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MINUTES

DICOM WORKING GROUP TWENTY

(Integration of Imaging and Information Systems)

and

HL7 IMAGING INTEGRATION WORK GROUP

Date: Sept. 24-25, 2013

Place: HL7 Meetings

Hyatt Hotel

Cambridge, MA, USA

Members Present Represented by

GE Healthcare Solomon, Harry

Philips Healthcare Chris Melo

Siemens Healthcare Koenig, Helmut

Members Absent Voting Representative

CoreLab Clunie, D. *

Merge Healthcare Cowan, Ron *

Others Present Affiliated with

Awfeldt, Gustav Stockholm County Council

Behlen, Fred American College of Radiology

Beebe, Calvin SD Co-Chair/Mayo Clinic

Brodsky, Victor AP Co-Chair /College of American Pathologists

Constable, Lorraine OO Co-Chair/Constable Consulting

Hartveit, Lars-Gunnar HL7-Norway

J.D. Nolen AP Co-Chair/Cerner

Marquard, Brett SD Co-Chair/River Rock Associates

Shabo, Amnon CG Co-Chair/IBM, Haifa

Vastagh, Stephen MITA

Presiding Officers Helmut Koenig, Siemens, Co-Chair
Harry Solomon, GE Healthcare, Co-Chair

1.  Opening

The daily meetings opened at 09.00. The antitrust rules were reviewed.

The agenda and previous minutes were approved.

2.  Administrative

2.1 II WG

o  The Secretary noted the ongoing Co-Chair elections and urged members to vote,

o  The HL7 Imaging Integration Work Group Mission & Charter review (biannual)

The Group reviewed the charter and discussed the revision if the Charter to include all “…ologies” in addition to the current scope of radiology oriented system and made other revisions, including adding the description of coordination of web services between DICOM and HL7.

C. Melo suggested relationship with CIC (Clinical Interoperability Council). It was discussed that WG-20 might visit a CIC meeting to explore common interests.

ACTION: The revised charter was approved unanimously by the Group – for submission to HL7.

2.2 HL7

H. Koenig reported on the FDA presentation on UID.

·  new requirement announced to sign-up before a ballot starts, to be eligible to vote

·  negative ballots, if not resolved, must be withdrawn directly by the person who casted the negative vote

·  DST updates: no new ballot is needed but must go through a review process (new process intended primarily for minor changes.)

3.  Joint meeting with HL7 Structured Documents (SD)

WG-20/II WG joined the HL7 SD for a joint meeting, on Tuesday. The joint meeting was hosted by SD, and therefore the SD minutes are the official record.

H. Koenig reported that …….

·  Comments were received on a new version of the Consolidated CDA Implementation Guide (C-CDA).

·  The comment from Clem McDonald who suggested to use more detailed CDA clinicalDocument LOINC codes instead of the current combination of generic CDA Diagnostic Imaging Report (DIR) clinicalDocument codes and detailed serviceEvent codes was discussed at length.

·  LOINC has 30 days to come up with a proposal for the definition of a value set and binding of codes to that purpose. If LOINC representatives fail to provide a proposal, no changes will be applied to the implementation guide. It was noted by F. Behlen that there is not an easy way to do it.

·  It was discussed that the work on RADLEX codes is underway.

·  C. Melo recalled further details of the discussion of service event and procedure codes.

·  Harry Solomon started a discussion on binding of vocabulary to CDA templates. The use of vocabulary should be decoupled from template document structure information in order to increase reuse of templates where only vocabulary changes. Participants of HL7 Structured Documents agreed with the proposal but pointed out that this would require changing the tools that are used for template management.

4.  Jt. Mtg with HL7 Anatomic Pathology (AP), Orders & Observations (O&O) and Clinical Genomics (Clin Gen)


WG-20/IIWG joined the HL7 OO, AP and CG for a joint meeting, on Sept. 25. The joint meeting was hosted by OO, and therefore the O&O minutes are the official record.

