IHE PCD 2009 Showcase Workshop 2008-10-28 to 30

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Meeting Purpose

All organizations participating in the HIMSS '09 IHE Showcase are required to participate in the Showcase Participants Workshop.

This wiki page provides details for the IHE PCD showcase participants breakout sessions Thursday and Friday (Oct. 29, 30).

WebEx Information

This meeting is being held both face-to-face and via WebEx. Organizations that have already participated in 2 showcases, could choose to participate remotely.

Topic: IHE PCD Showcase Participants Workshop Breakout Session

Date/Time: Thursday, October 30, 2008, 13:00-16:00 Eastern

Date/Time: Friday, October 31, 2008, 10:00-13:00 Eastern

Proposed Agenda

1 Introductions
2 Agenda Review & Approval
3 Overview & Background
  • Session Objectives
  • Showcase Objectives
4 General Showcase Discussion
  • Key Messages ("What's new?")
  • System Diagram Review
5 Profile Support
  • New profiles / options
  • Company-Profile Support (incl. Registration Review)
6 Showcase Layout
  • General Cube Layout
  • Physical Space Requirements
  • New Directions
7 Scenario Review
  • General Scenario
  • Clinical areas: OR, ICU, SDU + Transactions
  • Tours
8 Showcase Issues
  • AM-to-AC: New Directions?
  • ADT support (PCD "HIMSS Patient")
  • Terminology needs: Resolve NOW!!!
  • Wired/wireless Logistics
- BCMA/Pumps
- AC: Polycom
  • Distributed Demonstration
  • ACM: AR:AM alarm instance ID
9 Connectathon Issues
  • Testing Tools
  • Virtual Connectathon (esp. dealing with firewalls)
  • Timeline Review
  • Pre-Connectathon: ADT Server coordination
  • Verify connectathon tests are sufficient to support a reliable demonstration
  • PolyCom scheduling for Connectathon
10 Session Summary

Attachments / Materials


Participants

Chair/Host: Todd Cooper (Breakthrough Solutions) & Manny Furst (Improvement Technologies)
Rita Brahmbhatt (Cerner), Ruth Berge (GE), Dan Bowling (Polycom), Brett Coen (LiveData), Robert Cuyugan (Cardinal), Bikram Day (Capsule), Jeff Dern (Cardinal), Al Engelbert (B.Braun), Robert Flanders (GE), Brian Fors (GE), John Foy (GE), Colin FX (Epic), Jim Higgins (Cerner), Brad Lunde (Cardinal), Gary Meyer (Cardinal), Monroe Patillo (Philips/Emergin), John Rhoads (Philips), Jeff Rinda (Hospira), Kristina Wilson (Hospira), Khalid Zubaidi (Cardinal)

Discussion

Item Topic Discussion
1 Introductions & Agenda Review
- Todd
Status/Discussion:

Decisions/Issues:

Action(s):

2 3. Showcase Overview & Background
- Todd
Status/Discussion:
Last Year: Confusion whether this was one vendor or multiple vendors.
Last Year: Not clear about what was of interest to walk ups (both within PCD and IHE in general)

Decisions/Issues:

Action(s):

  • Business card for Showcase w/ all companies listed + Booth numbers
  • PCD Docent training WebEx / on site


3 4. General Showcase Discussion
- Todd
Status/Discussion:
  • Messages: What's New and perhaps one or two umbrella messages such as Patient Safety

Decisions/Issues:

  • New:
ACM PATIENT SAFETY
PIV PATIENT SAFETY
RTM PATIENT SAFETY
DEC(SPD) PATIENT SAFETY?!
  • Key Message:
What's new? Keeping interest for Year 3
"Patient Safety"? Efficiency?
(Bikram) confusing when you integrate all 4 profiles into the clinical scenario too soon; should try to minimize the IHE "jargon"
(Brett) What is the most important message to those who are attending? Is it Safety and / or efficiency?
(Brett) Perhaps the safety component of DEC, increased data availability ... make more information with consistent semantics available sooner for better decision making
(Zambuto) 2008 Survey Slide #17, "Improved Patient Care and Safety" was by far the greatest "incentives for IHE integration"; #2 was "Long term cost reduction"; #3 was improved workflow
(Monroe) Alarm comm for patient safety is remote annunciation - Have person in audience with "alarm" device
General messages should follow the above, highlight "5 Rights", "Remote Alarm Communication", etc.
  • System diagram review
Manny went over the physical layout
Pump DOR's: Add AR
SDU: GE block: Add "Centricity Enterprise"
Cerner: Change to CareAware
Add Polycom

Action(s):

