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MINUTES
DICOM WORKING GROUP TWENTY
(Integration of Imaging and Information Systems)
and
HL7 IMAGING INTEGRATION WORK GROUP
Date:
Jan. 21-23, 2014
Place:
HL7 Meetings
Hyatt Hotel
San Antonio, TX, USA
Members Present
Represented by
GE Healthcare
Philips Healthcare
Siemens Healthcare
Solomon, Harry
Chris Melo
Koenig, Helmut
Members Absent
Voting Representative
PixelMed
Merge Healthcare
Clunie, D. *
Cowan, Ron *
Others Present
Affiliated with
Victor Brodsky,
Chris Carr
AP Co-Chair /College of American Pathologists
IHE/WG-08/RSNA
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Minutes - DICOM WG-20, Jan. 21-23, 2014
Page 174
Charles Kahn
Riki Merrick
J.D. Nolen
Charles Parisot
Terry Sippel-Schmidt
Stephen Vastagh
Presiding Officers
RSNA/Co-Chair DICOM WG-08/Med.Coll. of Wis.
OO Co-Chair/Vernetzt LLC
AP Co-Chair/Cerner
GE Healthcare
WG-08/ Karos Health
MITA/Secretary
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.
H. Koenig reminded members of the group that the DICOM WG20 / II co-chair election will close
on January 22, 2014 and that they can place their vote until 5:00 pm. Harry Solomon was reelected co-chair of DICOM WG20 / II.
2. Supplement 155 (Templates for Imaging Procedure Reports encoded in CDA)
C-CDA for DICOM Sup 155
H. Solomon presented a Sup 155 draft document.
The group started with a discussion on the structure and scope of DICOM Sup 155. It was decided that
templates image-guided interventional procedures will be addressed by Sup 155. The RSNA Imaging
Template Project also provides templates for image-guided interventions. DICOM Sup 155 is based on
the HL7 CDA Diagnostic Imaging Report (DIR) IG and its updates that were included in the HL7 CCDA IG (Consolidated Clinical Document Architecture Implementation Guide). The group spent the
majority of its meeting time on detailed technical discussion and development of the document. The
main issues discussed included:

Discussion on main and sub-sections for diagnostic and interventional imaging procedures based
on CDA DIR IG and Procedure Note IG contents within the C-CDA IG.

Inclusion of dose summary information based on DICOM Sup 150 “Radiation Dose Summary
Information in Radiology Reports”

The group decided to address critical findings in DICOM Sup 155.
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Minutes - DICOM WG-20, Jan. 21-23, 2014
Page 175

Review of Canadian Imaging Report Templates (based on CDA DIR IG templates and XDS)
presented by Teri Sippel.

Discussion with members of the HL7 Anatomic Pathology Group on future CDA templates and
re-use of existing CDA IG materials. V. Brodsky presented his Medinfo publication on
Anatomic Pathology Reports.

DICOM WG20 / II reviewed about two thirds of DICOM Sup 155 in detail and revised the text
of the Sup 155 draft document .

The group talked about additional efforts and that are required to prepare the draft for first read
by DICOM WG6.
The draft document was revised during the discussion. The draft posted at the end of the meeting
contained these revisions. The current version is available at the private DICOM FTP server:
MEDICAL/Private/Dicom/WORKGRPS/Wg08/Sup155/Sup155_2014-01-31.docx.
3. 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 Jan. 22. The joint meeting
was hosted by OO, and therefore the O&O minutes are the official record. WG-20/IIWG
reported on recent progress that was made related to the work on DICOM Supplement 155
(Templates for Imaging Procedure Reports encoded in CDA). Chris Carr provided a summary on
the plans to harmonize Radlex Playbook procedure codes with LOINC.
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Minutes - DICOM WG-20, Jan. 21-23, 2014
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4. Report on WG-27
WG-27 was meeting simultaneously. J. Philbin and B. Genereaux reported to WG-20 on
potential future work items of DICOM WG 27 that are related and can be used in the context
of web and RESTful services that were also discussed with HL7 FHIR (FHIR (Fast Healthcare
Interoperable Resources):

Presentation State for Images

Unified Procedure Step Adoption and potential worklist approach in the context of
FHIR (current FHIR approach is to use order and order response resources)

Service Discovery Harmonization with HL7

Rendered Objects

Key Object Selection
5. DICOM and FHIR
DICOM WG 27 and WG 20 / II discussed DSTU ballot resolution related to FHIR imaging
resources. It was concluded that the comments submitted by DICOM have been appropriately
addressed. H. Koenig pointed out that additional text / clarifications should be added in future
FHIR DSTU documents on the use of ImagingStudy and Media resources (i.e. on use cases
and image references) as well as that coded attributes are missing in both to indicate why the
DICOM image(s) are referenced (e.g. best illustration of finding).
6. Next Meetings
Next meeting with HL7:
The next joint meetings between DICOM and HL7, and the WG-20 meetings will be held , during May
4-9, 2014 in Phoenix, AZ.
Preliminary Schedule:
Tuesday, May. 6, 2015
Jt Meetings hosted by HL7 WGs
Wednesday, May 7, 2015
09.00-17.00 II-WG-20 Meeting
Thursday, May 8, 2015
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Minutes - DICOM WG-20, Jan. 21-23, 2014
Page 177
Q1-Q3 Jt Mtg II/WG-20-WG-27
Q4
Jt Mtg II/WG-20-WG-27-FHIR
Preliminary WG-20 topics for the Agenda:
Harmonization
Supp. 155, DICOM Web Services / HL7 FHIR
Summary of Future Meetings of HL7:
May 4-9, 2014 - Phoenix, AZ
September 14-19, 2014 - Chicago, IL
Jan. 18-22, 2015 – Hyatt Regency, San Antonio, TX
May 10-14, 2015 – Paris France
Oct. 4-9, 2015 – Atlanta, GA
7. Adjournment
The meeting was adjourned at 5:00 pm on Jan. 23.
Reported by
Stephen Vastagh
Secretary
Reviewed by:
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Minutes - DICOM WG-20, Jan. 21-23, 2014
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