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Patient Care Device Domain Overview
The Patient Care Device Domain
PCD HistoryPCD History
• Established in 2005 when the “charter” was awarded to the ACCE
• Jointly sponsored by ACCE and HIMSS as of July 1, 2006
• Technical Framework 2006-7 developed to communicate patient data (asynchronous)
• Successful demonstration at the 2007 & 2008 Connectathons and HIMSS Interoperability Showcases
IHE Patient Care Devices (PCD)
IHE-PCD CharterIHE-PCD Charter
The Patient Care Devices Domain is The Patient Care Devices Domain is concerned with Use Cases in which at concerned with Use Cases in which at least one actor is a least one actor is a regulated patient care regulated patient care devicedevice. The PCD coordinates with other . The PCD coordinates with other IHE clinical specialty based domains IHE clinical specialty based domains such as medical imaging and laboratory.such as medical imaging and laboratory.
Emerging IHE-PCD Workflows
Key Objectives 2007/2008Key Objectives 2007/2008• Enterprise sharing of Patient Care Data• Patient Identity Binding to Device Data• Subscribe to Patient Data
Key Objectives 2008/2009Key Objectives 2008/2009• Rosetta Stone Terminology Project• PCD Alarm Communication Management• Infusion Pump Integration - Drug Administration
Key Objectives 2009 and beyondKey Objectives 2009 and beyond• Point of Care Plug and Play (multiyear effort)• Real-time data archiving and communication• Medical Device Management• Mobile, enterprise-wide, reliable vital signs monitoring• … many more!
Initial device classes…vital sign monitors, bedside monitors, infusion pumps and ventilators
Patient Care Device Key Values
• Heterogeneity – Coexistence in a multi-manufacturer / multi-modality world, leveraging shared infrastructure
• Semantic Interoperability – … from the sensor to the EHR
• Real-time Availability – Facilitating more timely clinical decisions
PCD Profile Value Propositions:PCD Profile Value Propositions:
HIMSS Showcase ‘08
HIMSS Showcase ’08 - Products
HIMSS Showcase ’08 – ER & OR
HIMSS Showcase ’08 – ICU
Relevant Domains and Profiles
IHE PCD profiles…IHE PCD profiles…
• DEC – Device-to-Enterprise Communication– Send data acquired from devices to enterprise
applications using consistent syntax & semantics
• PIB – Patient ID Binding– Methods for binding an authenticated patient identity
information with device data updates.
• SPD – Subscribe to Patient Data– Configure [DEC] data updates per desired information
… avoid the Fire Hose effect!
Relevant Domains and Profiles
IHE PCD profiles – new this cycle!IHE PCD profiles – new this cycle!
• RTM – Rosetta Terminology Map– Correlates comprehensive vendor-specific semantics
with a standardized representation
• ACM – Alarm Communication Management– Profiles the semantics and protocols for
communicating and managing device alarm events
• PIV – Point-of-Care Infusion Verification– Verify that the drug about to be delivered is for the
right patient, right drug, right dose, right interval and right path.
Rosetta for Semantic Interoperability
Rosetta for Semantic Interoperability
Migrating Toward True PCD Semantic Interoperability
Today HIMSS ’09!
ISO/IEEE 11073Semantic Standards
Vendor Semantics
IHE PCD TF Content
Vendor A
Vendor C
Vendor B
RosettaMappingTables(RTM)
11073PnP Comm
HL7 v3CDA/CCD
HL7 v2Messages
Relevant Domains and Profiles
IHE profiles also leveraged…IHE profiles also leveraged…
• CT – Consistent Time– Ensures system clocks and time stamps are well
synchronized (median error < 1 second)
• PAM – Patient Administration– Provides a stream of patient demographics updates,
ensuring continuity & integrity of patient data
• PDQ – Patient Demographics Query– Allows applications to query a central patient
information server to retrieve demographic & visit information
Test Tooling Support - NIST
• NIST Test Tools– ICSGeneratorICSGenerator
• Medical Device Profiles (specializations)• Implementation Conformance Statements
– ValidatePDUValidatePDU • X73 Application Layer Message Syntax and Semantic Validation
• NIST Medical Device Standards Work– ISO/IEEE 11073 Standard (X73): Medical Device Communication
• XML SchemaXML Schema: NIST P11073-10202 Domain Information Model
• Collaborations– Integrating Health Enterprise - Patient Care Devices (IHE-PCD)– IEEE 11073 Personal Health Devices (PHD) Working Group (WG)– ISO/IEEE 11073 WG
• On-going Work and Future Direction…– IHE-PCD profile and message generation and testing (includes enterprise – e.g.,
HL7 V2 & V3HL7 V2 & V3)– PHD X73 profile and message testing (ContinuaContinua)– X73 Java Class LibraryX73 Java Class Library
• NIST Team Members– John Garguilo ([email protected] 301-975-5248), Sandra Martinez,
Maria Cherkaoui (guest researcher), and Richard Theimer (contractor)
http://www.nist.gov/medicaldeviceshttp://www.nist.gov/medicaldevices
IHE PCD Active Profiles & HITSP RMON
Volume 1Integration Profiles
(Use Cases)
Volume 3Content
Volume 2Transactions
SemanticInteroperability
TechnicalInteroperability
Real-WorldProblems
DECDEC-PIBDEC-SPD
ACM
MEM
PnP
DS-PUMP
DS-VENT
DS-PHYSIO
PCD Technical
Framework
PCD Profiles
RTM
Legend: ACM Alarm Comm. Management DDT Device Document Template DEC Device Enterprise Comm. DS- Device Specializations MEM Medical Equipment Mgmt. PIB Patient ID Binding PIV Point-of-Care Infusion
Verification PnP Plug-and-Play RTM Rosetta Term Mapping RM Remote Monitoring SPD Subscribe to Patient Data
PIV
RM
DDT
= Potentially applicable to
RMON U/C
IHE PCD & HITSP RMON
IHE PCD & HITSP RMON
Device
Device Intermediary
(DI)
EHR System
Remote Monitoring Mgmt System (RMS)
PHR System
Health Info Exchange
(HIE
Interface#1
Interface#2
Interface#3
Interface#4
Interface#5
Interface#6
Interface#7
Actor #1
Actor #2
Actor #3Actor #4Actor #5
PCD Contacts
PCD CoChairs:– Todd Cooper [email protected] – Ken Fuchs [email protected] – Ray Zambuto
• PCD Technical Project Manager:– Manny Furst [email protected]
• IHE (International) Strategic Development Committee Co-Chair:– Elliot Sloane [email protected]
