IHE PCD for RMON.3b

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IHE PCD for RMON.3b Powered By Docstoc
					       Use of IHE DEC Profiles for
           Remote Monitoring




Authors: Paul Schluter and Todd Cooper
HITSP RMON discussion October 2, 2008
IHE-DEC: Same protocol used in two settings
…       Device
 Device Intermediary

                       Subset of IHE-DEC
        Home
        Setting
                                        EHR or Care
                                        Coordination
                                        Applications

          Device
                           IHE-DEC
                                        Hospital Setting
                            Device
                         Intermediary
IHE Device Enterprise Communication (DEC) and
related Profiles (PCD, SPD, ACM).
    Device
  Observation
Consumer (DOC)
           PCD-01 Transaction: Communicate Device Data
             • ISO/IEEE 11073-10101 nomenclature (does not rule out LOINC or
             SNOMED)
             • ISO/IEEE 11073 or UCUM units-of-measure
             • OBX-4 used for «mds.vmd.chan.metric», OBX-20 for measurement sites
             • Profile and simplify other aspects of HL7 V2.5 messaging
                         • Periodic Physiologic Data: Heart Rate, Respiration rate
    Device               •   Episodic Physiologic Data: NIBP, Weight, Cardiac tests
  Observation            •   Primarily structured data but facilities non structured data as well
                         •   Must include Patient ID
 Reporter (DOR)          •   > 1 minute sampling rate (but could be faster)
    Device               •   Waveform support is simple extension
                         •   Flexible extensions with:
                                 • Alarms and alerts supported through related profile (ACM)
                                 • Subscribe to Patient Data (SPD) Profile
                                 • Security, privacy, confidentiality through related profile (ATNA)
 Mapping Preserves Measurement
 Context                                                          Medical Device System (MDS)
                                                                                                     0..*
    Overall Device or System
                                                                    1                  1
                                                                                 Virtual Medical Device (VMD)
              Virtual Medical Device
                                                                             *

                                                                                   1
                                                                                                    Channel (Chan)
    Channel (only as needed)
                                                                                           *
                                                                                                                           Numeric
Subject                     Containment Tree Hierarchical Level
                                                                                                1
                                                                                                                 Metric
Medical:                <mds>         <vmd>        <chan>      <parametric
                                                                instance>
                                                                                                       *                  Enumeration

                                               OBX-4
Examples

1   Virtual (Medical)   <VS Mon>    <PulsOxim>      <Oxim>       <Spo2>
    Ordinal                 1             1            1           1

2   Virtual (Medical)   <VS Mon>    <PulsOxim>     <Ptach>        <PR>
    Ordinal                 1             1            2           2                                        A single observation
3   Virtual (Medical)   <VS Mon>       <ECG>       <Ctach>        <HR>

    Ordinal                 1             2            1           3

     Recommend that Ordinal value is unique among entire set
  PCD-01 Message Example (simple heart
  rate)
         IEEE EUI-64

MSH|^~\&|HL7^080019FFFF4F6AC0^EUI-64|MMS|||20070118133700||ORU^R01
                           |a4e2e3:11036b5cdbb:-|P|2.5|20070118133700||NE|AL||8859/1
PID|||6O008D^^^A^PI||DAVIDSON^DAVID^^^^^L
PV1||E|3WICU^305^305
OBR|1|080019FFFF4F6AFE200701|080019FFFF4F6AC0200701|126.3.3.1^2000^MDC|||20070118
133700
OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|80|/min^/min^UCUM|||||R

