PCD Showcase 2009 Scenario
Establishing Page
Patient Care Device Domain HIMSS 2009 Showcase Scenario Development
This page is provided to
- facilitate development of the Showcase demonstration and its clinical story
- enable the participating companies to post and refine their portion of the Showcase scenario and to develop their "script".
Companies and Systems
B Braun, Capsule, Cardinal Health, Cerner, Draeger, Epic, GE Gateway, GE Centricity Periop, GE Centricity Enterprise, Hospira VeriScan, Hospira MedNet, LiveData, Philips CIS, Philips IIC, Philips Emergin, Polycom
Settings and Tours
The physical structure will have four walls, which will display devices and systems that contribute to improved patient care, safety, workflow and/or productivity because of interoperability.
Three of the walls demonstrate specific devices and systems within a clinical scenario. The scenario is summarized below. Further down, each step in the scenario is described in greater detail by the company providing the device/system.
Three clinical "sites" are provided: OR, ICU, Step Down (SD). Visitors will participate in tours that start in one of these three areas and proceed to the next (OR to ICU, ICU to SD, SD to OR). Tours will rotate. Some devices/sytems participate in every tour that includes a site they participate in, while others rotate.
Docents will bring a group of visitors to the PCD structure and provide an introduction to the portion of the scenario they will see, and will seek a volunteer in the group to act as the patient for the demonstration.
Vendors will describe their contribution to interoperability, the benefits and the nature of their systems (see developing scripts, below)
Overview of the Scenario
Male patient, 65 years, BMI 32, weight 90 kg, coronary artery disease (AMI 6 months ago), moderate COPD (smoker), compensated renal insufficiency (40% GFR). Adenocarcinoma of the lower esophagus (close to the entry into the stomach), scheduled for gastrectomy and distal, transabdominal esophagectomy.
OR
Patient needs full invasive CV monitoring starting at induction.
Patient identified on each of the 3 vendor pumps and started on 3 infusions: Dextrose 5% 1000 mL @ 75 mL/hr, propofol, 1000 mg/ 100 mL @100 mcg/kg/min and morphine 100 mg/ dextrose 5% 100 mL @ 1 mg/hr. Status of all 3 infusions is viewable on monitors via PCD01/02
Intensive Care Unit
After surgery patient remains intubated and is transferred to ICU. After initial stabilization (fluids according to CO and SvO2, low dose Dopamine), rapid weaning of the ventilator on SmartCare/PS.
Using PIV, the nurse uses BCMA to send low dose Dopamine 400 mg in Dextrose 5% 250 mL @ 2.5 mcg/kg/min) to pump to aid kidney perfusion. The infusion status is viewable on monitors via PCD01/02
The patient is extubated 12 hours after admission to ICU. Ventilator Alarms are managed, routed and displayed Discharge to SDU after 36 hours.
Step-Down Unit
On SDU patient require still monitoring of HR, BP, RR and SpO2 (RR and SpO2 due to COPD).
Antibiotic continued for 72 hours. Vancomycin 1 g in Dextrose 5% 250 mL is infused over 60 minutes via IV device. Using PIV, the nurse uses BCMA to send Vancomycin order data to pump. The infusion status is viewable on monitors via PCD01/02
Clinical Sites and Steps
The Scripts supporting the demonstration in each site are provided in the next section, below.
