PCD Profile Device Point-of-Care Integration (DPI)

Overview

The Device Point-of-care Integration (DPI) profile proposal is concerned with use cases that involve the interoperability of equipment around the point-of-care, often patient connected. In previous PCD development Cycles, this profile was named "plug-and-play (PnP)"; however, after further consideration, this was seen as a bit too narrow and thus the DPI moniker more accurate and inclusive. The profile will focus primarily on technical interoperability (e.g., Volume 2 - Transactions) but will integrate with device specialization "semantic content" profiles to provide for interoperability from the physical connection to abstract device data and services.

It should be noted that the DPI profile is viewed as foundational (e.g., as the ITI XDS profile set), and additional profiles shall be added. For example, DPI-PNP vs. DPI-XC (external control). Therefore, some of the current discussion will look at the overall scope of DPI, and generate a roadmap of profiles, some of which are intended for the next PCD profile development cycle (e.g., basic Plug-and-Play), and some that will come in future cycles (e.g., closed-loop control).

NOTE: DPI-related wiki pages may be seen on the special DPI category page.

DPI Profile Discussions

NOTE: The following proposed links are pending approval by the IHE PCD in 2008.11. Proposal links can be found on the 2009/2010 brief profile proposal wiki page.

The following links are to specific profile proposal discussion pages that support the DPI work:

• DPI White Paper Discussion
• DPI-DnA Profile Discussion
• DPI-DR Discussion
• DPI-SYM Discussion
• DPI-XDC Profile Discussion <TBD>
• DPI-PIB Profile Discussion <TBD>

Design and prototyping activities of the DPI group in 2010 have been mainly concentrated on a use case from the ICE team: Rapid Device Configuration for ventilators in patient transfer scenarios:

• RDC (Rapid Device Configuration)

Also, though separate from the DPI profiles, the following links are to related profiling activities: <(Note: TBD Discussions>

• Device Specialization - Physiological Monitor Discussion
• Device Specialization - Infusion Pump Discusison
• Device Specialization - Ventilator Discussion

These white paper discussions are also relevant to the DPI work:

• Medical Device Semantic Architecture White Paper Discussion (Detailed Proposal)
• Regulatory Considerations White Paper Discussion

Discussion Participants

The DPI working group maintains a Google Group list for all communication during the development of the DPI white paper and subsequent technical framework supplements. The following organizations are currently included in this group:

Note: Participation in specific DPI activities are listed in the wiki pages that capture Discussion Notes for each WebEx session. Some of those listed are IHE International member organizations and others are experts interested in DPI development)

Baxter	Baystate Health	Breakthrough Solutions Foundry
Draeger	FDA / CDRH	Hospira
Improvement Technologies	Kaiser Permanente	Korean National University
LiveData	NIST	Philips Healthcare
Respironics (Philips)	Surgical Information Systems	Sutter Health

Background Documents

• From Previous PCD PnP Profile Development:

- PnP Brief Profile Proposal (2006.11.08)

- PnP Detailed Profile Proposal ()

• ICE Related Documents have been moved to the ICE-PAC Task Group Area

• A joint effort between DPI and ICE has been in the analysis and prototyping of transport of ventilated patients IHE PCD Rapid Device Configuration

• Historic References

- MDCIG Demo II Specification Document (2002)

Meetings

NOTE: See Discussion page links above for additional DPI meetings.

2009.01.29 Detailed Proposal Discussion Session

2009.01.23 Detailed Proposal Discussion Session

2008.11.11 Discussion Session

2008.10.23 & 24 F2F in Boston

2008.10.17 Discussion Session

2008.10.15 Discussion Session

2008.10.13 Discussion Session

2008.10.09 Discussion Session

2008.10.02 Discussion Session

2008.09.22 Post-Vancouver Standards Meetings Session

2008.09.12 Pre-Vancouver Standards Meetings Session

2008.09.09 Initial WebEx Session

Action Items

(add newest items to the top of the list)