            ‘Heart Rate’            OBX-4          Value         ‘/min’ UOM
PCD-01 Message Example (more
complex)
 MSH|^~\&|HL7^080019FFFF4F6AC0^EUI-64|MMS|||20070118133700||ORU^R01|a4e2e3:11036b5cdbb:-
 |P|2.5|20070118133700||NE|AL||8859/1
 PID|||6O008D^^^A^PI||DAVIDSON^DAVID^^^^^L
 PV1||E|3WICU^305^305
 OBR|1|080019FFFF4F6AFE200701|080019FFFF4F6AC0200701|126.3.3.1^2000^MDC|||20070118133700
 OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|80|/min^/min^UCUM|||||R
 OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|60|/min^/min^UCUM|||||R
 OBX|2|NM|131841^MDC_ECG_AMPL_ST_I^MDC|1.7.1.1|0.0|mm^mm^UCUM|||||R
 OBX|3|NM|131842^MDC_ECG_AMPL_ST_II^MDC|1.7.1.2|0.0|mm^mm^UCUM|||||R
 OBX|4|NM|131901^MDC_ECG_AMPL_ST_III^MDC|1.7.1.3|0.0|mm^mm^UCUM|||||R
 OBX|5|NM|131847^MDC_ECG_AMPL_ST_V5^MDC|1.7.1.4|0.0|mm^mm^UCUM|||||R
 OBX|6|NM|131902^MDC_ECG_AMPL_ST_AVR^MDC|1.7.1.5|0.0|mm^mm^UCUM|||||R
 OBX|9|NM|150035^MDC_PRESS_BLD_ART_MEAN^MDC|1.3.1.1|96|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|10|NM|150033^MDC_PRESS_BLD_ART_SYS^MDC|1.3.1.2|122|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|11|NM|150034^MDC_PRESS_BLD_ART_DIA^MDC|1.3.1.3|82|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|12|NM|149522^MDC_BLD_PULS_RATE_INV^MDC|1.2.1.1|60|/min^/min^UCUM|||||R
 OBX|13|NM|150047^MDC_PRESS_BLD_ART_PULM_MEAN^MDC|1.4.2.1|14|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|14|NM|150045^MDC_PRESS_BLD_ART_PULM_SYS^MDC|1.4.2.2|24|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|15|NM|150046^MDC_PRESS_BLD_ART_PULM_DIA^MDC|1.4.2.3|10|mm[Hg]^mm[Hg]^UCUM|||||R
 OBX|16|NM|151610^MDC_VENT_CO2_RESP_RATE^MDC|1.5.1.1|12|{breath}/min^{breath}/min^UCUM|||||R
 OBX|17|NM|151976^MDC_VENT_PRESS_AWAY_END_EXP_POS^MDC|1.5.1.2|4|cm[H20]^cm[H20]^UCUM|||||R
 OBX|18|NM|152008^MDC_VENT_VOL_MINUTE_AWAY^MDC|1.5.1.3|0.0|l/min^l/min^UCUM|||||R
 OBX|19|NM|151920^MDC_VENT_CONC_AWAY_O2_INSP^MDC|1.5.1.4|21|%^%^UCUM|||||R
 OBX|20|NM|151980^MDC_VENT_VOL_TIDAL^MDC|1.5.1.5|1096|ml^ml^UCUM|||||R
 OBX|21|NM|151957^MDC_VENT_PRESS_MAX^MDC|1.5.1.6|17|cm[H20]^cm[H20]^UCUM|||||R
 OBX|22|NM|151784^MDC_PRESS_RESP_PLAT^MDC|1.5.1.7|30|cm[H20]^cm[H20]^UCUM|||||R
 OBX|23|NM|151792^MDC_PRESS_AWAY^MDC|1.5.1.8|35|cm[H20]^cm[H20]^UCUM|||||R
 OBX|24|NM|151808^MDC_PRESS_AWAY_END_EXP_POS_INTRINSIC^MDC|1.5.1.9|1|cm[H20]^cm[H20]^UCUM|
 ||||R
IHE DEC (and associated) profiles
Provides a Unified Interface that --
• Supports the complete range of device data (except for high-
  bandwidth continuous waveforms) found in health related
  devices today and in the future.
• Provides a consistent interface in Health Record, Care
  Management Systems and Personal Health Records that is:
  -   Secure, private
  -   High performance even on low bandwidth links
  -   Scalable, from a simple device intermediary (a few devices for the
      same patient) to multiple devices for many patients. Trivial to
      implement.
  -   Straightforward mapping from proprietary and IEEE 11073 formats
      (uses same nomenclature as X73 Personal Health devices).
  -   Based on proven HL7 standards that are supported by all
      Care Management and EHRs products today

				
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posted:11/3/2011
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