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Authors : Jack Harrington, Ray Zambuto, Todd Cooper 20070227 Integrating the Healthcare Enterprise- Patient Care Device Domain (IHE-PCD)

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Presentation on theme: "Authors : Jack Harrington, Ray Zambuto, Todd Cooper 20070227 Integrating the Healthcare Enterprise- Patient Care Device Domain (IHE-PCD)"— Presentation transcript:

1 Authors : Jack Harrington, Ray Zambuto, Todd Cooper Integrating the Healthcare Enterprise- Patient Care Device Domain (IHE-PCD)

2 Jack Harrington, Ray Zambuto, Todd Cooper Agenda Evolution of the IHE PCD Year 1 - Device Enterprise Communication Profile Year 2 – Survey and Proposed Profile Development

3 Jack Harrington, Ray Zambuto, Todd Cooper Context and History R. Gilbert Jost, MD Chairman, Mallinckrodt Institute of Radiology Board of Directors, Radiological Society of North America

4 Jack Harrington, Ray Zambuto, Todd Cooper Andover Working Group Medical HL7 Enterprise Communication Framework Version 1.0

5 Jack Harrington, Ray Zambuto, Todd Cooper Discussion at 1996 RSNA annual meeting Kees Smedema – Philips Bill Mortimore – Merge Jack Harrington – Hewlett-Packard

6 Jack Harrington, Ray Zambuto, Todd Cooper

7 Jack Harrington, Ray Zambuto, Todd Cooper

8 Jack Harrington, Ray Zambuto, Todd Cooper Problem Identification: Clinicians and IT experts identify common integration problems in access to information, clinical workflow, administration and underlying infrastructure. Integration Profile Specification: Stakeholders select standards that address each identified integration need. The technical specifications for implementing these standards are documented in the IHE Technical Framework. Implementation and Testing: Vendors implement these profiles and test their systems with software tools and at a face-to-face Connectathon, where they test interoperability with other vendors systems. Integration Statements and RFPs: Vendors publish IHE Integration Statements to document the integration profiles supported by their products. Users can reference integration profiles in requests for proposals, simplifying the systems acquisition process. Process

9 Jack Harrington, Ray Zambuto, Todd Cooper Philips/AWG Contribution to IHE Process

10 Jack Harrington, Ray Zambuto, Todd Cooper Profiles Simplify Implementation Single Standard – Constrain optionality, choose terminology, define dynamic interactions – HL7 Conformance Multiple Standards – Coordinate workflow, define mappings between standards -HL7/DICOM – IHE Radiology -HL7/IEEE – Patient Care Devices

11 Jack Harrington, Ray Zambuto, Todd Cooper Static Message Profile

12 Jack Harrington, Ray Zambuto, Todd Cooper Profiles Simplify Implementation

13 Jack Harrington, Ray Zambuto, Todd Cooper

14 Jack Harrington, Ray Zambuto, Todd Cooper Over 100 vendors involved world-wide, 5 Technical Frameworks 39 Integration Profiles, Testing at Connectathons Demonstrations at major conferences world-wide 16 Active national chapters on 4 continents

15 Jack Harrington, Ray Zambuto, Todd Cooper IHE Patient Care Devices (PCD) HIMSS Survey IHE pre-2005 Annual Conference results: Survey of all IHE UsersSurvey of all IHE Users Over 50% of those surveyed said patient care devices should be the next area developed for IHE *Over 50% of those surveyed said patient care devices should be the next area developed for IHE *

16 Jack Harrington, Ray Zambuto, Todd Cooper IHE 2005 Summer Survey Results Highest priority devices for integration are Vital Signs Monitors, Blood Gas Analyzers (POC), and Infusion PumpsHighest priority devices for integration are Vital Signs Monitors, Blood Gas Analyzers (POC), and Infusion Pumps Highest priority departments are ICU, Emergency, OR/Anesthesia, and Lab (POC)Highest priority departments are ICU, Emergency, OR/Anesthesia, and Lab (POC) Highest technology priority is Enterprise Wide SharingHighest technology priority is Enterprise Wide Sharing Highest priority for clinical application is EHR or CIS integration followed by Improved Management and Decision SupportHighest priority for clinical application is EHR or CIS integration followed by Improved Management and Decision Support

17 Jack Harrington, Ray Zambuto, Todd Cooper IHE PCD Formed in September 2005 In September, 2005, the PCD gathered 60 vendors, purchasers, providers, and regulators in Washington D.C. for 2 days to explore the value propositions, explore the scope and mission of the domain, and begin the process of use case development. IHE Charter - The Patient Care Devices Domain is concerned with Use Cases in which at least one actor is a regulated patient care device. The PCD coordinates with other IHE clinical specialty based domains such as medical imaging. Current membership is 100+ and growing.

