PCD PC&TC 2010-05-03 to 07 F2F

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Meeting Objectives

These face-to-face meetings have a number of objectives depending on the committees involved:
  • Planning Committe: Review overall PCD activities, identify strategic next steps and update the "roadmap"
  • Technical Committee: Review all materials slated for publication in May / June and resolve any issues so that final editing and publication may proceed.
  • SDOs: There may be meetings Friday, Saturday (TBD).

Schedule & Agenda

Daily Schedule
08:00 - 08:30 Check in
Meeting will start promptly at 08:30 each day.
08:30 - 10:30 Session #1
11:00 - 12:30 Session #2
12:30 - 13:30 Lunch (location to be announced)
13:30 - 15:00 Session #3
15:30 - 17:00 Session #4


NOTES:
1. Additional evening working sessions may be scheduled as needed
2. Thursday the main PCD TC plenary meetings will end by 15:00
3. Friday the DPI / ICE-PAC WG meetings will end by 15:00
4. Thursday we have an optional tour of the simulation facility after 1500



Date Hours Committees Topics
Monday Q1

2010.05.03

08:30 - 10:30 IHE-PCD
Monday Q2-Q4

2010.05.03

11:00 - 17:00 PCD Planning Committee
- Technical Framework Updates
- Profile Development: Existing & New
- International PCD Activities
- Inter-domain Coordination
- Continua Coordination
- ICE-PAC Coordination
- Topic: Data acquisition modalities between enterprise applications & device data sources (e.g., PCD-02 retrospective queries for CDSS support)
- Topic: ARRA / HITECH & HIMSS MD&PS Meaningful Use Analysis: Valid?
- Topic: HITSP/TN905 Roadmap: Valid? Gaps?
- Topic: Medication Administration / Infusion Pump Integration Requirements
- Topic: Alarm Management: CE-IT Convergence meets Patient Safety
- Topic: Ventilation Requirements
- Open Discussion & Prioritization ("What do we need to do immediately?!")
  • Identify Key Interoperability Issues
  • DPI, ICE-PAC requirements
  • Review & Update PCD Roadmap (incl. per TN905 Roadmap)
Tuesday

2010.05.04

08:30 - 12:30 PCD Planning & Technical Committees
NOTE: Infusion Pump Working Group Breakout Tuesday A.M.
The infusion pump breakout has been canceled due to travel issues that have reduced the number of participants. It is anticipated that the proposed topics will be addressed in a number of subsequent WebEx sessions in May and June.
Tuesday

2010.05.04

13:30 - 17:00 PCD Technical Committee
  • HIMSS '11 Showcase Discussion
- Conceptual Approach
  • AAMI '10 Annual Conference
  • 2011 European Connectathon & PCD
  • PCD-enabled Products
  • PCD Marketing & Funding
- PCD "Success Stories" (Sparnon/IHE Marketing Cmte)
- Webinars, Presentation Slide Sets & Publications
- Web Presence Review
  • PCD Technical Framework Status Update
  • Review - Technical Framework Revision
- Volume 1
- Volume 2
  • Issue: Partitioning of HL7 specifications between TF v2 & v3 (& v4)?
  • Issue: Incorporating HL7 v3 specifications?
  • Issue: Single Specification for Generic HL7 v2 "Common Segments"?
  • Issue: HL7 v2.5 => v2.6 ...
- OBR Field specifications
- RE & "ignore if not specified"?
- National Extensions
Wednesday

2010.05.05

08:30 - 17:00 PCD Technical Committee
  • Technical Framework vol 2 Issue Discussion (continued)
  • DEC Updates
- PCD-02 "One Shot" Proposal
- Additional PCD-02 Change Proposals
- PCD-01 Out-of-Scope Parameter Communication
- Enhanced ACK Handling (e.g., on a different pipe)
- ORU^R40 Alarm Trigger Change Proposal
- PCD-05 Change Proposals
- AM-AC Interface
Thursday

2010.05.06

08:30 - 17:00 PCD Technical Committee
  • Waveform Communication Management (WCM) Final pre-Public Comment Draft Review
ftp://ftp.ihe.net/Patient_Care_Devices/TechnicalFrameworkForPublicComment/SupplementsYr5-2010-11/
  • Rosetta Updates
- Units of Measure
- Infusion Pump Terms (incl. events)
  • IHT SDO Coordination Update
  • LOINC Mapping Update
  • Ventilator Modeling Review
LUNCH
  • HL7 v2 Data Type Questions (color & NA)
  • Updated Diagram for ACK Discussion
  • Event Communication (EC) Profile
  • ISO/IEEE 11073 Standards Status Update
  • KP Perspective & Charge for IHE PCD (George P.)
  • Adjourn Plenary IHE PCD TC Meetings
  • 15:30 - Tour of KP Sim lab (Garfield Center)
  • Post-Tour Dinner Discussion
Friday

