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| <center>'''IHE Anatomic Pathology Domain F2F Meeting'''</center>
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| <center>'''August 5-6, 2013 Paris'''</center>
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| '''Attending:'''
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| {| class="prettytable"
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| '''Participants IHE AP'''
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| <center>'''August 5'''</center>
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| <center>'''August 6'''</center>
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| <center>'''Organization'''</center>
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| David Booker
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| <center>X</center>
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| <center>X</center>
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| College of American Pathologists/LabMedicine PC
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| Christel Daniel
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| <center>X</center>
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| <center>X</center>
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| CCS Domaine Patient - AP-HP - INSERM
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| Raj Dash
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| <center>X</center>
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| <center>X</center>
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| College of American Pathologists/Duke University
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| Gunter Haroske
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| <center>X</center>
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| <center>X</center>
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| Institute für Pathologie
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| KH Dresden-Friedrichstadt
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| HU Berlin Charite
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| FH Brandenburg
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| Mary Kennedy
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| <center>X</center>
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| <center>X</center>
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| College of American Pathologists
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| Jacques Klossa
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| <center>X</center>
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| <center>X</center>
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| Telepathology2014
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| François Macary
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| <center>X</center>
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| <center>X</center>
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| ASIP Santé
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| Thomas Schrader
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| <center>X</center>
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| <center>X</center>
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| Institute für Pathologie
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| KH Dresden-Friedrichstadt
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| HU Berlin Charite
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| FH Brandenburg
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| Riccardo Triunfo
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| <center>X</center>
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| <center>X</center>
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| CRS4
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| Gianluigi Zanetti
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| <center>X</center>
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| <center>X</center>
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| CRS4
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| '''NOTE: Presentations referenced can be found on the IHE AP Domain wiki site: '''
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| '''[http://wiki.ihe.net/index.php?title=Anatomic_Pathology http://wiki.ihe.net/index.php?title=Anatomic_Pathology''']
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| '''Agenda Items'''
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| * IHE Lab Overview
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| * APSR release 2013
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| * Change proposal modification to incorporate APSR
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| * Incorporation of Molecular Pathology/Genomics Requirements
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| * Strategy Session Initiation
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| * Telepathology
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| * Organization of Future Meetings
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| '''Action Items'''
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| {| class="prettytable"
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| '''<nowiki>#</nowiki>'''
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| '''Item'''
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| '''Responsible'''
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| '''Status'''
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| 1
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| Contact Chris Carr to determine if IHE has an IHTSDO namespace we could use
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| Mary
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| Open
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| 2
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| Determine if IHE needs permission from AJCC to use TNM terms in APSR
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| Mary
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| Open
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| 3
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| Create change proposal for APSR
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| Thomas / Gunter
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| Completed (see document)
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| 4
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| Request LOINC codes for Observation codes for APSR
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| TBD
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| Open
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| 5
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| Create a model for workflow use case
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| Gianluigi/Riccardo
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| November
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| 6
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| Create a use case for image reporting to be merged into CRS4 profile proposal
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| Jacques
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| November
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| 7
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| Send out call for new proposals
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| Co-chairs/Mary
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| November
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| 8
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| Update IHE Domain page
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| (change Trial Implementation RePub Request to 2013-10-31,etc.)
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| Mary
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| November
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| 9
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| Creation of examples of cancer/non-cancer (eg, breast/prostate; fibroadenoma) to be developed by France/Germany/US
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| Christel/Thomas/Raj
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| November
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| 10
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| Write summary of discussion and contact Epic development
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| Raj
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| November
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| 11
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| Develop mapping of values based on text using Excel template (Christel will share prototype Excel File)
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| Christel
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| Completed
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| |}
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| '''Minutes'''
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| # Welcome/Introductions
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| ## No domain sponsor announcements; however, the IHE AP meeting roster was updated.
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| ## Agenda reviewed and approved
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| ## Objectives of meeting:
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| ### Enumerate current projects and statuses
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| ### Lower barrier to incorporation of concepts into SNOMED CT
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| ### Identify ways to incorporate multinational vendor engagement
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| # Overview of IHE Lab work (Francois)
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| ## ILW has a change proposal from Harry Solomon that could be used for AP
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| ### Telepathology consultation
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| ## Lab Code Set distribution profile (IPI domain?) (Francois to share?)
