PaLM F2F Minutes 2016-May

Minutes of IHE Pathology and Laboratory Medicine (PaLM) meeting

May 23 - 25, 2016

Berlin, Germany

Attendees

Name	Company	May 23	May 24	May 25
Raj Dash	CAP, planning co-chair	X	X	X
Gunter Haroske	IHE Germany	X	X(tc)	X
Ed Heierman	Abbott	X(tc)	X(tc)
Naomi Ishii	JAHIS / Hitachi Hightech	X	X	X
John Hopson	Abbott	X	X
Mary Kennedy	CAP, board representative	X	X	X
Carolyn Knapik	CAP, secretary	X	X	X
Megumi Kondo	Sakura Finetek Japan			X(tc)
Laurent Lardin	bioMerieux	X	X	X
Alessandro Sulis	CRS4	X	X	X
Francois Macary	Phast, technical co-chair	X	X	X
Genichi Kato	Shiga Hospital	X	X	X
Riki Merrick	APHL, planning co-chair	X	X	X
Filip Migom	MIPS	X(tc)	X(tc)	X(tc)
Dmytro Rud	Roche	X	X	X
David de Mena	SAS		X	X
Francesca Frexia	CRS4	X	X	X
Francesca Vanzo	Arsenal IT		X	X
James Harrison	CAP	X(tc)
John David Nolen	Cerner	X(tc)	X(tc)
Jurgen De Decker	MIPS	X(tc)	X(tc)	X(tc)
Thomas Schrader	Brandenberg		X	X
Lamine Traore	UPMC - Paris	X	X	X
Victor Feria			X(tc)
Andre Huisman	Medical PHIT			X
Ralf Zwonitzer	DGP			X
Yves Sucaet	Pathomation			X
Mikael Wintell	DICOM			X
Frank van Apeldoorn	Digital Pathology Solutions (Philips)			X
Joachim Schmid	Rocke			X
Karl Weinbach	Hamamatsu			X
Marcial Gracia	Hosp Jeratz			X
Luis Alfaro	HV Consuelo Vaeincm			X
Johan Dore Hansel	Viseopharm			X
Arvyoas Laurinauicius	Vilnius Univ.			X

(tc) = Teleconference

Action Items/Wrap-Up

Action Items/ Wrap - Up

1. PaLM TF v7.0
   1. Appendix A: add Analyzer Manager - Francois
   2. When are actors added? ask Mary Jungers – Riki
   3. Documents are on sFTP – review and send comments to Francois by 5/31 – ALL
   4. Finish Volume 3 by May 29^th-Francois
   5. Submit all 6 volumes to Mary Jungers for publication on June 3 – Francois
2. APSR
   1. Art Décor:
      1. Form authoring group (Gunter, Francois, Raj, Riki, JD, Frank) and get webinar from Frank- Mary K
      2. Review specimen DAM for harmonization – Riki/Raj
   2. Word document
      1. Review for most current changes and value sets – Francois/Gunter
      2. Add specimen organizer changes agreed to in Paris - Francois

• Find other pathologists (more SME reviewers) - Raj

1. Model APSR example using SDC - Raj

3. Data Element Registry
   1. Share link to google drive to open source tooling for SDC form (Rich’s demo) definitions – Mary
   2. Data element registry white paper - bring up to DCC as plan – Riki/Raj
4. Ensure LCC use cases are known to FHIR workflow discussions – Riki
5. Find out more about HL7 CIMI work – Riki/Francois
6. LSH – John
   1. Resolve the open issue on the semantic of command response sent back by device, possibly through email and the 2^nd hour of PaLM monthly calls.
   2. Share the supplement for committee review, when its ready.
7. Update SET profile Volume 1 - Alessandro
   1. Entering the design phase of volume 1: Focus on SET. This profile has no required actor grouping
   2. Follow the supplement template for Vol 1.
   3. Possible actor groupings to be illustrated (lightly) in section “Cross Profile Considerations”
   4. Review specimen DAM for input to SET– Riki/Alessandro
8. Prepare the election announcement for email distribution in July/August– Mary/ Carolyn
   1. Japanese Co-Chair position renewal? - Naomi
9. Send link to CLSI Auto 16 draft when available – Ed
10. Review specimen DAM for input to SET– Riki/Alessandro
11. Upcoming PaLM F2F meetings:
    1. November 7 – 9, 2016 at CAP in Northfield, IL
    2. Spring 2017 (April?) – Tokyo, Japan – Naomi to send dates to Mary/Carolyn
    3. Fall 2017 – Europe (Paris or Sardinia)

Agenda

Notes May 23:

 

Welcome - thank you to the Charité personnel for setting us up!