H. Koenig reported that OO is planning to ballot the specimen domain analysis model in January 2014. AP is continuing its work on unique identifiers for specimens.

CG reported on a new cancer biomarker initiative that deals with mapping nucleotide changes to biomarker information.

5.  RSNA Imaging Template Project

This is an ongoing project in cooperation with DICOM WG-08. H. Koenig reported on the recent t-cons of WG-08 in which he participated and the proposal he provided on CDA annotated narrative text and associated structured entry observation patterns. He referred to and showed the presentation shown in a WG-08 t-con on RSNA Reporting Templates (in meeting folder of WG-08 2013-09-09.)

  1. Supplement 155 (Templates for Imaging Procedure Reports encoded in CDA)

H. Koenig reported on the coordination with WG-08 to move forward in the development of the draft. He participated in the WG-08 tcons this year. The planned presentation of Sup 155 for 1st reading, to WG-06, was postponed.

C-CDA for DICOM Sup 155

H. Solomon reviewed the Draft (09-08). The document was posted in the meeting folder (Working Draft for C-CDA for DICOM Supp 155(09-08).docx).

A New Concept request was submitted to SNOMED for communication of critical clinical result.

7.  DICOM Change Proposals (CP)

H. Solomon reviewed relevant pending CPs:

·  CP-1286 – The RSNA Reporting Initiative and WG-8 have identified additional imaging report section names. These are added to CID 7001.

The LOINC codes are used as primary for CID 7001; the DCM codes are specified as equivalents for those codes that existed in the CID prior to this CP; this cross reference is used in the HL7 Diagnostic Imaging Report CDA Implementation Guide.

·  CP-1321 Add Telecom Addresses--Since the original definition of the Patient Demographics Module, email has emerged as a major communications medium. It is possible in HL7 v2 messaging (since v2.3) to include an email address using the XTN data type in any generic telecom information field. It is proposed to add generic telecom information fields.

·  CP-1312 Add Report Titles to CID 7000-- Additional Report Titles needed for imaging. These titles are to be harmonized with use in CDA Implementation Guides.

Additionally, the code for X-ray report is incorrect. LOINC defines 18782-3 as “Radiology study observation section”, not the full report document code.

Titles without LOINC codes have been submitted to LOINC for assignment.

·  CP-1322 Add Consulting Physician - DICOM does not have a place in its model for identifying a consulting physician, which is a separate role from the referring physician, attending physician, ordering physician, or reading physician. The equivalent in HL7v2 is modeled in the PV1 segment, so it should be included in the Visit Admission Module (and thus be available in the MWL), and in the Study Module

8.  Next Meetings

Next meeting with HL7:

The next joint meetings between DICOM and HL7, and the WG-20 meetings will be held , during Jan 19, 2014 to Jan 24, 2014 - San Antonio, TX

Preliminary Schedule:

Tuesday, Jan. 19, 2014

Jt Meetings hosted by HL7 WGs

Wednesday, Jan. 20, 2014

09.00-17.00 II-WG-20 Meeting

Thursday, Jan. 21, 2014

Q1-Q3 Jt Mtg II/WG-20-WG-27

Q4 Jt Mtg II/WG-20-WG-27-FHIR

WG-20 topic: Explore how interventional procedures interact with patient care with FHIR type records. II will discuss with Patient Care.

HOMEWORK: H. Koenig will contact the Patient Care Work Group.

Future Meetings of HL7:

May 4-9, 214 - Phoenix, AZ

Oct. 4-9, 2015 - Sheraton Atlanta Hotel, Atlanta, GA

Jan. 18-22, 2015 – Hyatt Regency, San Antonio, TX

May 10-14, 2015 – Paris France

Oct. 4-9, 2015 – Atlanta, GA

9.  Adjournment

The meeting was adjourned at 17.00 on Sept. 26.

Reported by Stephen Vastagh

Secretary

Reviewed by: CRS 2013-10-10

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Minutes - DICOM WG-20, Sept. 24-25, 2013 Page 172