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:

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 - Vernetzt
Technical co-chairs: Alesandro Sulis (CRS4) ; Kenichi Takahashi - Hitachi Hightech
Secretary and Board representative: Mary Kennedy - CAP

Quick links

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: 2023 Planning and Development Cycle

Overall publication schedule: See the 2023 development cycle for PaLM
The following table outlines the activities of the domain planned for the 2023 year.

Timeframe	Activity	Scheduled	Location
Production of new items
November 15 2022	Proposals of new work items	Start of period for submission of new item proposals	email to palm@ihe.net
December 12 2022	Proposals of new work items	Closing of period for submission of new item proposals
January 11 2023	Decision for proposals of new work items finalized on call
Aug 2	Digital Pathology - Ordering & Reporting (DPOR)	End of public comment period for Digital Pathology - Ordering & Reporting (DPOR) supplement for public comment	email to Mary Jungers
Oct 1	Digital Pathology - Ordering & Reporting (DPOR)	Request for publication of Digital Pathology - Ordering & Reporting (DPOR) supplement for Trial Implementation	email to Mary Jungers
June 15	Technical Framework	Request for publication of Techincal Framework to accommodate Change Requests	email to Mary Jungers
TBD
Maintenance of PaLM TF
Year long	Change proposal process		email to Mary Jungers
Testing
March 6-10, 2023	NA Connectathon	https://www.iheusa.org/ihe-na-connectathon/system-registration-2023	Austin, Texas
September 25-29, 2023	EU Connectathon	https://connectathon.ihe-europe.net/ihe-europe-connectathon-week-2023	Rennes, France
TBD	Japan Connectathon	UPDATE LINK	UPDATE LOCATION, Japan
TBD	Joint DICOM Connectathon	UPDATE LINK	UPDATE LOCATION
Meetings
Year long	Conference calls	2nd Wednesday of each month 8-10 am (CET), 1st hour: planning & mgmt, 2nd hour: technical	conf calls + Zoom
June 13 - 14	PaLM Committee Face to face	European Congress Of Digital Pathology	Location Budapest, Hungary

Current Activity

Digital Pathology (DP) Profiles - Providing interoperability for solutions in support of a digital pathology workflow.
- IHE PALM's Digital Pathology vision is captured in this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240547/
- Digital Pathology Image Acquisition Profile: <add wiki page from template>
- Digital Pathology Profile: <add wiki page from template>
- Digital Pathology Profile: <add wiki page from template>

Radiology Pathology Correlation (RPC) Profile - Providing linkages between radiology reports and pathology reports
- [Radiology Pathology Correlation (RPC) profile description|http://wiki.ihe.net/index.php/Radiology_Pathology_Correlation]
Digital Pathology Aid for Telemedicine (DP-AT) Profile - Sharing digital assests during consultation using telemedicine
- [Digital Pathology Aid for Telemedicine (DP-AT) profile description|http://wiki.ihe.net/index.php/Digital_Pathology_Aid_for_Telemedicine_Profile ]
Laboratory Specimen Handoff (LSH)
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 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
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

Published Profile links:

DPIA
- https://www.ihe.net/uploadedFiles/Documents/PaLM/IHE_PaLM_Suppl_DPIA.pdf
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
Anatomic Pathology Structured Report release 2.1 (APSR 2.1)
IHE Profile to US Realm Lab Guide Gap Analysis

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:

Becoming a IHE Member Organization
Request to join our IHE PaLM Google Group
Attend telephone conferences and face to face meetings
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
Jan 16-20, 2023	HL7 WGM	Las Vega Resort, Henderson, NV	https://hl7.force.com/LightningMemberPortal/s/lt-event?id=a1Y7V00000X9AvZUAV
TBD	Lab LOINC Conference	LOCATION TBD	https://loinc.org/meetings/
May 8 -12, 2023	HL7 WGM	New Orleans, LA	https://www.hl7.org/events/workgroupmeetings.cfm?ref=nav
June 14 - 17 2023	European Congress on Digital Pathology (ECDP 2023)	Catania, Italy
TBD in Sep 2023	HL7 WGM	TBD	https://www.hl7.org/events/workgroupmeetings.cfm?ref=nav
October 26-27, 2023	SNOMED CT Expo	Atlanta, Georgia, USA (and online)	https://www.snomed.org/news-and-events/events