PCD PC&TC F2F 2018 Oct 16-18 Webex

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PCD Home


Meeting Objectives

These face-to-face meetings have a number of objectives depending on the committees involved:
  • Planning Committee: Review, plan and initiate PCD activities; contribute to planning of the HIMSS Interoperability Showcase and other Showcases and events; recruit vendors and users.
  • Technical Committee: Review and adopt brief profile proposals; contribute to Connectathon test tools, tests, and procedures.


Location & General Schedule

Location:
- Center for Medical Interoperability
8 City Boulevard, Suite 203 | Nashville, TN 37209
(615) 257-6400
- Meeting rooms Rooms 206-207
- Parking - P2 in the garage
- Contact: Elizabeth Cuccias email: ecuccias@center4mi.org
Hotel: Per Committee decision, there is no group booking. The following are Hotel options provided:
- Courtyard by Marriott Nashville Vanderbilt/West End- 1901 West End Ave, Nashville, TN 37203 Phone: (615) 327-9900
- Holiday Inn Nashville-Vanderbilt (Dwtn)- 2613 West End Ave, Nashville, TN 37203 Phone: (615) 327-4707
- Nashville Marriott at Vanderbilt University- 2555 West End Ave, Nashville, TN 37203 Phone: (615) 321-1300
- Homewood Suites by Hilton Nashville Vanderbilt- 2400 West End Ave, Nashville, TN 37203 Phone: (615) 340-8000
- Hampton Inn & Suites Nashville-Vanderbilt-Elliston Place - 2330 Elliston Place, Nashville, TN 37203 Phone: (615) 320-6060
- Extended StayAmerica Nashville – Vanderbilt – Address: 311 West End Ave, Nashville, TN Phone 866-599-6674 $147/night (grab n go bkfst, advance purchase, studio, queen bed)
- Comfort Inn West – Address: 412 White Bridge Place, Nashville, TN Phone: 855-809-3507 $108/night (hot breakfast, microwave, refrigerator, 2 double beds)


Dates
Tuesday October 16: Pump Working Group
Wednesday October 17 morning: PCD Planning Committee
Wednesday October 17 afternoon: Joint PCD Planning and Technical Committees
Thursday October 18: PCD Technical Committee


Daily Schedule -
08:00 - 08:30 Meet at CMI, Nashville, TN
Meeting will start promptly at 08:30 Central Time each day.
08:30 - 10:15 Session #1
10:30 - 12:30 Session #2
12:30 - 13:30 Lunch (location to be announced)
13:30 - 15:15 Session #3
15:30 - 17:00 Session #4

Agenda Suggestions

Please submit suggestions for agenda topics here or through emails to the committee co-chairs.

From the PC Action Items PCD Planning Committee Action Items:

168 Execute Stakeholder Survey

From the TC Action Items: PCD Technical Committee Action Items:

196 Add PCD specific values to HL7 table 78
200 MDS and VMD Requirements
201 Pump utilization - publicizing

Webex

Webex meetings have been set up in anticipation of interest. They will be provided when requested in advance; i.e., the log in information is provided here, and the Webex will be initiated for those portions of the agenda that are of interest. Please let the co-chairs and Paul know of your interest and when you are available. The co-chairs will try to arrange the agenda to permit your remote participation.

Reminders: the IP agreement is in force, and participation counts toward voting rights.

Please note: the log in and phone number for each meeting is the same as for our WG meetings. The password is different, and has been included in the email sent to participants. These are not provided here for security reasons (this is a public Wiki page).

The HIMSS Webex page is [here]

Tuesday morning, October 16: Pump WG: Meeting Number: 920 677 146

Tuesday Afternoon, October 16: Pump WG: Meeting Number: 921 520 451

Wednesday morning, October 17: PC: Meeting Number: 926 807 921

Wednesday afternoon, October 17: Joint PC, TC: Meeting Number: 923 642 752

Thursday morning October 18: TC: Meeting Number: 923 188 645

Thursday afternoon October 18: TC: Meeting Number: 924 625 598

Attachments / Materials

Documents related to the meeting when available will be found at the [ftp site] unless otherwise noted. Documents are available without a password.

Schedule/Deadlines: Patient Care Device and Domain Milestones

PCD PC Action Items PCD Planning Committee Action Items. Significant changes, other than dates, will be in bold.

PCD TC Action Items PCD Technical Committee Action Items. Significant changes, other than dates, will be in bold.

