PaLM Conf Minutes 2023-November-08
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Attendees
Ralf Herzog | Jim McNulty |
Kevin Schap | Riki Merrick |
Megumi Kondo | Ruben Fernandes |
Rob Rae | Gunter Haroske |
Alessandro Sulis | JD Nolen |
Roy CL | Jan Schutrups |
Jim Harrison | Norman Zerbe |
Hunter Putzke | Mary Kennedy |
Raj Dash | Dan Rutz |
Next PaLM Meeting: December 13, 2023
Agenda items:
- 4 CPs for approval
- CPs for TF
- 268 – Result Predicate Correction in LAB-80
- This is for OML^O33.
- David Clunie has SAC before the SPM - which is NOT in any of the available message structures for orders in base HL7 V2 standard up to V2.9.1, so we should provide feedback to David – Link?
- Motion to approve: Alessandro/Raj – against: 0, abstain: 0, in favor: all.
- 272 – CDA Battery organizer update to allow for some, but not all results being available (still pending) at the order level.
- Motion to approve: Alessandro/Riki – against: 0, abstain: 0, in favor: all
- 273 – CDA Lab Observation update
- This result is still pending; should be the description.
- We are limited by the codes in the underlying V3 actStatus code system: https://terminology.hl7.org/CodeSystem-v3-ActStatus.html
- Use result pending as the description, to match what we have for battery level
- Motion to approve: Alessandro/Riki – against: 0, abstain: 0, in favor: all
- 274 – End of patient group
- Motion to approve: Riki/Ralf – against: 0, abstain: 0, in favor: all
- Alessandro will make the edits and put it on the wiki. He will send the edited versions to Mary Jungers to be published.
- CPs for TF
- PT Profile update
- Slides from Jim Harrison
- Met with CAP around the data elements for the prototyping of data elements needed for PT.
- Rename to “Performance Monitoring Workflow (PMW)”
- We have all transactions and segments already available.
- Duke had done some mapping to HL7 data elements – shared proposed mapping = get spreadsheet from Jim.
- Reviewing the mappings
- CAP number – should not use OBX-15, since that is a CWE (but it si different from the performing lab ID, which is in OBX-23.10 as CLIA number) – CAP number is a 7-digit ID assumed for PT testing.
- ENV – should map to MSH-11.
- KITUID – should NOT be PV1-1 – need to better understand how this is used to decide where to map.
- Operating tech – maps to OBX-16.
- Verifier tech – maps the OBX-16 (do we need both?)
- You might need the operator name field for cytology specimens which are individually graded by cytotechs; same with pathologists.
- Instrument name – need to discuss mapping OBX-17 – should use PRT.
- Instrument ID – need to discuss mapping - OBX-18– should use PRT.
- Instrument type – need to discuss mapping OBX-17 in LRI / OBX-18 in LAW – should use PRT.
- Test kit ID etc also go into PRT.
- Reagents and calibrators (not being able to be sent out from the instrument yet) – could also use PRT for these or the INV segment.
- So far we are not using the PRT segment in IHE
- We may not need to change LAW, since they can send the instrument data in OBX-18 and INV segments.
- The PRT segment could also be purposed for the verifier.
- Reviewing the mappings
- DPIA change proposal
- Raj to look at SNOMED model for substances vs procedures for staining (eg, IHE vs H&E)
- Review DICOM value set
- SPM-6 Additives (formalin vs fresh vs alcohol)
- SPM-4 Specimen type
- SPM-7 Collection Method (not a stain); do not use
- For v2, propose OBX after SPM to discuss processing steps. For now, will contain the local descriptive text.
- How should we standardize? Could require SNOMED procedure codes but where would this information come from? Not typically stored in the LIS, only the “task name”/local name are stored).
- For stain (eg, Ki67, ER, PR, H&E, PIN4)
- Do not need all methodology to interpret all stains; only the final stain (eg, Ki67)
- Some stains are cryptic (eg, multiplex stains with different chromagens, eg, PIN4); may benefit from availability of multiple metadata elements
- SPM-6 is a coded field; CWE repeatable (not sure this will work)
- For short term, need a more flexible field (free text) [post call Riki comment: you can use the CWE.9 for the free text, when you don’t have codes]
- Ideally would have a SNOMED code.
- OBX on specimen level would be more flexible.
- Stain cocktails combine multiple antibodies (p63+AE1/AE3) – a repeatable OBX would allow for capturing this granularity.
- OR, we only allow a single OBX with the name of the cocktail (eg,PIN4), but this might not be scalable. If this can be resolved, Raj will put into a CP.
- Raj to mockup a complex example using SPM-6 vs OBX
- Need to discuss with DICOM WG26. Raj will attend next DICOM call on November 21; Kevin will facilitate getting this on the agenda.
- Raj to send his PPT to Kevin for him to post to DICOM.