2014 PCD Domain Update. Jeff McGeath Iatric Systems IHE PCD Technical Committee Co-Chair
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1 2014 PCD Domain Update Jeff McGeath Iatric Systems IHE PCD Technical Committee Co-Chair
2 Patient Care Device (PCD) Domain Formed in 2005 to address issues related to integration of Point-of-Care Medical Devices Mission enable Out of the Box, Reliable, Functionally Interoperable solutions Using IHE & PCD open Processes and open Standards Technical Underpinnings HL7 version 2.6 IEEE Standards Standardized Nomenclature, Standardized Information Model Wireless Communication Transfer Protocol (WCTP) IHE ITI domain Consistent Time (CT) profile Network Time Protocol (NTP) IHE PCD Co-sponsors
3 Patient Care Device (PCD) Domain Focus is on devices associated with patients, including Patient monitors, vital signs monitors, pulse oximetry, ventilators, Infusion pumps, syringe pumps, PCA pumps, etc. Collecting and reporting data from devices for immediate access and for retrospective storage and retrieval (EMR) Device to Enterprise Communication (DEC) (leveraged by Continua Alliance for feeding data into health records) Implantable Device - Cardiac Observation (IDCO) Retrospective Data Query (RDQ)
4 Patient Care Device (PCD) Domain (contd.) Getting alerts (alarms & advisories) to staff (clinicians, clinical engineers, IT, etc.) on mobile & desktop devices Alert Communication Management (ACM) (formerly Alarm Communication Management) Improving infusion order safety (including a 6 th right, right pump) Point of care Infusion Verification (PIV) Infusion Pump Event Communication/Event Communication (IPEC/EC)
5 Patient Care Device (PCD) Domain (contd.) Harmonizing terminology Rosetta Terminology Mapping (RTM) RTM Management System in conjunction with NIST Waveform support Waveform Content Module (WCM) communicating evidentiary data for storage and alerting Medical Equipment Management Device Management Communication (MEMDMC) Location Services (MEMLS)
6 Device to Enterprise Communication (DEC)
7 Alert Communication Management (ACM) HL7 Messages per ACM and WCM profiles Parameters, waveforms, etc. as evidentiary data items Device Specific graphics Alert Source Alert Reporter AR Report Alert PCD-04 PCD-05 Report Alert Status Alert Manager AM Disseminate Alert PCD-06 PCD-07 Disseminate Alert Status Alert Communicator AC Alert Information Source, Phase, State, Priority Patient Location Instance Alert text Callback Timestamp Evidentiary data Dissemination Status Instance Accepted by AC Undeliverable Delivered Read Accepted Rejected Cancelled Callback start/stop
8 Point of care Infusion Verification (PIV) Physician s Order Nurse Review Pharmacist Review BCMA to Pump (PCD-03) Pump may provide data to EMR (PCD-01) Medication Administered Medication Nurse confirms 6 Rights: Right Patient Right Medication Right Dose Right Time Right Route Right Device
9 Infusion Pump Event Communication (IPEC) Infusion Pump Event Communication enables reporting of clinical and operational events from an infusion pump to a Bedside Computer-assisted Medication Administration (BCMA) system or EMR. Clinicians can then view and validate this information for infusion documentation. BCMA/EMR Prior to medication administration, nurse confirms the 6 Rights of administration using BCMA/EMR: Right Patient Right Medication Right Dose Right Time Right Route Right Device Infusion order sent from BCMA/EMR to Pump (PCD-03) Infusion-related events are displayed, validated, and/or recorded by the clinician using the BCMA/EMR Pump provides information on infusion-related events to BCMA/EMR (PCD-10) such as: Delivery Start Delivery Stop Delivery Complete
10 Implantable Device Cardiac Observation (IDCO)
11 Retrospective Data Query (RDQ) Supports retrospective query of PCD data from databases. Supports Use Cases such as Clinical Decision Support, backfilling of EMR databases, etc. Data Query PCD-12 Data Query PCD-12 Data Response PCD-13 Data Server and/or Data Requester Full Disclosure Data Response PCD-13 EMR, CDSS, CIS, Etc. Data Query PCD-12 Data Response PCD-13 Data Servers Data Requesters
12 Waveform Content Module (WCM)
13 Device Management, Location Services
14 Device Interoperability CPOE/ Pharmacy System Anesthesia Ventilation and Other Systems Physiologic Monitoring System Clinical Decision Support System ACM, DEC, ECM, WCM ACM, ECM, DEC, WCM ACM, ECM, ADQ, DEC, WCM Barcode Med Admin System P I V Infusion Pump ACM, DEC IPEC EMR/EHR CIS Interface Systems IDCO Implantable Device Phones and Other Devices for Clinicians Current PCD ACM, ECM, WCM Future PCD Home Based Systems Future Non- PCD DEC ACM, ECM, DEC, WCM Other Devices ACM, DMC, ECM CMMS and RTLS Systems ACM Alert Communication Management DEC Device Enterprise Communication DMC Device Management Communication EC Event Communication IPEC Infusion Pump Event Communication IDCO Implantable Device Cardiac Observation PIV Point-of-Care Infusion Verification RDQ Retrospective Data Query WCM Waveform Content Module
15 NIST Testing Tools HL7 Message Definitions Value Set Constraints IEEE / Rosetta Nomenclature Test Case Specific Assertions Etc.