Detailed Schedule & Agenda

Tuesday, October 16, 2018 (Pump Workgroup)

Date Hours Committees Topics


Tuesday 08:30 - 17:00 Pump workgroup
  • Morning (08:45-12:30)
8:45 Drug table for Connectathon 30min
9:15 Common terminology/process for drug library import/export 1 hr
  • Break 10:15-10:30
10:30 Whiteboard session, create simple UML diagram of implementation workflow 1.5 hr
  • Lunch (12:00-12:45)
  • Afternoon (12:45-17:00)
12:45 Review work to date 30 min
13:15 Review new terms in RTMMS 1 hr
14:15 Work on containment tree for terms 1 hr
  • Break 15:15-15:30
15:30 Future idea status check: multistep, child order, bolus from bag 1hr
16:30 Wrapup
  • 17:00 > Meeting Adjournment

Wednesday October 17, 2018

Date Hours Committees Topics


Wednesday Q1 08:30 - 10:15 PCD Planning Committee (PC)
  • 08:30 > IHE IP Management Process
  • 08:35 > Introductions and Agenda Review
  • 09:00 > Review current PCD programs (statuses, plans only, details during TC sessions):
- ACM (Rob Wilder, for Monroe P)
- MEM DMC ((Rob Wilder, for Monroe P)
- MEM LS ((Rob Wilder, for Monroe P)
- DEC (updated PCD TF) (John R)
- IDCO (Paul Schluter)
- PIV (Al E)
- IPEC (Al E)
- EC (John R)
- WCM (Paul Schluter)
- OMS (Ken F)
- RTM (Paul Schluter)
Break 10:15 - 10:30 AM
Wednesday Q2 10:30 AM - 12:30 PM PCD Planning Committee (PC)(Cont)
  • 10:30 > Continue reviewing current PCD programs
- RDQ (John R)
- DPI (John R)
- PCIM (John R)
- Pump (Al E, Jeff R.)
- Physio monitor (John R)
- Vent (Paul Schluter)
  • 11:30 > Action item Discussion
Cochair Item 106 - Activities Promoting PCD
168 Execute Stakeholder Survey
  • Location, Dates of the PCD 2019 Spring F2F
  • Review IHE Milestones from now until Pre-Connectathon
IHE 2018 Publication Schedule [1]
  • 12:30 > Adjourn PCD Planning Committee (PC) Meeting
Lunch 12:30 PM - 1:30 PM
Wednesday Q3 1:30 - 3:00 PM PCD Joint Planning & Technical Committee (PC & TC)
  • 1:30 > Start Joint PC/TC meeting
  • Introduction
- IHE IP Management Process (5 minutes)
  • 1:45 >
- Review & Approve Joint PC & TC Agenda
- Review prior PC & TC Meeting Discussion Summary PCD PC&TC 2018-10-10 Webex
  • 2:00 > Review new Proposals
  • 3:00 > IHE International Update (Todd Cooper, AFC)


Break 3:30 - 3:45 PM
Wednesday Q4 3:45 - 5:00 PM PCD PC&TC Cont)
  • 3:45 > AAMI Interoperability Experience
  • 4:00 > IHE 2019 NA Connectathon
  • HIMSS 2019 Interoperability Showcase

Adjourn Joint PC/TC


Thursday October 18, 2018

Quarter Time Lead Agenda Items
Thursday Q1 08:30 - 9:45 AM PCD Technical Committee (TC)
  • 08:30 > Open PCD Technical Committee (TC)
TC Welcome and Agenda Review (Tom Kowalczyk)
Announcement – Decision Making meeting (TC Co-Chairs)
- Intellectual Property Requirements
- IHE IP Management Process
  • PCD Program review:
ACM ((Rob Wilder, for Monroe P)
MEM DMC ((Rob Wilder, for Monroe P)
MEM LS ((Rob Wilder, for Monroe P)
DEC (updated PCD TF) (John R)
IPEC (Al E, Jeff R)
PIV (Al E)
DEC (John R)
DPI (John R)
Pump (Al E, Jeff R.)
Physio monitor (John R)
Vent (Paul Schluter)
PCIM (John R)