No.	Action Item	Owner	Participants	Due	Open/Closed	Description/Update
16	Complete draft brief profile proposals	Cooper	Rhoads / Wittenber	2008.11.11	Open	Complete an initial drafting pass at the DPI Brief Profile Proposals (DnA, DR & SYM)
15	External Control Use Cases	Jan Wittenber	Group	TBD	Open	Flesh out attributes associated with external control ... drudge out of the use cases ...
14	Use Cases supporting Symmetric Communication	Todd Cooper	Jan Wittenber	2008.10.17	Open	In order to evaluate the requirements & roadmap priority relating to a symmetric communication profile, use cases from previous work (e.g., 11073-20302) should be retrieved and added to the DPI use case set.
13	Determine Method for Handling "Transaction Packages"	Todd Cooper		2008.10.17	Open	DPI profiles such as PnP include dialogs that define a prescribed sequence of messages via a state model / phased conversation. Thus it isn't a single transaction / message but a set of messages. How should this be handled within the IHE framework? Poll IHE co-chairs and other experts to see (a) if this has already been handled, and (b) the best alternatives that we should consider. Status: Analyzing query response from IHE Co-Chairs
12	Establish Mechanisms for Use Case Description & analysis.	Todd Cooper		2008.10.15	Open	Review the various constructs used within IHE (incl. wiki content) for capturing use case descriptions & analysis.
11	DPI Scope Statement	Todd Cooper		2008.10.13	Closed	An initial scope statement for the DPI profiles should be drafted for review at the 2008.10.13 WebEx session. This should be based on content from the DPI minutes as well as the PCD PnP proposal documents from 2007.06.
10	Coordinate w/ Dr. Goldman	Todd Cooper		2008.10.21	Closed	Coordinate with Dr. Julian Goldman re. the Boston F2F schedule & agenda, and regarding IHE PCD sync with ICE & MDPnP work.
9	DPI WP & Process	Todd Cooper		2008.10.13	Closed	Publish DPI White Paper outline & process. Process complete (same as Supplement save the Trial Implementation stage).
8	Arrange DPI Sessions	Todd Cooper		2008.10.02	Complete	Publish Doodle poll for 3-4 WebEx sessions over the next two weeks.
7	Arrange 2008.10.24 Meeting @ CIMIT	Todd Cooper		2008.10.02	Complete	Contact Susan Whitehead to see if a joint meeting can be arranged @ CIMIT (65 Landsdowne Street, Cambridge).
6	Add Decisions table to DPI wiki page	Todd Cooper		2008.09.22	Complete	See below. The minutes need to be more consistent regarding the capture of key decisions.
5	Schedule DPI meeting on 2008.09.22	Todd Cooper		2008.09.12	Complete	Only one day during the week of 2008.09.22 is available for meetings. Schedule one for that Monday (i.e., draft a Doodle poll for this). Doodle Schedule poll Scheduled for 2008.09.22 @ 10:00 Eastern.
4	Clearly define the relationship between DPI and other IHE TF Profiles (existing & proposed)	Todd Cooper		2008.09.12	Open	Create a graphic representation of these profile relationships. This should be similar to diagrams provided by IHE domains such as ITI.
3	Change mail groups etc. to reflect "DPI"	Todd Cooper		2008.09.12	Complete	Change the PnP Google Group to reflect the decision for DPI. Harmonize also with any related wiki information.
2	Migrate Current PCD "PnP" Detailed Profile Proposal Content	Todd Cooper		2008.10.01	Open	Move the content that was previously in the the PCD PnP detailed profile proposal into either a white paper for DPI or one or more profile proposals. To reduce duplication, profile proposals may reference use cases identified in the white paper.
1	Add White Paper proposals for PCD Consideration	Todd Cooper		2008.09.12	Open	Add white paper proposals for: Device Point-of-Care Integration Regulatory Considerations (esp. for medical device related profiles) Medical Device Semantic Architecture NOTE: The process for white papers will reviewed from domains such as ITI, which has developed quite a few of these papers

Working Group Decisions

NOTE: These decisions are in addition to the action items listed above.

No.	Decision	Date	Description
1	Profile Name	2008.09.09	Name of profile set shall be "Device Point-of-care Integration" (DPI)
2	Device Scope	2008.09.09	DPI shall include: All equipment around the point-of-care (as much as possible), not just traditional critical care devices. Not only acute care contexts, but per the PCD charter, other use cases that include at least one medical device.
3	ICE Use Case Support	2008.09.22	As appropriate & agreed upon, the DPI White Paper should include / reference use cases identified in the ICE document. It is the intent that PCD DPI profiles will directly support ICE compliant networks.
4	DPI WP Layered Perspective	2008.09.22	The DPI White Paper should contain a "layered perspective" of the technologies that need to be profiled (e.g., transports (wired & wireless), service models (e.g., polled & asynchronous), device semantics & services, external control (open & closed loop), etc.).
5	2008.10.24 Meeting @ CIMIT	2008.10.02	The DPI WG confirmed that a joint meeting with the "ICE" team & MDPnP team should be held at CIMIT (Cambridge Landsdowne Street offices) on Friday, 2008.10.24 immediately after the scheduled IHE PCD F2F meetings in Boston. A key goal should be coordination with the ICE & MDPnP groups.
6	Target 11073-00000 F&0 Content	2008.10.02	The DPI WG shall include content that is intended to be added in the ISO/IEEE 11073 Framework & Overview standard that is currently under revision.
7	Mixed Device Classes & Care Contexts	2008.10.09	DPI shall address use cases that include both clinical and non-clinical care contexts, as well as, traditional critical care and non-acute care devices (e.g., personal health devices in a home care context).
8	White Paper Development Process	2008.10.13	The PCD shall use the following process for developing the DPI white paper: :::- Brief Profile Proposal (only for a White Paper) - Detailed Profile Proposal - Document Development - Publication for Public Comment - Publication (with revision history)
9	DPI PoC Definition	2008.10.15	For the purposes of IHE PCD & specifically DPI, PoC shall be defined as where the patient is located. Use cases with remote clinicians may also be considered; however, DPI will focus on a patient-centric PoC.
10	Roadmap Priority & Phasing	2008.10.15	Initial priority should be on critical care contexts. Number of interface profiles / technologies should be minimized, as appropriate based on the supported use cases. Development of the DPI roadmap should balance between technical feasibility, stakeholder business value propositions, and available resources, maximizing the net benefit.
11	White Paper - Business Value Propositions Section	2008.10.15	DPI White Paper should include a section on business propositions - What can DPI provide over other solutions / technologies currently in the marketplace? This should include both vendor and end user value propositions.
12	DPI-PnP Prototyping Focus	[[ 2008.10.15	DPI-PnP profiling & prototyping should focus initially on... - Physiological Monitors, Infusion Pumps & Ventilators - Should be connection oriented - Should support a LAN architecture (though transport independent)
13	White Paper - non-DPI Transport Use	2008.10.15	White Paper should include a use case and discussion regarding the re-use of a DPI PnP transport for non-DPI vendor-specific applications such as configuration or PM servicing and test.
14	"PnP" Clarification	2008.10.17	White paper should clarify the description of PnP per the above discussion (esp. the need for pre-coordination).
15	Wireless Connectivity Phasing	2008.10.17	Wireless DPI connections will not be addressed in the first prototyping cycle.
16	External Portal Support	2008.10.17	DPI should support an "external portal" function for devices to establish (potentially concurrent) non-DPI connections, either inttermittent or persistent.
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