Lab AP Conf Minutes 2015-Aug-11

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You can listen to the recording from the call HERE


Carolyn Knapik CAP
Riki Merrick APHL
Frank Oemig
Raj Dash CAP
Dymtro Rudd Roche
Jim Harrison CAP
Ed Heierman Abbott
John Hopson Abbott
Joanna Selinsky Beckman Coulter
Mary Kennedy CAP
Jurgen De Decker MIPS
James Wulkan Beckman Coulter
Filip Migom MIPS
Anna Orlova
Benoit Denisselle Beckman Coulter
Christel Daniel AP-HP

Regrets: Francois Macary


  • Riki reviewed the agenda.
  • Reminder of the structure of the monthly teleconference calls: 1st hour is for planning topics. 2nd hour is for technical topics, which need to be announced way ahead of the call so that the committee members interested in the topic can plan their attendance to the 2nd

Topics related to the DCC (Riki) – nothing to report

LCC (Jim)– nothing new

Report from AACC event and demonstration of LAW (Ed)

  • IICC had booth at AACC Expo week of 7/27
    • Highlighted the vendors supporting LAW
    • 4 live demonstrations of analyzer of Abbott and Orchard
      • Analyzer reflex
      • Rejection of AWOS
      • Results coming in in multiple messages – how to use the AWS ID and highlighted the semantic understanding
    • Remote site access to gazelle tool’s order manager (Beckman Coulter)
      • Rerun
    • Highlighted the virtual connectathon
    • Highlighted the different options supported by the analyzers
    • Highlighted Gazelle tool availability and capability

    Powerpoint: Media:IICC Demo - 2015 Final.pdf


  • Reminder of the process and schedule and next steps
  • Voting process is underway – posted on AP and Lab google groups – link to the survey for voting and document
    • Will send out reminder prior to voting ending 9/17
    • Assuming we have quorum (on-going process to determine what quorum is) and positive outcome - result of vote will be sent to the Pre-board IHE Board agenda
    • Assuming they agree, then go to IHE board agenda
    • DCC, Board Chairs and Secretary are aware of this voting
  • Discussion on the scope of the future domain – will need Christel for that
  • Digital imaging and structured reporting both are high priority
  • Discussion on the possible name for the future domain
    • At F2F we tentatively chose Pathology and Lab Domain (PaLM) – wanted to include molecular – will delay

Discussion of ArtDecor (Frank)