Break 09:45 - 10:00 AM
Thursday Q2 10:00 AM - 12:30 PM PCD Technical Committee (TC)
- Continue Program review
IDCO (Paul Schluter)
RTM (Paul Schluter)
- New Observations
- 10101R
- Vents and Alerts
- Dialysis
EC (John R)
- Standards Coordination
HL7
Nomenclature (Paul Schluter)
PCHA/Continua (Paul Schluter)
  • Tool Review (John G)
  • 11:00 CMI Update and Collaboration discussion
IHE Intellectual Property Requirements
- IHE IP Management Process
  • 12:00 TC Action item review
196 Add PCD specific values to HL7 table 78
200 MDS and VMD Requirements
201 Pump utilization - publicizing
Lunch 12:30 - 1:30 PM
Thursday Q3 1:30 - 3:00 PM PCD Technical Committee (TC)
  • 1:30 >
  • 2:00 > Events and Alerts Nomenclature (Paul Schluter)
Break 3:00 - 3:15 PM
Thursday Q4 3:15 - 5:00 PM PCD Technical Committee (TC)
  • 3:15 > Proposal Review
  • 4:00 > F2F Action Review (from this week)
  • 4:45 > TC Meeting Wrap up and Adjournment (Kowalczyk)


|}

Note: Additional evening working sessions may be scheduled as needed.
Note: Time slot TBD: IDCO

Webex Support

Webex will likely be available for those who could not attend in person. The links will be provided below. Reminder: the IP agreement is in force, and participation counts toward voting rights.

Participants

Tuesday, October 16

On Site: Kurt Elliason(Smiths Medical), Tom Kowalczyk(BBraun), Brian Witkowski(Epic), Dan Kernan(Epic), John Rhoads(Philips), Caroline Cornelius(Baxter), Oliveir Coeffic(Qualcomm Life), Ray Kan (Baxter), Al Englebert (BBraun), Rob Wilder (Spok), Christophe Fournier (Fresenius), Jeff Rinda (ICU Medical), Bill Haralson (Smiths), Paul Schluter (CMI), Trevor Pavey (CMI), Richard Tayrien(CMI), Spencer(CMI)

Remote: Afternoon: Michael Faughn, Konstantinos Makrodimitris


Wednesday, October 17

On Site:


Remote:


Thursday, October 18

On Site:


Remote:

Discussion

Discussion Summaries do not require formal approval, while minutes of meetings where votes are taken do. Participants are encouraged to review and bring up significant issues with discussion summaries of previous meetings. Votes will be taken to approve meetings where votes took place; these may be email ballots.

Tuesday Pump WG Meeting

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

Decisions/Issues:

Agenda approved

Action(s):

2 General Discussion
Status/Discussion:
Reviewed IHE IP Management Process
  • Morning (08:45-12:30)
8:45 Drug table for Connectathon 30min
Reviewed drug table for Connectathon, Updated drug names for PCA
9:15 Common terminology/process for drug library import/export
Discussion of common terms, brainstorming of possible terms, identified whether they are provided by or used by the EMR or pump system.
  • Break 10:15-10:30
Continued discussion of common terms. Identified a subset of terms that could be shared.
Next step to create definitions of each term.
  • Lunch (12:00-12:45)
12:45 Review work to date
Review new terms in RTMMS
Work on containment tree for terms
Reviewed work done in Prometheus tool
14:30 Future idea status check: multistep, child order, bolus from bag
Updated notes from previous discussion
New Feature: Bolus from bag(existing infusion)
Prerequisite: an infusion is currently programmed on the pump; a new order for a bolus of the same medication is ordered to be given from the same bag
Possible new error condition: “not enough fluid remaining to deliver bolus”
The rate of the bolus is not additive to the underlying infusion.
 
PIV
ORC and OBR can both contain a parent order ID
Still need to indicate (primary or secondary) or (IV/IVPB) in transaction
3 types of bolus:
· Dose (amount) + rate
· Dose (amount) + duration
· Rate + duration
Order control code = “CH” (change) with child order number
Use OBX with MDC_FLOW_FLUID_PUMP to contain the rate when RXG contains a dose
 
IPEC/DEC
Clinician dose info using parent and child IDs in OBR segment
New notes
· General parent-child order concept exists in HL7
· May not need new terms for parent and child orders, OBR can contain both
· May want to add MDCX_INFUSION_PROGRAM_MODE and enums to RTMMS for multi-step but don't need for bolus from bag
· Add error code to PIV for not enough medication in container
· Add error code that the parent orderID does not match the currently programmed order
· Add error code that the drug or concentration do not match the currently programmed order
Updated notes from previous discussion 
New Feature: Multistep
PIV
Med/concentration must be same in all steps
Each step contains step number and program mode
Dosing units can be same or different in each step
 
