september 2014 medicalinteroperability.org | @MedInterop

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Interoperability – the ability of health information to be shared and used seamlessly across medical devices and systems – is essential to improving the delivery of health care to individual patients and managing the health of populations. The Center for Medical Interoperability (Center) is a recently formed, 501(c)(3) organization led by health systems to drive interoperability of medical technologies to improve the safety, quality and affordability of health care. The Center is dedicated to solving the shared technical challenges that hospitals face in making information flow across the devices, machines and IT systems used in patient care.

The Medical Device Interoperability (MDI) campaign is focused on improving the ability of point-of-care medical devices such as patient monitors, ventilators and pumps to exchange data with each other and with clinical IT systems. Today, each device uses its own proprietary protocol to communicate measurements, waveforms, alarms, etc. This results in very complex and costly integration efforts and dissuades many providers from attempting to acquire data from these devices. The overall result is poor quality, limited access to medical device data, negative clinical workflow impact and other second and third order effects.

• Received IRS determination of status as a 501(c)(3) public charity (May 8)

• Obtained additional $5.5 million in funding from Gary and Mary West Foundation (GMWF) (July 15)

• Convened GMWF, Center and executives that will serve as the founding Board of Directors (July 23)

• Agreed upon a funding model and membership agreement that were guided by and accepted by the Board (expect all agreements to be finalized by the end of September)

• Preparing for first plenary meeting of founding Technical Advisory Committee (October 23-24)

• Continued progress on technical campaigns, including Medical Grade Wireless pilot launch

• Began targeted membership recruiting efforts, which have been well received

• Expanded leadership team with EVP, Membership and VP, Public Policy and Communications

• Participated in public forums to broadly engage stakeholders and drive awareness of the Center

september 2014

Q2 and Q3 2014 Highlights

Technical Campaign UpdateMedical Device Interoperability

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The MDI campaign mission is to move vendors from proprietary to standards-based data exchange and control, thereby enabling seamless interoperability. This is a two-pronged approach, with providers using their purchasing power to encourage vendor conformance as well as provision of technical components and support to accelerate vendor implementation and adoption.

The MDI team is developing an open-source library, termed the Protocol Interoperability Manager (PIM), which will allow vendors to easily incorporate one or more standards-based ‘plug-in’ protocol modules in their devices and IT systems through the use of a single API. We are currently implementing protocol modules that support IEEE 11073 (Classic) and IHE-PCD interoperability standards. Future module possibilities include IEEE 11073 PHD, OpenICE (from the MDPnP WG), HL7 FHIR, and OpenSDC (which is on track to become the IEEE 11073 network standard). Our approach is inclusive, supporting multiple protocols, as different protocols may be warranted for different use cases. The Center will provide source code, design documentation, risk management documentation, simulated devices, test opportunities and conformance assessment services. We are currently working with a number of vendors including Philips Healthcare, Moberg Medical and Hamilton Medical in a design and prototyping effort.

Wireless has become an indispensable utility for hospitals. This campaign helps hospitals ensure that their wireless networks perform with a known, reliable level of assurance to ensure safe, high-quality care for patients. The Center launched its first pilot project with a member, Scripps Health, to help members deploy and manage a medical grade wireless utility (MGWU). Through this project, we are creating a set of trust capabilities (tools and services that ensure confidence across all stakeholders that their interoperable technologies will work as expected, safely and securely). We are also preparing to guide Vanderbilt University Medical Center, another member, through the MGWU assessment process.

A National Medical Grade Wireless Lab is needed for both vendors and providers to test their devices before deployment in a real clinical environment. From a vendor perspective, it is very difficult and expensive to properly verify the performance of a device in a hospital-like setting. Another complexity is the lack of consistency between wireless infrastructure vendors, which requires testing with each one, as well as changes that may be introduced in infrastructure firmware releases. Provider organizations face similar issues and many larger institutions are considering establishing their own test labs. The National Medical Grade Wireless lab would be a shared resource for test, certification and validation of devices and infrastructure in a realistic environment that would be impractical to implement on a case-by-case basis The Center continues its efforts to establish such a centralized lab.