2010.05.07

08:30 - 15:00 PCD Technical Committee Device Point-of-care Integration (DPI) WG
  • Review PCD DPI Development Status
  • KP Perspective on DPI
  • Review ICE-PAC Activities
  • Identify DPI-related requirements from preceding F2F Discussions
  • DPI Work Plan for 2010/11 Development Cycle
- Identify target use cases, esp. ICE functions
- Identify potential systems
- Detail standards & profile development requirements & milestones

Adjourn PCD TC Meetings by 15:00

Friday

2010.05.07

15:30 - 17:00 HL7 DEV WG Out-of-Cycle Meeting <this session is TBD>
  • ISO/IEEE 11073 & HL7 v3 Projects

Adjourn PCD TC Meetings by 15:00

Saturday

2010.05.07

08:30 - 15:00 HL7 DEV WG Out-of-Cycle Meeting
NOTE: The Saturday sessions have been canceled.

Location Information

Kaiser Permanente ("KP")
Meetings will be held at Kaiser's Clinical Technology Offices except on Thursday:
1795 Second St., Berkeley, CA 94710
Meetings Thursday May 6 are at the Sheraton Four Points SF Bay Bridge hotel
1603 Powell St., Emeryville, CA 94608, (510) 547-7888
There is an optional tour of the simulation laboratory late Thursday afternoon.
  • IMPORTANT REGISTRATION INFORMATION: Though there are no fees for this meeting, all participants must indicate their intention to attend by sending an advanced notification e-mail to Manny Furst (IHE PCD).
  • General location information:
Hotel:
You can make reservations at the Sheraton Four Points, San Francisco Bay Bridge in Emeryville. The hotel address is 1603 Powell St., Emeryville, 94608. Reference "PCD May Group" to make reservations. Group room rate is $95/night from Sunday through Friday. You can call directly to the hotel and ask for reservations: 510.547.7888 or call Sheraton central reservations at 800-325-3535.
Please stay at this hotel to assure that the minimum number of hotel rooms are used – this is required to obtain this low room rate and a reasonable cost for use of the hotel meeting room for Thursday’s meeting.
There is no charge for parking at the hotel.
Travel:
You can efficiently reach the hotel via public transportation from either Oakland International or San Francisco International. Ask for directions to BART (Bay Area Rapid Transit) at the airport and then take a bus. You may obtain detailed directions from Manny Furst (IHE PCD).
There are multiple ways to commute between the hotel and the Kaiser facility. These are about 3 miles apart. Driving (or taxi) will take about 7 minutes (details below). Amtrack is available about an eight minute walk from the hotel, and about a 7 minute walk from the destination station.
Parking is available on the street near the Kaiser office. There’s a parking lot, but currently construction personnel are arriving and filling the lot by 7:30 am. It will be available earlier, and if construction is complete by May 3.

Attachments / Materials

Reference materials can be downloaded from ftp://ftp.ihe.net/Patient_Care_Devices/IHEPCDyr5-2009-2011/F2F-May2010

Please note: some of the materials are in the recent Microsoft .docx, pptx formats. These have been converted to the earlier .doc and .ppt formats and are provided on the ftp site as well. Note: the conversions may have resulted in the loss of some details.

Decisions Summary

NOTE: These decisions are in addition to the action items listed above.

This section was established to track any items that came up that would require a ballot following the meeting.

No. Decision Date Description
1 xyz 2010.05.03
  • ...
2 xyz ...
  • ...


Action Items Summary

Action Items listed below were developed during the meetings.

PCD_Planning_Committee_Action_Items and

PCD_Technical_Committee_Action_Items

No. Action Item Owner Participants Due Open/Closed Description/Update
1 - - - - Open -


2 - - - - Open -
3 - - - - Open -
4 - - - - Open -


XX - - - - Open -


Meeting Minutes

Monday 2010.05.03

Participants, Monday Morning, The Overview:

Christel Anderson (HIMSS), George Bertos (Baxter), Brian Birch (Kaiser), Jon Blasingame (Philips), Anupriyo Chakravarti (Surgical Information Systems), Todd Cooper (Breakthrough Solutions), Bikram Day (Capsule), Ken Fuchs (Draeger), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Christof Gessner (MxDx), Paul Jones (Cisco), Paul Kelley (Washington Medical Center, representing AAMI), Allen King (Sutter), Curt Mah (Cisco), Dennis McIntosh (DocBox), Tapan Mehta (Cisco), Monroe Pattillo (Philips), Tracy Rausch (DocBox), John Rhoads (Philips), Jeff Rinda (Hospira), Christian Saucier (Hill-Rom), Paul Schluter (GE), Ioana Singureanu (VHA), Sjon Smith (Sutter), Erin Sparnon (ECRI Institute), Greg Staudenmaier (VHA), Jerry Tonies (Cisco), Axel Wirth (Symantec), Jan Wittenber (Philips

Webex: Ted Cohen, Ann Farrell, Karl Gumpper, Marcy Harris, Vineeta Khemani, Hank Mayers, Steve Merritt, Eric Nemec, Karen Pope, Connie Saltsman, Karen Sherrerd, Luigi Sison

Chairs: Ken Fuchs, Steve Merritt

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS

  • Todd presented the overview. The slides are available at _____________ . Some of the key discussion points are:
• Promise, yet to be seen, to improve vendors' and users' ability to meet regulatory requirements
• Benefits for companies marketing internationally
• Slides by Luis Melendez and Erin Sparnon illustrate the complexity and difficulty of achieving the promise of interoperable and well designed systems. It includes all the other systems and clinical activities that need to be integrated into the overall solution.
• Ken’s slide “Who means what?” indicates the many ways the problems are cast
• Todd noted the significant differences between enterprise and point of care integration.
• Ken noted that certification is a critical future component; this will assure that systems that are said to be conforming actually meet all requirements.
• Todd noted that the IEEE, CEN, HL7, and IHT SDO are now collaborating within ISO 215 WG7 to seek well coordinated harmonized standards.


Participants, Monday Morning, Scheduled to Follow the Overview:

Christel Anderson (HIMSS), George Bertos (Baxter), Brian Birch (Kaiser), Jon Blasingame (Philips), Anupriyo Chakravarti (Surgical Information Systems), Todd Cooper (Breakthrough Solutions), Bikram Day (Capsule), Ken Fuchs (Draeger), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Colin Gartska (Epic), Christof Gessner (MxDx), Paul Jones (Cisco), Paul Kelley (Washington Medical Center, representing AAMI), Allen King (Sutter), Curt Mah (Cisco), Dennis McIntosh (DocBox), Tapan Mehta (Cisco), George Panagiotopoulos (Kaiser), Monroe Pattillo (Philips), Tracy Rausch (DocBox), John Rhoads (Philips), Jeff Rinda (Hospira), Mike Romig (Patient Solutions), Christian Saucier (Hill-Rom), Paul Schluter (GE), Ioana Singureanu (VHA), Sjon Smith (Sutter), Erin Sparnon (ECRI Institute), Greg Staudenmaier (VHA), Jerry Tonies (Cisco), Axel Wirth (Symantec), Jan Wittenber (Philips), Vaughan Zakian (Nuvon)

Webex: Steve Merritt

Chairs: Ken Fuchs, Steve Merritt

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion


1 Opening the PC Meeting Status/Discussion:
  • Ken opened the meeting by reviewing today’s agenda. Participants introduced themselves.
  • Ken led discussion of the IP Policy, using the slides provided by IHE.
2 European and Asian Activities Status/Discussion:
  • Christof and Bikram summarized recent European activities. Christof observed the need for more user participation in their effort. Bikram mentioned the small showcase in Belgium. Both groups expect more participation next year. Todd noted IHE-Japan’s recent deployment and IHE-Korea will hold its first Connectathon in August.

Decisions/Issues:

Action(s):

3 IHE Strategic Plan Status/Discussion:
  • Todd reported that Karen Witting will be ITI’s liaison to PCD for coordination and support as the IHE develops the overarching strategic plan.

Decisions/Issues:

Action(s):

4 IHE-Continua Collaboration Status/Discussion:
  • Paul described the IHE-Continua collaboration supporting the use of PCD-01 profile for communication. The MDC Codes for observables and constraints developed by Continua will be made public, enabling a single harmonized Rosetta table supporting home health as well as acute care. PCD-01 was updated via CPs to accommodate this effort as well as several corrections.

Decisions/Issues:

Action(s):

5 ICE-PAC WG Status/Discussion:
  • Tracy provided update of the ICE-PAC WG which is a joint WG with ASTM and IHE focused on the point of care (POC). There are implications beyond the POC. The WG has analyzed 7 scenarios in the ASTM F2961 Standard, nearly complete on IV pumps, and conducting analysis of the ventilator process. The ventilator effort is much more complex than the pump effort. The hazard analysis becomes more complex and more hazards arise as multiple device types are included. Their work product will provide requirements for meeting clinical needs, but will not specify the technical solution. Please see the slides for more information _____. Jan noted that ventilator parameters were not well structured when that work began, so much effort has been devoted to this. They have also attempted to represent the many different workflow approaches used and have looked at common elements.