New terms:
MDCX_INFUSION_PROGRAM_MODE with enumerations for clinician dose, loading dose, and continuous
MDCX_PUMP_ORDER_STEP_NUMBER
IPEC/DEC
First PCD-10 “start” message contains info for all steps (dose, rate, VTBI are repeated for each step)
Ideally, subsequent messages contain info for only the current step
Question for discussion: Can pump vendor filter subsequent start messages based on VI > zero?
Current step number is required in all messages (delivery channel?)
Steps are always numbered (1….n) regardless of whether step 1 is a loading dose
New notes
Program mode from programmer is useful for reporting purposes.
Defer to future discussion
Other new topics:
TCI
Used only in anesthesia. Tries to attain and maintain a certain level of drug in the body.
May need new terms.
Follow-up in future pump WG meeting
Channel relay - two syringe pumps working in cooperation to maintain a consistent rate as one syringe becomes empty

Decisions/Issues:

Terminology

Reviewed new terms for MEMDMC, ACM, PCA
Proposed PCA terms
MDC_DEV_PUMP_NOT_DELIVERING_REASON
Proposed additional enums
Pump-stopped-patient-dose-lockout
Pump-stopped-maximum-dose-lockout
Proposed additional terms (refer to current status)
MDC_TIME_PCA_LOCKOUT_REMAINING
MDC_TIME_PD_PCA_DOSE_LIMIT_REMAINING


Action(s): See above

Wednesday Morning

Item Topic Discussion
1 Introductions & Agenda Review
- Chair
Status/Discussion:
Monroe reviewed the IHE IP Management Process
Introductions and Agenda Review

Decisions/Issues:

Agenda approved

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair
Status/Discussion:
Minutes approved

Decisions/Issues:

Action(s):

3 Agenda Items
-
Status/Discussion:

Review current PCD programs (statuses, plans only, details during TC sessions):

- ACM (Rob Wilder, for Monroe P) – Presentations are on the ftp site.
Pure AC actors are rare, most participants are both. Discussed presenting waveforms on ACs. Some members have the ability to present them, hope to test this CN or the next. Spok is working with nurses to identify what they need. Is a 1 second interval enough? Seems to.
ITI mACM – wanted to use FHIR, found V2 had most of it. FHIR limits functionality, removing true ACM alerting capabilities. They’ve worked it mostly out.
Lab – other items took priorities, plan to get back to it this iteration.
- MEM DMC ((Rob Wilder, for Monroe P)
Still in TI, in CN and demo’d at HIMSS. Was at AAMI unofficially. Rec’vd REFIDs and … Need more CMMS vendors. FT likely 2020. PCD 15 updated by CMI.
- MEM LS ((Rob Wilder, for Monroe P)
In TI at HIMSS, and AAMI. Terms are in 10101r. No TI updates. IEEE workgroup may bring another vendor in (Versus). B Braun is working with Versus (now MidMark) on a deployment, hope to get them to participate. Some others are interested. Plan on FT in 2020.
RDC Plan to develop Profile supplement in 2020.
- DEC (updated PCD TF) (John R)
Stable, doesn’t undergo a lot of change. One is handling alternate ECG lead configurations. IEEE – 10101 is in revision; treatment of term life cycle casual at HL7, becoming more formalized with IEEE. Will IPEC be altered to comply? Likely, but should be good.
- IDCO (Paul Schluter)
They're hard at work, updating and adding to the profile. Hope to be ready to test at 2020 Connectathon.
- EC (John R)
Profile proposal came in, he just sent it to us for discussion. Tries to minimize alarm fatigue. Came from Germany. IHE Germany has minimal participation, but that should change. There are some related AAMI projects regarding interoperability.
- WCM (Paul Schluter)
Update published, looks well received. Includes additional data added on to message. New terms released as provisional, in 10101r.
- OMS (Ken F) – no update.
- RTM (Paul Schluter)
Working on 10101b update, taking back seat to 10101 revision (4 years overdue). PHD working on getting their terms aligned with ours and published. All terms will be in one place, groups can work together without interfering with each other. Paul will cover more thoroughly in TC meeting.
- RDQ (John R)
Not much new. Not quite at the level of testing yet.
- DPI (John R)
Originally about high speed/intensity/ device interaction at point of care.
- PCIM (John R)
Became a WP, out for public comment as a Profile (ends Thursday). Will be issued after comments addressed.
- Physio monitor (John R)
Primitive model in V3 (static). Tooling available to help fill it. How to handle documentation? May be helpful to have tutorials and machine readable content (via DIM editor). Some FHIR work may help with this.
- Vent (Paul Schluter)
Have comprehensive list of terms. Draeger has proposed some. Also some inspiration/exhalation ratios. Will try to get terms into 10101r. Starting to address events and alerts, complete and mostly comprehensive (300 terms). Anesthesia machine is a good extension; close, but not quite done.