18 Jack Harrington, Ray Zambuto, Todd Cooper IHE-PCD Domain Vision Statement The IHE Patient Care Device Domain (IHE PCD) is the nexus for vendors and providers to jointly define and demonstrate unambiguous interoperability specifications, called profiles, which are based on industry standards, and which can be brought to market.

19 Jack Harrington, Ray Zambuto, Todd Cooper IHE-PCD Mission The IHE Patient Care Devices Domain will apply the proven, Use Case driven IHE processes to:The IHE Patient Care Devices Domain will apply the proven, Use Case driven IHE processes to: –Deliver the technical framework for the IHE-PCD domain profiles; –Validate IHE-PCD profile implementations via Connectathons; and –Demonstrate marketable solutions at public trade shows.

20 Jack Harrington, Ray Zambuto, Todd Cooper Agenda Evolution of the IHE PCD Year 1 - Device Enterprise Communication Profile Year 2 – Survey and Proposed Profile Development

21 Jack Harrington, Ray Zambuto, Todd Cooper IHE Patient Care Devices (PCD) One Patient – Many Devices

22 Jack Harrington, Ray Zambuto, Todd Cooper IHE Process IHE Integration Profiles B IHE Integration Profile A Easy to Integrate Products IHE Demonstration User Site RFP Standards IHE Technical Framework Product IHE Integration Statement IHE Connect-a-thon Product With IHE IHE Connect-a-thon Results

23 Jack Harrington, Ray Zambuto, Todd Cooper

24 Jack Harrington, Ray Zambuto, Todd Cooper

25 Jack Harrington, Ray Zambuto, Todd Cooper Device Enterprise Communication (DEC) Profile - Year 1

26 Jack Harrington, Ray Zambuto, Todd Cooper DEC Profile Mapping Model ISO/IEEE Domain Information Model and Nomenclature mapped to HL7 Observation Report ISO/IEEE Data Types mapped to HL7 Data Types Mapping preserves measurement context for complex devices.

27 Jack Harrington, Ray Zambuto, Todd Cooper Measurement Context is Dynamic

28 Jack Harrington, Ray Zambuto, Todd Cooper IEEE Domain Information Model Defines Device Context 1 0..n0..n

29 Jack Harrington, Ray Zambuto, Todd Cooper Mapping preserves measurement context

30 Jack Harrington, Ray Zambuto, Todd Cooper Example PCD-01 Message MSH|^~\&|INFO_SRC_PHILIPS^ACDE ABCD^EUI-64|||| ||ORU^R01^ORU_R01|PMS | P|2.5|||NE|AL||8859/1 PID|||AB60001^^^Philips Medical^PI||Brooks^Albert^^^^^L|| |M PV1||I|UNIT_1^^Bed1 OBR|1|PMS ^INFO_SRC_PHILIPS^ACDE ABCD^EUI-64| PMS ^INFO_SRC_PHILIPS^ACDE ABCD^EUI-64| 69837^MDC_DEV_METER_PHYSIO_MULTI_PARAM_MDS^MDC||| OBX|1|ST|184326^MDC_ECG_STAT_ECT^MDC| |""||||||F OBX|2|ST|184327^MDC_ECG_STAT_RHY^MDC| |Sinus Rhythm||||||F OBX|3|NM|150456^MDC_PULS_OXIM_SAT_O2^MDC| |99|262688^MDC_DIM_PERCENT^MDC|||||F OBX|4|NM|147842^MDC_ECG_HEART_RATE^MDC| |81|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|5|NM|150037^MDC_PRESS_BLD_ART_ABP_SYS^MDC| |126|266016^MDC_DIM_MMHG^MDC|||||F OBX|6|NM|150038^MDC_PRESS_BLD_ART_ABP_DIA^MDC| |76|266016^MDC_DIM_MMHG^MDC|||||F OBX|7|NM|150039^MDC_PRESS_BLD_ART_ABP_MEAN^MDC| |92|266016^MDC_DIM_MMHG^MDC|||||F OBX|8|NM|148065^MDC_ECG_V_P_C_CNT^MDC| |0|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|9|NM|150045^MDC_PRESS_BLD_ART_PULM_SYS^MDC| |26|266016^MDC_DIM_MMHG^MDC|||||F OBX|10|NM|150046^MDC_PRESS_BLD_ART_PULM_DIA^MDC| |9|266016^MDC_DIM_MMHG^MDC|||||F OBX|11|NM|150047^MDC_PRESS_BLD_ART_PULM_MEAN^MDC| |14|266016^MDC_DIM_MMHG^MDC|||||F OBX|12|NM|149538^MDC_PLETH_PULS_RATE^MDC| |55|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|13|NM|150067^MDC_PRESS_BLD_ATR_LEFT_MEAN^MDC| |4|266016^MDC_DIM_MMHG^MDC|||||F OBX|14|NM|150087^MDC_PRESS_BLD_VEN_CENT_MEAN^MDC| |12|266016^MDC_DIM_MMHG^MDC|||||F

