PaLM Conf Minutes 2021-December-08
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Attendees
| Name | |
|---|---|
| Alessandro Sulis | alessandro.sulis@crs4.it |
| James McNulty | jmcnult@cap.org |
| Mary Kennedy | mkenned@cap.org |
| Dan Rutz | drutz@epic.com |
| Raj Dash | r.dash@duke.edu |
| Craig Sayers | |
| Jim Harrison | james.harrison@virginia.edu |
| Ralf Herzog | ralf.herzog@roche.com |
| JD Nolen | jdlnolen@gmail.com |
| Demetrios Divaris | dimitrios.divaris@grhosp.on.ca |
| Gunter Haroske | haroske@icloud.com |
| Filip Migom | filip.migom@gmail.com |
| Alex Goel | agoel@cap.org |
| Steve Nichols | |
| Veronica Klepeis | vklepeis@mgh.harvard.edu |
| Jurgen Brandstatter | j.brandstaetter@codewerk.at |
| Hynek Kruzik | kruzik@gnomon.cz |
| Norman Zerbe | |
| Riki Merrick | rikimerrick@gmail.com |
| Kenichi Takahashi | kenichi_takahashi@hotmail.com |
Next meeting: January 12, 2022
Agenda
- Announcements:
- Congratulations to Alessandro on the birth of his son!
- Change proposal voting
- Received some affirmative votes so all CP are considered approved
- No vote equates to affirmative
- SET and RAD published
- RAD comment
- Alexis posted a comment https://docs.google.com/spreadsheets/u/1/d/1DzmX5s6SL1g1VytHjL4O9h7j0W-ohYODBd-yT8ydsBY/notify/show?rev=179&fromRev=179&s=AM5m-fgk23VHQMwHR9WNvfcLVuHR_MPR5Q
- Harry Solomon’s comment is about this use case not being very common and how the score will be used – we do have examples of this workflow at academic institutions and this profile is designed to make them more common and interoperable – We will look for vendors to implement - Riki will send the comment back to Harry Solomon
- Administration
- ECDP annual conference may be an alternative date for the F2F if Ghent does not work out
- F2F is still scheduled for 5/2 – 5/4, 2022
- Will send out another Save the Date
- IHE Board report due to DCC in January 2022; Riki is working on it
- IHE PaLM wiki page needs updating; Co-Chairs and Mary will work on it
- ECDP annual conference may be an alternative date for the F2F if Ghent does not work out
- Updates/Discussion
- HL7 FHIR reporting for lab results to public health (PH) and between labs and providers
- Germany (labs results reported to PH using FHIR); Belgium
- HL7 work around cancer reporting in progress
- Blood banking profiles
- Ordering blood products profile suggested
- IHE Japan Connection:
- It was held at Asakusa, Tokyo on 25 thru 29 Octtober 2021. However, LAB was canceled in the same manner with last year because of COVID-19. Four domains RAD, ITI CARD and ENDO were carried out. 34 systems of 21 vendor were joined. In ITI domain, FHIR profile PDQm – Patient Demographics Query for Mobile was newly tried this year.
- IHE Japan Promotion Activities:
- Ms. Megumi Kondo and Mr. Naomi Ishii gave IHE Tutorial session titled ‘IHE Updates 2021’ at the 41st Japanese Medical Informatics Union Convention on 21 November 2021.
- Ms. Megumi Kondo gave a presentation entitled “IHE-J Anatomic Pathology Committee activity report – Standardization trends in Anatomic Pathology domain” at the 19th annual meeting of the Japanese Society of Digital Pathology on August 21, 2021.
- Steve Nichols – DICOM WG 20
- Tracking HL7 ballot on US core FHIR profile for diagnostic imaging reports and clinical tests; both point to the same profile on DiagnosticReport and includes media and ImagingStudy; lab seems to be missing from the profile
- There is also a genomic profile and in the pathology profile they have links to media and DICOM objects: https://simplifier.net/medizininformatikinitiative-modulpathologie
- We should provide feedback to HL7 on that – EMR vendors will be required to meet certification criteria to these API, so MUST support AP, if we want to stay relevant – ballot comment http://build.fhir.org/ig/HL7/US-Core/branches/master/StructureDefinition-us-core-diagnosticreport-note.html
- https://build.fhir.org/ig/HL7/fhir-cancer-reporting-ig/ - US Core not addressing pathology, especially structured pathology data is a huge gap we need to address. In US CORE there is a place to address it ; the profile linked above is the CDC’s attempt at filling that gap
- IHE Europe is developing test offering IHE Sharezone (www.ihe-europe.net/IHE_SHARAZONE): continuous testing platform = framework for different vendors to exchange DICOM objects for testing purposes – https://drive.google.com/file/d/1A27-5seQZa_NufM3EBn4CTPZJj8WE9lL/view?usp=sharing
- HL7 FHIR reporting for lab results to public health (PH) and between labs and providers
- New project proposal
- Expand LTW for proficiency testing (PT) in the US (Raj)
- Modification of LAB-1, LAB-2, LAB-3 to accommodate PT
- May expand profile to Europe and/or Canada.
- In Belgium the lab is not supposed to know that these are PT samples, so that the lab doesn’t change anything from what they would normally do
- In Germany use microarrays for PT also
- Dimitri is in Ontario, Canada – PT program is testing the clinical / operational side for any licensed test they do – treated as a patient sample, results are entered electronically and those can then be reviewed individual results as well as in cohort of results done with the same instrument – and if outlier will have to do review as to why
- May have to set up different use cases for Digital Pathology
- This could improve lab-lab PT testing, where commercial PT is not available and help with standardization activities currently; will also need to look at ILW
- Motion to accept work for next cycle JD, Raj, further discussion: can this proposal be uploaded to google, so it can be shared with potential implementers, against: 0, abstain: 0, in favor: unanimous
- Expand LTW for proficiency testing (PT) in the US (Raj)
- X-ehealth update (Juergen/ Hynek)
- This is a cross border exchange for Europe that will develop FHIR equivalence for use case (lab results; image reports) and is meant to exchange lab reports on a document basis across countries.