Decisions/Issues:

Action(s):


6 Veterans Health Administration’s update Status/Discussion:
  • Greg and Ioana provided the Veterans Health Administration’s update immediately after lunch. The VHA’s stakeholders were surveyed. The VHA has identified medical device interoperability as a priority. Motivators include moving the existing individual site based approaches to a system wide approach; ARRA; and leveraging the size and influence of the system. Current objectives include stakeholder forum that includes clinical engineers, patient safety, IT in the VHA; communicating with users such as Kaiser and Sutter and with SDOs and others. The effort is focused on using existing standards.

Decisions/Issues:

Action(s):


Participants, Monday Afternoon:

Christel Anderson (HIMSS), George Bertos (Baxter), Brian Birch (Kaiser), Jon Blasingame (Philips), Anupriyo Chakravarti (Surgical Information Systems), Todd Cooper (Breakthrough Solutions), Bikram Day (Capsule), Ken Fuchs (Draeger), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Colin Gartska (Epic), Christof Gessner (MxDx), Chad Hays (Cerner), Sarah Hopkins (Cerner), Paul Jones (Cisco), Paul Kelley (Washington Medical Center, representing AAMI), Allen King (Sutter), Kurt Mah (Cisco), Dennis McIntosh (DocBox), Tapan Mehta (Cisco), George Panagiotopoulos (Kaiser), Monroe Pattillo (Philips), Tracy Rausch (DocBox), John Rhoads (Philips), Jeff Rinda (Hospira), Mike Romig (Patient Solutions), Christian Saucier (Hill-Rom), Paul Schluter (GE), Ioana Singureanu (VHA), Sjon Smith (Sutter), Erin Sparnon (ECRI Institute), Ken Staudenmaier (VHA), Jerry Tonies (Cisco), Axel Wirth (Symantec), Jan Wittenber (Philips), Vaughan Zakian (Nuvon)

Chair: Ken Fuchs

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion


1 User Handbook Status/Discussion:
  • Ken described the User Handbook, its utility and implications for the purchaser. He described the information to be found in the Table of Contents. Erin is developing language for RFPs that is meaningful to clinicians. Ioana offered to help. Christof suggested that HIMSS’ Patient Safety publication be integrated with the User Handbook. Christel noted this; she and Erin described the differences with the CE-IT Quick Start Guide. Erin indicated that the Quick Start Guide looks at ARRA, showing devices do contribute to meaningful use.

Decisions/Issues: Action(s):

  • Erin is developing language for RFPs that is meaningful to clinicians. Ioana offered to help.
  • Christof suggested that HIMSS’ Patient Safety publication be integrated with the User Handbook.
2 Clinical System Integration Workshop Status/Discussion:
  • Topic: Data acquisition modalities between enterprise applications and device data sources (e.g., PCD-02 retrospective queries for CDSS support):
  • Topic: Medication Administration/Infusion Pump Integration Requirements:
- Erin raised the issue of workflow – e.g., infusion pump messaging takes too long, hospitals complain. Christian observed that clinicians need an indication when data is not reliable for the purpose (e.g., latency, other). John Rhoads indicated that applications need to specify their own behavior. John Garguilo suggested that the implementation guide needs to address these issues.
  • Topic: Alarm Management:
- Brian raised the questions (a) of the ability of the alarm to work when the distances are on the order of 1000 miles, (b) what is the topology for a network that may fail? While wired systems are more reliable, it is necessary to run many systems wirelessly. Monroe noted that priorities established by different devices differ (may want high level alarms on a pump to be different than the high level alarm on a monitor). Christian noted that the rank of the alarm levels may differ between clinical units. The Emergin system includes oversight and notification when the latency exceeds a certain level. Manny asked how 80001 fits into this. 80001helps proactively assess the design and control of these applications. Vaughan mentioned that their system monitors every element on the network. Christian says Hill-Rom’s has built in QoS monitgoring. He asked what built in alarm messages are needed by the User. Anupriyo noted that this should be addressed in the TF for all systems. Todd summarized: (a) build the ability to identify these issues and (b) implement a response. An alert and/or log should be sent/noted when it is needed. Tracy observed that these are two issues: a QoS and a QoD (quality of data) issues.
  • Topic: Ventilation Requirements
  • Topic: ARRA/HITECH & HIMSS MD&PS Meaningful Use Analysis:
- Ken and Todd presented a table showing how PCD profiles fit into the schedule for a few years. Refer to HITSP_V1.0_2010… For the most part, the PCD will have profiles in place or under development in time to meet HITSP 2011 deadlines. Gaps do exist, and will be addressed in the PCD roadmap and various TC agenda items. While in process, discovery and association issues won't fully be met. The 80000-1 will go to ballot in a few months.
- For 2012 many of the additional devices present an issue in locating interested vendors. This includes perinatal, RTLS, other profiles. Christian and Erin suggested middleware vendors would be more likely to participate. Christian and Barbara Majchrowski will share information and attempt to recruit participants. Bikram indicated that Capsule has a product. Comprehensive data archiving also presents a challenge. Vaughan offered his open source solution, including the service API and persistent data interchange format. Ken volunteered to work with Vaughan and noted that QBD (Query Bulk Data) was an early brief profile proposal that didn’t gain traction and might be a useful. John Rhoads joined the effort. The other challenge relates to the Medical IT-network management where wireless medical device networking and QoS alerting have not been addressed.