31 Jack Harrington, Ray Zambuto, Todd Cooper IHE PCD Connectathon Systems LiveData OR Mgr GE Centricity Periop CIS Philips CareVue CIS DOR DOC ADT A04 Feed MWB Draeger Innovian CIS GE Aware GW Philips IIC GW B. Braun DoseTrac GW Welch Allyn Connex CIS Validated VS, Vent, Anesth & Med Export, max every 3 minutes Validated Vitals export, Batch Unvalidated VS, Vent, Anesth. Data export every 1 minute VS Mon Pt Mon, Vent, Anesthesia Pt Mon, Vent, Anesthesia Pt Mon, Vent, Anesthesia Infusion Devices CT (Time) Feed Philips CareVue CIS Pt Mon, Vent, Anesthesia Validated VS, Vent, Anesth & Med Export, max every 5 minutes Unvalidated Med (Infusion System) exported every 1 minute

32 Jack Harrington, Ray Zambuto, Todd Cooper Connectathon 2007: 430 engineers, 80+ organizations, 160+ systems and applications

33 Jack Harrington, Ray Zambuto, Todd Cooper

34 Jack Harrington, Ray Zambuto, Todd Cooper HIMSS Showcase Scenario Welch Allyn Connex TM DataManagementSystem Vital Signs Monitor GEAwareGateway Patient Monitor, Ventilator PhilipsIntellivueInformationCenter Patient Monitor, Ventilator Emergency CareIntensive Care LiveDataOR-DashBoardGE Centricity ® Periop Anesthesia Draeger Innovian ® Solution Suite Patient Monitor, Anesthesia Sys B. Braun DoseTrac TM InfusionManagementSoftware Infusion Devices Perioperative Care Philips Intellivue Clinical InformationPortfolio

35 Jack Harrington, Ray Zambuto, Todd Cooper Agenda Evolution of the IHE PCD Year 1 - Device Enterprise Communication Profile Year 2 – Survey and Proposed Profile Development

36 Jack Harrington, Ray Zambuto, Todd Cooper Device Enterprise Communication Profile – Year 2

37 Jack Harrington, Ray Zambuto, Todd Cooper Process for Year Survey Call for Short Proposals Vetting by Planning and Technical Committees Setting of Priorities

38 Jack Harrington, Ray Zambuto, Todd Cooper IHE-PCD Survey Summer-Fall 2006 Survey Managed by HIMSS Analytics Open Solicitation to HIMSS, ACCE, AdvaMed, Anesthesia Patient Safety Foundation, ECRI 171 Responses, (103 Users, 68 Vendors)

39 Jack Harrington, Ray Zambuto, Todd Cooper Respondent Demographics 171 Individual Responses = Hospital Based

40 Jack Harrington, Ray Zambuto, Todd Cooper Vendor Position on IHE and Interoperability 68 Vendor Responses (Checking all that apply)

41 Jack Harrington, Ray Zambuto, Todd Cooper Vendor Demographics: Vendor Products 68 Vendor Responses

42 Jack Harrington, Ray Zambuto, Todd Cooper Demographics: User Organization Types 77 Hospital Based Respondents* *26 of the 103 Non-Vendor Respondents do not work in hospitals

43 Jack Harrington, Ray Zambuto, Todd Cooper Relationship of Clinical Engineering and IT at Respondents Hospitals 77 Hospital Based Respondents* *26 of the 103 Non-Vendor Respondents do not work in hospitals

44 Jack Harrington, Ray Zambuto, Todd Cooper Importance of Interoperability to Hospital Based Respondents

45 Jack Harrington, Ray Zambuto, Todd Cooper Survey Question: With respect to Medical Devices, how important is it for the following devices to become integrated under the IHE? = Users= Vendors Percent of respondents that consider it important

