PCD Profile RTM Proposal Brief

1. Proposed Workitem: Rosetta Terminology Mapping [RTM]

• Proposal Editor: Todd Cooper & Paul Schluter
• Editor: Todd Cooper & Paul Schluter
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: Patient Care Device

2. The Problem

The majority of PCD devices use vendor-specific or proprietary nomenclatures and terminologies. As a result, even though information may be exchanged using standards-based transactions such as Device Enterprise Communication, semantic interoperability is not achieved until the content is mapped to a standard representation. This mapping is often inconsistent and subject to loss of information (e.g., mapping from a specific term to a more general semantic). Also given the lack of tooling, utilizing standardized medical device terminology in production systems is difficult and often cost prohibitive.

This profile will focus on identifying a core set of semantcs that are shared between multiple devices with the same modality (e.g., physiological monitors, ventilators, infusoin pumps, etc.), and then mapping them to a standard terminology. This will include both parameters, as well as their associated units of measurement and in some cases enumerated values. Additionally, this "Rosetta Stone" map shall be realized in a representation that facilitates usage in production systems (e.g., XML).

It should be noted that during this analysis, gaps in the standardized medical device terminology shall be identified. In these cases, proposals shall be made for adding the semantics to the appropriate terminologies. Note also that though the immediate focus of this profile will be to standardize the content in transaction profiles such as DEC, which are typically between a device data gateway and enterprise level applications, the standardized terms should also support direct device communication, enabling semantic interoperability literally from the sensor to the EHR.

<Paul: May also want to mention the fact that the lack of semantic interoperability limits real-time clinical decision support, smart alarms, safety interlocks, clinical algorithms, data mining / research etc. Also should we mention the various classes of information so that it is clear that it isn't simply parameters, but settings, monitors, device ID & configuration, R-T waves, etc.?>

3. Key Use Case

<Paul: Probably only need a single scenario similar to the last showcase, where a patient starts at home, uploads their information to their PHR, goes into the ER, then to OR then to ICU...similar physiological information is uploaded to their EHR from multiple make&model devices and systems>

<Paul: We could also include an ICEie type use case example or an anesthesia record analysis example>

4. Standards & Systems

<ISO/IEEE 11073-1010x nomenclature/terminology>

<UCUM>

<...>

5. Discussion

1. Detailed mapping content should not be included in the RTM profile document, but in separate files that could be more easily updated and manipulated.
2. Issue: Addressing gaps and having them quickly addressed by the appropriate standards organization
3. ...