Pathology and Laboratory Medicine (PaLM)

Origin

The Pathology and Laboratory Medicine (PaLM) domain of IHE becomes active as of January 2016. This domain merges and supersedes the two prior domains Laboratory (LAB) and Anatomic Pathology (AP) respectively launched in 2003 and 2006. The main reason for this merger was the recognition of a significant amount of similarities of the two prior domains scopes, and a long practice of reuse of assets (content modules, transactions) and common thinking from one another. The decision for this merger has been prepared collectively along year 2015 by the LAB and AP leaderships, common secretariat and memberships, and was approved by the Board of IHE International on November 12, 2015.

Scope

The PaLM domain covers:

• the representation and exchange of digital structured data, digital documents, digital images related to ordering, scheduling, performing and reporting diagnostic observations on in-vitro specimens collected from a patient or a non-living subject ;
• the representation and exchange of digital structured data related to specimen management (preparation, transportation, handoff, aliquoting, storage, retrieval)
• the secondary use and exchange of the observation results
• the diagnostic storage and reuse of specimens in bio banks

when a pathology laboratory is involved and in charge of the production of the observation report following the diagnostic/prognostic/screening tests, this laboratory having at least one of the specialties listed below:

Laboratory specialty	Sub-specialties
anatomic pathology specialties	surgical pathology, autopsy, cytopathology, image cytometry, immunohistochemistry
clinical pathology specialties	clinical chemistry, hematology, coagulation, blood gas, microbiology, immunology (allergy, auto-immunity, serology), transfusion medicine (blood bank testing), transplant compatibility testing (HLA), fertility, assisted medical procreation, cytogenetic (karyotype, molecular cytogenetic), drug monitoring and toxicology, flow cytometry
molecular pathology specialties	gene mutations detection in tumor cells, genetic identification and characterization of infectious agents, diagnostic of genetic disorders

As of 2017, the scope of the PaLM domain also covers the transfusion medicine workflows.

Sponsorship

The current sponsors of the PaLM domain are:

• College of American Pathologists (CAP)
• JAHIS
• PHAST

In their first years of existence the prior domains LAB and/or AP were also sponsored by GMSIH, ADICAP,SEIS, SEAP, SFIL and IHE Japan, ASIP Santé.

Current leadership

• Planning co-chairs: Raj Dash, MD - FCAP ; Riki Merrick - Vernetz
• Technical co-chairs: François Macary - Phast ; Yoshimi Hirasawa - Techno Medica
• Secretary and Board representative: Mary Kennedy - CAP

Quick links

• PaLM Planning Committee
• PaLM Technical Committee
• PaLM Meeting Roster (2016)
• PaLM 2017 Meeting Roster
• PaLM 2018 Meeting Roster
• PaLM Profiles
• PaLM Technical Framework
• IHE PaLM Google Group
• PaLM Board Report

Overview of the PaLM profiles

[Brief descriptions of the PaLM profiles]

IT Systems that can leverage PaLM profiles

Non-comprehensive list:

• EHR-S in hospital and ambulatory care settings.
• clinical and/or anatomic pathology laboratory information systems (LIS)
• public health information systems and public health lab information systems
• transfusion medicine systems
• electronic healthcare record shared infrastructures (PHR, HIE …)
• robotic specimen container distributers
• barcode labelers
• robotic specimen transportation systems
• robotic peri-analytical devices in the laboratory work area
• IVD analyzers in laboratory or on the point of care
• middleware systems handling a set of analyzers and/or of peri-analytical devices, in laboratory or on the point of care.
• imaging modalities
• PACS and digital archive systems
• biobank management systems

Guidance material and tools

• Implementation guide for bacteriology mycology and parasitology, published by IHE PaLM France (en-US)

Timeline: 2019 Planning and Development Cycle

Overall publication schedule: See the 2019 development cycle for PaLM
The following table outlines the activities of the domain planned for the 2019 year.

