PaLM Conf Minutes 2019-August-14
Attendees
Name | |
---|---|
David Beckman | dbeckman@epic.com |
Raj Dash | r.dash@duke.edu |
Gunter Haroke | haroske@icloud.com |
Nick Hasselhorst | Nick.haarselhorst@philips.com |
Ralf Herzog | Ralf.Herzog@roche.com |
Mary Kennedy | mkenned@cap.org |
Megumi Kondo | Kondo.Megumi@sysmex-cp.co.jp |
Francois Macary | Francois.macary@phast.fr |
Riki Merrick | rikimerrick@gmail.com |
Kevin Schap | kschap@cap.org |
Alessandro Sulis | Allesandro.sulis@crs4.it |
Rob Wilder | Rob.wilder@spok.com |
Eddie Albert | ealbert@lifeimage.com |
Francesca Frexia | Francesca.frexia@gmail.com |
JD Nolen | jnolen@cmh.edu |
Dana Marcelonis | jnolen@cmh.edu |
Ian Gabriel | Ian.gabriel@siemens-healthineers.com |
Dan Rutz | dRutz@epic.com |
Next call is September 11, 2019
F2F Meeting at CAP headquarters
- November 13-15, 2019 in Northfield, IL, USA
- Please RSVP: https://www.surveymonkey.com/r/ihepalmnov2019
Digital Pathology Profile and White Paper
- Digital Pathology:
- Supporting OBX/SPM as well as OBX/OBR
- OBX/SPM required, if the stain name MUST be OBX/SPM, then there must be at least 1 OBX/SPM to cover that, since that is a DICOM required element and clearly related to the specimen
- Where does the study UID go – ask David Clunie if OBX should be after SPM or OBR, and, who assigns that (the original submitter / the placer of this scan order (LIS / IA manager?) / the modality)?
- Is a Series instance UID needed? Or, is it the same as placer order number? No, because we are talking to the scanner – that is for each scan – series is more the order from the placer to the lab, not from the lab to the scanner – so would that be ORC-38?
From HL7 v2.9: ORC-38 Filler Order Group Number (EI) nnnnn Components: <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)> Definition: This field contains a unique identifier for the Order Group as referenced by the Filler application. An Order Group is a set of orders grouped together by the placer application. The first component is a string that uniquely identifies all order groups from the placer application. A limit of fifteen (15) characters is suggested but not required. The second through fourth components constitute a filler application ID identical to the analogous components of ORC-2-placer order number or ORC-3-filler order number . Order groups and how to use them are described in detail in Section 4.5.1, "ORC – Common Order Segment."
- Need to update the mapping spreadsheet but it is still be good to check with David Clunie.
- Cancellation from the Scanner – how is that done? Can we get a real world example from Nick for that? The technician realizes the wrong batch is being scanned and pushes cancelation button.
- In LAW can the analyzer send a cancelation? Send LAB-29 with the status as order completed and observation status as X or N – that would be at the order level so using the OBX does not work here so well
- OBR-25 = X
- ORC-1 = OC (for filler applications, so that should work, since that is te same is
- ORC-5 = CA
- Raj will create a google doc with the list of questions and answers
SET
- We need two events to distinguish collection performed (S39) from collection failed (S40) sharing the same message structure SET_S38; we need two events to distinguish procedure step performed (S51) from procedure step failed (S52) sharing the same message structure SET_S51.
- We need a distinct event (S50) and message structure (SET_S50) to track the derivation of a child specimen. The derivation of a child specimen is always a success.
- For consideration:
- When a specimen is processed to produce a derived (child) specimen the events tracked are:
- 1 S51 (procedure step performed) on the input (parent) specimen;
- n S50 (child specimen derived) for each child specimen produced;
- When the derivation process fails, the single event tracked is:
- S52 (procedure step failed) on the input specimen
- When a specimen is processed to produce a derived (child) specimen the events tracked are:
- We were having lengthy discussions about what processing produces a derived specimen and what doesn't - there are some clear examples:
- culture -> isolate(s)
- organ -> block -.> section -is really -> slide
- sample -> aliquots (this is really just a splitting of the same sample across multiple containers, but then if the containers have different additives, they alter the specimen)
- slide -> digital image
- pooling multiple samples into one is less clear
- centrifuging and using only the plasma / serum (if that was the intent of the blood collected in the tube with appropriate additives?)
- We were having lengthy discussions about what processing produces a derived specimen and what doesn't - there are some clear examples:
- Per Riki: the difference between a successful processing step and a derived specimen is the inclusion of the information about the derived specimen, right?
- Are there advantages of having parent specimen and child specimen in the same message?
- Options are:
- #1 Use S50 for any processing successful message, with optionally reporting the derived specimen
- #2 Use S50 only to declare the derived specimen (no information on the parent specimen other than SPM-3) and then use S51 for successful processing of the parent specimen
- We need a message structure to report unsuccessful processing events, but need to examine if that message structure is at all different from the successful processing event.
PCD Joint Work
- Rob Wilder, from Spoc, and part of the PC domain (planning Co-Chair)
- ACM management working group = alerting
- Mobile desktop managing for patient workflow in EHR-S
- Lab and radiology alert managers – providing notification to docs to mobile devices, when results are ready, would like to standardize that
- Successful implementations have reduced response times in result reviewed by the physicians
- The PCD white paper with this group – looking for input around the described actors
- Want to promote use of the CD profiles and PaLM profiles for best implementations and to try to get this as joint Connectathons across domains.
- There was a problem previously with endpoint communication devices in prior – adopted WPCT – extended that protocol
- Added prioritization of URL
- Enable lab systems remote readers and automate accessing radiology image on mobile devices
- There is a need to be more specific of what to send alerts about vs creating a digest of bank of tests ordered
- ORU^R40 – used for initial notification
- There is a Radiology profile called MACM, but it was never adopted. ACM is widely adopted – working with radiology to migrate over to that
- Some of the alerting is used for the dashboard in the EHR-S
- LOE for this project? Need the domain expertise to make this successful ORU^R40 vs ORU^R01…
- Maybe see if LIS can implement PCD-04 and maybe PCD-05 (doc has seen and accepted lab results)
- Need pathologist expertise to continue
- Please read white paper and send questions to Rob at Rob.wilder@spok.com
- We will discuss this on the next call in the second hour.