Location, Dates of the PCD 2019 Spring F2F

Qualcomm San Diego is out, some discussion of Paris. Rob can check on Phoenix. Paul Sherman will ping Bikram and Portland State U for meeting locations in Portland.
  • Prep a Google poll to see who can make it to Paris.

Continue Program Review

- PIV, IPEC, and Pumps (Al E, Jeff R.)
Expanding PCD-03 to include bolus on demand. Expand to include multi-step protocol. Discussed with Europe on TCI and channel relaying (Infusing critical, short life drugs in a very limited time) – need to confirm consumer’s needs. Can then incorporate those messages into PCD-01 and PCD-10. Additional terms – Infusion time and some more. Also dealt with pump drug library alignment. Added PCA morphine term. Brian presented on pump modelling (Prometheus tool), identified a couple of items to add.

Tour of CMI Lab and discussion of numerous topics of mutual interest.

Action item Discussion

  • Cochair Item 106 - Activities Promoting PCD
Rob talked to Mayo and Banner and met with Banner to discuss, What are we missing? RDC, some other items that drive early adoption. Also discussed contacting Dave Dickey at McLaren about participating.. Tom will ask Jack Hoffman to contact Dave, copying Paul Sherman.
  • 168 Execute Stakeholder Survey (Paul S)
Challenge: How to get responses. Ray mentioned that some survey companies offer compensation to participate. Perhaps HIMSS/IHE could offer a giveaway (a year's membership?) at HIMSS.

Review IHE Milestones from now until Pre-Connectathon

IHE 2018 Publication Schedule [2]


Adjourn PCD Planning Committee (PC)


Decisions/Issues:


Action(s):

Spring F2F -

- Rob will check on Phoenix.
- Paul Sherman will ping Bikram and Portland State U for meeting locations in Portland.
- Prep a Google poll to see who can make it to Paris.


Wednesday Afternoon

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

Decisions/Issues:

Introductions
Reviewed the IHE IP Management Process
Reviewed & approve Agenda

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair
Status/Discussion:

Decisions/Issues:

Action(s):

Oct 10 summary approved
3 Agenda Items
-
Status/Discussion:


AAMI Interoperability Experience

No space on floor for an interoperability demo for 2019. For 2018, Smiths and EQ2 put something together on the floor. Had some sessions. Had great participation in the past. Discussed feasibility of having an EMR vendor there. Can we do a vignette at AAMI? If no demo for 2019, then we have time to put something together again. Paul Sherman will contact Steve Campbell to see if the demo fits with their plan.

Review new Proposals:

- Event and Alert Processing (John Rhoads)
How do we provide a substrate, comply with IEC, legacy and new alarm systems. Todd provided some comments within the document.
- Discussion: Rob – Sounds like turning the standard into a rules engine. Some works with trending; much is on the market now, and using the standards. The conditions are set by the users. Capsule does some, but are limited by their FDA MDDS status. They would need to go through the 510K process to do more. It’s tough to standardize, as most of it is set on a patient to patient basis. Can we add this in Vol 3 as additions to existing messages? Yes, this is part of it. Part of it is wrapping the rules info to support these needs. Can adjust the content of existing messages to apply to the specific need. What we have can do the job, we need to see some evidence that more is needed. We need to be careful that it doesn’t affect existing systems’ status. A content module allows implementing in HL7 V2 or FHIR. We can assume the proposers have limited awareness of ACM.
- Takeaway: Set up some discussions with the proposers (in Germany) to sort out what is needed and what is already available.

