PaLM Conf Minutes 2020-October-07

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Name Email
Gunter Haroske
Mary Kennedy
Francois Macary
Rikki Merrick
Alessandro Sulis
Megumi Kondo
Dan Rutz
Kevin Schap
David Beckman
Raj Dash
Francesca Vanzo
Jim Harrison
Ralf Herzog
JD Nolen
Francesca Frexia
Sujith Nair
Sam Spencer
George Birdsong
Ross Simpson
Alex Goel
Veronica Klepeis
Brian Bialecki
Markus Herrmann
Peter O’Toole
John Hargett
David Clunie
Peter Mello
Craig Sayers

Next meeting: November 11, 2020

  • Agenda Review
  • New proposals
    • Timeframe?
      • Riki will send out the call for call for proposals – will give 1 month to submit and review on Nov and Dec calls
    • Evidence Creation profile for digital pathology
      • Looking for possible vendor support – who from the DICOM WG26 can we ask to help?
    • Radiology / Pathology Concordance Reporting Proposal
      • Proposal Link:
      • PPT Link:
      • Discussion:
        • Key use case was described
        • Proposed profile is a new type of concordance workflow
        • Raj agrees with the generalizable paradigm
          • Surgery / biobanking reconciliation between research and clinical concordance is a good example
        • Problems raised are that different reports are produced in silos – not good access between different reports
          • Which data elements are fed to the concordance reporter?
            • Discussed the sharing of the concordance scores, not the data / reports per se
              • Example: specific images in radiology implies certain findings should be in a pathology report, but if that is not the case, there may have been something different going on (the pathology result should match what would be expected)
        • Where is the change in workflow that will be needed – how will that be addressed?
          • Mammography report:
            • Single number in radiology, but there is not that value in pathology – how do you get the scores to compare?
            • This may require recommendations from professional organizations/specialty society as best practice to adjust to a new workflow
            • This will take a long time and there will be pushback
        • Recommend focusing on the use cases where we do not need workflow changes
          • Biobanking
          • Maybe in APSR create a score section (later)
      • Best next step would be to identify use cases where we already have resonance with vendors
        • Need to have concrete examples to get vendor buy-in
          • Vendors needs to understand the value and what the gain is for their customers
      • IHE PaLM would like to have the support for APSR included in the profile
      • Proposed mechanisms:
        • FHIR
        • SDC format (captures the CAP’s electronic cancer data (eCC), but does not include anything else in a structured report) – there are some vendors implementing eCC SDC format)
          • IHE SDC working group is working on that
            • Using observation
            • Storing the SDC form as docRef
            • bundling into message or composition bundle
          • want to leverage use of observation for this profile
        • Translate APSR to FHIR – project ongoing in Germany (funded by the Ministry of Higher Education, not as part of HL7 Germany); all the activities are based on using APSR as the starting point – hope this will be the case that this is as generic as possible)
          • HL7 has a to-do item to describe how to express structured reports like pathology and radiology reports
        • CDA management group is discussing how to map CDA to FHIR later today
          • We need to keep an eye on that as well
      • The data transfer of the elements should be FHIR, but the content format should be kept out of this work
      • Next steps:
        • Overall decision vote could be in November
        • Need to identify vendors and implementers that are interested in supporting this proposal
          • Grady hospital in GA is interested in this for mammography
          • Also Mass General Hospital is interested
          • Pathologist/radiologist/vendors working on this:
            • Pathologists: George Birdsong; Veronica Klepeis; Ross Simpson
            • Radiologists:
            • Vendors who have confirmed support: Nuance Communications; Voicebrook; mTuitive
            • American College of Radiology and College of American Pathologists are leading the proposal
        • Narrow down the proposal to what we can accomplish in 18 months
        • Reach out to IHE Radiology as well before next call
        • Also reach out to IHE QRPH since that is where the SDC work is ongoing
        • Also may need to engage IHE ITI
  • SET
    • Updated document with comments to review for the next call / or close via email
    • Then bring back the message structure CR to HL7 OO
    • SET is being used to define a new FHIR resource in HL7 OO specimen project
  • Digital Pathology White Paper
    • Paper has been submitted
      • Some comments have been sent to Raj and he will review them
      • Revised document will still be shared later this week
      • A conclusion has been added in the updated paper; please review
  • Connectathon support for DPIA – not discussed