  • (Brett) Get name for LiveData SDU product
  • Remove arrowheads on gold device connections
  • Update devices on bottom based on scenario discussions
4 Profile Support
- Todd
Status/Discussion:
  • Company Profile Support - Updated diagram
B.Braun: OK
Causule: OK
Cardinal: ACM (only PCD-04)
Cerner: Need to add CT to Kudu
Draeger: OK
Epic: OK
GE (Ruth): TBD - Patient ID Feed
Philips: PCD-02 (RISK)
Hospira (VeriScan): PCD-01 (RISK)
Hospira (MedNet): Adding PCD-04
LiveData: OK
Philips (CIS): DOC-PCD-02 (RISK)
Polycom: OK

Decisions/Issues:

Action(s):

5 Showcase Layout
- Todd
Status/Discussion:
  • Discussion about the physical equipment & layout
Manny showed 2008 Layout
Each company will be asked to provide required physical dimensions, power layout
ISSUE: B.Braun & DoseTrac display ... yes? No?
ICU / SDU: Epic & GE should swap IOP/DOC roles based on tours.
Enterprise DOC's share U/I in each display space; feasibility possible, but MUST DETERMINE NEEDED EQUIPMENT
IOP & Enterprise DOCs: Since these systems share their display between the IOP & DOC, they need to be sync'd if they are both being presented simultaneously.
AR & OR: Is this needed? Will it result in increased demo's of one vendor over another.
Stepdown / ICU: Capsule in SDU w/ Welch Allyn vital signs monitor
BEDs: All care contexts. Stryker & Hill-Rom in ICU & Step-Down; if only one bed can be connected (i.e., to Cerner) then @ the showcase, they can be swapped every other day.
ISSUE: Stryker & Capsule for ICU? Balance
OR: LiveData AR to Emergin AM to Polycom AC w/ procedural / workflow alerts

Decisions/Issues:

Action(s):

6 Scenario Review
- Todd
Status/Discussion:
  • Tours
OR=>ICU
SDU=>OR
ICU=>SDU
EMR/DOC:
Two ICUs? NO
  • General IHE Showcase Issues
Video presentation @ start of IHE PCD Tour (2-3 minutes)
HITSP & PCD: By completing CT, all vendors can also tick the box for HITSP/T16
HIMSS Badge: MRN-only barcode? Donnelly indicated that he would check on this possibility.
SINGLE DOCENT: PCD Docents will perform tours; detailed profile-specific tours can involve vendors. (?!?!?!?!)
NOTE:
Time Allocations
Starting Video (3 minutes)
Patient ID (2 minutes)
DEC (5 minutes)
DEC/SPD (???)
ACM (5 minutes)
PIV (5 minutes)
Summary (2 minutes)
NOTE: Above spread out across tour/care contexts...does 5 minutes include 1 minute for profile overview (docent); 2 minutes (sending actor); 2 minutes (for receiving actors)
  • OR-> Scenario
Short video (2-3 minutes)
Clinical: Patient ID
Take Badge from volunteer patient
Send out to systems
Print out badges (if no MRN on badge!)
More: PDQ usage
DOR
Pumps: All pumps send simultaneously to both Periop & LiveData
AR-AM-AC
LiveData: Generate an alert based on procedure / workflow (e.g., "time out not documented alert" to nurse doing documentation)
Draeger: Alarm (device technical) to Biomed
MOVE AM'S to TOP
PUMP DOR Application Display
PENDING PROPOSAL: Use video switch to share pump vendor server applications
  • ICU Scenario
Patient ID (scanned / physically entered) to GE
Alarms
Capsule - Alarm from device
Philips - (risk) RTDSS alarm, or pass through from GE aware gateway
Pump - Alarm ...
Emergin - Alarm display ...
PIV
Epic - pull up same chart from OR, pull up med admin, scan DEVICE ID, med, clinician, ...,
PRE-FLIGHT (static): Coordinate Device ID w/ Server to send IOP to
PRE-FLIGHT (dynamic): Associate pump & patient
Cerner - CareMobile (wired / wireless),...
ISSUE: mobile unit REMOTE SCREEN DISPLAY
IOP/DOC Display: Cerner & Hospira can dual use display
ISSUE: Do we need a camera of the mobile unit being programmed?
DOC/EMR - Finalize & show that the EMR has captured
  • SDU Scenario
DOR's - all report to the enterprise DOC's all the time
IOP
Epic / GE: If they are Enterprise/DOC ... & IOP turn ... they should be same system since you wouldn't have an enterprise application from Epic & an IOP from GE (you would have this though with Hospira
NOTE: Medication Orders are CANNED (statically configured)

Decisions/Issues:

Action(s):

