PaLM Conf Minutes 2018-July-11

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Riki Merrick Alesandro Sulis
Raj Dash Francesca Frexia
David Beckman Nicholas Jones
David Clunie Dan Rutz
Kevin Schap Mario Vallace
Mary Kennedy Nick Hasselhorst
Gunter Haroke


Riki reviewed the agenda. SET update: Alessandro is building the z structure messages and will share the proposed structures and issues for each event. His goal is the end of this week or prior to the next call (8/8/2018). We will use the second hour for his updates. See the follow up on SET related items on the F2F summary slides #3/5.

Riki is finishing the LCC. The updated LCC publication date is July Riki will follow up with Mary Jungers on TF publication TMA: The changes have not been made yet; it will be published for trial implementation after 8/8 SNOMED CT follow up: Riki will send a note to with Chris Carr requesting status. Digital pathology: Raj reviewed the work from the F2F.

  • Acquisition is top priority = looking at workflow and how to split between HL7 and DICOM transactions
  • There MUST be an HL7 option instead of RAD-49 = Instance availability notification
  • Image archive to support both, but in the lab side mostly using HL7 only
  • Order filler to Acquisition manger transactions:

o Current HL7 interfaces don’t have receive messages at this time – DICOM transaction can tell you , if they worked and include meta data about the image

  • Issues that are standard independent:

o Both DICOM and HL7 support acknowledgements for receipt and application level

  • Radiology just defined new ORU message in encounter-based workflow profile:
  • Broker use is attractive for the architecture = acquisition manager actor has value to help with install base (Is this query or broadcast?)
  • Scanners do not want push notification of all possible s=order vs query for order, when barcode has been scanned; use of queries in HL7 world has been elusive. This is where LAW comes in – defines both push and query.
  • Protocol assignment based on accession number is how a lot of the clinical chemistry analyzers work. No issue to have IHE create both options and see what comes through in the market
  • There are three models of Acquisition:

o PUSH = explicit order o QUERY o Image identification reconciliation

  • Real time notification ahead of image being available
  • EHR may not want individual slide level detail ahead of time – when you need to pass images around outside the report is different
  • Hierarchical ID = study instance ID that is the highest level, that then have unique IDs for each slide – proxy is accession number in RAD, probably the same in AP
  • AP comes in asynchronously from the slide perspective compared to a single radiology process in a larger study (e.g. a CT scan is not missing a slide in the set of CTs)
  • Order filler here is AP LIS – that needs to know that ALL slides have been produced.
  • Need to be able to identify when case is incomplete – how do we translate that to digital pathology?
  • Order filler vs acquisition manager – protocol defines what a complete study needs – that can be specified between order filler and acquisition manager
  • There is still a need for human interactions in the AP workflow – so you don’t have to standardize EVERYTHING; need to have meta-data about what is available – but to decide if that is everything you need for a case should be human decision for now (or defined by proprietary protocol)
  • Keep transaction for now at the individual image level for starter. Include explanation of how some of this will work in addition to the definition of testable profiles
  • Need to include thoughts on how systems can break / error handling = that can include normative rules
  • Look at RAD-14 and 16 for whole object transactions
  • There are new TCCP transactions DICOM WG26 has been working with – web image access uses these RESTful transactions (Radiology – may be reusable but adjust for AP microscopy – part 18 in DICOM

The call ended at 10:10am Central. 1