Digital Pathology Ordering & Workflow (DPOW)
0.1.0-current - ci-build
Digital Pathology Ordering & Workflow (DPOW)
0.1.0-current - ci-build
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
This section corresponds to transaction [LAB-104] of the IHE PaLM Technical Framework. Transaction [LAB-104] is used by the Image Manager / Image Archive (IMA), Physical Asset Workflow Manager (PAWM), and Digital Asset Workflow Manager (DAWM) actors. It is initiated using OML^O21 and acknowledged with ORL^O22; common segment definitions are specified in the Volume 2 Appendices.
Editor's note: The section number
3.LAB-104uses the provisional transaction number as its section identifier pending formal IHE transaction number registration.
This transaction is used by the Image Manager / Image Archive (IMA) to notify the PAWM and/or DAWM that a digital whole slide image is available (or has been removed/de-associated) in the image archive.
Table 2:3.LAB-104.2-1: Actor Roles
| Actor | Role |
|---|---|
| Image Manager / Image Archive (IMA) | Sends image availability or de-association notifications. |
| Physical Asset Workflow Manager (PAWM) | Receives notification. Updates slide status accordingly. |
| Digital Asset Workflow Manager (DAWM) | Receives notification. Updates case readiness status. |
The process flow for this transaction is illustrated in Volume 1, Use Cases #6 and #7 (image availability and de-association notification).
The message is OML^O21. MSH-21 SHALL be populated with DPOW-IMAGE-NOTIF^IHE.
SPM-20 SHALL be used to convey image state:
Y - image is availableN - image has been de-associated or removedSPM-18 SHALL carry the scan date/time (the date and time the WSI was created by the scanner).
The IMA MAY include both the Study Instance UID and the Series Instance UID as OBX segments to allow the receiving actor to retrieve the image via DICOM/DICOMweb. Per DPIA (as amended by CP-LAB-279), all images from a single scan of a single slide share the same Series Instance UID.
Open Issue 9:
OUL^R22may be required as an alternative message type when result content (e.g., thumbnail, QC status) needs to be conveyed. This will be evaluated at Trial Implementation. See Significant Changes and Issues.
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 | |
| Slide ID | SPM-2 | R | B23-17890-A1-01 | correlates to the LAB-100 slide |
| Scan date/time | SPM-18 | R | 20230822100052 | scan date/time in LAB-104 |
| Image state | SPM-20 | R | Y / N | Y = available; N = de-associated |
| Study Instance UID | OBX (StudyInstanceUID) | O | 1.2.3.4.5.1234567890 | DICOM Study Instance UID |
| Series Instance UID | OBX (SeriesInstanceUID) | O | 1.2.3.4.5.9876543210 | DICOM Series Instance UID |
Upon receiving an image availability notification (SPM-20 = Y), the PAWM SHALL update the slide status. The DAWM SHALL update the case view and, if all expected slides for a case have images available, MAY transition the case to ready for pathologist review. A subsequent [LAB-101] Case Update with ORC-1: SC and ORC-5: IP from the PAWM signals that all images for the case have been imported (examination in progress).
For de-association notifications (SPM-20 = N), the PAWM and DAWM SHALL treat any previously available image(s) for the identified asset as no longer associated and clear any "images available" indication for that asset (for example, a slide-level flag in the LIS). De-association applies whether the underlying image was physically deleted or merely de-associated; DPOW does not distinguish the two. Implementations are expected to log de-association events, either through an application log or, for actors grouped with ATNA, as an audit event.
Each receiving actor then returns the ORL^O22 acknowledgement described below.
OML^O21 Image Availability Notification message by the PAWM and/or DAWM.Each receiving actor 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.
The IMA SHALL process each acknowledgement. On AE/AR the IMA SHOULD log the failure and MAY retransmit the notification to the affected actor.
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.
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).
When grouped with an ATNA Secure Node or Secure Application, the IMA (sender) SHALL record an audit event when it sends a [LAB-104] message.
When grouped with an ATNA Secure Node or Secure Application, each receiving actor (PAWM and DAWM) SHALL record an audit event when it receives a [LAB-104] message.
IG © 2026+ IHE Pathology and Laboratory Medicine Technical Committee. Package ihe.palm.dpow#0.1.0-current based on FHIR 4.0.1. Generated 2026-09-23
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