1. 11073-20401-20130925 SLIDE 1 IEEE 11073 20401 Common Network Services Vivek Kamath, vpkamath@westhealth.org

2. 11073-20401-20130925 SLIDE 2 IEEE 11073-20401 Project (PAR) Scope: Within the framework of IEEE 11073 standards, this standard will define a common, transport neutral set of networking services that will enable plug- and-play interoperability of medical devices. This project shall not address quality of service over RF wireless network connections.

3. 11073-20401-20130925 SLIDE 3 Scope Summary: l Define common set of networking services l Transport Neutral l Enable plug-and-play l For medical devices

4. 11073-20401-20130925 SLIDE 4 Aspects of CNS l Describes topological framework to standardize network semantics for medical devices l Enables profiling of clinical scenarios from a communication perspective. l Defines a Transport Independent System Layer (TISL) as a standard interface for upper layers l Recommends technologies that can be used for networking medical devices

5. 11073-20401-20130925 SLIDE 5 CNS Discussion Outline l Topological View l Clinical Scenarios l Profiles and Services l Transport Stack l Preferred Technologies l TISL l Services

6. 11073-20401-20130925 SLIDE 6

7. 11073-20401-20130925 SLIDE 7 Clinical Scenarios - ENV 13735 Annex E 2.1 ScenarioCommunication Requirements Emergency Situation – One of the main scenarios is alarm (2.1.1) Plug and Play - the device communication must start immediately after device connection without any further user intervention. That implies e.g. automatic device recognition, identification, and initialization of communication. Safety and reliability of communication and network - connection of a new device must not influence the communication of other devices connected earlier Unique device identification Normal patient nursing condition in ICU, non emergency situations (2.2) Same as above

8. 11073-20401-20130925 SLIDE 8 ScenarioCommunication Requirements Data Logger ( 3.1)Graphic parameter data volumes can require high bandwidth ‘Loose’ device time stamp synchronization, in the order of 0.01 second, is required. Real Time Data Display (3.2) Latency of data between amplifier output and display on screen must be less than 0.2 seconds to be invisible for user. Patient Alarm Monitoring (3.3) The communication of alarm related information must be expedited, in order to be processed prior to other data, and must be reliable. Display Device must be able to detect when a Data Agent is removed. Ideally it should be able to distinguish between an intentional disconnection and unintentional disconnection. The latency of occurrence of alarm and signaling to user must be less than 0.25 seconds.

9. 11073-20401-20130925 SLIDE 9 ScenarioCommunication Requirements Remote Control (3.4)In a remote control system, the communication must fulfill a higher level of reliability, because of a higher risk for the patient. This includes the needs for comprehensive message validation, data verification, message retries, and notification of communication system failures. This implies the need for system management functionality. A mechanism to send control data to the data agent and acknowledge receipt is required. In some cases manual control of the device should be precluded. Patient Viewing Interoperability (3.5) There must be some level of control such that a remote user (i.e. outside the care unit) cannot change the settings established by a nurse at the bedside. Harmonization of communication methods for RF telemetry systems would be required in order to support interoperable telemetry systems. Bandwidth management may become a big issue. The issue of managing multiple associations between a Data Agent and multiple Data Loggers or Data Dis - play needs attention.

10. 11073-20401-20130925 SLIDE 10 ScenarioCommunication Requirements Patient Monitoring Interoperability (3.6) Communication over different hospital LANs and maybe even on the Internet. Ordering of physiological data is important. Latency from Data Agent to Remote Monitoring Device must be controlled and specified. Generally, this should be less than one second to be acceptable. Maintenance and Configuration Support (3.8) Physical connect/disconnect sensing for devices. System management protocol Intrabed Symmetric Data Exchange between DCC and BCC (4.1) Interbed Symmetric Data Exchange over an "Interbed Network“ (4.2) Symmetry in communication between device (DCC) and BCC Symmetry in data propagation in through the BCC - from device (DCC) through BCC to Application System and vice versa Propagation of a containment tree of a remote device to the receiver (DCC)

