Paul Schluter, GE Healthcare IEEE 11073 Nomenclature IHE PCD F2F, Boca Raton, FL October 11-13, 2016 Paul Schluter, GE Healthcare

Topics IEEE Std 11073-10101 and NIST RTMMS Update IEEE P11073-10101b – new terminology IEEE P11073-10101c – events and alerts NIST RTMMS – accelerating numeric code assignments

IEEE Std 11073-10101a and NIST RTMMS update NIST RTMMS has been updated with -10101a nomenclature and was used for limited testing at IHE NA Connectathon. Co-constraints (units, enums and sites) for new -10101a terms have been uploaded to NIST RTMMS are available, and should be available this week (October 11-13, 2016). The second-generation harmonized Rosetta, hRTM2, combines the ‘old’ 10101 and ‘new’ 10101a terms and co-constraints, and use -10102 aECG lead offsets  65. hRTM2exp.3j.x3j.2016-09-16T16.expALL.html (hRTM2 html) Co-constraints for several PHD devices (NBP, SpO2, Glu, Coag) have been added, based on the published -20601 PHD and -104xx device specializations. PHD-nibp-spo2-glu-inr.1e.x3g.2016-05-24T12.html

IEEE P11073-10101b [PAR approved] Extends ISO/IEEE Std 11073-10101:2004 and -10101a-2015: Initial Proposal REFIDS Defn’s UoM Enums WG Appr Codes XYZ Infusion pumps and infusion events (IHE PCD PIV and IPEC) Ventilator mode, high-frequency ventilation, annotations NMT Neuromuscular transmission (level of neuromuscular block) Finalize the WCM waveform attributes Ventilator E:I ratio, Ipart, Epart and other terms IHE PCD Device Management Control (DMC) IHE PCD Real-Time Location Services (LS) Generalized Signal Quality Index Dialysis Surgical and OR devices (by OR.NET at http://www.ornet.org/) Additional observation identifiers and settings 1. IEEE-SA staff has already merged -10101:2004 and -10101a-2015 into a single document. 2. Inclusion of new terms in draft standard is contingent on timely completion.

IEEE P11073-10101c [PAR approval in progress] Existing list of ISO/IEEE 11073-10101:2004 MDC_EVT_ identifiers will be extended to support the IHE PCD Rosetta for Events and Alerts. Will cover physiologic alerts and essential technical events and alerts PAR: IEEE P11073-10101c- PAR Detail_jw1.pdf Status: PAR submission deferred, strongly consider adding MDC_EVT terms to IEEE P11073-10101b instead.

IEEE P11073-10103a [PAR approved] Extends IEEE P11073-10103:2012 Implanted Devices Cardiac New IDC term codes, extending IEEE P11073-10103:2012 Considering EGM waveforms. New terms were presented and discussed at the Heart Rhythm Society (HRS) meeting in San Francisco See presentation: IDC Nomenclature Status 20-Sep-2016.ppt

New Term REFID and Code Assignments Background for this discussion, motivated by the desirability of assigning numeric codes at the earliest possible time. Use the NIST RTMMS as the authoritative numeric code validator (and generator) for new terms to guarantee non-overlap between multiple organizations, e.g. IEEE 11073 PoCD, IEEE 11073 PHD, IHE PCD Rosetta PCHA/Continua, OR.NET and others. If the assigned Reference ID, Disc, Part::Code is discarded during balloting, it is retired as a “zombie term” and cannot be re-used. Terms that are assigned codes must have complete definitions, UoMs, enum values and other information when they are submitted as an Excel worksheet, formatted exactly as it would appear in the published standard. Is this a good idea? Yes, if we can keep the number of “zombie terms” to a small number (e.g. < 1 to 5% of new terms defined). No, we could end up with a ‘free-for-all’ if this is uncontrolled without any degree of editorial review and curation.

Code and Term Assignment (final) Code and term assignment process is similar to term assignment flow using the NIST RTMMS four years ago. Fully defined terms proposed and approved by a recognized working group (e.g. IEEE 11073 PoCD, PHD, IHE PCD Rosetta, PCHA/Continua, OR.NET and others) can have numeric codes assigned to them prior to IEEE balloting for deployed in messages. The status of each term (proposed, assigned, approved) would be maintained on the NIST RTMMS. If the assigned { Reference ID, Disc, Part::Code } is rejected during IEEE balloting, it will be retired as a “zombie term” and the Part::Code shall not deployed in messages nor recycled for use with another term in the future. CF_CODE10 and REFID Meaning nnnnn^MDC_term IEEE 11073 Balloted and Approved Assigned numeric code (could become zombie) 0^MDCX_term Proposed term