Digital Pathology Ordering & Workflow (DPOW), published by IHE Pathology and Laboratory Medicine Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.1.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/PaLM.DPOW/ and changes regularly. See the Directory of published versions

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Official URL: https://profiles.ihe.net/PaLM/DPOW/ImplementationGuide/ihe.palm.dpow				Version: 0.1.0-current
Draft as of 2026-09-23				Computable Name: IHE_PaLM_DPOW

The Digital Pathology Ordering & Workflow (DPOW) Profile empowers the different systems in the digital pathology ecosystem with the data needed to drive the reading and ordering workflow. It addresses physical specimen registration (specimen, block, slide), case-level synchronisation, digital image availability notification, and the ordering of additional techniques. These use cases are expressed as messaging transactions using HL7® v2.5.1.

DPOW defines three actors - the Physical Asset Workflow Manager (PAWM), the Digital Asset Workflow Manager (DAWM), and the Image Manager / Image Archive (IMA) - and the HL7 v2 transactions between them. Adherence to the IHE Digital Pathology Image Acquisition (DPIA) profile plays an important role in a successful DPOW implementation, particularly because of the enriched metadata associated with DICOM Whole Slide Imaging (WSI) objects.

Editorial note: The transaction numbers used throughout this guide (LAB-100 through LAB-104) are placeholders and have not yet been formally agreed; they are pending assignment by the IHE Domain Coordination Committee (DCC).

Ecosystem Overview

The diagram below illustrates the broader digital pathology ecosystem and highlights the scope covered by DPOW within it. Systems shown outside the DPOW scope boundary are not specified by this profile.

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graph LR
  subgraph EXT_L["Out of Scope"]
    EHR["EHR\n(Order Placer)"]
  end

  subgraph DPIA_S["DPIA Scope"]
    SCANNER["WSI\nScanner"]
  end

  subgraph DPOW_S["DPOW Scope"]
    IMA["Image Manager /\nImage Archive\n(IMA)"]
    PAWM["Physical Asset\nWorkflow Manager\n(PAWM)"]
    DAWM["Digital Asset\nWorkflow Manager\n(DAWM)"]
  end

  EHR --> PAWM
  SCANNER -->|"DPIA"| IMA
  IMA --> PAWM
  IMA --> DAWM
  PAWM --> DAWM
  DAWM --> PAWM
  DAWM --> IMA

  style EHR fill:#f0f0f0,stroke:#b0b0b0,color:#1a1a1a
  style SCANNER fill:#ededed,stroke:#999999,color:#1a1a1a
  style PAWM fill:#e6e6e6,stroke:#666666,color:#1a1a1a
  style IMA fill:#cccccc,stroke:#666666,color:#1a1a1a
  style DAWM fill:#d9d9d9,stroke:#666666,color:#1a1a1a
  style DPOW_S fill:#f7f7f7,stroke:#555555,stroke-width:1.5px
  style DPIA_S fill:#fbfbfb,stroke:#aaaaaa,stroke-width:1px
  style EXT_L fill:#fafafa,stroke:#c0c0c0,stroke-dasharray:4 2

Organization of This Guide

This guide is organized into the following sections:

1. Volume 1: Profile Detail
   1. Introduction
   2. Actors, Transactions, and Content Modules
   3. Actor Options
   4. Required Actor Groupings
   5. Overview
   6. Security Considerations
   7. Cross-Profile Considerations
2. Volume 2: Transaction Detail
   1. Physical Asset Registration [LAB-100]
   2. Case Update [LAB-101]
   3. Place Work Order [LAB-102]
   4. Accept Work Order [LAB-103]
   5. Image Availability Notification [LAB-104]
   6. Volume 2 Appendices - Message abstract syntax and common HL7 segment definitions
3. Volume 3: Content Modules - Not applicable. DPOW defines no content modules.
4. Volume 4: National Extensions - Not applicable. DPOW defines no national extensions.
5. Other
   1. Changes to Other IHE Specifications
   2. Download and Analysis
   3. Test Plan

See also the Table of Contents and the index of Artifacts defined as part of this implementation guide.

Conformance Expectations

IHE uses the normative words: "MUST", "MUST NOT", "REQUIRED", "SHALL", "SHALL NOT", "SHOULD", "SHOULD NOT", "RECOMMENDED", "MAY", and "OPTIONAL" according to standards conventions.

Because DPOW is an HL7 v2.5.1 messaging profile, conformance for individual message fields is additionally expressed using the HL7 v2 Usage codes in the segment tables of the Volume 2 Appendices:

Usage	Meaning
R	Required
RE	Required but may be empty (populate if a value is available)
O	Optional
C	Conditional
X	Not supported

Must Support

This guide contains no FHIR StructureDefinition profiles, so the FHIR mustSupport flag (equivalent to the IHE R2 convention in ITI TF-2 Appendix Z) does not apply. DPOW conformance is defined entirely by the HL7 v2 message and segment specifications in Volume 2. The HL7 v2 Usage code RE is the DPOW equivalent of R2: the source actor SHALL populate an RE element when a value is available, and consuming actors SHALL handle the element being present or absent.