- Developed specifically for broad type of labs but will create specifications for clinical lab primarily.
- Now includes patient summary and e-dispense; next to be developed is lab orders and results, imaging reports and images.
- Currently working on requirements gathering
- XD Lab is the obvious choice, but found that some items are missing
- Will also move toward using FHIR
- Will also need to deal with translations between different languages; there will be a translation from the European accepted codes to the local codes/descriptions
- From chat: Can't we use the v2 to FHIR mapping project and layer that onto XD-LAB? = https://build.fhir.org/ig/HL7/v2-to-fhir/
- From chat: Belgium HL7 site link: https://www.vas.ehealth.fgov.be/webretam/retam/home.htm?eventName=SEARCH_BY_LOINC_CODE
- From chat: Germany link: DEMIS : HL7 FHIR Diagnostic Reports https://simplifier.net/demis/~introduction
- There is a lot of work going on on representing lab content in FHIR resources:
- NIH has this profile on US Core DiagnosticReport (and US Core observation) for COVID-19 at home testing: https://nibibdrupal8stg.prod.acquia-sites.com/hl7-fhir-specifications-for-at-home-covid-test-reporting
- Cancer pathology reporting IG was balloted in Sep2021:
- HL7 OO has lab calls on Fridays 1 – 2 PM ET- call – may want to attend those meeting
- PaLM will need to make sure we don’t do something different from Austria / France / Belgium – would be best if IHE can deliver that common profile for use by all
- Questions regarding XD-Lab
- Issue 1: FHIR standards for Report and Order; Filip would like to discuss this also at the F2F. Belgium uses FHIR diagnostic report. Riki will provide a link to the profile on diagnostic report for COVID which will be balloted at HL7 soon. Also the cancer path FHIR reporting project at HL7 went to ballot in Sept. From Alex: From Alex: https://build.fhir.org/ig/HL7/fhir-cancer-reporting-ig/ - US Core not addressing pathology, especially structured pathology data is a huge gap we need to address. In US CORE is a great place to address it - the profile linked here is the CDC’s attempt at filling that gap.
- Issue 2 – Representation of content in 2 variants of expression of lab content in XD-Lab – which to use? has 2 variants – but most places use variant 1 = narrative block + Lab Data Processing Entry. Austria uses closed template and only variant 1. Good question for Francois. Riki to follow up with Francois as to why XD-Lab allowed the second variant with the subsections (which creates a break up of the narrative block – otherwise the structured part can create the subsections). Prefer to just allow one of the variants.
- Issue 3 – Specialty section: value-set of codes. The list of codes for Lab specialty sections seems to be fixed to the values described in the profile. Is it mandatory to use the list in the profile? Can we relax the constraint on the LOINC valueset? This seems to be lab types, but the value set binding is not clear. Riki: create a value set that says it shall be a LOINC code for each class. We may need to update with an intentional definition of which LOINC codes to use – this needs to be made more precise by declaring the vocabulary binding ideally to example, but if SHALL, then make expandable and update the section name to Laboratory Study Type Section. This is used for organizing the data in the report, which may be different at the receiver side, when incorporating the data into their own data model. Specialty names across European countries standardize based on SNOMED CT, but will not actually standardize the study type. ArtDecor implementation of XD-Lab – SHALL be drawn from value set. From Filip: https://www.vas.ehealth.fgov.be/webretam/retam/home.htm?eventName=SEARCH_BY_LOINC_CODE
- Issue 4 – Status of lab observations. To be discussed at the next call.
- From chat:
- From Gunter: https://simplifier.net/medizininformatikinitiative-modulpathologie
- From Filip: https://www.vas.ehealth.fgov.be/webretam/retam/home.htm?eventName=SEARCH_BY_LOINC_CODE
- From Filip: https://wiki.hl7belgium.org/index.php?title=Laboratory_Workgroup
- From Raj: Can't we use the v2 to FHIR mapping project and layer that onto XD-LAB? https://build.fhir.org/ig/HL7/v2-to-fhir/
- From Jim H: HL7 Orders and Observations Workgroup handles lab orders and results, there are active projects to map HL7 v. 2 to FHIR. There’s a Lab workgroup with weekly conference calls. Minutes of the lab workgroup are at https://confluence.hl7.org/display/OO/OO+Meeting+Minutes (click LAB in the list).
- From Filip: https://simplifier.net/demis/~introduction
- From Riki: https://nibibdrupal8stg.prod.acquia-sites.com/hl7-fhir-specifications-for-at-home-covid-test-reporting
- From Filip: https://www.ihe.net/uploadedFiles/Documents/PaLM/IHE_PaLM_TF_Vol2x.pdf.
- Germany link: DEMIS : HL7 FHIR Diagnostic Reports https://simplifier.net/demis/~introduction
- Sent from Steve after call:
- The US Core: Clinical test and Diagnostic Imaging report – https://docs.google.com/presentation/d/1ZFwTEDTkxSmssELxBJZWjVNWjNeA5dVS/edit?usp=sharing&ouid=116119429285485236437&rtpof=true&sd=true
- The DiagnosticReport profile for lab does not include references for media or ImagingStudy: https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport-lab.html. A potential concern is that Digital Pathology does not have an option to include or reference imaging in a DiagnosticReport.