Introductions All Around

 

Agenda review and objectives (see PaLM_Committee_ Berlin_meeting_agenda_objectives.docx)

• Registry covers the vendor’s integration statement – attestation about profile and options implemented in their product
• Connectathon matrix (actor, profile, transactions as search axis) consolidates results from Japan, Europe, North America

Data Exchange

• Would like to understand the scope of DEX – seems to be for a specific profile data element exchange only (IHE wide data element registry would be nice – any IHE profile – this does not exit at this time we think – each profile is required to list the data elements in the registry that it supports / with constraints etc)
• DEX is very recent profile (2015) – but only a specification for clinical research– if we think this is a good idea, we should bring this up to the DCC
• AHIMA also has project reviewing tools that allow non-IT users to create definitions for clinical pathways by combining and possibly further constraining pre-defined data elements and describing the business rules around them, having all harmonized to one set of specifications.
• CaDSR has a data element registry. The hardest part was the maintenance of the registry and the QC of what goes into it. Should we make an IHE project to create governance around that? We should propose for AHIMA to look at this as part of their tool evaluation project
• FHIR has a registry of resources and profiles built on resources = simplifier.net.
• So far for publication we have scheduled: TF and one Supplement for 2016 year.

 

Relationships of PaLM

• IHE Board: Mary attends these. The focus is mostly on the new membership model and planning the IHE International meeting in Amsterdam. <a href="http://www.ehealthweek.org/ehome/128630/ihe-world-summit/">http://www.ehealthweek.org/ehome/128630/ihe-world-summit/</a>
  • Membership is still evolving. Visitors are allowed to attend 1 or 2 meetings; SMEs are always allowed, when needed.
• Domain Coordination Committee (DCC): Riki attends these. This group focuses on how common processes can be applied to multiple IHE projects that are shared across the various domains.
  • IHE publication cycles are rather short; 1 to publication and 1.5 till connectathon is expected, so projects are for specification.
  • White papers have 1 year to be published.
• HL7 has HSI (Healthcare Standard Integration) WG, which summarizes ALL HL7 work projects that list cooperation with other SDOs
• HL7 AP WG will be focusing on the IHE project. The decisions was made to move the AP WG back into OO (Orders and Observations) and focus on project work until / if we have critical mass to create a separate WG. HL7 AP is currently working through this process of moving back to OO.

 

PaLM TF 7.0:

• New template plus adding LBL and LAW that are now final text.
• ILW is implemented by one vendor in France, but never tested in connectathon – may have discussion about how to get this ILW final text, now that we have virtual connectathons, hope to get more participation so that we can get to final text.
• APW profile part will be used in digital pathology workflow – more likely split into several profiles to support the digital workflow – as well as ordering / reporting, which is close to existing LTW.
• Vol 1 has been reviewed by a few folks.
• Section 1.2:
  • Scope – need to be sure to cover the workflow of specimen handling.
  • Need to clarify that the first bullet covers the primary clinical use of patient care and prevention.
  • Storage of specimen needs to be fleshed out so that it covers logistics as well as clinical data.
• Appendix A:
  • Need to add Analyzer Manager - Francois
  • Review to make sure ALL actors listed in PaLM TF are listed there.
  • Find out when actors are added – assume during publication of supplement (ask Mary)
• Appendix D:
  • Review glossary definitions
• Appendix E – has all the definitions that work across ALL IHE domains – no work needed
  • Reviewing change summary
• Chapter 2:
  • Review what is in the diagram.
  • After review of SET tomorrow, may add it.
• What about the SD data element reuse project? Once we have published as a whitepaper with indication of actors, then we can add the new profiles into the diagram for possibly the next version of the TF.
• All transactions will be labeled LAB-<number>, so for the 3 LSH transactions we will assign those this meeting.
• AP profiles published as supplements, don’t currently have LAB-<number> transactions identified, will be changed, when they are updated – example: APW will be split into digital workflow and the order and resulting, which was just LTW transactions
• APHR profile – how will this move to final text?
  • Should coincide with HL7 OO. PHER project to address NAACCR DSTU comments on ELR R2, which most likely affects data elements from LRI and ELR.
• For review of the documents – pull OFF the sFTP site and send your edits (with track changes on) to Francois
  • Committee review ends May 31, 2016

 

IHE PaLM Webinar discussion: (see IHE-PaLM_Webinar20160726.pptx)

• Create a table with expected delivery dates for the current project.
• Raj to supply an SDC slide for webinar.
• Add more about XD-Lab.
• For LAW recruitment is for implementation.
• Include a slide on benefits of participating in connectathon. Include the dates of future connectathons
• Highlight the benefit of change for improved handling of data exchange topics, better understanding of processes (see slides from Eric)

 

APSR v1.0 to 2.0 comparison (see SDC_APSR 2.0.pptx)

