PaLM Conf Minutes 2022-May-2-4

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Attendees

Name May 2 May 3 May 4
Riki Merrick X X X
Raj Dash X X X
Kenichi Takahashi X
Ralf Herzog X X X
Filip Migom X X X
Jim Harrison X X X
Mary Kennedy X X X
Gunter Haroke X X X
Alesandro Sulis X X
Francesca Frexia (Sectra) X X X
Mauro Zanardini X X X
Dan Rutz X
Gianluca Pavan X X X
Juergen Brandstatter X X
RoyCL X X
Francesca Vanzo X
Megumi Kondo X X X
Ruben Fernandes X X X
Tobias Dahlberg X X X
Gregorio Canal X
Takuya Haga X X
Jim McNulty X X

May 2, 2022 – Day 1

  1. Administration and agenda review
    • Raj to update the DPIA pages
    • Francesca to update the SET page to link to Gazelle test cases under Implementer Support
    • Riki to update links to TF on LTW (and check for other broken links)
    • Riki or Raj to update the diagram of the PaLM use cases and update the wiki with them
    • CP for APW in TF indicating that this profile is in the process of being deprecated by NEW Digital Pathology Profiles - reference the current activity wiki page
    • CP for LAW and LDA – Ralf to write and bring back
    • Have Alex update DPIA
    • Around the world Update
    • PT discussion
  2. Around the world update
    • Japan JAHIS updates (JAHIS presentation:# 1)
    • US updates (US updates: #2)
      • LOI and LRI were both balloted in September
      • COVID data elements were added
    • Filip: LTW lab testing lab order is in place – in all their installations; in Belgium and Netherlands there are a lot
      • Austria has some
      • France: configuration of LOINC is being done by PHAST
      • Italy and Germany are converting CDA into FHIR
  3. Transfusion Medicine TMA – (Transfusion Medicine presentation: #3)
    • MIPS has three customers using TMA.
    • Typical workflow: https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=6059318_bmjoq-2017-000270f01.jpg From this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059318/
    • Workflow steps:
      • Ordering – could use LAB-1 / proposed use of HL7 OMB^O27 messages
      • Matching and inventory
      • Individual units are tracked on dispense – using LAB-3 with some specific OBX segments / propose to use DPS^O
      • Have TMA covered
    • Actors
      • For ordering use Order Placer (use generic actor)
      • For dispense status reporting use OrderResultTracker – we can check the IHE actor list for appropriate actor (assume pharmacy has a correct term) – NEED TO DO!
        • While ordering a blood product need to communicate the blood group of the patient – who will set this up (need blood type and crossmatch) and how do we communicate that
          • In Belgium need to test blood group testing on 2 separate specimen, prefer this as reflex test to the blood product order (if it is known in the system, that test is not needed)
            • Should be included, but not required
            • Is part of LAB-1 message now
            • Need to assign the transaction ID _ can we use LAB-71? – Riki to check
        • Can you change / update the order?
          • Initially ordered 3 bags, then want to add more
            • Do you cancel all 3 and then order 4 (may end up with 7 bags), or do you just add 1 more (preferred)
          • Initially ordered 3 bags, then want only 2
            • How do you cancel just 1 of the 3 bags
            • Has risk of having all bags canceled
          • Maybe allow use of LCC in addition to this profile for anything but ADDING more bags
    • OMB_O27
      • NEW segment compared to LAB-1
        • BPO:
          • Type of blood product
          • BPO-5 (not used often, because blood bags have the same defined volume and is often standardized for adults)
          • In US it is not standardized – ordering number of blood bags vs blood volume
          • Orderer should not need to know the size of the bag
          • Focus on BPO-3, BPO-4 for now
          • BPO-13 – CWE datatype, allows clinical indication
        • Copy definitions for PID, ORC, and TQi from LAB-1
        • Use OBX under the order (as these may be different for different blood product types) – check if we can use the same definition as in LAB-1
        • Suggest to use v2.5.1, don’t need ARV and don’t want to support PRT
    • Code systems: Use ISBT128 (HL70575 is user defined without any suggested values, so we should identify the code system as IBT per HL70396
    • Support OMB_028 as application acknowledgement
    • To support reflex orders use LAB-1 in addition – note that the reflex order does not need to identify what triggered this blood type crossmatch order
    • Dispense
      • Has more complicated issues – examples:
        • Which blood bag is available and can be administered to the patient (support for positive patient ID process)
        • Transport of the blood product needs to be considered
          • Picked up from lab
          • Where is it now?
            • Refrigerator near the lab
            • Could we use SET for this?
      • Check in pharmacy to see, if we can identify any IHE profiles (no TF, only trial) that already dispense medication
      • Check with HL7 chapters
        • inpatient is v2 RDE for order and RDS for the dispense in the US
          • RXD – request to dispense
          • RXG – request to give
          • RXA – post administration
          • Chapter 4A
        • Outpatient in US is NCPDP
      • Identify the proper patient and the blood product matches
    • Suggest use of BPS_029 which has the BPX segment (assume this is similar to the RDX segment)
    • Important to know how much blood was transfused = in TMA
      • Currently only counting the number of blood products that have been transfused; not covering the volume of each bag – do we need to add this?
        • We have not yet addressed adverse event reporting in TMA other than transfusion was interrupted
        • In the US, the FDA has Adverse Event reporting in V3 but it is only supported by specific adverse event documentation system; separated out of clinical HER-s from workflow and legal reasons which is similar to other safety reporting (e.g., liquid spill).
    • Next steps
      • Riki to share the template links with Filip
      • Filip to draft 2 profiles: TMO and TMD
      • Review the actor list to find suitable actor for TMD
      • Update TMA profile to remove TMO and TMD as open issues (once published)
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