal IT
George Birdsong CAP
Gunter Haroske IHE Germany
Jessica Poisson Duke
Megumi Kondo Sakura Finetek Japan
Philip Foulis CAP
Ross Simpson CAP
Sandy Jones CDC


Agenda Reviewed and adjusted for content


F2F meeting logistics – scheduled 11/13 – 11/15 – invitation will be sent end of the call

  • Cagliari, Sardinia – close to train and airport
  • The meeting will be held at Manifattura Tabacchi, a historical building in the very center of Cagliari, previously a home to a tobacco processing plant and now allocated for cultural events and research meetings ("" ).
    • The complete address of the venue is:
    • Manifattura Tabacchi,

      viale Regina Margherita 33

      09125 - Cagliari (Italy)


  • Hotel information to follow.
  • Please email Francesca to inform her if you are attending either in person or remotely: ""
  • Email Alessandro and Francesca  for trip information or hotel information


Project updates:

  • APSR 2.0:
    • Have created the pdf document and have set up a call between François and Mary Junger on Friday – still fixing a few bugs in pdf creation
    • End product will be handed over to IHE wiki for publication, then editing can be handed over to approved IHE editors
  • Digital Pathology white paper:
    • Sharing the word document from Raj: APW_modification_for_Digital_Pathology_1.1.docx
    • Whole Slide Imaging (WSI) solution was just approved in US by FDA for diagnostic use
    • Sweden is the lead in the development for this technology
    • Did some research on existing work in the radiology DICOM specification:
      • Want to share a smaller amount of the entire DICOM document to capture the multi-frame aspect of the WSI
    • Reach out to David and Marcial for follow up
  • Digital anatomic pathology workflow development considerations.docx
    • Vendor participants – Mary reached out to Michael and found out, that there was no further development:
    • DICOM WG 26 is meeting October 1 – collect questions for them = share the APW specifications and modification proposal to the DICOM WG meeting
    • Looking for more input from across the globe
    • Goal is the modified APW draft for review at F2F
    • EPIC is interested (Connect with David Beckman) – give update on where they are, Raj and Dan will meet next week
    • Recommended modifications to APW as working title for the white paper
    • Will need to coordinate with DICOM folks
    • Mary to reach out to Bruce Beckwith - main focus at the DICOM WG will be connectathon
  • Structured Reporting Profile for Data Capture project
    • Sharing Raj’s word document: PALM_SR_v09202017.docx
    • Enhance interoperability between disparate system
    • Rather political than technical, so we will describe the problem first – in white paper
    • Happy to see the work that has been done in Art Décor, as that supports this kind of federated development and tooling of what we try to do here
    • Collected use cases and prioritized those
    • Describes standards and systems
    • Potentially using SDC
      • eCC protocols are now published in SDC fomat (beta version)
      • Public specification
      • Open for use in crowd source development
      • IHE in radiology working on structured reporting – would be good to do cross-domain collaboration; need to find out what tools are used there
      • Cancer Care Ontario has been working on development in SDC in radiology domain (David Quan? Sandy to share)
    • Share this white paper with DCC to get better exposure
    • Development for common data element registry to be addressed cross domain
    • Tooling available in Art Décor
      • Some education on how to use, but potentially needs to be improved – try out a pilot
      • Consider the technical framework as well as the semantic interoperability layer – so we will need to set up IP licensing / agreements – so need to get some legal help with that
      • Synoptic reports from CAP were moved into the SDC, but not identified as such and then also map into some of the questions in the forms to LOINC / SCT – all of that will have to happen to make that work – need to have the data element identified in a globally unique manner
        • CAP is using the CQ? In SDC – so if you track them back they should be the same, as long as the semantic meaning hasn’t changed
        • Also working on mapping into SNOMED CT – working with university of Nebraska– large task; also the granularity of SCT will have to be considered when we do this mapping and the utility for coding the data element level – as pre-coordinated or post-coordinated approach – they have some examples of the mappings for eCC
        • Nebraska created some local codes to create the pre-coordinated concepts
        • EPIC interested in that development
        • Discuss at user group meeting next week
    • Next update at F2F
  • LCC:
    • Jim and Riki reviewed the document last week, needs a few modifications
    • Postponed the publication date with Mary Jungers to between now and October 9, 2017
    • How should we address marketing this to vendors as part of the public comment period, so we can get their comments?
    • Send a notice to the new outreach marketing side and ask on the DCC call next week
  • LSH:
    • Carolyn to reach out to John for an update
  • SET:
    • Alessandro and Francesca sent out updated version for review, have updated the use case for container production (robotic machine) track it separately from collection of specimen
    • Robotic system is presenting container in location different from location where specimen is collected, so that we can track time between container production and collection event
    • LAB-63 transaction could trigger container production event – as optional transaction in use case #1 (specimen collection)
    • Updated the event matrix table accordingly
      • Goal is to complete discussion on elements in this table
      • Collector information – Riki to send attributes on performer associated with the collection event
    • For F2F discuss how the meta data matrix can be translated into messages – testing the model
    • How to handle specimen collection data time range, when it is not collected – then would the event itself event triggered?
      • If not triggered, then how to get the missed reason?
      • May be make conditional – if missed reason, then  not required
  • TMA:
    • Still intend to publish for comment
    • More procedural  questions for Francois for editing
    • HL7 is doing a bit of work on adverse event and adverse reaction – modeling in FHIR
    • Also regulatory issue with the term ‘adverse event’
    • We should not specify adverse events now in the TMA but rather list as open issue for now until HL7 has sorted that out, but document the requirements for sharing that information
    • Still discussion on how the “blame is assigned” versus just having a reaction (not necessarily based on an allergy, i.e. when you give the incorrect blood type)
    • When you talk about a patient condition versus when the symptom is due to adverse reaction
  • Vendor Outreach – no update today


Next Meeting:  Propose changing the date to October 18th, as October 11 falls during the CAP17 Annual Meeting