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