Timeframe	Activity	Scheduled	Location
Production of new items
Nov 16 2018	Call for proposals of new work items	Start of period for submission of new item proposals	email to palm@ihe.net
Jan 3		Closing of period for submission of new item proposals
Maintenance of PaLM TF
Year long	Change proposal process	July 1, 2019: Request for publication of PaLM TF 10.0	email to Mary Jungers
Testing
Jan 21-25	NA Connectathon		Cleveland, USA
April 8-12	EU Connectathon		Rennes, France
October 7-11	Japan Connectathon		Yokohama, Japan
Meetings
Year long	Conference calls	2nd Wednesday of each month 8-10 am (CET), 1st hour: planning & mgmt, 2nd hour: technical	conf calls + gotoMeeting
May	PaLM Committee Face to face	May 27-29, hosted by JAHIS	Tokyo, Japan

Current Activity

• Laboratory Analytical Workflow (LAW) has reached final text status after a session of intensive testing at the January 2016 NA connectathon. This integration profile, which has been built in a joint project between IHE and the IVD Industry Connectivity Consortium (IICC), will also be published in 2019 as the new standard “AUTO16” for analyzers interfaces by the Clinical Laboratory Standards Institute (CLSI).
  • The wiki working space that was used along the process
• Laboratory Clinical Communication (LCC) profile: standardizing how to indicate suggested replacement orders from the filler side and requesting follow up work by the placer.
  • Laboratory-Clinical Communications(LCC) initial proposal
  • release for public comment
• Laboratory Specimen Handoff (LSH)
• IHE Profile to US Realm Lab Guide Gap Analysis
• Specimen Event Tracking (SET) Profile - changes to specimen during processing at all steps from collection, receipt in the lab to storage, including derived material (e.g. slides created from specimen)
  • SET profile description
• Anatomic Pathology Structured Report release 2.1 (APSR 2.1)
  • APSR 2.1 published for Trial Implementation
  • ART-DECOR
  • example report case 1 (press right click and download)
  • example report case 3 (press right click and download)
  • example preliminary report version 1 (press right click and download)
  • example final report version 2 replacing version 1 (press right click and download)
  • the CDA xsl to put in the same folder to view the examples in a web browser (press right click and download)
• Anatomic Pathology Workflow in an Era of Digital Medicine (APW-EDM):
  • Upgrade APW to Digital Pathology i.e. the storage and retrieval of images created from pathology slides - in collaboration with DICOM WG 26
  • Digital Pathology initial proposal
  • The wiki collaborative space used to prepare the white paper
  • The wiki collaborative space used to prepare the content for the profile
• Representation of laboratory results in patient summaries using both HL7 CDA and FHIR, LOINC, UCUM and SNOMED CT - collaborations with IHTSDO, Regenstrief and HL7
  • Lab result in patient summaries brief proposal
  • [http://wiki.hl7.org/index.php?title=International_Patient_Summary_(IPS) International Patient Summary (IPS) project of HL7 International
    • IPS CDA R2 IG
    • IPS FHIR IG
  • International Patient Summary of the Trillium II project funded by Europe EC + US ONC
• Digital Pathology and Structured Reporting (SR) Profile for Clinical Data Capture/Reporting across Multiple Domains
  • Current APSR, using CDA standard, is focused on anatomic pathology, so broaden content; this will be a white paper to explore the current state around data element definitions (SDC, DEX) and how these can be integrated into clinical pathways using business rules, without relying on a specific standard for exchange - requires cross domain collaboration (DCC notified)
  • SR brief proposal

How to Participate

As a Laboratorian, Pathologist, or Advocate

Get involved in the planning committee. This is where the clinical problems are discussed and prioritized. The planning committee is an open group and is interested in having your input. Bring us your interoperability problems. You can also help by participating in the HIMSS showcase scenario definitions.

You can do this by:

1. Becoming a IHE Member Organization
2. Request to join our IHE PaLM Google Group
3. Attend telephone conferences and face to face meetings
4. Submit new profile proposals

As a Health IT Implementer

Get involved in the technical committee. Help make sure profiles are feasible and will work for you. Implement the profile, and come experience the IHE Connectathon event. 2011 Connectathon video clip

As a Health IT Buyer

In addition to getting involved in the planning committee, hold your vendors accountable. Put a statement in your RFP that indicates you want the vendor to support the actor in the profile you desire.

Demonstrations & Presentations

The following are recent and upcoming public presentations and demonstrations about IHE Lab. Email our IHE PaLM Google Group about presentations or demonstrations you know about.

Date	Location	Event	Details

Standards Organization - Professional Meetings/Conferences

Date	Organization	Location	More Information

See Also

Committees

Mailing Lists

Milestones for all IHE domains

Standard Organizations Link List

This page is based on the Domain Template.