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| ### LOINC recommended (Japan incorporating LOINC)
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| ### JLAC-10 Japanese required coding system
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| ## Implementation of IHE Lab profiles in France
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| ### XD-LAB accepted as national framework for France
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| #### Lab reports need to be conformant to XD-Lab to go into EHR
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| #### LTW (APHP); LCSD and LTW deployed in France
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| #### LOINC has been selected for France and has been partially translated in French (20,000 codes to date)
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| # CRS4 presentation: Can/How do we put data intensive biology in the picture? (see presentation)(Riccardo/Gianluigi)
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| ## CRS4 is an interdisciplinary, not for profit research center focused on computational sciences
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| ## Focus on clinical domain interconnection and traceability; semantic and computable management of biomedical data; telemedicine and distributed medicine
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| ## Main IHE experience in the IHE Lab and ITI domains
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| ### Technical framework supplement for lab specimen barcode labeling
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| ### One CRS4 monitor at Connectathon 2013
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| ## Currently dealing with production, managing and analysis of data intensive biology outputs (NGS, proteomics, etc) and moving toward confluence with digital pathology
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| ### Support to large scale population studies
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| ### Genetic therapy quality control
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| ## Building a biobank system
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| ### To provide consistent computable platform
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| ### To support scalable error propagation/graph of dependency data model
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| ## Industrial consulting
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| ### Pre-analytic automation and clinical lab automation systems
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| ## Support to regional healthcare systems
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| ### HL7/IHE integration
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| ### Clinical processes modeling
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| ### Real time telemedicine systems
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| ## Reasons for approaching IHE AP domain WG:
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| ### Research interests and their intersection
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| ### Is there a basis for a new IHE profile for this?
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| ### New profile could fuse data intensive molecular biology with digital pathology using extensive automation of pathology lab (tissue transport; processing; imaging; NGS and mass spectrometry; archive and storage)
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| ### A new profile could also include ordering ancillary techniques and molecular biology (Review IHE Lab automation profile/LAW)
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| ## New profile needs to address the following
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| ### Ways to do referencing
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| ### Expressions to show that result is tied to a specific area of a specific specimen
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| ### How to deal with links
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| ### Reference implementation
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| ### Need for a model for workflow (Gianluigi/Riccardo to write use case)
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| ### Need for a use case to show integration with AP
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| ### Will need to review previous DICOM work on workflow
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| ### Develop a use case for image reporting that can be merged into the profile (Jacques)
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| # APSR overview of current work (see presentation)(Francois/Christel)
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| ## APSR in a CDA format
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| ### Six 1st level sections
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| ### Only one mandatory and mandating structured data elements
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| ## Handling “none” in an observation of the <entry>
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| ### “None” and “None known” represent effective values which are part of the value sets attached to the observation
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| ## Handling missing information in an observation of the <entry>
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| ### These situations are handled with the nullFlavor attribute
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| ## Handling unexpected information in an observation of the <entry>
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| ### “Other, specify” – The actual value does not belong to the assigned value set and the author of the report provides this ''foreign value''
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| ### The value set is open to extensions
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| ### No code is available in any terminology for the value observed
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| ## New APSR templates
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| ### Ten new templates representing cancers
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| # APSR change proposal discussion (see presentation)(Thomas/Gunter)
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| ## Background for German/Austrian proposal
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| ### HL7 background reviewed
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| ### HL7 Germany has solutions for reporting to cancer registries using generic TNM and ICD-O
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| ### Uses Detailed Clinical Models (DCM)
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| ### Recommend using a generic model of meaning vs perpetuated specific observations (DCM)
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| ### Organ specific templates well suited for data entry and communication but are not suited for system maintenance
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| ### Can be supported by CDA