Operating Room (OR)
Step | Company | System | Type | Function | Actor | Role |
---|---|---|---|---|---|---|
1 | Epic or GE, alternating | Inpatient EMR or Centricity Enterprise | EMR | Patient ID, Admit | PAM | Admit patient, generate bar code and MRN; this step takes place only when tour starts in OR; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving |
2 | Draeger | Infinity Gateway | Gateway | Phys Mon | DOR | Patient attached to physiologic monitor |
3 | B Braun or Cardinal or Hospira, alternating | Pump | Pump | Pump | DOR | Connected to patient for drug delivery |
4 | GE | Periop Anesthesia | CIS | Display | DOC | Display data the system received consistent with the Scenario |
5 | LiveData | OR Dashboard | Dashboard | Display | DOC | Display data the system received consistent with the Scenario |
6 | LiveData | OR Dashboard | Send Alarm | Alarm | AR | Local workflow alarm |
7 | Philips Emergin | Alarm Manager | Receive Alarm | Alarm | AM | Receive alarm, forward to Polycom, receive response |
8 | Polycom | SpectraLink | Clinician's Phone | Alarm | AC | Receive alarm, respond to AM |
9 | Epic or GE, alternating | Inpatient EMR or Centricity Enterprise | EMR | EMR | DOC | All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU |
10 |
Intensive Care Unit (ICU)
Step | Company | System | Type | Function | Actor | Role |
---|---|---|---|---|---|---|
1 | Epic or GE | Inpatient EMR or Centricity Enterprise | EMR | Patient ID, Admit | PAM | Admit patient, generate bar code and MRN; this step takes place only when tour starts in ICU; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving |
2 | GE or Capsule | Gateway or DataCaptor | Monitor & Central St or Middleware/Gateway | Display | DOR or DOR and AR | NOTE: Patient attached to physiologic monitor; if Capsule connects unique devices it will become step 3; it may be moved to SD |
3 | Capsule | DataCaptor | Middleware | Gateway | DOR, AR | Can be step 3 if unique devices attached |
4 | Philips | Intellivue Clin Info Portfolio | CIS | Display | DOC, AR | Display of all data the system received consistent with the Scenario |
5 | B Braun and Cardinal and Hospira | Pumps | Pumps | DOR, IOC and AR for Cardinal, Hospira | Pump(s) added; PIV to be employed | |
6 | Cerner or Epic | CareMobile or Inpatient EMR | BCMA or EMR | BCMA | DOC, IOP | Employ PIV |
7 | LiveData | OR Dashboard | Alarm | Alarm | AR | Send alarm, later receive clinician acknowledgement |
8 | Emergin | Alarm | Alarm | AM | Receive alarm, forward to Polycom, receive response, forward to AR | |
9 | Polycom | SpectraLink | Phone | Alarm | AC | Receive alarm, respond to AM |
10 | Epic or GE, alternating | Inpatient EMR or Centricity Enterprise | EMR | EMR | DOC | All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU
|
Step Down Unit (SD)
Step | Company | System | Type | Function | Actor | Role |
---|---|---|---|---|---|---|
1 | Epic or GE | Inpatient EMR or Centricity Enterprise, alternating | EMR | Patient ID, Admit | PAM | Admit patient, generate bar code and MRN; this step takes place only when tour starts in SD; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving |
2 | Philips | Intellivue Info Ctr | Monitor | Phys Mon | DOR, AR | Obtain data, forward to EMR; for Philips, participate in ACM |
3 | Cerner | CareAware | Middleware | Gateway | DOR | Connected to both beds (ICU, SD); need to determine what is displayed |
4 | Draeger | Innovian Web | CIS | CIS | DOC | Display of all data the system received consistent with the Scenario |
5 | GE or Hospira | Centricity Enterprise or VeriScan | BCMA | PIV | IOP | Employ PIV |
6 | B Braun and Cardinal and Hospira | Pumps | Pumps | DOR, IOC and AR for Cardinal, Hospira | Pump(s) added; PIV to be employed -- but no description if this follows ICU where this was described | |
7 | LiveData | Alert Manager | Alarm | Alarm | AM | Receive alarm, forward to Polycom, receive response |
8 | Polycom | SpectraLink | Phone | Alarm | AC | Receive alarm, respond to AM |
9 | Epic or GE, alternating | Inpatient EMR or Centricity Enterprise | EMR | EMR | DOC | All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU
|
10 |
Scripts
<Please assure that your script is properly placed by Step Number within the Scenario>
Operating Room (OR)
1
2
3
4
5
6
7
8
9
10
Intensive Care Unit (ICU)
1
2
3
4
5
6
7
8
9
10
Step Down Unit (SD)
1
2
3
4
5
6
7
8
9
10
Links
http://wiki.ihe.net/index.php?title=PCD_Connectathon%26Showcase_WG_2008-9