Board Report: IHE <DomainName>PaLM Domain

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Sponsors:

  • College of American Pathologists (CAP) [
  • Japanese Association of Health Information Systems (JAHIS) [
  • PHAST [

Leadership:

  • Secretariat: Carolyn Knapik, CAP (email: )
  • Secretariat: Mary Kennedy, CAP (email: )
  • Board Representative: Carolyn Knapik, CAP (email: )
  • Board Representative: Mary Kennedy, CAP (email: )
  • Plan Cmte Co-chair:Riki Merrick, Vernetzt, LLC, / APHL staff (email: )
  • Plan Cmte Co-chair:Rajesh Chandra Dash, Duke / CAP (email: )
  • Tech Cmte Co-chair:Francois Macary, ASIP Santé (email: )
  • Tech Cmte Co-chair:Yoshimi Hirasawa, Techno Medica (email: )

Membership Rosters:

  • Planning Cmte: (our planning and technical committees meet together and share a single roster)
  • Technical Cmte: ​

Activity:

  • Domain Scope: The IHE Pathology and Laboratory Medicine Domain addresses information sharing and workflow related to in vitro diagnostic testing performed in anatomic and/orclinical pathology laboratories, or on the point of care devices under a clinical laboratory supervision.The PaLM domain also covers representation of biologic specimens metadata in laboratories and in biobanks. And last, the domain covers information sharing and workflow related to transfusion medicine. See more:
  • Current Cycle Timeline:
  • Background: IHE Laboratory was established in 2003 by GMSIH, IHE-Japan, JAHIS and SFIL.IHE Anatomic Pathology was established in 2006 by SEIS, SEAP and ADICAP.

In January 2016 Anatomic Pathology and Laboratory merged to form The IHE Pathology and Laboratory Medicine Domain, covering the scope of both prior domains. That same year the scope of the domain was extended to transfusion medicine, after discussion in DCC.

Most Significant Profiles:

Title / # vendor (Cthon) / # product (Registry) / Description / Significance
Sharing Laboratory Reports (XD-LAB) / 8 / 19 / A clinical laboratory report as a CDA document exchanged using one of the XD* profiles from ITI. / Austrian national ELGA policy / specifications:
French ASIP Santé national interoperability framework:

Swiss national eHealth implementation guide:
German Discharge Summary Implementation guide (Laboratory Addendum):
Adopted by the European Commission, for reference in public tenders:
Incorporated into the health regulatory framework for France in January 2016:
Laboratory Analytical Workflow (LAW) / 3 + Japan# / 1 / Intra hospital workflow of ordering and reporting lab tests / Has been tested at several connectathons lately and will be the basis for Clinical Laboratory Standards Institute (CLSI) AUTO16 standard in Spring 2018.
Adopted by the European Commission, for reference in public tenders:
Deployed in Japan and FranceCovering acute care settings
Adopted by the European Commission, for reference in public tenders:
Laboratory Testing Workflow (LTW) / 2 + Japan# / 8 / Analytical robotic devices in the laboratory / Covering acute care settings
Adopted by the European Commission, for reference in public tenders: been tested at several connectathons lately and will be the basis for Clinical Laboratory Standards Institute (CLSI) AUTO16 standard in Spring 2018.
Adopted by the European Commission, for reference in public tenders:
Deployed in Japan and France

Note: *Japanese vendors don’t register their products into the IHE International product registry – Japan: LTW = 11 vendors, LBL = 9 vendors, LAW = 5 vendors

Significant Deployment Activity:

  • The XD-LAB profile is officially adopted at the national level by Austria, Switzerland, France and Saudi Arabia, and is used regionally in North America, Europe, Middle-East, Asia, Italy.
  • Uptake of the LAB domain by the major companies of the in vitro diagnostic industry, via the IVD Industry Connectivity Consortium (IICC). The LAW profile will become a Clinical Laboratory Standards Institute (CLSI) standard in 2018 and that should raise visibility in 2018.