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| ### PathLex is logical consequence of organ specific template approach but causes unnecessary multiplication of terms
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| ## Proposed changes to APSR by German/Austrian workgroup:
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| ### Create HL7 generic model value for concepts (eg, TNM; tumor descriptions; assessment scales;)
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| ### Open APSR 05 and replace by TNM/ICD-O German, with consecutive changes in PathLex
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| ### Cancel 4.1.2.2 organ-specific APSR document content modules with consecutive changes in PathLex
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| ### Create generic document modules and templates only and organ-specific templates are now part of the appendix to be used for example, as blueprints for data entry forms (checklist functionality)
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| ### Re-launch of an ontology based PathLex (for AP observations)
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| ### Need to differentiate between terminology models, specimen and problem organizers
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| ### Advantages to this approach are few, easy to implement generic templates that can be reused in other profiles (eg, QRPH-Ca; XDS-MS)
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| ### Separate validation using schematron can be used
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| ### Would need approximately 15 required elements in total
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| ## Discussion of new proposal/next steps
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| ### Acceptance of concept of a more generic model
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| ### Current APSR files will be used as examples
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| ### Thomas/Gunter to submit a change proposal (see document)
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| ### Determine if IHE needs agreement with AJCC to use TNM in a profile
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| ### Decision is to accept many proposed changes
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| ### A generic model for APSR will be created and the appendix will contain examples of specific malignant and benign conditions
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| ### The general structure of APSR will not change and follows the CDA hierarchical tree of section, entries, organizers
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| ### Need to correlate radiology/pathology diagnosis (Birads)(Tumor board templates within IHE France may serve as a model)
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| ### Examples of cancer/non-cancer (eg breast/prostate ca; fibroadenoma) will be developed by France/Germany/US (Chirstel/Thomas/Raj)
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| ### Share mapping of values based on text using Excel template (Christel will share prototype Excel file)(see spreadsheet)
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| ### Write summary of discussion and contact Epic development (Raj)
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| Note: A change proposal was submitted by Thomas/Gunter post-meeting. Christel reviewed and edited the CP. (See document). Further discussion of the CP and final determination will occur on the next IHE AP conference call.
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| # APSR/CDISC (Christel)
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| ## Possible collaboration with CDISC
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| ## Clinical Data Warehouse and i2B2
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| ## Unicare – clinical data warehouse
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| ## Uses IHE QRPH Exchange profile
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| ## Should we collaborate with CDISC SHARE OPEN project?
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| ## Christel will forward information of next IHE AP conference call
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| # IHTSDO/SNOMED CT and AJCC
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| ## Discussion regarding APSR example concepts (eg, cancer staging)
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| ## PathLex developed as stop gap for concepts without SCT codes
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| ## Should we build an SCT extension for concepts not covered in SCT?
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| ### Determine if IHE has an IHTSDO namespace (Mary)
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| ### Draft proposal for assignment of extension namespace to IHE vs IHE AP or draft joint proposal with IPaLM SIG and submit from within the IHTSDO governance
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| ### Alternatively, use LOINC codes immediately for observation names until such time as a SNOMED CT option is available
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| ## AJCC / UICC discussion
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| ### Determine if an IP agreement is needed between staging organizations and IHE
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| ### Use LOINC codes until such time as IP agreement established
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| ## Further discussion is needed on next steps
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| ## Discussion of Procedure/Specimen Type
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| ### Review Marcial’s work (possibly have him present on next conference call)
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| # 12th European Congress on Digital Pathology
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| ## Formerly “12th European Congress on Telepathology and 6th International Congress on Virtual Microscopy”
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| ## To be held in Paris 18-21 June 2014
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| ## Plan on a joint DICOM 26/IHE AP F2F
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| ## All are encouraged to attend (see brochure)
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| # New business
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| ## Send out call for new proposals
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| ## Need to update the IHE Domain page (Trial Implementation RePub Request; Call for Proposals; Proposal Deadline; # of white papers)
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| # Next IHE AP Meetings
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| ## Next conference call November 12 (9am Central US)??
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| ## F2F meeting planned for Paris around June 18-21, 2014
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| ## Proposed F2F to take place during 12th European Congress on Digital Pathology meeting
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