  • QUESTION/ISSUE: (Ruth) Does this include the 5-rights data entry?
7 Showcase Issues
- Todd
Status/Discussion:
1. ADT Feed:
Last year, either used Bar Coded label OR manual entry (for non-PIB enabled systems)
(Colin) People could register @ the Showcase kiosk; if they had not, Colin pulled up the HIMSS registration web page, entered the info, and sent an A04 to the systems; location information was in the original A04 transaction - location was always the same; Printed out a barcode with the MRN which they could then scan in if they didn't receive A04's;
(Ruth) HIMSS registration provides a method for retrieving a standard set of registrations (A04 Message); @ PCD, we admit the patient & generate an A01 Message.w/ patient location. Yes? Is there a transfer (A02)? Discharged? (colin) Only A04 sent from registration system with a single location. Using MRN, gateways would look up patient demographics data BUT ignore location.
Are A04, A01, A02... supported by PAM?
Location support w/ multiple patients? Previous years the unt/bed was fixed ... should that work for this year? This is further complicated in 2009 with the ACM where phones are paired with care contexts / beds. Devices are typically fixed per patient location.
2. ISSUE: Terry (Welch Allyn) Brought printer ... this year? May need multiples. Contact Zebra to see if they would provide printers. May use NETWORK PRINT SERVER for generating the barcode strips for follow-on system entry.
Manny is making the necessary contacts
3. ISSUE: Use badge ID bar code (what can we use this? Too much information?) note: all we need is an MRN; Could another barcode be added with only MRN?
Donnelly is making the request. Since we are asking early, it may be possible.
4. ISSUE: PIV barcode: Clinician ID & Drug ID ... over multiple vendors; perhaps use a fixed set of patients
5. ISSUE: Is there one static location or three locations between which we transfer the patient.
See (1) above
6. ISSUE: Need to be "canned" infusion orders
7. ISSUE: PCD ICU wall & other Pods - too close in 2008!
8. ISSUE: Patient ID to infusion pumps (manual & bar codes); OR 3 Simultaneously; ICU/SDU can delay DOR to 2nd tour context.
Discussion to be continued w/ pump vendors
9. ISSUE: Timings for dynamic setup based on Patient IDs
10. ISSUE: Capsule/ICU/DataCaptor - need method for supporting PIB + patient on tour
WIRELESS MANAGEMENT: Need someone who can manage this (as well as other connections / video switches / tour sequencing ...)
DISTRIBUTED DEMO:
Capsule
Polycom
Emergin
Philips

Decisions/Issues:

  • Issues above.

Action(s):

  • A04, A01, A02... supported by PAM?
  • Colin / Ruth - summarize requirements / issues from discussion. Group will then review and discuss in a subsequent WebEx session.
  • Capsule wants to have bidirectional distributed demo - pushing data in from their booth to the demo.
8 Connectathon Issues
- Todd
Status/Discussion:
1. Virtual Connectathon (esp. dealing with firewalls)
GE & Philips had issues w/ firewall tunneling; may have to connect off site, but server is a problem.
2. Testing tools
3. Timeline
4. PolyCom scheduling for Connectathon
After Emergin & LiveData have tested AR/AM interactions
5. Pre-Connectathon: ADT Server coordination (see Bill Klaver / Initiate)
6. Verify connectathon tests are sufficient to support a reliable demonstration (e.g., loss of comm, power, etc.)
7. Wireless testing?
Moore said that if there were static MAC addresses early so he can configure wireless network.
BCMAs & Polycom

Decisions/Issues:

Action(s):

  • Create Wiki page for "virtual connectathon" on Connectathon '09 page. Include, partners, issues list / resolution, status, etc.
9 Other Issues
- Todd
Status/Discussion:
1. Intro video to be provided again this year @ start of PCD tour? Donnelly: Yes, most probably.
2. HITSP support: All vendors should add HITSP T16 to their test list since it will be automatically tested as part of Consistent Time.
3. MRN Only bar code on HIMSS badges? Donnelly: "Should be early enough to get this in place. Will ask."
4. ITI Infrastructure BoG:
4.1 They identified an issue w.r.t. "PAM" ... assume that they will bring this up to PCD leadership for resolution
4.2 Bill Klaver? (Initiate) had a great "Basic HIMSS Courtesy" slide ... we should get that deck and post it for the group.
5. Bikram & Docents:
5.1 Trained docents per tour (not care area) to promote continuity
5.2 At Connectathon ... run throughs of the clinical story lines
5.3 K.I.S.S.


Decisions/Issues:

Action(s):

  • Provide notes to Lisa


10 Workshop Feedback Summary
- Todd
Status/Discussion:
1. (Khalid) Reorder Workshop Agenda to enable PCD-only participants to minimize wasted effort; Also - publish agenda in time to book personnel for attendance on specific dates.
2. (Brett) Halloween?!

Decisions/Issues:

Action(s):

  • Provide notes to Lisa

Next Meeting

The showcase participants participate in weekly WebEx sessions.


<Add review line here when minutes are approved; e.g., "(Reviewed & approved by PCD RTM Vent TG 2008-04-16)">


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