Decisions/Issues:

Action(s):

  • Implementation Guide should address issues raised above under Medication Administration/Infusion Pump Integration Requirements.
  • QoS and a QoD (quality of data) issues need to be addressed within the alarm/alert communications.
  • Christian and Barbara Majchrowski will share information and attempt to recruit participants to develop profiles and participate in subsequent activities.
  • Ken and Vaughan will address an open source solution to archiving persistent data.
3 PCD Roadmap Status/Discussion:
  • For 2009-10: Ken noted that WCM addresses snippets and continuous data, but doesn’t yet address retrospective data. Other deferred work includes HL7 v3.x wireless.
  • For 2010-11: For MEM Ken suggested that this broad profile is best handled by selecting one or two useful issues. Similarly, POC integration is best handled in segments. Additional work on semantic terminology will be addressed for device specialization and alarm communication, events. It is questionable if pharmacy terminology will be available next year. Several extensions are proposed for PIV, including PCA safety.
  • Jan observed that the roadmap doesn’t include an overarching integration of these various profiles and therefore, have core critical-mass functionality that forms a solid foundation. The solution vendors will provide the additional functionality. The lack of integration with other domains is additional evidence of this need. He recommends that vendors develop this IHE core.

Decisions/Issues:

Action(s):

  • Develop a strong core of functionality.
4 HITSP TN905 Roadmap Status/Discussion:
  • Todd asked if the roadmap is valid and if there are any gaps. Discussion did not raise any significant issues.

Decisions/Issues:

Action(s):

5 Recognition of Paul's Contributions Status/Discussion:
  • Jan presented an award to Paul Schluter in recognition of his work in developing the Rosetta Terminology project

Decisions/Issues:

Action(s):

Tuesday Morning PC and TC Meeting 2010.05.04

Participants:

Christel Anderson (HIMSS), George Bertos (Baxter), Jon Blasingame (Philips), Anupriyo Chakravarti (Surgical Information Systems), Todd Cooper (Breakthrough Solutions), Bikram Day (Capsule), Ken Fuchs (Draeger), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Colin Gartska (Epic), Christof Gessner (MxDx), Chad Hays (Cerner), Sarah Hopkins (Cerner), Vedran Jukic (Nuvon), Paul Kelley (Washington Medical Center, representing AAMI), Curt Mah (Cisco), Tapan Mehta (Cisco), Monroe Pattillo (Philips), John Rhoads (Philips), Jeff Rinda (Hospira), Mike Romig (Patient Solutions), Paul Schluter (GE), Ioana Singureanu (VHA), Erin Sparnon (ECRI Institute), Ken Staudenmaier (VHA), Kristina Wilson (Hospira), Jan Wittenber (Philips), Vaughan Zakian (Nuvon)

Webex: Al Engelbert, Tom Schultz

Chair: Ken Fuchs

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion
1 Agenda Review Status/Discussion:
  • Ken led a discussion of the agenda and Todd followed with a brief introduction to the work ahead.

Decisions/Issues:

Action(s):

2 Clinical System Integration Status/Discussion:
  • Todd emphasized the need for use cases that emphasize the benefits to clinicians. Jan emphasized the implications for contributions from multiple domains. This Anupriyo, Jon, Paul Kelley, Steve, Ken, George, Mike and Christel will address opportunities to increase clinician involvement (companies have clinicians who will contribute). Christel will coordinate. They will contribute to Use Case development.

Decisions/Issues:

Action(s):

3 Influences on PCD Status/Discussion:
  • Todd noted that global spread of PCD will require support for Connectathons and Showcases overseas.
  • Todd noted that additional sponsorship for PCD will be required, since additional support will be required beyond the ability of HIMSS and ACCE to support PCD.

