Digital Pathology Ordering & Workflow (DPOW)
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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

2:3.LAB-100 Physical Asset Registration [LAB-100]

This section corresponds to transaction [LAB-100] of the IHE PaLM Technical Framework. Transaction [LAB-100] is used by the Physical Asset Workflow Manager (PAWM) and Digital Asset Workflow Manager (DAWM) actors.

All DPOW transactions leverage a constrained profile of HL7 OML^O21. The OML^O21 (Laboratory Order) message initiates each transaction; ORL^O22 (Laboratory Order Response) is the application acknowledgement. Common segment definitions used by this transaction are specified in the Volume 2 Appendices.

Editor's note: The section number 3.LAB-100 uses the provisional transaction number as its section identifier pending formal IHE transaction number registration.

2:3.LAB-100.1 Scope

This transaction is used by the Physical Asset Workflow Manager (PAWM) to register a physical asset (specimen, block, or glass slide) and broadcast its availability and metadata to the Digital Asset Workflow Manager (DAWM). The type of asset being registered is identified by the MSH-21 profile identifier.

2:3.LAB-100.2 Actor Roles

Table 2:3.LAB-100.2-1: Actor Roles

Actor Role
Physical Asset Workflow Manager (PAWM) Registers a new physical asset and sends its metadata to the DAWM. Acts as the order placer in the HL7 model.
Digital Asset Workflow Manager (DAWM) Receives physical asset registration. Creates or updates the case-level view. Acts as the order filler in the HL7 model.

2:3.LAB-100.3 Referenced Standards

  • HL7 v2.5.1: Chapter 4 (OML^O21, ORL^O22), Chapter 7 (SPM segment), Chapter 13 (SAC segment)
  • Pre-adoptions: SAC-48 (HL7 v2.9.1). See Significant Changes and Issues, Closed Issue 3.

2:3.LAB-100.4 Messages

The process flow for this transaction is illustrated in Volume 1, Use Cases #1-#3 (specimen, block, and slide registration).

2:3.LAB-100.4.1 OML^O21 - Physical Asset Registration Message

2:3.LAB-100.4.1.1 Trigger Events
  • A new physical asset (specimen, block, or slide) is received and registered in the PAWM.
  • Physical asset metadata is updated (e.g., stain applied to a previously unstained slide).
  • A physical asset registration is cancelled or corrected.
2:3.LAB-100.4.1.2 Message Semantics

The message is OML^O21. MSH-21 Message Profile Identifier SHALL be populated to identify the asset type:

MSH-21 Value Asset Type
DPOW-SPECIMEN^IHE Specimen / container registration
DPOW-BLOCK^IHE Block / cassette registration
DPOW-SLIDE^IHE Glass slide registration

ORC-1 Order Control values used in this transaction:

ORC-1 Value Meaning
NW New asset registered
XO Update to existing asset metadata
CA Cancellation of asset registration

Specimen-type-specific fields:

Asset Type Key Fields
Specimen SPM-8 (source site, ideally SCT); fixative in OBX-5 (CWE)
Block SPM-3 (parent specimen ID); SPM-9 (laterality, ideally SCT); embedding medium in OBX-5 (CWE)
Slide SPM-3 (parent block ID); stain in OBX-5 (CWE) when stained; SAC-48 = WSI when eligible for scanning

Note on SPM fields: SPM-4 SHALL use TISS or an appropriate SCT code. Biopsy and similar terms are procedures, not specimen types, and SHALL NOT be used in SPM-4. SPM-8 and SPM-9 SHOULD use SNOMED CT codes (body structure hierarchy and laterality respectively) rather than locally defined codes.

Note on OBX-5 for preparation metadata: Fixative (specimen level), embedding medium (block level), and staining (slide level) SHALL be conveyed in OBX-5 (CWE) segments following the SPM segment. This aligns with the approach adopted in DPIA. SPM-6 SHALL NOT be used for this purpose in DPOW.

Full segment definitions are provided in the Volume 2 Appendices (Appendix A).

Field mapping. Fields this transaction populates (full segment definitions in the Volume 2 Appendices, Appendix A):

Concept HL7 Field (v2.5.1) Usage Example Notes
Patient ID PID-3 R 1234567890 patient identifier list
Patient name PID-5 R SMITH^MARY  
Order control ORC-1 R NW / XO / CA XO = update trigger for an existing registration
Placer / filler order no. ORC-2 / ORC-3 O A4486 / B23-17890 The filler order number is frequently the case number / accession number
Universal service ID OBR-4 R 687891.024^Digital AP Study^L  
Accession number SPM-30 / ORC-38 R S25.0001 case key; ORC-38 (Filler Order Group No.) added for DPIA alignment
Asset ID SPM-2 R B23-17890-A1-01 specimen, block or slide id
Parent asset ID SPM-3 RE B23-17890-A1 block -> specimen; slide -> block
Specimen type SPM-4 R TISS^Tissue^HL70487 not a procedure
Source site / laterality SPM-8 / SPM-9 RE 80248007^Breast structure^SCT SNOMED CT
Container type SPM-27 O GLASS see SPM-27 value set
Container material SAC-48 O WSI slide; v2.9 pre-adoption
Preparation metadata OBX-5 RE 431510009^Formalin^SCT fixative/embedding/stain
Asset type (flavour) MSH-21 R DPOW-SLIDE^IHE DPOW-SPECIMEN / DPOW-BLOCK / DPOW-SLIDE
2:3.LAB-100.4.1.3 Expected Actions

The DAWM SHALL create or update the appropriate entry (case, block, or slide) for the patient and accession number identified in the message, linked to the parent asset via SPM-3 where applicable. For unstained slides (no OBX stain), the DAWM SHALL create a placeholder entry. When a subsequent update message is received with stain metadata, the DAWM SHALL update the existing placeholder. The DAWM then returns the ORL^O22 acknowledgement described below.

2:3.LAB-100.4.2 ORL^O22 - Acknowledgement

2:3.LAB-100.4.2.1 Trigger Events
  • Receipt of the OML^O21 Physical Asset Registration message by the DAWM.
2:3.LAB-100.4.2.2 Message Semantics

The DAWM returns ORL^O22 as the application acknowledgement. MSA-1 conveys the acknowledgement code: AA (accept), AE (application error), or AR (application reject). When MSA-1 is AE or AR, an ERR segment SHOULD convey the error detail.

Validation required - see WI-DPOW-01. The exact MSA/ERR usage is subject to message validation before Trial Implementation.

2:3.LAB-100.4.2.3 Expected Actions

The PAWM SHALL process the acknowledgement. On AE/AR the PAWM SHOULD log the failure and MAY retransmit the registration.

2:3.LAB-100.4.3 CapabilityStatement Resource

Not applicable. DPOW is an HL7 v2.5.1 messaging profile and defines no FHIR CapabilityStatements; actor conformance is defined by the HL7 v2 message and segment specifications above and in the Volume 2 Appendices.

2:3.LAB-100.5 Security Considerations

This transaction conveys PHI. All actors SHOULD be grouped with ATNA and the Consistent Time (CT) Time Client (see Volume 1, Section 1:XX.5).

2:3.LAB-100.5.1 Security Audit Considerations

2:3.LAB-100.5.1.1 Physical Asset Workflow Manager (PAWM) Audit

When grouped with an ATNA Secure Node or Secure Application, the PAWM SHALL record an audit event when it sends a [LAB-100] message.

2:3.LAB-100.5.1.2 Digital Asset Workflow Manager (DAWM) Audit

When grouped with an ATNA Secure Node or Secure Application, the DAWM SHALL record an audit event when it receives a [LAB-100] message.