PCD Brief Profile Proposal 2008 QBD

1. Proposed Workitem: Query for Bulk Data [QBD]

• Proposal Editor: Ken Fuchs / Jack Harrington
• Editor: Ken Fuchs
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: Patient Care Device

2. The Problem

In multiple HIMSS surveys the respondents identified Cross Enterprise Sharing of Patient Care Device Data as their highest priority. Goals include increased shortening decision time, increasing productivity, minimizing transcription errors, and obtaining increased contextual information regarding the data.

Within the PCD various profiles address access to “real-time” streams of patient data such as parameters, settings, alarms and waveforms. This data can also be stored in various types of “simple” data archives such as trend data archives, data logs, full-disclosure logs which can be located in simple patient-specific archives or more complex central-server multi-patient archives.

The scope of this proposal is a consistent mechanism for querying and retrieving bulk data from archives of structured time-based data typically acquired from “real-time” streams. The archives themselves can be built using other PCD profiles based on DEC and/or DPI and/or proprietary vendor protocols. The retrieval approach is proposed to be limited to patient-specific, “simple” queries which will allow the querier to discover for what data period data is available, what data types are available and ask for a bulk data transfer of specific data types over a specified time period.

This is not intended to be used as a general querying mechanism of EMR, EHR, CIS or other complex databases but could be used by these kinds of systems to populate their own archives.

Examples of patient care device data included in this profile include, but are not limited to, discrete vital signs parameters, infusion rates and constituents, ventilation rates and settings, and snapshots of waveforms.

3. Key Use Case(s)

1. Bulk Data Retrieval from a Patient Care Device. - Periodic data from the patient care device is stored within the device such as discrete and continuous (waveform snapshot). The primary intent is communication of structured data however provisions are made for inclusion of unstructured data. Other devices or systems are able to retrieve data using a query and retrieval mechanism which is independent of the local storage implementation.
2. Storage and retrieval from a Patient Care Device Manager. - Periodic data from all of the patient care devices associated with a particular patient are communicated to a Patient Care Device Manager. Examples include data from a bedside monitor, point of care lab devices, ventilators, and infusion pumps. Both discrete and continuous (waveform snapshot) data are communicated to the Patient Care Device Manager. The primary intent is communication of structured data however provisions are made for inclusion of unstructured data. The patient associated with the data may be identified by the device from which it is gathered and the data is time stamped with a consistent time across the respective patient care devices. Interested devices or systems are able to retrieve data using a query and retrieval mechanism which is independent of the local storage implementation.
3. Storage and retrieval from a Full-Disclosure System. - Periodic data from all of the patient care devices (or patient care device managers) associated with a number of specified patients or beds. Both discrete and continuous (waveform snapshot) data are collected by the Full-Disclosure System. The primary intent is communication of structured periodic data however provisions are made for inclusion of unstructured and aperiodic data. Interested devices or systems are able to retrieve data using a query and retrieval mechanism which is independent of the local storage implementation.
4. Storage and retrieval from a Forensic Log. - Aperiodic event data from all devices associated with a patient are stored in a Forensic Log. This log may include alarm events, settings changes, configuration changes, error messages, etc. which can be used to track the equipment interactions. This would be similar to an airplane Black Box which data can be used to assist in discovery after a critical event. The primary intent is communication of structured aperiodic data however provisions are made for inclusion of unstructured data. Interested devices or systems are able to retrieve data using a query and retrieval mechanism which is independent of the local storage implementation.

4. Standards & Systems

ISO/IEEE 11073-10101 Health informatics — Point-of-care medical device communication — Part 10101: Nomenclature, First edition, 2004-12-15. ISO and IEEE, 2004.

DICOM

CLSI-POCT

The ‘Unified Code for Units of Measure’ (UCUM), [1].

Health Level 7, version 2.5 (which supports large observation messages)

5. Discussion

Cross enterprise sharing of patient care device data has been identified as the top priority in a HIMSS survey. This proposal complements the Cross Enterprise Sharing of Patient Care Device Data-Asynchronous proposal by considering the storage and subsequent retrieval of the PCD data. There are a number of standards which can be used for this purpose and there is a need to select the appropriate profiles among those standards to meet use cases of sufficient breadth to be of interests to both the clinical user and patient care device vendor communities. The proposed profile addresses a broad range of uses of patient care data which do not require “real-time” storage and retrieval.