PaLM Conf Minutes 2020-October-07

Attendees

Name	Email
Gunter Haroske	haroske@icloud.com
Mary Kennedy	mkenned@cap.org
Francois Macary	francois.macary@phast.fr
Rikki Merrick	rikimerrick@gmail.com
Alessandro Sulis	Allesandro.sulis@crs4.it
Megumi Kondo	megumi.kondo.sakura.japan@gmail.com
Dan Rutz	drutz@epic.com
Kevin Schap	kschap@cap.org
David Beckman	dbeckman@epic.com
Raj Dash	r.dash@duke.edu
Francesca Vanzo	fvanzo@consorzioarsenal.it
Jim Harrison	james.harrison@virginia.edu
Ralf Herzog	ralf.herzog@roche.com
JD Nolen	jdlnolen@gmail.com
Francesca Frexia	Francesca.frexia@crs4.it
Sujith Nair	snair@acr.org
Sam Spencer	sspence@cap.org
George Birdsong	gbirdso@emory.edu
Ross Simpson	ross.w.simpson@healthpartners.com
Alex Goel	agoel@cap.org
Veronica Klepeis	vklepeis@mgh.harvard.edu
Brian Bialecki	bbialecki@acr.org
Markus Herrmann	mdherrmann@mgh.hardvard.edu
Peter O’Toole	peter.otoole@mtuitive.com
John Hargett	jhargett@epic.com
David Clunie	dclunie@dclunie.com
Peter Mello	peter.mello@mtuitive.com
Craig Sayers

Next meeting: November 11, 2020

• Agenda Review
• New proposals
  • Timeframe?
    • Riki will send out the call for call for proposals – will give 1 month to submit and review on Nov and Dec calls
  • Evidence Creation profile for digital pathology
    • Looking for possible vendor support – who from the DICOM WG26 can we ask to help?
  • Radiology / Pathology Concordance Reporting Proposal
    • Proposal Link: https://drive.google.com/file/d/14-Xovvnbbh3_X-MYn3MidICYrBlcxlrP/view?usp=sharing
    • PPT Link: https://drive.google.com/file/d/1hXxETo7GCEpwAiZkiUJVKUQHYWAXB0Mj/view?usp=sharing
    • Discussion:
      • Key use case was described
      • Proposed profile is a new type of concordance workflow
      • Raj agrees with the generalizable paradigm
        • Surgery / biobanking reconciliation between research and clinical concordance is a good example
      • Problems raised are that different reports are produced in silos – not good access between different reports
        • Which data elements are fed to the concordance reporter?
          • Discussed the sharing of the concordance scores, not the data / reports per se
            • Example: specific images in radiology implies certain findings should be in a pathology report, but if that is not the case, there may have been something different going on (the pathology result should match what would be expected)
      • Where is the change in workflow that will be needed – how will that be addressed?
        • Mammography report:
          • Single number in radiology, but there is not that value in pathology – how do you get the scores to compare?
          • This may require recommendations from professional organizations/specialty society as best practice to adjust to a new workflow
          • This will take a long time and there will be pushback
      • Recommend focusing on the use cases where we do not need workflow changes
        • Biobanking
        • Maybe in APSR create a score section (later)
    • Best next step would be to identify use cases where we already have resonance with vendors
      • Need to have concrete examples to get vendor buy-in
        • Vendors needs to understand the value and what the gain is for their customers
    • IHE PaLM would like to have the support for APSR included in the profile
    • Proposed mechanisms:
      • FHIR
      • SDC format (captures the CAP’s electronic cancer data (eCC), but does not include anything else in a structured report) – there are some vendors implementing eCC SDC format)
        • IHE SDC working group is working on that
          • Using observation
          • Storing the SDC form as docRef
          • bundling into message or composition bundle
        • want to leverage use of observation for this profile
      • Translate APSR to FHIR – project ongoing in Germany (funded by the Ministry of Higher Education, not as part of HL7 Germany); all the activities are based on using APSR as the starting point – hope this will be the case that this is as generic as possible)
        • HL7 has a to-do item to describe how to express structured reports like pathology and radiology reports
      • CDA management group is discussing how to map CDA to FHIR later today
        • We need to keep an eye on that as well
    • The data transfer of the elements should be FHIR, but the content format should be kept out of this work
    • Next steps:
      • Overall decision vote could be in November
      • Need to identify vendors and implementers that are interested in supporting this proposal
        • Grady hospital in GA is interested in this for mammography
        • Also Mass General Hospital is interested
        • Pathologist/radiologist/vendors working on this:
          • Pathologists: George Birdsong; Veronica Klepeis; Ross Simpson
          • Radiologists:
          • Vendors who have confirmed support: Nuance Communications; Voicebrook; mTuitive
          • American College of Radiology and College of American Pathologists are leading the proposal
      • Narrow down the proposal to what we can accomplish in 18 months
      • Reach out to IHE Radiology as well before next call
      • Also reach out to IHE QRPH since that is where the SDC work is ongoing
      • Also may need to engage IHE ITI
• SET
  • Updated document with comments to review for the next call / or close via email
  • Then bring back the message structure CR to HL7 OO
  • SET is being used to define a new FHIR resource in HL7 OO specimen project
• Digital Pathology White Paper
  • Paper has been submitted
    • Some comments have been sent to Raj and he will review them
    • Revised document will still be shared later this week
    • A conclusion has been added in the updated paper; please review
• Connectathon support for DPIA – not discussed