11. 11073-20401-20130925 SLIDE 11 CNS- Profiles

12. 11073-20401-20130925 SLIDE 12 Transport Stack View ethernet 11073 “upper layers” Wi-Fi Cellular Data Wi-Max 802.3 10/100/ 1000BT 802.11 RF GPRS EDGE 1xRTT 4G /LTE RF 802.16 RF IP RTP/SCTP TCPUDPSCTP IrLAP IR IrLMP TinyTP RS-232 IP Support Services 11073 config service 11073 assoc service DHCP DNS Net. capacity service LDAP NTP Radius Location services Presence services SNMP 802.1x NAT USB BlueTooth PHDC MDP currentshort term point to point links short termpossible future IP centric links USB ether class drv BlueTooth IP profile MICS WMTS ZigBee possible future Interface to ‘upper layers” - TISL

13. 11073-20401-20130925 SLIDE 13 Technologies that can be used for CNS(Initial Scope) ComponentsLayerTechnology InterfacePhysical/Link802.3 ConnectivityTransport/NetworkUDP/IP v4 and TCP/IP v4 SecurityNetworkIPSec over UDP, IPSec over TCP, None Quality Of ServiceApplicationRTP over UDP, RSVP DiscoveryApplicationmDNS, DNS ProvisioningApplicationDHCP, Statically provisioned CNS requirements fall between Transport Type3-Transport Type4

14. 11073-20401-20130925 SLIDE 14 TISL l Provides uniform interface to upper layers l Provides support for following services l Discovery of services l Connectivity l Provisioning l Security l Quality Of Service (QoS)

15. 11073-20401-20130925 SLIDE 15 Interface – Physical/Link Layer 802.3 l Will be used as specified in IEEE 11073-30400 l MAC/PHY specified in 11073-30400

16. 11073-20401-20130925 SLIDE 16 Provisioning Services DHCP l Apart from IP address l Following options will be implemented l Domain Name Server Option. Code = 6 l Subnet Mask Option. Code=1 l Time Server Option. Code=4 l Others?

17. 11073-20401-20130925 SLIDE 17 Provisioning Services DHCP Medical Device (DHCP Client) DHCP Server (not selected) DHCP Server (selected) Begins Initialization DHCPDISCOVER Determines Configuration DHCPOFFER Collects replies Selects configuration DHCPREQUEST Commits Configuration DHCPACK Initialization complete Graceful shutdown DHCPRELEASE Discards Lease DHCP Server can be used to provision IP Address and other artifacts

18. 11073-20401-20130925 SLIDE 18 Provisioning Services DHCP – Autonet address selection Medical Device (DHCP Client) Begins Initialization Pick random address in 169.* scope Is address available? No Response Self assign selected address

19. 11073-20401-20130925 SLIDE 19 Provisioning Services (TISL primitives) NameDescription TISL_provisioning_initInitialize provisioning services TISL_provisioning_enum_providersEnumerate available provisioning providers TISL_provisioning_set_providerSet current provider TISL_provisioning_add_itemAdd provisioning item given the code TISL_provisioning_remove_itemRemove provisioning item given the code TISL_provisioning_get_itemGet item value given code TISL_provisioning_auto_startStart automatic provisioning using current provider. TISL_provisioning_uninitUninitialize provisioning services Providers DHCP, none (for static provisioning)

20. 11073-20401-20130925 SLIDE 20 Provisioning Services (TISL State Chart)

21. 11073-20401-20130925 SLIDE 21 Discovery Services – DNS mDNS l Plug and Play scenarios need provisioning in order to successfully associate with the peer l Can be used to discover services on a medical network l Examples : l An Agent starts up and tries to find Manager on local sub- network with some additional information to connect l Manager needs to find one of the IHE applications on the enterprise network to send PCD01 message

22. 11073-20401-20130925 SLIDE 22 Discovery Services – DNS mDNS l Can be done using multicast DNS for local subnet and unicast DNS for enterprise scope l Has two parts to it: l Resource Description l Resource Discovery

23. 11073-20401-20130925 SLIDE 23 Discovery Services –DNS discovery in domain Medical Device (DNS Client)DNS Server DNS Standard Query(SRV) DNS Standard Query Response (SRV) DNS Standard Query(A/AAAA) DNS Standard Query Response (A/AAAA)

24. 11073-20401-20130925 SLIDE 24 Discovery Services – mDNS Name Selection and Publication Medical Device (mDNS Client) Use configured name bed2floor1unit4._11073PocAgent._udp.local. Is address available? No Response Start Service with configured Name on udp port XXXX Register SRV record with bed2floor1unit4._11073PocAgent._udp.local. Now available bed2floor1unit4._11073PocAgent._udp.local.

