1. IHE PCD F2F Agenda
Virtual / projectathon / certification testing program requirements
MDPRI progress and next steps
Certification plans
Potential innovation center vignette

2. Medical Device Patient Record Integration (MDPRI) Project
January 29, 2014

3. The Patient Data is Here....

4. But Not Here

6. Project History – Participants To DATE
IHE International PCD Domain
IHE PCD Leadership
Manny Furst
Paul Schluter
John Garguilo
John Rhoads
HIMSS
Lisa Gallagher
Tom Leary
Stephanie Jamison
Jeff Coughlin
HIMSS and IHE USA
Alex Lippitt
Joyce Sensmeier
Kearney & Co
Jackie Hunt
Kim Douglas
Karla Chryar
HL7 – Todd Cooper
IEEE – Bill Ash
CAP
Debbie Klieman
Paloma Hawry
EHRA (HIMSS)
Angie Gorden
Charles Parisot
FDA – Terrie Reed
Pew Charitable Trusts – Ben Moscovitch

7. Partner SEARCH Project and Government Relationship Management
Kearney & Company, HIMSS?
Development/Testing/ Deployment Management
(TBD)
Development/Testing/ Deployment Management
(Consultancy TBD)
Development/Testing/ Deployment Management
(EHRA Recco Consultancy)
Health Device
Testing
Pilot Execution
Health System
Medical Device Vendors
Medical Device Middleware Vendors
Semantic Harmonization
Terminology Baseline
Terminology Mapping
Application
Mapping
Maintenance & Support
NIST
NLM
Semantic Domain Consultants
EHR / Clinical Monitoring
Application Development
Testing
Pilot Execution
Health System
Interface Engine
EHR Vendor(s)
Leadership, End to End Testing, Standards and Metrics - IHE USA (Lippitt) / ONC S&I Frameworks
Charter, Business Case, Use Case Development
Requirements, Specifications, Implementation Guides
Measurement, Sustainability
Test Management and Quality Assurance

8. MDPRI Technical Solution
Device Observation Reporters (DOR)
Network Gateways
Device Integration Engines
Individual Devices
Device Observation Consumers (DOC)
Enterprise EMR, EHR, … 1 2
ISO/IEEE mapping to SNOMED and/or LOINC
for vital sign numerics
Numerics
Waveforms
Annotations
Events
Alerts
Configuration
Commands
IHE PCD DEC
IHE PCD DEC
WCM, EC, ACM, … 3 4

9. MDPRI Technical Solution
Enterprise gateways, device integration engines (e.g. Capsule, iSiron, Nuvon) and possibly individual devices send near real-time medical device data using the IHE PCD DEC Profiles (HL7 V2.6 messaging and ISO/IEEE nomenclatures.
For numeric vital signs observations, a normative mapping from ISO/IEEE to SNOMED and/or LOINC are developed (by organizations representing SNOMED and/or LOINC) and are made available on the NIST RTMMS and other nomenclature repositories. Enterprise “Device Observation Consumers” would use the normative mapping table to translate the ISO/IEEE nomenclature to SNOMED and/or LOINC.
Device-centric data (waveforms, events, alerts, configuration and commands) would use the ISO/IEEE nomenclature.
The IHE PCD DEC (Device Enterprise Communication) Technical Framework and ISO/IEEE nomenclature are recognized as “Meaningful Use” profiles and standards for medical device data transfer to and from enterprise entities.

10. ICU Use Case (all standards based IHE Profiles)
Device
Clinical Data (Typical)
Arrives In or Is Placed in Smart Bed
Weight, Variety of Alarms, Advisories
Physiologic Monitoring
Vital Signs with Alarms, Advisories Question: Do we include Events (work in process)?
Medication Admin. (PIV IOP)
Bedside (or Bar-Code) Medication Administration system communicates physician orders to pump system for clinician's review and initiation
IV Pump
Delivers medication as prescribed and reports drug therapy delivery, progress, alarms, advisories and events
PCA Pump
Delivers pain meds in response to patient's needs . Reports drug therapy delivery, progress, alarms, advisories and events
Ventilator
Provides oxygenated air
Pulse Oximeter
May be part of the physiologic monitor
Transferred to Local Community Hospital
Discharge Summary (future)