Lab Conf Minutes 11February2014

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  • Francois Macary (Co-Chair)
  • Riki Merrick (Co-Chair)
  • Mary Kennedy (Secretary)
  • JDL Nolen (Cerner)
  • Juergen De Decker (MIPS)
  • Filip Migom (MIPS)
  • Alessandro Sulis (CRS4)
  • Laurent Lardin (bioMerieux)
  • Ed Heierman (ABBOTT, CTO of IICC)
  • Andrzej Knafel (Roche)
  • Dmytro Rud (Roche)
  • James M Wulkan (Beckman Coulter)
  • Jim Harrison (Viginia University, CAP)
  • Daniel Moncusi (SYSTELAB)
  • Daniel Nebot(IZASA)


1. Agenda Review (all)

2. Update from HL7 WGM

Riki was elected interim Co-Chair for Orders and Observations (OO) WG, had a few joint sessions with Clinical Genomics (CG), Anatomic Pathology (AP), Imaging (II), FHIR, Public Health Emergency and Response (PHER) and EHR Working Groups; had several sessions on v2.9 proposals- spent mostly on discussing representation of supplemental clinical information (Ask at Order Entry questions) as well as discussions on topics related to US realm lab domain guides Laboratory Results Interface (LRI), part of Meaningful Use (MU) incentive program for EHR system adoption in the US, Laboratory Orders Interface (LOI) and electronic Directory of Services (eDOS) – planned for next stage of MU. Also discussed the development of a functional requirements implementation guide for lab domain – as a joint project between EHR WG, Conformance & Guidance for Implementation/Testing (CGIT) and OO – first focus is on behavior to incorporate lab results per LRI guide, then will expand to incorporate orders and other data. Had email exchange with Hans about harmonizing US realm LOI, LRI and eDOS with IHE profiles - preferably before those IGs go to normative.

According to François:

  • eDOS to be harmonized with IHE LAB LCSD profile
  • LOI to be harmonized with LTW (transaction LAB-1) and ILW (transaction LAB-35) profiles
  • LRI to be haromonized with LTW profile (transaction LAB-3)

Question about FHIR and how that will affect the IHE profiles? Not sure yet – here is the link to the FHIR DSTU:

3. Update from North-America Connectathon in January

Had 2 lab profiles tested:

  • XD-LAB: not really tested by lab vendor companies, it was tested by generic system vendors;
  • LAW: everyone successfully completed – had 4 analyzers, 1 analyzer manager, had lab with chem and immunoassay, hematology and microbiology.


  • Were able to discuss outstanding items, like how to represent plots, histograms etc - standard on how to transfer images.
  • Beckman Coulter related to hematology interface had specific suggestion for improvement and they will actively participate in the updated and further work on LAW – will need to get detail. James Wulkan will request access to the google group – Welcome to the team!
  • Discussion related on Laboratory Device Automation (all devices, except analyzers) – spend some more time on how to use that, potentially add more use cases for LDA – Abbot and Beckman Coulter may submit a proposal on a project, Andre Knafel (Roche) also interested – plan is to get this adopted by CLSI also;
  • Ed spent time with IHE representatives Elliot Sloan, Sonja Robinson - they are working with ICSA on lab certification pilot projects – they are looking on ways to bring this up outside of connectathons - discussed the LAW profile and path towards certification for LAW in the future – will set up some discussion on that in the future;
  • Setting up a place for all outstanding items for LAW – at up time on monthly calls, or arrange meetings to create CPs based on those – strategy of LAW publication as part of the LTF, need to get feedback from all connectathons – off-cycle early next year possibly;
  • Next NA connectathon is end of January 2015 and LAB TF would integrate LAW in Final Text and be republished after that, in March 2015. To reach this goal we need to keep LAW tested at all connectathons (Europe, Japan, North America) in 2014 and early 2015;
  • Vocab issue for missing code in HL7 0487 (Cerebrospinal fluid) – new CR at HL7 OO for v2.9 – triggered review of all values missing in VHl70487 compared to;
  • LAW redundancy of scenarios "LAW_Manual_Urgent_AWOS" and "LAW_Process_Exception" – sample at analyzer, but no AWOS yet. The analyzer behavior may vary across IVD instruments. This will be a new merged scenario combining both scenarios – will try that out at the European Connectathon next April in Vienna.

4. Update on LCC Discussion

  • Questions had been raised on using the parent child relationship for linking orders to Austin Kreisler for clarification, waiting for feedback – if we get positive feedback, then we would use this;
  • We will request a new ORC field to carry the time window data – Jim to write a v2.9 CR for this one;
  • What state do we need HL7 be in before we can write the LCC specification – when the CR has been accepted by OO – don’t have to wait for publication of v2.9 before building the profile;
  • Content for v2.9 unofficially should be submitted by May 2014;
  • LRI has a paragraph about parent child use – could we add this usage into that – or possibly in the LOI;
  • Jim also would like to get the order replacement part into the next version of the LOI – good entry for LOI/LRI/eDOS harmonization proposal;
  • After the May 2014 WGM we should know if the HL7 path is clear to start editing the LCC spec. – aim for fall 2014 LCC public comment in September and then open for Trial Implementation Nov 2014;
  • Francois updates the publication wiki page – in 2014: will publish LCC this year, and LAW March 2015 as part of the LTF:

5. Call for proposals went out – deadline to submit is 3/31/2014:

  • Suggested Proposals:
    • LDA re-engineering
    • LOI/LRI/eDOS harmonization with IHE profiles

6. Face to Face meeting in Paris May 12-14, discussion on work plan:

  • LCC
  • Proposals Review and selection
  • CPs for LAW feedback  re-publish as a TI supplement in Sept 2014 in time for Japanese and NA connectathon

ACTION: Francois will draft agenda for Face to Face

7. Use of local codes in HL7 defined tables Discussion

  • Recommendation: If a code is used in several implementations create a code systems and submit to Hl7 (for example all LAW implementations), otherwise se 99zzz, where zzz can be replaced with any length character s to identify the local code system
  • HL7 CGIT is working on more explicitly representing value set binding in version 2.x – will keep you updated – good to be explicit in how to do this.
  • Andrzej asked if anyone is attending HIMMS? – no one else is attending

Call adjourned at 12:01PM ET

Next Call

March 18, 2014 11:00AM ET/ 10:00AM Central