Region / Organization Name / Profiles / Status (planning, installation, operational) / Contact
Italy / LBL / Italy
Japan / Okazaki City Hospital
National Institute of Radiological Sciences (NIRS) Hospital
Kyoto 1st Red Cross Hospital
University of the Ryukyus Hospital
Osaka Medical College Hospital
Aicki Medical University Hospital / LBL; LTW; LPOCT
LBL; LTW
LBL; LTW
LBL
LBL; LTW
LBL / Implemented in 2006; LBL and LPOCT replaced in 2013
Implemented in 2006; LBL replaced in 2012
Implemented in 2009
Implemented in 2010
Implemented in 2012
Implemented in 2014 / Japan
France / LBL
France / Assistance Publique – Hôpitaux de Paris
(AP-HP)
Lyon University Hospitals (HCL)
Bordeaux University Hospital
Paris American Hospital
Caen University Hospital / LTW / Deployed in many university hospitals, including ( AP-HP for Paris region).
The AP-HP system (39 hospitals, 8Mil patients) is considered the biggest hospital of Europe. In 2016, LTW is operational?) in all sites.
Japan / Fujitsu Healthcare Center
Akita University Hsopital
Yokosuka City Hospital
Okayama Red Cross Hospital / LTW
LTW
LTW
LTW / Implemented in 2009
Implemented in 2009
Implemented in 2010
Implemented in 2010
France / Assistance Publique – Hôpitaux de Paris (AP-HP),
CERBA,
BOMNIS
Labo France / LCSD / Operational 2017?since 2012
AP-HP shares a single catalog across the CPOE and LIS in its 39 hospitals
National reference labs CERBA and BIOMNIS communicate their catalogs to hundreds of corresponding labs.Being used to exchange lab results between AP-HP and the CERBA and BIOMNIS lab networks.
Labo France shares its catalog across a hundred of member labs.

Demonstrations and Other Events:

●Japanese Society of Digital Pathology (September 21-23 in Tokyo, Japan): Introduction of current work: SET, APSR 2.0 and APW modification for Digital Pathology

●WAS LAW at AACC in 2017 again? – What about HIMSS?[FM3]

New Profiles:

  • APSR 2.0: The Anatomic Pathology Structured Report v2.0 is updating the existing templates to accommodate a more generic approach to handling specimen processing information, as well as moving them into Art Décor to be able to provide schematron files for ease of implementation and validation. Published for Comment September 2017
  • Transfusion Medicine – Administration (TMA): Covers the handling of blood transfusion administration updates including the communication of adverse reactions. Published for Public Comment October 2017[RM4][FM5]
  • LCC profile– The purpose of the Laboratory Clinical Communications (LCC) profile is to standardize and electronically capture common laboratory – provider communications around order modifications and result verification and interpretation. LCC is in progress. This profile requires a continuous discussion with HL7, by which, HL7 V2.x is being upgraded through the change request process. The LCC profile will pre-adopt some features of the most recent 2.x versions of HL7. The building of this profile is a long term process. Published for Comment November 2017.

Trends:

●In Lab domain it is less a matter of not having standards than of choosing the right ones and considering IHE profiles as a starting point, when national profiles are being developed.

●The IVD Industry Connectivity Consortium (IICC) is helping promote uptake of PaLM Profiles by the major companies of the in vitro diagnostic industry.

Summary of Future Plans:

●Work ongoing and planned for publication in 2018.

○Continue Small edits to the PaLM Technical Framework to facilitate the uptake of its content, and to cover the issues and additional use cases coming back from the field (hospitals having deployed existing profiles). In particular improve the guidance on the microbiology workflow with all the profiles of the TF.

○LSH profile: The LDA profile has been further divided. The Laboratory Specimen Hand-off (LSH) profile covers the communication between the analyzer and the track system that moves the specimen through the lab automation track, from pre-processors to the analyzers to storage.

○SET profile: The Specimen Event Tracking (SET) profile describes the requirements and data elements for tracking any kind of specimen movement and operations, except what is covered by LSH.

○APW profile update for Digital Pathology: There is a need to update the Anatomic Pathology Workflow (APW) in order to accommodate image modifications in support of digital pathology. This project is working closely with DICOM 26 Working Group. A white paper is planned as a first step to raise awareness and recruit vendors to participate in the development work, prior to development of the updated profile. The existing APW profile was very comprehensive and hard to get adoption by vendors, so for the next generation, the plan is to create a collection of smaller profiles that can work in concert to support all of what is currently the APW.[RM6]

●Harmonization proposal for alignment between IHE profiles and US realm S&I Framework lab related Implementation Guides – the related gap analysis has been completed in 2016 and may result in CPs to the Technical Framework, if harmonization is desired

○eDOS (electronic Directory Of Service) to IHE LAB LCSD profile

○LOI (Lab Order Interface) to LTW (transaction LAB-1) and ILW (transaction LAB-35) profiles

○LRI (Lab Result Interface) to LTW profile (transaction LAB-3)

●The Lab results in patient summaries will beare the contribution of IHE PaLM to the projects of international patient summaries, such as HL7 IPS, and Trillium II. It aims to define the appropriate representation of laboratory results in patient summaries using both HL7 CDA and FHIR, LOINC and SNOMED CT and will requirein close collaboration with IHTSDO, Regenstrief and HL7.

[RM1]UPDATE wiki and then link!

[FM2]Yes.. You can use my wrapup timeline slide from Cagliari for the update.

[FM3]Nope.

[RM4]Tis one does not yet have a wiki page describing it! Can use some help here now and then we need to set that up

[FM5]Thanks for reminder. At the latest it will have to have one when we publish TI version end of September.

[RM6]Reword to expand beyond APW