16 NIST Testing Tools
17 Current Efforts Alerts (alarms & advisories) & Events Rosetta Terminology Mapping Device Specializations Pulse Oximeter, Infusion Device, Ventilator Medical Device Security Management PCD Profile Version Management FHIR Resources general FHIR technology review to culminate in a whitepaper describing PCD terminology mapping to FHIR FDA UDI Working with the HL7.org committees to advance UDI support in HL7 v2.
18 Optimized Message Syntax (OMS) Optimized Message Syntax is an effort to adapt IHE PCD profiles for devices that have slow legacy RS-232 serial ports. OMS will optimize the PCD messages to reduce their size but still maintain consistency with mainstream PCD messages. OMS Messages Bedside Computer EMR, CDSS, CIS, Etc. Data Collection System
19 Future Efforts Medical Device Technical Management Error logs, access to device logs Software & Hardware revisions Medical Device Cyber Security Medical Device to Device Communication Medical Device Specializations Improving device management, safety, and availability (DMC, RTLS) Utilization, Location, Failure alerts, Battery condition Improved asset management (qty rented/purchased)
20 Role of Healthcare Organizations Support the Mission of IHE PCD Participate in IHE PCD The voice of the users of what vendors produce be heard Plant the Seed Support and Request IHE Interoperability Encourage active IHE participation by vendors Purchase IHE PCD compliant products Request vendors to provide IHE Integration Statements Specify IHE PCD compliant solutions in RFPs by profile/actor
21 IHE PCD Compliant Systems COMPANY SYSTEM SYSTEM TYPE PCD PROFILES Accent on Integration, Inc. (AOI) Accelero Connect Medical Device Integration DEC Amcom Messenger Alarm Manager ACM B Braun DoseTrac Infusion Management Software Gateway software DEC, ACM, PIV BIOTRONIK SE & Co. KG Home Monitoring Service Center Implantable Cardiac Device Observer System IDCO Carefusion CGW Gateway DEC Cerner CareAware ibus Device Connectivity Platform DEC Epic EpicCare Inpatient and associated modules EMR/EHR DEC, PIV,IDCO GE HealthCare CARESCAPE Gateway Gateway DEC Hospira Hospira MedNet Infusion pump gateway PIV imdsoft MetaVision Suite CIS, AIMS DEC isirona DeviceConX Medical Device Integration DEC Mindray DS USA, Inc. egateway HL7 Gateway ACM, DEC Mindray DS USA, Inc. A5 Anesthesia machine DEC Nuvon VEGA Gateway DEC OZ Systems esp Interface DEC Philips Emergin IntelliSpace Event Management Alarm Manager ACM Philips Healthcare Philips IntelliVue and Philips IntelliBridge SC200 Monitoring central station and gateway DEC ScottCare ScottCare OneView Sysrtem Implantable Cardiac Device Observer System IDCO St. Jude Medical, Inc. Merlin.net MN5000 Implantable Cardiac Device Observer System IDCO Surgical Information Systems SIS Periop CIS, EHR, AIMS ACM, DEC Welch Allyn Connex VM Vital Signs Monitor DEC
22 Additional Resources IHE PCD Getting Started Tiny.cc/PCDStart IHE PCD User Guide Tiny.cc/PCDHandbook IHE web site PCD web site IHE ftp site ftp://ftp.ihe.net PCD ftp site ftp://ftp.ihe.net/patient_care_devices/ PCD wiki wiki.ihe.net/index.php?title=patient_care_devices Test Tool web sites PCD Pre-Connectathon tinyurl.com/nist-pcdtt PCD Connectathon tinyurl.com/nist-pcdctt Rosetta Terminology tinyurl.com/nist-rtmms
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