FHIR Update) (Todd Cooper)

- Foundation is a 501 c3 to promote implementation. Some challenges – HL7 knows their business model is challenged. FHIR still heavily dependent on Graham Green. R4 has been all consuming, discussions on back burner. Possible resolution in 2019. Finally came up with a way to represent x73, something won’t now make the cut for 2019. But should be ready in 2020. Cancer staging is progressing well, promoting working together. PCD FHIR profiles: Continues to perk along; tooling is a challenge. One commercial solution (expensive) and some OS ones. They’re working on the solution,

IHE International Update (Todd Cooper, AFC)

- Questions? IHE Individual Certification – No recent info, IHE continues to go through reorg discussion. Hope to have timeline after RSNA meeting. Elliott’s hope – none.

Certification – Amit working for IHE, should be good for the process.

IHE 2019 NA Connectathon

  • Will new terms affect Connectathon? If not submitted to NIST for inclusion, they won’t be recognized. Discussion of how to submit them to RTM for addition and NIST for inclusion in the tools.

HIMSS 2019 Interoperability Showcase

  • Voalte is registered at the Showcase, but hasn’t participated in a Connectathon. We think it’s a prerequisite. Paul Sherman will contact Bronwyn to confirm.

Decisions/Issues:


Action(s):

Event and Alert Processing Proposal - ACM will set up some discussions with the proposers (in Germany) to sort out what is needed and what is already available.

AAMI Showcase - Paul Sherman to contact Steve Campbell to see if the demo fits with their plan.

HIMSS Showcase - Paul Sherman will contact Bronwyn to confirm if CN participation required for Showcase participation.


Thursday

Item Topic Discussion
1 TC Welcome and Agenda Review (Tom Kowalczyk)
- Chair
Status/Discussion:

Decisions/Issues:

Agenda approved
IHE IP Management Process
Announcements –
- Decision Making meeting (TC Co-Chairs)


Action(s):

2 Discussion Summary
- Chair
Status/Discussion:
-

Decisions/Issues:

Action(s):

3 Agenda Items
-
Status/Discussion:
  • 8:30 > Open PCD Technical Committee (TC)
- IHE IP Management Process
- Intellectual Property Requirements

PCD Program Reviews

ACM (Rob Wilder, for Monroe P) Presentations on ftp site
  • CPs merged into Profile. REALLY need virtual AC actor. Two EHRs have AC actors, there are six available, not that many at Connectathon. How many are AC only? Just Voalte. Does a dial back provide a log for read back? Vendors need to confirm this works.
MEM DMC, MEM LS, MEM RDC- (Rob Wilder, for Monroe P)
  • Ready to move forward. Is there a document ready? Yes, the White Paper. Examples – pause alert, mute alert, clear volume infused, unlock a device panel. Want to minimize regulatory impact. Is there a group that discusses it? Yes, the standard Friday call, but can schedule an earlier time to accommodate others. Need implementing vendors. Spok is very interested. Would like a short walk through today. Monroe did one a few F2Fs back. Plan for ½ hour this afternoon. Another idea – sharing information between devices. Extensive discussion on the topic. AAMI/UL 2800 - the FDA is very interested in these capabilities, but also want risk mitigation. They’re thinking multi-vendor systems. But this is moving VERY slowly. IHE and CMI can create the testing environment. How do we get more involved with getting into a mess? The walk-through this afternoon would help. Kosta from the FDA is interested, could get him on a MEM call. The current examples are the minimally impactful option. Discussed sharing SPO2 info between monitor and a pump. This is available in a proprietary aspect.
Devices on FHIR (John R)
  • Conceived by Todd Cooper. Number of realistic scenarios. Others use FHIR a lot; PCC, Radiology for a start. Why? Not normative, but people are using it for non-regulated exchanges. Ballot for R4 being set up; this one will be somewhat normative.
FHIR Overview – has many buzzwords. Graham Greve is the FHIR product manager, very enthusiastic about it. HL7 v3 has crashed and burned (British NHS failure). Recommend looking at the spec (a website, not a document). John gave site tour. Rob – need a roadmap to be able to use it. How are they providing a shareable path forward? A wiki has some info out there, but this is a challenge. FHIR Dev Days has that info, it’s expensive to attend. Older info on-line, but most recent isn’t shared freely. John can provide some info. It’s a challenge. Different implementations seem to be not conformant (Smart on FHIR). Mass General has a person working on this a lot. Can be specific for a person or used in large scale analytics. Risk of multiple implementations of the same activity. Discussed how the process works. Why and/when will it fit in, what will it solve that’s not already solved in V2? Excellent question. We need to address this to the consumer community. FHIR won’t replace V2 in the real world, but it can do a lot of jobs. We need to lay down some info to preclude others from using FHIR in a way that prevents us from doing so.
DEC (updated PCD TF) (John R) – Covered on Wednesday
IPEC, PIV, Pump (Al E, Jeff R.) – Covered on Wednesday
DPI (John R) (Docs will be on ftp site)
  • Revised Domain Info Model taking a lot of time. Next topic in queue is the DIM editor. Highlighted its modelling capabilities. Could use some on-line tutorials or user’s guide. Can see some sessions as how-to. Vol 3 can become a hybrid of device samples and files with details to generate useful tables. John has submitted docs etc. to IEEE.
PCIM (John R) (Docs will be on ftp site)
  • Out for comment as a Proposal, close tomorrow. Big thanks to Doug Pratt, Megan Tetlow, Stan Wiley, Chris Courville, Bob Flanders. Showed association graphic, described fields and actors. In normal PIV case info is scanned and sent to EMR, what is normal way to this? No normal, depends upon configuration. Implementation will be risk analyzed. Question – Managing competing info sources? Not included yet, could use addressing, referred back to WP. But it will return an error and notification. Alignment between PIV and this? Inspired by PIV, complementary Profiles.
Physio monitors (John R) (Docs will be on ftp site)
  • Simple model in Vol 3. In FHIR modelling have a simple example, interesting link between FHIR and PCD-01 worlds.
RTM (Paul Schluter) (Docs will be on ftp site)
  • Added some new vent terms. Event/Alert work continues. Have a bit more work, then will be ready publication. Will soon have pump terms as well. Will review IEEE/LOINC mapping. Covered IEEE/LOINC descriptions, differences and focii. Have some guides to arbitrate conflicts. Hope to have a solid versioning path. Proposed content/governance model. Discussed a model, Rosetta becomes a standard. Would need some fleshing to work, slide shows the intent, was fairly well received. But limited resources to develop. CMI is interested in moving it forward. Process Diagram and Term States – would need to be incorporated. MEM terms are in 10101r. Low level underpinning to support higher functions. Having a list to review LOINC terms would help. Need to have resources available as well. Need to balance expertise vs. turnaround to make this remain viable.
EC (John R) – Covered on Wednesday
Standards Coordination
  • Nomenclature, Events and Alerts Nomenclature, PCHA/Continua (Paul Schluter) - Covered Wednesday
Tool Review (John G) - unavailable

