PaLM Conf Minutes 2022-September-14

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Riki Merrick Jason Lowder
Raj Dash Jim McNulty
Dan Rutz Rob Rae
Alessandro Sulis Mary Kennedy
Jim Harrison Kevin Schap
Ruben Fernandes Mandel Mickley
Will Humphrey Megumi Kondo
Ralf Herzog David Beckman
Gianluca Pavan

Next IHE PaLM call: Oct 12, 2022


  1. Agenda review – no new items added
  2. Minutes – All posted minutes have been approved by general consent.
  3. Telemedicine white pater has been published and is in public comment until September 25. Any comments will be reviewed at the October PaLM call.
  4. HL7 / DICOM general questions
    • See IHE PaLM listserv posting from Ruben 9.13.22
    • How should block, slide, digital asset be distinguished?
      • Currently we are discussing using specimen (SPM) and identifying the parent and using role to indicate which specimen information is “historical” -i.e., not submitted
      • Each scan has a different ID
      • We are currently using a pattern for the identifier to identify the block – cut – slide etc.
      • Epic is not planning on extending the accessionID but will add in the DICOM ID into the model for each scan
      • Phillips also has an additional image ID
      • Can we identify the glass slice (using SAC) and would we do the same for the digital slide?
      • Stains would be using SPM-6 (Additives) – had discussed that H&E stain (in both DICOM and HL7) that this would be 2 substances. We need to add these as codes to HL7 (might be harder in SNOMED, as these are substances vs H&E staining is a procedure). In FHIR we have specimen.processsing where we can use the procedure code from SCT = 104210008 H&E Stain (Procedure).
        • There may be different protocols for H&E staining between labs; over time this can affect staining color. This is not currently covered or captured by the lab. This may be important for the future when using AI, etc.
    • In the specimen DAM we have used a reference to the protocol ID so that the steps used can be documented elsewhere.
    • This is similar to the harmonization field being discussed in other lab domains.
    • Additive field is not designed to capture all the steps of a procedure, just the substances used.
    • Using snapshot to indicate stain – unstained (empty SPM-8) and re-stained
    • DICOM file has specific attributes that we need to get across in HL7
    • Next Step:
      • Identify all the use cases we need to document for AI
      • Raj said the CAP AI committee can work on these use cases. Then, we can see what attributes are needed.
  5. Digital Pathology
    • Waiting for someone to lead the Evidence Creation profile
    • Have reached out to DICOM WG26 Co-Chairs, but no answers since they are currently prepping for their connectathon at Path Visions.
      • How to deal with DICOM web
      • DPIA may need to be updated for that
      • No work on the DICOM 26 annotations supplement currently.
    • Raj working on CR for DPIA
    • For DPIA we could also check Query By Parameter (QBP); could help some of the scanner and LIS vendors.
  6. Plan for SET and DPIA Testing
    • Need to create the message profiles
    • Alessandro working on creating profile in IGAMT for SET – needs to also build it for DPIA (may be easier, since they are using existing message structures) – Alessandro will work on both – goal is to review during October 12 PaLM call.
    • Need test cases written up for each of these profiles:
      • Which to use and how many to include in a test plan for the 2023 Connectathons (US in February? and Europe in April)
  7. Next step for the LAW CR: send out to the group for voting
  8. Concordance Profile – no one from this item on call
  9. X-eHealth – no one from the item on call
  10. Next call is October 12, 2022