Chapter 03 Mechanisms for Interfacing and Integrating Device Data SaigonTech – Engineering Division Integrating Device Data into the Electronic Medical Record by John Zaleski © 2009 by Publicis KommunikationsAgentur GmbH, GWA, Erlangen

2 Contents 1.Medical Device Interfaces 2.Communication Interface Architectures 3.Standardized Data Interfacing Formats 4.Other Medical Device Data SaigonTech – Engineering Division

3 1. Medical Device Interfaces 1.1 The basic communications mechanism  The most simple and straightforward methods to retrieve data from medical instrumentation is the terminal emulator program  Many systems only provide the capability for retrieving and archiving data in ASCII format SaigonTech – Engineering Division

4 1.2 Examples of transmitted and received data from ventilators SaigonTech – Engineering Division

5  DB: Define Breath  RB: Read Breath  CVR: Coded Value Response  FV: Finding Value

6 2. Communication Interface Architectures  Medical devices and device manufacturers tend to employ their own proprietary mechanisms at the device level for data communication which mandates the need for an independent-third party-interfacing mechanism (software device) to translate the data into the correct format and to ensure that data are interpreted correctly SaigonTech – Engineering Division

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10 3. Standardized Data Interfacing Formats  The data received from medical devices can be retrieved and stored in flat files on the computing hardware platform for tertiary processing and transmission to the EMR  They can also be transformed directly into a more standardized message, such as HL7 Observation Report—Unsolicited (ORU) transactions (also referred to as an HL7 ORU^R01 message)  The HL7 provides messaging templates to support communication of observations, orders, laboratory data, pharmaceutical information, demographics, etc SaigonTech – Engineering Division

11 ORU message example  The ORU is termed an R01 Event, to coincide with its use for transmitting laboratory results to tertiary systems  While the object is laboratory results, the R01 event is oftentimes used as the primary message for communicating vitals transactions from a source system (in this case, a medical device) to an EMR SaigonTech – Engineering Division

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13  The patient identification (PID) segment establishes the identity of the patient and associates information such as medical record number, patient number, name, and other associating information. An example of a typical PID segment is as follows:  The following OBX segments represent examples of pulse (symbol: HR) and temperature (symbol: T): SaigonTech – Engineering Division

14 4. Other Medical Device Data  We have focused on the communication of discrete event data: findings or values that are transmitted to the EMR  In discussing data, the story is incomplete without addressing those data that are available at the point of care and which are used for real-time clinical diagnosis and intervention SaigonTech – Engineering Division

15 References  Zalesky J.R. (2009) Integrating Device Data into the Electronic Medical Record: A Developer's Guide to Design and a Practitioner's Guide to Application. Publicis Publishing, Erlangen. SaigonTech – Engineering Division