CMI Update and Collaboration discussion - Good discussion yesterday during tour.

TC Action item review - [TC Action items]

196 Add PCD specific values to HL7 table 78
  • John not available, move to next TC meeting.
200 MDS and VMD Requirements
  • Loose, not tested by NIST tools. Required disclosure at CMI. Need to assemble ‘uber’ models. How rigorous. Part may include retrofitting specificity in TF. May need general x-type path. May be able to use a tool like FHIR’s to create the containment models. Also want to clearly state what containment is. Discussed options and current process with some examples. Need to work out wrinkles for multiple devices doing the same thing. Need to solve persistence issue. Example: BP monitoring channels, when expanding channels, need to ensure the original maintains its channel number. Discussed different IV pump models as well as monitoring. Found a challenge with ACM; Alarms and other messages. If the alarm is in the first message, then another message is generated with another field completed, the alarm may not be at the same location in the message. Oliver will draft a White Paper to address MDS, persistence and channel identification, what works, doesn’t work and mine fields. He has a lot of notes already. Will review Dec TC meeting.
201 Pump utilization – publicizing
  • AAMI article – AAMI willing to publish an article, Paul still needs to put it together. White Paper – No progress either. Set to Dec TC call.


> TC Meeting Wrap up and Adjournment (Kowalczyk)


Decisions/Issues:


Action(s):

Oliver will draft a White Paper to address MDS, persistence and channel identification, what works, doesn’t work and mine fields.

RDC security work – Monroe and Rob start working on this. For 1st pass, wait a bit to share this work to review on it. Will likely use a MEM call to work on it. Will look into changing next week’s time.


Action Items - PC

The Action Items that follow and approved in subsequent committee meetings will be added to the committee Action Item page.

Action Items - TC and WGs

The Action Items that follow and approved in subsequent committee meetings will be added to the committee Action Item page.

Next Meetings

PC and TC: PCD PC&TC 2018-10-24 Webex

TC: PCD TC 2018-11-07 Webex

PC: PCD PC 2018-11-14 Webex