• APSR v1.0 was published in 2013
• Have discussed the title change to Pathology Structured Report (PSR)(the leading A for Anatomic is dropped)
• CPs from 2014/2015 from Germany still need to be applied (work with Christel was done on some of these, but need to locate who has the latest version)
  • Problems around procedure steps were discussed in Paris (specimen related processing)
  • Frank and Gunter have transferred APSR into Art Décor tooling = v2.0:
• Start with data sets which include terminology binding capabilities.
• Scenario describes the actors and descriptions of the use case(s).
• All CDA templates are in the repository that can then be further constrained.
• Diagramming function will show the template in UML.
• Can also be linked to wiki to share the changes performed in art décor with the larger group
• Frank Oemig developed an APP for Data capture based on Art Décor definitions – have asked if he can write an app for SDC.
• Schema from the tool for conformance testing is being developed.
• The SDR project can reuse the data elements defined in Art Décor.
• Need more authors in Art Décor. Can we request a webinar by Kai for those who have decided to become authors?
• We should write PSR in Art Décor to have the schematron generation and checking available and link with the wiki for the text. Then combine them into the final document.
• Need to check the work that has been transferred into Art Décor
• Need resources:
  • Identify the plan for Art Décor updates.
  • Compare against SDC roadmap – concept behind SDC is to provide elements to create the flexible research project.
  • In the PSR Art Décor creation focus on the proper tagging of the elements with the right name / value pair to describe the context and content.
  • Concentrate on creating the generic definitions for the elements: what is a “stage”, what is “circumference”,
  • QRPH developed phase 2 of SDC with a schema that can describe the behavior of a data element for data entry as well as reporting.
  • Oct 2015 publication takes into consideration some template aspects, like different realm handling / or language coverage.
  • How should APSR and XD-Lab be compared for future consideration to be able to create the consolidated report supporting both of them. (APSR can include clinical pathology observation = lab observation) –> PSR
• XD-Lab is mandated in France, Austria, Switzerland and is preferred in the EU.
• Next Steps:
  • APSR as is transferred needs review to the existing word document (does the general template cover the specific templates for the anatomic locations as described in the current word document). The value sets will change. (Francois)
  • Specimen procedure step adjustments (see slides from Paris F2F, not yet in the document).
  • Discussion of handling of the organizer templates.
  • First step is to become familiar with Art Décor tooling. Team of identified: Gunter, Francois, Raj, and Riki (specimen focus).
  • Raj will recruit other pathologists to find more SME reviewers (CAP meeting in Seattle in June – will put on agenda).
  • Will the discussion with Andre about specimen workflow (APW) influence the APSR development as that may affect the entries in the APSR? Re-engineering is part of the plan for the intra lab specimen processing.
  • Are the radiological approaches the right way to go since the digital images are used for direct interpretation?
  • JD Nolan will also help with participation of Frank and Kai.

LCC

Working through HL7 Change Requests for v2.x. We need to make sure the FHIR workflow discussions cover the LCC use cases.

 

LSH

• John’s image of the 3 transaction:
  • SPD = Specimen ProcessingDevice, STM = Specimen Transport Manager
• Wiki for specimen in place acquisition – ADD LINK – asked John H for link
• Use case #1: Specimen handoff- re-initialization
• Use case #2: cancel specific specimen
  • Question about difference between not sending start and sending the SPD cancel?
  • Cancel should never be sent after the specimen acquisition has been completed.
  • STM gets the specimen Acquisition Complete and then it can move the specimen around.
• Use case #3:
  • Cancel all specimen preparations to be able to start with a clean slate, e.g. for interface start up. Are there more steps after the cancel all request?
  • Change name of use case to “specimen handoff interface Reset or Re-initialization” – this also encompasses the risk that the STM needs to reset during specimen presentation.
  • Should this be the first thing for EVERY time the interface is started? Could be, but not required.
  • Whenever any ambiguity about the status of specimen orders occurs to the STM, not just when powering up the interface for the first time, could come up at any time in the use case 1 workflow – should highlight that this applies to ALL sequences the SPD should compete the initialize sequence before responding to the re-Initialization message – clarify that as part of use case #3.
  • Consider breaking up LSH-3 Command and Response?
  • How should errors be handled when the SPD is down, waiting etc.? This is implementation specific and not defined here. If there are more than two conditions where the STM does not know the reason, then the Response does not come back. Need to suggest a way to indicate reason for failure and guidance on handling those failures (time out for example).
• Would this profile apply to micro automatic photos of culture plates? Out of scope / not actually taking the specimen but taking a picture – so could the response include the image along with the response complete? – would be a variation of the LAW more than LSH.
• Should keep single transaction with 2 trigger events, because it would not make sense for SPD to only take commands, and not send responses.
• Individual LSH-03 transactions can overlap each other for different specimen, which should not be an issue
• Specimen processing capability of the SPD is requested by the STM.
  • SPD role is report status
  • STM is request status
• Use latest HL7 version = 2.8.2 – should not have material changes. MSH has 4 extra elements (sending and receiving responsible organization and sending and receiving network address) and EQU uses CWE instead of CE.
• Need to rename LSH-01 to proper LAB-<number>.
• Under expected actions: add the expected LSH-02 response.
• No security considerations – basic practice of the current status of lab security policy is that these transactions are inside the lab. IHE in general, expects a sometimes pairing with the specific.
• Will have to add milestone for publication of supplement.