25. 11073-20401-20130925 SLIDE 25 Discovery Services – mDNS Service Discovery Medical Device (mDNS Client) Configured to find _11073PocAgent._udp.local. Any services of type _11073PocManager._udp.local. bed2floor1unit4._11073PocManager._udp.local. configured as bed2floor1unit4._11073PocManager._ udp.local. Request domain name and port for service bed2floor1unit4._11073PocManager._udp.local. machine1.local.:2030 IP:10.10.10.23

26. 11073-20401-20130925 SLIDE 26 Discovery Services – DNS Service URL format l General Service URL format l.. l _tcp – used when tcp is the underlying protocol l _udp – used for everything else l Example, _11073PoCAgent._udp.example.com – 11073 agent services that don’t use tcp in the domain example.com l Instance name is a user friendly name consisting of upto 63 Net-Unicode [RFC5198] characters. l Example, bed2Floor1Unit4._11073PoCAgent._tcp.example.com

27. 11073-20401-20130925 SLIDE 27 Discovery Services – Resource Types l Device Resource Types l _11073PoCAgent l _11073PoCManager l More? l Additional information in TXT record l Data-proto-id=“20101”,”20202” l More?

28. 11073-20401-20130925 SLIDE 28 Discovery Services - TISL Primitives NameDescription TISL_discovery_initInitializes discovery services TISL_discovery_enum_providersEnumerates available discovery service providers TISL_discovery_init_providerInitializes provider for use TISL_discovery_register_service_notificationSets callback for service discovery TISL_discovery_startStart discovery TISL_discovery_cancelCancel discovery in progress TISL_discovery_setDiscoverableSet current device as discoverable for zero- touch mode TISL_discovery_resetDiscoverableCancel current device as discoverable for zero-touch mode TISL_discovery_uninitUninitialize discovery services Providers mDNS for local. scope, DNS for managed network

29. 11073-20401-20130925 SLIDE 29 Discovery Services – State Chart

30. 11073-20401-20130925 SLIDE 30 Connectivity Services – TCP/IP and UDP/IP v4 l TCP or UDP can be used to establish communication between agent and manager l IP address and port needed for manager or agent service can be obtained using DNS or mDNS mechanism

31. 11073-20401-20130925 SLIDE 31 Connectivity Services – TISL primitives NameDescription TISL_connectivity_initInitialize connectivity services TISL_connectivity_enum_providersEnumerate connectivity service providers TISL_connectivity_init_providerInitialize provider TISL_connectivity_set_notificationSet connectivity notification TISL_connectivity_set_modeSet synchronous or asynchronous mode of operation TISL_connectivity_connectConnect to peer TISL_connectivity_disconnectDisconnect from peer TISL_connectivity_acceptAccept connection from peer TISL_connectivity_listenListen for connections TISL_connectivity_sendSend data TISL_connectivity_receiveReceive data TISL_connectivity_sendtoSend datagram TISL_connectivity_uninitUninitialize connectivity services

32. 11073-20401-20130925 SLIDE 32 CNS Topics for further discussion

33. 11073-20401-20130925 SLIDE 33 Quality Of Service (QoS) l Reliability l Latency l Priority l Bandwidth

34. 11073-20401-20130925 SLIDE 34 QoS Services – Requirements (11073-00101-2008)

35. 11073-20401-20130925 SLIDE 35 QoS Services – Preferred Technologies l RTP over UDP l RTP provides a reliability layer over UDP l TCP/IP l Guaranteed delivery l RSVP for bandwidth reservation l All hops in the network have to participate to reserve bandwidth

36. 11073-20401-20130925 SLIDE 36 Security Services IPSec l CNS will provide mechanisms to allow for secure connection l Technologies such as IPSec can be used for end to end security.

37. 11073-20401-20130925 SLIDE 37 Security Services - TISL NameDescription TISL_security_initInitialize security services TISL_security_enum_providersEnumerate security providers TISL_security_set_providerSet current security provider TISL_security_uninitUninitialize security services

38. 11073-20401-20130925 SLIDE 38 What’s next … l Next steps: o Align with IHE DPI Discussions @ Thursdays 11:00 “AFC” Pacific o Get content to completion by 2014 January WGM o Draft by 2014 January WGM l Questions?