Decisions/Issues:

Action(s):

4 IDCO Update Status/Discussion:
  • Tom Schultz provided an update on IDCO: Their nomenclature will be balloted by IEEE, including renewal of their Project Approval Request. They are forming the ballot group, and working with professional organizations to identify clinician participation and to make sure clinicians are well informed. Ken suggested they review the WCM effort to learn if that fits their plans. George asked if IDCO is coordinating with Continua. Tom indicated that there appears to be synergy, and they will look to Paul Schluter for guidance. Paul suggested that the WSI basic profile used by Continua would be appropriate yet not require Continua membership. He recommended WCM for the waveform and annotation and that this would be a good thing to work on in this next cycle. PCD-01 would serve this purpose. Paul suggested that they consider adding lab data. Manny asked what their plans are for the 2011 Connectathon and Showcase. Consistent Time and WCM might fit. Medtronic plans to participate.

Decisions/Issues:

Action(s):

5 NIST Tools and the 2011 Cycle Status/Discussion:
  • John Garguilo provided an update on NIST’s work in supporting PCD testing; with primary focus for the upcoming IHE-PCD cycle to verify messages. The web tools (developed last cycle and currently available) are available year ‘round. NIST is collaborating with Steve Moore with regard to the Gazelle work which to date mainly has been developed to superceed the existing IHE the administrative software. His PPT presentation is available on wiki site (see meeting agenda)_________ . Sandra Martinez (NIST) is defining in detail the requirements consistent with the profiles, TF and Supplements. Test Agents, referred to in the slides, are equivalent to Actors in the profiles. NIST has two test tools for PCD: Pre-Connectathon and Connectathon. Work is continuing to develop in software test system “Test Agents” as part of addressing instance and isolated environment type testing.
  • John mentioned the usefulness of the Message Workbench (MWB) developed by Peter Rontey of the VA. The MWB tool has utility for vendors with helping to develop profiles and can be used as an engine for both sending and receiving as a system (actor) (i.e., to test sending and receiving systems). NIST is working to provide this (or a similar) capability, but the no time frame has been identified. Manny noted that PCD participants post their sample messages, but without being assured that the messages are error free.
  • Todd noted that companies address greater rigor in their own testing than PCD is using. He asked if the other domains are seeking the same rigor in NIST’s tools as PCD is seeking, yet likely less than the rigorous testing by vendors.
  • John Garguilo went on to describe NIST Tooling to support the RTM process. This will permit users to add terms and to submit new terms to IEEE ballot process. The Rosetta Terminology Mapping Management System (RTMMS) slides are available on the meeting agenda page of the wiki . The system ‘use case’ works across three primary areas tied to variant user rolses (see slides). The RTMMS will serve vendors proposing additions and deletions as well facilitate discussion. Technical Experts/Reviewers and SDOs would ultimately ‘approve’ the terms as normative additions. General users can download the harmonized Rosetta terms. Jan noted that the RTM tables can be used to map terms and that the FDA will find this useful. This system also goes a long way to providing device terminology and co-constraints to the ITISDO work.
  • John Garguilo then addressed the ICS Generator: Using the device type it will provide the Domain Integration Model (DIM) that will constrain it to fit the model by functionality (e.g., infusion pump). It bridges X73 and IHE specifications (semantic content of HL7 message) and will be integrated with the test tools.
  • John suggested and Manny agreed that we, as a group, will begin meetings to review the existing test cases as well the test plans developed by NIST last cycle. Encourage at least a lead from each Integration Profile; with potentially meetings focused w/ individual Integration Profile groups. Suggested time frame includes later this month or early in June, with consideration of likely extensions as well. That will be followed by development of test cases for WCM.


Decisions/Issues:

Action(s):

  • Manny will schedule review of existing test cases and then extensions and new test cases.


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):

Tuesday Afternoon TC Meeting 2010.05.04

Participants:

Christel Anderson (HIMSS), George Bertos (Baxter), Jon Blasingame (Philips), Anupriyo Chakravarti (Surgical Information Systems), Todd Cooper (Breakthrough Solutions), Bikram Day (Capsule), Ken Fuchs (Draeger), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Colin Gartska (Epic), Christof Gessner (MxDx), Chad Hays (Cerner), Vedran Jukic (Nuvon), Paul Kelley (Washington Medical Center, representing AAMI), Monroe Pattillo (Philips), John Rhoads (Philips), Jeff Rinda (Hospira), Mike Romig (Patient Solutions), Christian Saucier (Hill-Rom), Paul Schluter (GE), Ioana Singureanu (VHA), Ken Staudenmaier (VHA), Axel Wirth (Symantec), Kristina Wilson (Hospira), Jan Wittenber (Philips), Vaughan Zakian (Nuvon)

Webex: Al Engelbert

Chair: Todd Cooper

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion
1 Greetings Status/Discussion:
  • Todd mentioned the IP requirements.
  • Todd reviewed the agenda for the rest of the week.