46 Jack Harrington, Ray Zambuto, Todd Cooper Survey Question: Rate the importance to each department below in terms of the benefit from implementing IHE = Users= Vendors Percent of respondents that consider it important

47 Jack Harrington, Ray Zambuto, Todd Cooper Survey Question: Which clinical applications should IHE target? = Users= Vendors Percent of respondents that consider it important

48 Jack Harrington, Ray Zambuto, Todd Cooper Survey Question: Which technological areas are the most important for Patient Care Device integration? = Users= Vendors

49 Jack Harrington, Ray Zambuto, Todd Cooper IHE Profile Proposal (Short) Proposed Profile: Patient Identification Proposal Editor: Ray Zambuto Date: February 16, 2006 Version: 3 Domain: Patient Care Devices The Problem Manual entry of patient identification to Patient Care Devices is inefficient and subject to error. Patient Identification is perhaps the most essential component of any interoperability and communication process, particularly when PCD data is exported to the enterprise. It is the basis for communication and control of any medical device, data analysis, reporting and record keeping. Automation of the entry of patient identification to Patient Care Devices has the potential for reducing errors, and is an essential component of any effort to increase safety, device and drug effectiveness, and efficiency. Key Use Case 1) Setup of PCD. The caregiver connects the patient to a Patient Care Device. The patient is physically identified by some institutionally unique means of identification such as a wrist band barcode, RFID or other means which may or may not be solely considered as authoritative. The caregiver uses the information from the physical patient identification to obtain an authoritative electronic identifier which is associated with all data communicated from the PCD. The interaction may involve direct entry of the data to the device based on the physical identifier, a dialog between a PCD Manager and an authoritative source, and the use of more than one identifier. The end result is that data communicated from the PCD or PCD Manager contains an authoritative institutionally unique identifier. 2) Disconnect PCD. The caregiver removes the PCD causing the data from that device to no longer be communicated to the enterprise. Standards & Systems This profile is intended for identification of patients by patient monitors, infusion pumps, ventilators, point of care glucometers etc..> ISO/IEEE 11073, HL7, IHE-ITI Patient Administration, IHE-ITI PDQ Discussion Patient identification is a fundamental requirement for any electronic communication from or to a medical device. As such, the IHE with its broad scope, full range of stakeholders, and present or future involvement in the development of interoperability specifications for the vast number of types of medical devices and information technology is the ideal (and only) logical place for this universally needed specification.

50 Jack Harrington, Ray Zambuto, Todd Cooper Short Proposals Submitted for 2007 Profile Name Patient ID Cross-Enterprise Sharing of Patient Care Device Data Synchronous Real-Time Clinical Data Management Storage and Retrieval IHE-ECG-Workflow Infusion Pump Integration to Medication Administration Process PoC Real-Time PnP Device Integration Small Data Element Exchange HomeTelehealth Alarm Interoperability PCA Infusion Safety PCD-02 Query

51 Jack Harrington, Ray Zambuto, Todd Cooper Short Proposals Vetting 2007 vs reconsideration in 2008 Profile Name Patient ID Cross-Enterprise Sharing of Patient Care Device Data-Synchronous Real-Time Clinical Data Management Storage and Retrieval IHE-ECG-Workflow Infusion Pump Integration to Medication Administration Process PoC Real-Time PnP Device Integration Small Data Element Exchange Home Telehealth Alarm Interoperability PCA Infusion Safety PCD-02 Query

52 Jack Harrington, Ray Zambuto, Todd Cooper Short Proposals Setting Priorities Polling Results of Planning Committee Three Proposals for 2007* Profile Name Patient ID PCD-02 Query PoCRealTimePnPDeviceIntegration HomeTelehealth Small Data Element Exchange PCA Infusion Safety * Based on resource limitations. Additional work can be added if author/champion demonstrates sufficient additional resources

53 Jack Harrington, Ray Zambuto, Todd Cooper Summary From its inception in September 2005 the IHE PCD has grown to 100+ members representing vendors, purchasers, providers, and regulatory agencies. The Device Enterprise Communication (DEC) Framework for Trial Implementation published in August Vendors and 8 systems/applications tested at Connectathon 2007 Process for developing Year 2 profiles is in progress.

54 Jack Harrington, Ray Zambuto, Todd Cooper To Learn More This Week – Visit the IHE PCD in the HIMSS Interoperability Showcase

55 Jack Harrington, Ray Zambuto, Todd Cooper Your Participation in IHE PCD is Encouraged PCD CoChairs: – Todd Cooper - – Jack Harrington - – Ray Zambuto - Other Contacts: – Manny Furst - – Elliot Sloane -

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