PaLM Conf Minutes 2022-January-12

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Name Email
Alessandro Sulis
Jim McNulty
Mary Kennedy
Dan Rutz
Raj Dash
David DeMena
Jim Harrison
Francesca Frexia
JD Nolen
Gianluca Pavan Arsenal.IT
Gunter Haroske
Filip Migom
Nick Haarselhorst
Kevin Schap
Megumi Kondo
Jurgen Brandstatter
Hynek Kruzik
Francois Macary
Riki Merrick

Next meeting: February 9, 2022

  • Administration:
    • F2F: The group will stick with the dates currently scheduled, 5/2-5/4, 2022
    • Wiki changes needed:
      • Milestones for 2021 and 2022 need to do this before the IHE PaLM Board report is finalized this week.
      • Dates are needed for the publication matrix for 2022.
      • As a group, we should make sure EVERY published profile has a wiki page using the correct template
    • IHE PaLM Board report:
      • Alessandro will check on participation numbers for Connectathon participation in 2021.
      • The tables will be combined into the first table.
      • Riki will send a draft to the email list - please provide feedback by the end of this week.
  • DP-AT project update
    • The white paper will be sent out by email to provide feedback. Please send feedback by the next PaLM committee call
    • Please share the document as a pdf and send comments back to Gianluca
    • The challenge of vendors receiving DP-AT because of PACs system drive workflow was discussed.
  • HL7 Germany
    • DEMIS FHIR specs are the official spec for reporting micro to PH starting tomorrow.
    • APSR work is separate from DEMIS FHIR
      • IHE PaLM Image1 01-12-2022.jpg
      • Link to the current draft:
      • There is work creating the Diagnostic Report section.
      • Diagnostic Conclusion will be a very short observation in the report.
      • Group observations to cover the grouping into the CDA sections were created, and then those have all the observations.
      • A bundle was created and used composition to support the document. The document will have IG available for the ballot at HL7 Germany in March
    • Are there plans to coordinate with SDC for structured data?
      • Yes, those structured data are in the individual observations
    • Creating a logical model in eXHealth
      • Gunter is also the primary author of APSR 2.1 in art décor. He can help support the eXHealth effort, too
      • These two efforts might fit together well.
      • It was requested that Gunter attends the Tuesday morning meetings.
    • OO also came up with the solution of combining composition with DiagnosticReport
      • The two approaches should be compared to ensure we can resolve any differences (also include the genomics reporting)
        • In Germany, genomics doesn't use composition but does build a similar diagnostic report.
        • It should be determined to find a project to make this comparison soon:
        • The PH (Helios) and genomics accelerators at HL7 may be the best home for this.
        • JD will add awareness for the genomics quarter next week.
        • However, we may need a separate project
  • Xe-health
    • Two variant options to express the lab content?
      • 4/5 countries only using variant 1;
      • What was the reasoning for having two variants?
        • We allowed this to accommodate the various pdf printed reports - in France; we had two possible layouts:
        • French extension of XD-Lab is here: ADD LINK!!!
        • variant 1 = single chapter with all results
        • variant two = only organizes the narrative blocks by creating a high-level section (Laboratory Speciality section) with subsections (laboratory Report Item)
          • The issue is that the example uses a code for a single lab test in the subsection rather than a subsection code, causing some confusion
    • It may be worth revising the examples to make it clearer to use a section code here instead.
    • The next step is for Juergen to write the CP.
  • The list of LOINC section codes will need to be updated
    • It must be understood that these are example codes and not a complete list.
    • ArtDecor implemented this as SHALL.
    • Do we also want to allow other code systems?
    • SHOULD can have two value set bindings
      • Extensible = must be LOINC but can add more codes
      • Preferred = could be this or any other code system
    • We need to increase the content and make the value set extensible.
    • This does not need to track the type of laboratory that created these results, so rename the section to Lab test type rather than lab specialty
    • The next step is for Juergen to write the CP to make the value set extensible and change the name from Specialty to Study Type. Juergen will write the CP
    • Juergen will have Francois and some others review the above CPs
  • Status codes:
    • There are three levels:
      • Status of observation:
        • There is a need for at least: preliminary, completed, aborted, corrected
        • XD-lab is intended to support ONLY the communications when the workflow is complete, so preliminary is not needed in that case.
        • The group should think about correcting and entered-in-error.
          • Entered-in-error:
            • It seems to be more of an annotation on the electronic record in the dB.
          • The laboratory should be able to reconstruct the history of everything that has been shared, but it is not easy on the consumer side to do with this.
          • Corrected:
            • What if you send results in different formats? How do you track corrections across various means, and what status should be assigned to each.
      • Status of order:
        • We didn't discuss this.
        • For V2, we have a matrix of order status based on observation status
          • From LRI:
          • IHE PaLM Image2 01-12-2022.jpg
          • In IHE Pathology & Laboratory Medicine Technical Framework, Vol. 2x (PaLM TF-2x): C.10 Correlations of Status between ORC, OBR, OBX
      • Status of document:
        • It should not be computed from the status of the observations.
      • Juergen will share the discussion around this document
      • Riki will share minutes from Lab calls (Fridays 1 – 2 PM ET on OO meeting coordinates) when we are discussing statuses - in general, meeting notes are here – Click on LAB:
      • Using CDA for workflow?
        • CDA is expected to be a snapshot of the data at a specific point in time; CDA can point to the previous report that this report replaces
        • CDA is not made to handle workflows - IHE created XDW to address some of these issues.
        • France will create a CDA to document orders to a data repository, but not for actual order workflow handling.
        • Cross-border e-prescription use is acceptable because you share a persisted prescription document (think of it as a copy) of only those who still have open prescriptions.
        • They are updated by providing a new version, but the dispensing status is not part of that new version.
  • We will continue the next IHE PaLM call on Feb 9