PaLM Conf Minutes 2023-August-09

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Raj Dash Jim McNulty
Kevin Schap Riki Merrick
Megumi Kondo Gunter Haroske
Rob Rae Ruben Fernandes
Jim Harrison Jason Lowder
Alex Goel Jan Schutrups
Mary Kennedy JD Nolen
Next PaLM Meeting: September 20, 2023


  • F2F logistics:
    • PathVisions
      • DICOM wants to get together again, but they would only have 2 hours for a joint call/in-person
      • Topics for consideration
        • Follow up from last F2F
          • Identifying use cases we need to support and evaluate the DICM standard (Ruben)
            • Digital example files from Markus
          • Questions related to DPIA profile (What goes into DICOM header vs what is in the profile?)
        • Next Step: Kevin to get date and time set – 10/29 either 8-10 or 10-12 AM ET
          • Do we know what vendors will be there?
            • Sectra (could send US rep)
        • If this meeting does not work, we could use second hour of the IHE PaLM calls
    • European F2F
      • For Digital Pathology profile, it would be good to have Leica and Sectra present.
      • Aim for spring 2024 March or April, but not week of April 8th – Mary and Ruben to send out some options on the listserv.
    • No updates on Gazelle, LTW CP, Technical Framework since Alessandro was not on the call.
  • DICOM update:
  • Proficiency profile update:
    • Jim H has a good to do list for the next couple of weeks.
    • The primary activity has been negotiations between CAP PT and Duke on how to do the presentation project
      • Identifying the core data elements needed for the orders and results
      • Crosswalk to HL7 V2.5.1 and to set this set up for a proof of concept.
      • Will also identify the elements needed for FDA / SHIELD BAA.
        • Identify the use cases for PaLM (PT – anything else? that fits into this – like IVD datahub, or datahub to PH – the way the test is identified should be the same for both, though may need additional patient demographics for PH).
        • As SHIELD moves forward with identifying tests – need to check how closely CAP PT testing elements map to it.
  • Digital Pathology
  • Comments on DPIA
    • MSH-9 suggests using a different message structure – use ORL_O34 instead of ORL_O42 – Riki to check on the message structure we are using. But since we are describing the ORL_O34 later, it is most likely a typo.
    • Paragraph around 730 – one order per specimen for modality
      • Would not make a difference to send multiple orders to Leica, but for each specimen would expect only 1 order in 1 message – that’s what we have, so the ORL, which is the answer, would only have a single order to respond to. We will need to fix the table.
  • DPIO
    • Physical steps of specimen prep are tracked in the LIS; PACS is responsible only for the images.
    • Slide 32:
      • PACs needs to know the scan ID is issued by the LIS.
      • Need to differentiate between just a rescan – same slide ID, vs recut on different slide ID.
    • Slide 36:
      • Percent of cells that are positive – data element in PACS.
      • Display gross examination report from LIS.
    • Slide 37:
      • Unsolicited result to subscription list – list of applications that get results, so if result is available will send everything that is ready – this is NOT described in this profile – could use IHE cross enterprise service bus (
        • For example, PACS would be on the list to receive the gross report from the LIS and this can have multiple updates. There is not really a final, as this will get updated when the pathologist gets more info back from the micro examination.
        • Will have to set up reconciliation to ensure the report is the latest, but not as hard to do, as long only 1 of the systems is doing the reporting (PACS should not allow the editing of gross report or other fields that are populated with data from reports by other systems).
      • Query for specific data element – using QBP messages.
        • Mostly to ask for specific patient, but not common.
        • Do we need to describe?
    • Slide 39 – need more research around LB4
    • Slide 40:
      • Actions described here come from image viewer.
    • Slide 41:
      • Treating DICOM CID, which is using SCT as the codes; can reference its OID in SPM-6.15.
      • Ruben will create an example of HL7 messages.
      • Raj will work off-line to progress based on this.
  • Next call will be Sept 20 - in the first hour, will have to split with UDI topic / second hour is for proficiency profile.

Adjourned 10:30 AM ET