PCD Detailed Profile Proposal 2009 DPI-SYM

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Proposed Workitem: Device Point-of-care Integration - Symmetric Communication (DPI-SYM)

  • Proposal Editor: Todd Cooper
  • Editor: Todd Cooper
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: PCD

The Problem

Within the framework of Device Point-of-Care Integration (DPI) profiles, many participating systems not only report their internal information but also have need for discovering, connecting to and retrieving information from external sources. This discovery and retrieval may be a one time occurrance (e.g., current patient weight), or it may be a persistent connection with specific quality of service requirements needed to support internal algorithmic functions. The information can be from other systems around the point-of-care or from a remote system that is brokered / proxied to the DPI network.

This profile shall support those functions needed to achieve this bi-directional or "symmetric" communication between devices and systems in a DPI network.


Key Use Case

Example #1: Medication delivery using vital signs feedback from a physiological monitor or ventilator:

  • Pump uses respiration and heart rate information to enable/disable delivery of a medication
  • Pump identifies the source(s) of the needed information and configures a link to receive continuous periodic updates.
  • When the vital signs exceed a clinician-specified limit, an alert is generated and medication delivery disallowed
  • When the vital signs fall back within the specified limites, medication delivery is enabled

Additional use cases include acute care CRRT (Continuous Renal Replacement Therapy) dialysis systems that not only report their status but also need to collect patient "fluids" information (in & out flows; e.g., from infusion pumps) so as to properly drive their calculations.

Standards & Systems

1. ISO/IEEE 11073 standards, including draft 11073-20302 Optional Package - Symmetric Communication
2. HL7 and IHE Publish & Subscribe Standards / Profiles


Technical Approach

Existing actors

<Indicate what existing actors could be used or might be affected by the profile.>

New actors

<List possible new actors>


Existing transactions

<Indicate how existing transactions might be used or might need to be extended.>

New transactions (standards used)

<Describe possible new transactions (indicating what standards would likely be used for each. Transaction diagrams are very helpful here. Feel free to go into as much detail as seems useful.>


Impact on existing integration profiles

<Indicate how existing profiles might need to be modified.>

New integration profiles needed

<Indicate what new profile(s) might need to be created.>


Breakdown of tasks that need to be accomplished

<A list of tasks would be helpful for the technical committee who will have to estimate the effort required to design, review and implement the profile.>

Support & Resources

The following organizations have either actively participated or indicated interest in DPI profile development activities:

  • Baystate Health
  • Breakthrough Solutions Foundry
  • Cardinal/VIASYS
  • Draeger
  • FDA
  • Hospira
  • Improvement Technologies
  • Kaiser Permanente
  • LiveData
  • NIST
  • Philips Healthcare
  • Respironics (Philips)

It is anticipated that these companies will support at some level the development of the white paper.


Risks

Primary risk is the potential lack of standards that may be profiled to provide the required services.

Open Issues

1. This profile is one of the set of DPI profiles. It is dependent on the (proposed) DPI-DnA and DPI-DR profiles.
2. The associated standards are either in draft form or need some development. Completion of this profile is dependent on completion of those standards.
3. The draft 11073-20302 standard could be seen as overly heavy for applications where a device needs a simple parameter for display.


Tech Cmte Evaluation

Effort Evaluation (as a % of Tech Cmte Bandwidth):

  • Progress as appropriate based on DPI WP status and related output.
  • One 2-hour WebEx session per week starting after HIMSS '09 ... 2009.04.13
  • Primary focus on Phase I content (related DPI profiles are of secondary priority)
  • Target Phase I completion & publication for public comment by 2009.05.15.

Responses to Issues:

See italics in Risk and Open Issue sections

Candidate Editor:

Todd Cooper