PCD PIV 2010-02-16 F2F

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Infusion Pump Summit

February 16 - 18, 2010 @ CareFusion in San Diego "America's Finest City"


This 2nd IHE Infusion Pump Summit face-to-face meeting will provide a opportunity to focus on those key issues that need to be resolved to enable completion of PCD technical framework components that are needed to support infusion pump interoperability. See also the PIV Current Issues Discussion wiki page http://wiki.ihe.net/index.php?title=PCD_PIV_Current_Issues_Discussion for additional details.


WebEx Information

This is a face-to-face meeting (no WebEx support).


Location

The meetings will be held at CareFusion's Corporate Headquarters:

CareFusion
Corporate Headquarters
3750 Torrey View Court
San Diego, CA 92130
858.617.2000
888.876.7128 (toll-free)
Google Map for Location
Local hotel information...

Agenda

Please let Todd Cooper (t.cooper@ieee.org) know ASAP if there are any change proposals to this agenda...


Day Time Topic
Tuesday

(2010.02.16)

09:00 - 10:30
  • Introductions & Agenda Review
  • Intellectual Property / Patient Disclosure Policy Review
  • Review the pump working group road map & work plan:
- TN905 & infusion pump interoperability
- ICE-PAC Update (+ Quality of Data Indicators)
- HL7 & Other SDO Activities (incl. Pharmacy & RCRIM)
- NIST tooling - IHE testing & <???> certification
- FDA, 80001 & "ad hoc integration" issues
10:30 - 10:45
Break
10:45 - 12:00
  • Review the pump working group road map & work plan (continued)
  • HIMSS '10 Showcase - Pump Logistics (esp. Wall 4)
12:00 - 12:30
Lunch
12:30 - 13:45
  • ECRI Perspectives
  • Users Guide Review (w.r.t. pump profiles)
  • Issues arising from 2010 Connectathon testing:
- Minor wording change needed to PIV supplement in Expected Actions section re: MSH-16: add “from original PCD-03 message”
- Missing REFIDs and term codes for alarms
- “Source of truth” issue when pump/gateway uses its own information instead of info from the transaction
> Patient weight
> Infusion rate
-PCD-01 reporting for values that are unknown or not applicable (height, weight, drug name)
- NIST Test Tooling Update
- HL7 Enhanced ACK (single vs. dual pipes...)
- PCD-02 Subscribe to Patient Data (SPD) Filter Specification vs. "one shot" Query
13:45 - 14:00
Break
14:00 - 15:30
  • Issues arising from 2010 Connectathon testing (continued)
15:30 - 15:45
Break
15:45 - 17:00
  • Roadmap + Moving to Productization: Critical success factors!
Wednesday

(2010.02.17)

08:00 - 09:00
  • (OPTIONAL) IHE PCD Weekly WebEx
09:00 - 10:30
  • Review Revised Agenda + Day 1 Notes (incl. posted files)
  • Issues arising from 2010 Connectathon testing (continued)...
- HL7 Enhanced ACK (single vs. dual pipes...)
- PCD-02 Subscribe to Patient Data (SPD) Filter Specification vs. "one shot" Query
10:30 - 10:45
Break
10:45 - 12:00
  • Discussion Continued
  • Infusion Pump Reporting Issue Inventory Discussion
12:00 - 12:30
Lunch
12:30 - 13:45
  • Pump Event Communication
13:45 - 14:00
Break
14:00 - 17:00
  • Pump Event Communication (continued)
Thursday

(2010.02.18)

08:30 - 10:30
  • Revised Agenda Review
  • Day 2 Summary & Action Item Review
  • Infusion Pump Information Modeling - Strategy Discussion
- Review General/Generic Model (per 11073 documents + ICSGenerator)
- Inventory items to be addressed by model (scope)
- Infusion Profile Support: primary, piggyback, bolus dosing, intermittent/multi-dosing, concurrent delivery, R&T, ...
- Device Type: Single Channel, Multi-Channel, Multi-Modality, Syringe, PCA
  • PCA Reporting Using IHE PCD DEC
10:30 - 10:45
Break
10:45 - 12:00
  • PCA Reporting Using IHE PCD DEC
12:00 - 12:30
Lunch
12:30 - 13:45
  • Dose vs. Dose Rate Reporting (Schluter)
  • Discuss Residual Terminology Gaps
- Issues Submitted by Fred Ehrhardt (Capsule)
- Terminology Issues Arising ...
  • Wrap Up Discussions
13:45 - 14:00
Break
14:00 - 15:00
  • Detailed Profile Proposals Review:
- Patient-Device Association Profile Proposal
- General Device Context Content Profile Proposal
- Device Integration Profile Proposal
  • Review Action Items & Work Plan
  • Next Meetings
- @ HIMSS?
- 2010.03.10 WebEx (normal pump slot - 2 hours?)
  • Adjourn