Medical Grade Wireless

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Jeffrey Balser, MD, PhDVice Chancellor for Health AffairsVanderbilt University Medical Center

Ed CantwellExecutive DirectorCenter for Medical Interoperability

Benjamin Chu, MDExecutive Vice President, Kaiser Foundation Hospitals and Health PlanKaiser Permanente

Steven Corwin, MD Chief Executive Officer NewYork-Presbyterian

Richard DakersInterim PresidentCenter for Medical Interoperability

Dean HarrisonPresident and Chief Executive Officer Northwestern Memorial HealthCare

Michael M. E. Johns, MD Chairman of the BoardCenter for Medical Interoperability

R. Milton JohnsonPresident and Chief Executive Officer Hospital Corporation of America

Stephen JonesPresidentRobert Wood Johnson Health System

Shelley LyfordPresidentGary and Mary West Foundation

Thomas Priselac (unable to attend) President and CEOCedars-Sinai Health System

Jon Pryor, MDChief Executive Officer Hennepin Health System

Paul Rothman, MD Chief Executive Officer Johns Hopkins Medicine

Michael Schatzlein, MDPresident and CEOSaint Thomas HealthMarket Leader, Indiana and Tennessee MinistriesAscension Health

Joseph M. Smith, MD, PhDChief Science and Medical Officer Gary and Mary West Health Institute

Wayne SmithChairman of the Board and CEOCommunity Health Systems, Inc.

Glenn Steele, Jr., MDPresident and CEOGeisinger Health System

Nicholas Valeriani Chief Executive West Health

Chris Van GorderPresident and CEOScripps Health

september 2014

Stakeholder EngagementThe Center continues to emphasize stakeholder engagement and established three primary mechanisms to do so: 1) Advisory Board, 2) technical and 3) informational. The Advisory Board will provide strategic input into Center activities and foster collaboration across initiatives. Formal engagement will begin following the October TAC plenary meeting. The Center will maintain direct interaction with relevant vendors, standards development organizations, government and others for specific technical campaigns. Consistent with its principles of transparency, the Center will uphold open communication with the broader community to vet and share Center outputs.

Key stakeholder outreach has included federal agencies (eg, FDA, FCC, ONC and Defense Health Agency), electronic health record vendors (eg, Epic and Cerner), medical device manufacturers (eg, Philips, Masimo, Draeger, Sotera and Stryker), IT service providers (eg, Harris, IBM and 3M), healthcare associations (eg, HIMSS, CHIME and America’s Essential Hospitals), standards development organizations (eg, HL7, AAMI and UL), and other relevant parties (eg, ECRI and CableLabs).

Participants in the July 23 operations review and board meeting included the following:

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Jay AndersonSenior Vice President, Performance Improvement and Chief Information Officer Northwestern Memorial HealthCare

Aurelia Boyer, RN, MBASenior Vice President & Chief Information OfficerNewYork-Presbyterian

Darren DworkinChief Information Officer Cedars-Sinai Health System

Alistair Erskine, MDChief Clinical Informatics Officer Geisinger Health System

Nancy Garrett, PhDChief Analytics OfficerHennepin County Medical Center

Stan Huff, MDChief Medical Informatics Officer Intermountain Healthcare

Robert IrwinChief Information OfficerRobert Wood Johnson Health System

Jonathan Perlin, MDPresident of Clinical Services & Chief Medical OfficerHospital Corporation of America

John Pirolo, MDChief Medical Officer, Saint Thomas Health Ascension Health

Marc ProbstChief Information Officer and Vice President for Information SystemsIntermountain Healthcare

Bruce RaineyCorporate Vice President, Construction & FacilitiesScripps Health

Stephanie ReelSenior Vice President for Management Systems and Information ServicesJohns Hopkins Health SystemVice Provost for Information Technologies Johns Hopkins University

Lynn Simon, MD, MBAPresident, Clinical Services & Chief Quality OfficerCommunity Health Systems, Inc.

William Stead, MDAssociate Vice-Chancellor for Health Affairs and Chief Strategy OfficerVanderbilt University Medical Center

Steven Steinhubl, MDDirector of Digital Medicine at the Scripps Translational Science InstituteScripps Health

The Technical Advisory Committee (TAC), made up of technical leadership from member organizations, is responsible for overseeing the development and execution of the Center’s technical roadmap. Industry leaders will be sought to participate on medical and technical advisory boards and work groups. The Center maintains a dedicated technical staff.

Technical Advisory Committee (TAC)

The founding TAC Members include:

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