  • Working on APSR
  • Demonstration of ArtDecor:
    • Dashboard for project account is linked
    • GERMAN project: Oncologic Structured Report
    • Pathology Structured Reporting
    • Need to add IHE to the copyright tab
    • Have 3 main columns
      • data sets = data elements (hierarchically organized)
      • terminology = value sets (can capture the hierarchy of the terminology) / code system / associations; allows mixed source value sets – or could create different value sets based on code systems as well (created these based on USCC edition for example)
      • templates = document / section / entry levels; can assign the value sets in these templates – can dive down by clicking on the detail
    • use more generic templates and allow tools to apply additional constraints to allow mixing and matching of the templates
    • template hierarchy is left out of the design
    • Could XD-Lab be included in these templates?
      • So far have only focused on AP so far – Gunther is working on that
      • Would need to test the PSR design to see, if the diagnosis section could be used in molecular report or lab interpretation
      • In Germany have a more proprietary version of codes
      • Supports multi-language support
      • Consider this to be a starting point – looking for ways to collaborate
    • Art Décor is free – open source, can install on your own server, but that could create maintenance issues
    • For global use have as hosting – import and re-use and reference other templates also hosted on the site
    • IHE has selected Art Décor as the tool to create content profiles for the IHE work
      • CAP has a tool (CAP electronic cancer checklist) with 92 templates. Works closely with QRPH content developers (SDC)– would be nice to have collaboration there as well
      • Need to have discussion about where to create and present the knowledge of the business logic and should we have all that logic included
      • Should that business logic be part of the interface specification? Frank thinks not, as that would force you to maintain that in 2 areas
      • Frank’s approach: use generic templates and then use schematron rules for the business logic to identify the issues – also easier to implement for vendors – that is the reason we would like to move to PSR (generic templates) and then move the rules to schematrons
      • How would rules be implemented? Want forms to behave differently based on content may be? How would that be defined?
      • Interface specification is another level of effort and focusing on content is good idea, but we still would need to capture the rules to ensure the content is implemented consistently
      • Guidance can be in just words, but should be captured somewhere – that type of information is missing in SDC and PSR at the moment
      • SDC and AP LAB should be working together on the PSR that could be the basis – need to work with QRPH on this one
      • Guidance on how to focus the generic templates to the specific use cases that have specific requirements
      • Need to determine how to write profiles on the generic templates – need to create a hierarchical way to represent this
      • Art Décor should be able to support schematron development
      • Once the entry level templates have been defined, then review the specific artifacts we have to support – example breast cancer uses Nottingham scale (or derivation of that) could be calculated from the required information and can that calculation be supported? Schematron rules can only verify assertions, not create new data
      • Sondra Renly has been working on MDHT development and tried to build CDA templates in that tool – we were able to build the models on PH case report, but when we started implementing the models, they used additional things – so we realized we need to also capture the additional rules needed for each institution
      • Next steps:
        • research what is missing from PSR and SDC to encompass the rule expression that would allow for application to implement content consistently
        • Have organizations come together – SDC, CAP committee (PERT), IHE/AP/LAB and QRPH come together – this is not necessarily domain specific – larger IHE issue?
        • Need to get handle of licensing issues for use of coding systems
        • Evaluate XD-Lab against the PSR effort
        • Would APSR content need to be updated? Not sure we have all folks on the call that we need to make specific decisions – digital imaging is important – collect information on what changes are needed – Frank is working on re-design – next step is to verify that the PSR redesign covers all the APSR templates – we are not starting from scratch – using APSR and have discussed the general structure – same structure as radiology report – if you provide new version, need to create new IG for documentation
        • Documentation is kept on wiki – should be following the IHE process
        • IHE AP meeting agreed we would use German HL7 and IHE work and then move to generic tool
        • We need to publish– current state of the content is in the tool – what format the guide will be in is yet to be determined
        • APSR needs to be compared to the current work
        • Need to discuss the process of how to apply changes to the tool content and how to validate the content
      • ISO is working on creating reference bundle of standards for clinical imaging – overlaps on cancer reporting side
      • Anna can help on SNOMED CT collaboration – Can Mary forward letter that was written to IHTSDO to Anna? Letter was sent to Chris Carr – so this is larger than IHE Lab
      • IHE International Board meeting is held this week – IHE AP/LAB should participate in that 10:00 – 11:30 AM EDT on 8/13 – prepare for next call so we have more concise questions – might be good to at least to introduce the topic – here or at DCC level, or both
      • Frank is working on the German cancer reporting version of QRPH is not currently being supported by the German cancer committee – not coordinated effort unfortunately
      • Art Décor has some versioning, but does not have everything available Frank would like – this will need to be part of the larger IHE work – administrative approach / tooling updates are needed
      • Does ITI know about the migration to the testing tool? We don’t think so. ITI has sharing value set and data elements exchange, so they should be involved on the tooling side
      • ?? building tooling for Art Décor – should be available for NA 2016
      • Frank and Rob Snelick are working on a book describing how to achieve interoperability – more than just using XML script
      • QRPH is a very good example – is ONLY US realm specific, that is why we introduced the German version on the other side – but for interoperability we need reusable resources with additional constraints
      • PSR will be used in Germany, but German Cancer Association is not supporting is this work and they are not collaborating with CAP
      • Christel will propose how IHE AP can support the content and how to review it and validate it against the APSR and then provide the change proposals from that analysis – Gunther, Frank and Christel to work on that to help that work to become visible!
      • Mary and Riki will brainstorm on how to approach the topic to the IHE International board or at DCC or both

      To the presentation on how to use Art Décor: PLAY RECORDING (1 hr 29 min 2 sec)

    LSH (John) – deferred to next call 08 September 2015

    LAW – Dmytro’s change proposal

    • Unify the options and not require just these profiles to be communicated in MSH-1 (none of the others need to)
    • Several typos / missed synchronization of information
    • Change usage of OBX-21 for AM to RE
    • Fix incorrect message structure of OML for patient group (thought that was already corrected)
    • Got some feedback as part of virtual connectathon additional guidance on how to use the profile – discuss on the technical call next month and then finalize at the F2F in October

    Agenda topics for next Teleconference 9/8/2015:

    • First Hour:
      • Timeslot for AP report progression
      • Managing distributed review and editing within Art Décor (explore this tool and CP in advance of September teleconference please)
      • Prepare question(s) for Mary and Riki to present to board
      • LSH (John Hopson)
        • Review LSH Supplement
        • Discuss HL7 Carrier/Tray Status Messages
    • Second hour:
      • LAW CPs

    Next Meeting is scheduled for 08 September 2015 at 0800am CDT