Attachments / Materials

Meeting Materials Loaded on the IHE PCD FTP site...
Pump Summit Notes


ECRI Pump Perspectives Update (Sparnon)
Event Comm Detailed Profile Proposal (Rhoads)
FDA UDI Update (Reed)
Fred Ehrhardt Term Issues Table (orig) (Updated @ F2F 2010.03.12)
HITSP/TN905
HL7 RCRIM SPL Project Proposal
Pump Events_2.doc Infusion Pump Events Table ver2

Discussion Notes

Participants

Meeting Chair: Todd Cooper (Co-chair, IHE PCD Technical Committee)
Meeting Host: Khalid Zubaidi (CareFusion)
Pump WG Chair: Jeff Rinda (Hospira)
Participating Member Organizations:
B.Braun (Al Engelbert)
Baxter (Anna Moeller, Pat Baird)
Capsule (Fred Ehrhardt)
CareFusion (Gregory Borges, Jeff Dern, Janet Ireland, Brad Lunde, Gary Meyer, Daniel Vik, Khalid Zubaidi)
ECRI (Erin Sparnon)
Epic (Colin "FX" Garstka)
Hospira (Jeff Rinda, Kristina Wilson)


Action Items

NOTE: The items in the table below are not in priority order - they are in the order of the discussion during the F2F meetings.


Number Action Owner Participants Due Date Status Comments
1 HL7 (v2/v3) Infusion Med Admin Extension Proposal Meyer Al, Jeff, Khalid, Ruth, Todd 2010.03.10 OPEN Develop a proposal to HL7 to extend both v2 messaging & v3 to support a more extended set of infusion pump medication administration orders. Initial proposal review shall be during the first infusion pump WG meeting after HIMSS '10 on Wednesday 2010.03.10. Target is to submit a proposal in time for consideration at the 2010 May HL7 meetings in Rio.
2 FDA Interop Workshop Link Cooper ... 2010.02.22 OPEN Post a web link for the presentations at the FDA Interoperability Workshop 2010.01.25-27 when it has been made public.
3 PCD Users Guide Comments Sparnon Jeff, Todd 2010.02.22 OPEN Post the Users Guide public comments based on the Pump Summit discussions to the RSNA site (www.IHE.net Handbooks page has link). Key considerations include:
  • Organization to make it easier for care providers to quickly get the information they need to make evaluation and purchasing decisions. (e.g., a "capability" (per HITSP/TN905) or "device modality" focus)
  • Create a map for locating clinical requirements within the IHE handbook, possibly as a separate appendix titled "Clinical Considerations".
  • Extend the RFP templating language - perhaps coordinate with ECRI in drafting & publication of statements
4 FDA "Thing" Test Scenario Support Cooper / Sparnon Gary, Jeff, Khalid, Pat 2010.03.10 OPEN Investigate the possibility of participating in the proposed FDA "Thing" Trial Submission, based on IHE (PCD) interoperability profiles supporting enterprise integration. This may be based on the medication administration diagram (see presentation at the Summit).
5 Update Infusion Terms in the Rosetta Lunde Al, Fred, Kristina, Pat, Todd 2010.04.14 OPEN Update the infusion pump terms in the Rosetta tables, including:
  • Assignment of term codes for the MDC_ATTR_AL_COND enumerations
  • Units (incl. proposed from Al)
  • <alarm proposals>
  • <event proposals>
  • <parameter proposals>
NOTE: Lunde - check which other term codes are missing ...
6 Clarify TF vol 2 re. 11073/Rosetta Usage Cooper ... 2010.03.10 OPEN Clarify in the PCD technical framework volume 2 appendix D the requirement to use 11073 semantics + those contained in the harmonized Rosetta tables.
7 IOP/IOC "Source of Truth" Sync Meyer Al, Colin, Erin, Khalid, Rinda, Todd 2010.05.01 OPEN Update the PIV supplement to address synchronization issues when parameters in a PCD-03 are not actioned by the IOC. Updates include:
  • Develop use case scenarios to better define the problem space.
  • Add text describing the "source of truth" problem and need to address both in system interface design + clinical workflow / policy definition. For example, the clinician may need to be alerted on both systems
  • IF PCD-03 parameter(s) are not acted upon in the IOC, an application error should be returned indicating the error condition. This response may (optionally) include the actual value that was used on the pump.
  • HL7 Table 0533 (in the supplement, section 3.3.5.3) needs to be extended to include these conditions, including rate mismatch ("dose rate differs from drug library starting dose")

Additional Issues:

  • (Meyer) to determine ability to signal the issue in the application ack w/o signaling an error.
  • Mechanism for the IOP to override a parameter based on clinician input. Determine need / approach.
  • Determine whether a set of events (vs. PCD-01 parameter updates) could be used for critical sync issues or parameter change notifications.
  • Evaluate benefits of an IOC always issuing an enhanced ack, regardless of error condition presence.
8 Clarify Reporting of Out-of-Scope Parameters Cooper / Rhoads Brad 2010.03.10 OPEN Clarify the Technical Framework vol 2 wording around the reporting of parameters that are either out-of-scope (based on the device's operational mode & state) or questionable status. Approach should be:
  • If the value is displayed, it should be reported
  • If it is out of scope, the DOR may choose not to report it and omit the OBX
  • If it does include the OBX, appropriate status should be included (e.g., based on special values such as NaN, MetricStatus or MeasurementStatus ... from the 11073-20101 & 11073-10201 standards).
9 NIST HL7 Validation Tool Feedback Lunde Todd 2010.03.10 CLOSED Provide feedback to NIST regarding experience using the HL7 validation tool during the 2010 Connectathon cycle. Feedback should include:
  • Copy & paste into tool window is ... painful and time consuming. A more automated approach would be very useful.
  • Dynamically updating tables (e.g., patient names) or turning off / reducing alert level of certain conditions would facilitate tool usage.
  • ...
10 IHE PCD 2010 May F2F Agenda Cooper Al, Gary, Jeff, Khalid 2010.05 OPEN Include on the IHE PCD 2010 May F2F agenda:
  • Review infusion pump model definitions as formalized in the NIST ICSGenerator tool.
  • Concurrent pump discussion
  • ...
11 Update enhanced ACK handling PCD TF vol 2 FX Al, Brad, John R., Kristina, Ruth, Todd 2010.03.10 OPEN Update the IHE PCD Technical Framework volume 2 to:
  • Reference HL7 v2.6 2.9.3 in the TF's discussion of acknowledgement handling.
  • HL7 standard practice is that the enhanced ack is returned on a separate channel / pipe.
  • Provide an example of the workflow around an IOP-IOC-Pump interaction.
12 Coordinate PIV Supplement Updates w/ TF ver 2.0 Drafting Rinda John R., Ken, Todd 2010.06.01 OPEN Ensure that supplement updates to PIV are coordinated in the version that is being rolled into the updated technical framework (for trial implementation).
13 PCD-02 "one shot" Specification Lunde Al, Gary, Kristina, Paul 2010.04.07 OPEN The current PCD-02 specification does not detail how a "one shot" function should be implemented. The spec should be updated to:
  • Specify the approach for "one shot" usage. Note: a current practice is to utilize subscription start and end times, where the effective window is shorter than the update period.
  • Clarify what happens if no filter specification is active.

Note: Review filter predicate proposals from the IHE PCD F2F meetings 2008 October for possible inclusion in this update activity.

14 Develop Event Comm Transaction Proposal Cooper Al, Brad, Colin, John R., Khalid, Kristina, Paul 2010.03.10 OPEN Based on the Summit discussion, further investigate event reporting options and propose a direction at the 2010.03.10 Pump WG WebEx meeting. Options include:
  • As part of DEC using existing actors
  • As part of DEC w/ Event Reporter actor
  • As an option of DEC: Event Communication

The proposed transaction (PCD-99) is tailored for for episodic event communication using ORU^RO1, possibly using MSH message type OID to identify event message (vs. yet another trigger), to support CDSS & workflow automation types of applications

Additionally,

  • Update DEC language for usage of PCD-01 to report events for data logging / archival purposes vs. -99
  • Use the same data formatting (i.e., OBX sequence) for both PCD-01 & -99 transactions
See Summit notes for additional information.
15 Develop Infusion Pump Event Content Proposal Cooper Al, Anna, Brad, Colin, Erin, John R., Kristina, Pat, Paul 2010.03.10 OPEN Develop a proposal for the infusion pump event set + content, factoring in...
  • Event model developed by the Infusion Pump WG during the 2009.10 F2F meetings in Dallas
  • Additional event content discussions during the 2010.02 Summit
  • Early set of proposed events from consumer applications (e.g., from Epic & GE)
  • General event comm. modeled approaches based on 11073-10201 Information Model
  • Coordination / input from the ICE-PAC group & extended set of "consumer" application vendors (e.g., VA, Meditech, etc.)
16 Develop Basic Program/Mode-based Reporting Proposal Cooper Al, Brad, Colin, Erin, Fred, Kristina, Pat 2010.03.17 OPEN Based on the discussions to date, develop a proposal for reporting basic infusion therapy / mode-based data model & messaging. Initial focus is on primary, piggyback & bolus. Additional therapies factored in subsequently.
17 <tbd> <dude> <group> <2010.02.16> OPEN ...
18 <tbd> <dude> <group> <2010.02.16> OPEN ...
19 <tbd> <dude> <group> <2010.02.16> OPEN ...
20 <tbd> <dude> <group> <2010.02.16> OPEN ...
21 <tbd> <dude> <group> <2010.02.16> OPEN ...
22 <tbd> <dude> <group> <2010.02.16> OPEN ...
23 <tbd> <dude> <group> <2010.02.16> OPEN ...
24 <tbd> <dude> <group> <2010.02.16> OPEN ...
25 <tbd> <dude> <group> <2010.02.16> OPEN ...
26 <tbd> <dude> <group> <2010.02.16> OPEN ...
27 <tbd> <dude> <group> <2010.02.16> OPEN ...

Discussion

  • <link to discussion notes on ftp site>

Next Meeting

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(Reviewed & approved by <meeting wiki page reference>)


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