Decisions/Issues:

Action(s):

2 HIMSS11, AAMI10 and Other Showcase Plans Status/Discussion:
  • Manny discussed the plans for the AAMI Mini-Showcase and for HIMSS11. The plans are available at ___ . There appear to be four major themes for HIMSS11 and these are indicated with green highlighting. The Continua and Cardiology links may be linked to one wall with a theme of home to hospital communication. Other walls are:
- Medication Administration where an additional standalone wall will show a physician CPOE with a hospital pharmacy leading to IOP, IOC, DOR, etc.
- CDSS where lab and other domains will be represented at pods or another free standing wall.
- Clinical Workflow
-
  • Christof provided an update on IHE-Europe’s effort and indicated there will be come country based small demonstrations.

Decisions/Issues:

Action(s):

3 IHE Marketing Status/Discussion:
  • Erin requested short “success stories” for HIMSS marketing. Volunteers included Scott Zaffrin (B Braun), Mike (Patient Safe Solutions), Anupriyo (SIS).

Decisions/Issues:

Action(s):

  • Develop Success Stories - Erin, Scott, Mike, Anupriyo
4 PCD Implementations Status/Discussion:
  • Devices and Systems release of conforming products: B Braun has already released product; Emergin is releasing product in June; SIS is releasing product in January.
  • Integration Statements Page and Products Registry, under ihe.com is the place for companies to post products.

Decisions/Issues:

Action(s):

5 PCD Schedule Status/Discussion:
  • PCD needs to update the Wiki page with the schedule.
  • The group settled on dates for the PC/TC meetings in October and May. An additional TC meeting was to be scheduled for February but that was later placed on hold.

Decisions/Issues:

Action(s):


XX TF Update and Revisions Status/Discussion:
  • John Rhoads suggested that PCD remove items in the messages when not needed. The example offered was removal of specific, unused portions of the ADT demographics specifications. The response was to deemphasize those items without removing them.
  • John Rhoads referred to the transition to HL7 2.6 from 2.5. Ioana suggested that nothing other than the version and additional fields PCD needs will need to be changed as long nothing needed was deprecated. Paul suggested that no additional fields be added to the tables beyond the highest number PCD uses.
  • Todd recommended that all messages with OBXs be discussed in one place, identifying the commonalities and differences. Monroe suggested that this is especially beneficial when commonality exists for multiple transactions (e.g. PCD-01 and -04).
  • PCD placed the device identifier in the universal service id field. John suggested that a better use will be to use what Paul has suggested in the recent CP, recommending __________. John Garguilo suggested this is best handled in implementation guides.


Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):


XX Item Status/Discussion:

Decisions/Issues:

Action(s):

Pump Breakout, Tuesday Morning 2010.05.04

Cancelled

|}


Wednesday 2010.05.05

Participants:

Name - Member Organization, Name - Member Organization

Chairs: Todd Cooper, John Rhoads

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion
1 Item Status/Discussion:

Decisions/Issues:

Action(s):

2 Item Status/Discussion:

Decisions/Issues:

Action(s):

3 Item Status/Discussion:

Decisions/Issues:

Action(s):

4 Item Status/Discussion:

Decisions/Issues:

Action(s):

XX Item Status/Discussion:

Decisions/Issues:

Action(s):

Thursday 2010.05.06

Participants:

Name - Member Organization, Name - Member Organization

Chairs: Todd Cooper, John Rhoads

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS


Item Topic Discussion
1 Item Status/Discussion:

Decisions/Issues:

Action(s):

2 Item Status/Discussion:

Decisions/Issues:

Action(s):

3 Item Status/Discussion:

Decisions/Issues:

Action(s):

4 Item Status/Discussion:

Decisions/Issues:

Action(s):

XX Item Status/Discussion:

Decisions/Issues:

Action(s):

Friday 2010.05.07

Participants:

George Bertos (Baxter), Brian Birch (Kaiser), Jon Blasingame (Philips), Todd Cooper (Breakthrough Solutions), Manny Furst (Improvement Technologies), Carla Gallegos (Cisco), John Garguilo (NIST), Christof Gessner (MxDx), Peter Hendler (Kaiser), Michael Ly (Cisco), George Panagiotopoulos (Kaiser), Monroe Pattillo (Philips), Tracy Rausch (DocBox), John Rhoads (Philips), Paul Schluter (GE), Ioana Singureanu (VHA), Jerry Tonies (Cisco), Jan Wittenber (Philips), Vaughan Zakian (Nuvon)

Webex: Al Engelbert, Gary Meyer

Chairs: Todd Cooper, John Rhoads

Technical Project Manager: Manny Furst – Improvement Technologies/HIMSS

Friday Focused on the DPI Profile

Item Topic Discussion
1 Opening Remarks Status/Discussion:
  • Opening Remarks - George Panagiotopolous set the stage for the discussion:
- Patient-Device Association at the Point of Care (POC) is a major major problem
- All HIT resources (e.g., EHR, labs, ...) should be available at the POC without overly complicating / causing distractions in the care context.
- Context Awareness: When a device connects, its information and configuration should be managed based on the clinical context or "awareness" (e.g., patient morbidities, therapeutic intent, drugs being delivered, clinical unit (MICU vs. NICU), etc.)
- Medical device operational complexity-b-bad:
o Very frustrating for nursing staff, especially varying user interfaces within same modalities
o Holds back innovation
- Ubiquitous wireless sensors - decouple sensors from gateways to enable more local functions; incl. sensor data not available because patient is out of the bed...
  • Additional Remarks - Brian Birch / KP (CE perspective)
- MEM is very important
- Device performance monitoring to support "intelligent" PM
- Support Quality of Data specifications and monitoring
- Standardize the basic data streams in / out: Take care of the "boring" IT stuff!
  • Additional Remarks - Manny (CE perspective)
- Alarm management is very important (incl. the AM=>AC interface)
- PnP - Rapid device deployment & configuration is also VERY important
- PnP - Rapid reconfiguration support (not just hot swapping)
  • Additional Remarks - Peter Hendler / Brian Birch
- Must be open standards based
- Must make the I.T. connection ... work (baseline functionality)
- Data flows should be self-describing w/ metadata
- At least baseline functionality should be established w/ open standards-based solutions / higher-level functionality may initially be based on proprietary technology - w/o breaking the baseline
- Note: user interfaces is not directly the subject of IHE PCD efforts (IHE focuses on implementation of standards-based system interoperability, not how those systems support the clinical environment, for example)

Decisions/Issues:

Action(s):

2 Value Propositions Status/Discussion:
  • Lengthy DPI Value Propositions Discussion Ensued
- Jan W: primary persistent problem with DPI is aligning clinical/care provider VPs w/ technology provider VPs to establish the business case for developing, testing and deploying IHE PCD TF profile-based solutions
- ONC/HITSP? It was hoped that w/ the development of TN905, some VPs from the U.S. national ONC would be realized; however, since HITSP suspended activities there is the perception that this "VP" has disappeared; Tracy R. though reminded us that in Dr. Friedman's FDA (2010.01.25) presentation <see posted materials on the ftp site> he indicated the importance of device interoperability - which based on various discussions, is an educated opinion.
- Note: The "denovo submission" that was proposed at the end of the FDA Workshop in January is the subject of a planning group that meets weekly, including strong industry involvement.
- Jon B.: Doctors know need ... but not the difficulty in deploying solutions.
- George P.: Perhaps take a top-down / bottom-up "sandwich" approach, engaging a clinical group to drive requirements & "need" + technology providers working the solution ... IOW - addressing the chicken/egg problem.
- Paul S.: Continua ...
- Manny: Reiterated need for establishing a stronger clinical "users group"
- Tracy R.: The ICE use cases provide a strong VP / motivation (especially the X-Ray / ventilator sync clinical scenario)
- Group: DPI needs much better analysis of requirements matched w/ VPs; problem is that PCD focused on the "easy" stuff first ... DPI is hard

Decisions/Issues:

Action(s):

3 DPI/ICE-PAC Project Status/Discussion:
  • DPI/ICE-PAC Project Discussion
- DPI: Can we focus on semantic interop first? no need both SI + technical interoperability - PnP
- Note: Neither DPI nor ICE framework mandate a non-intermediary architecture (e.g., manager w/ agents)
- Multi-protocol support? Yes, but for example, an x-ray machine typically has two ports. One for exchanging imaging information using DICOM, and another service port that can be used for synchronization services.
- Briefly reviewed ICE-PAC work to date, focusing on infusion pump & ventilator work flow
- Project proposal: Device configuration transfer during patient transfer "handoffs"; semantics would focus on settings, technical interoperability would focus on DPI & facilitation of automated configuration / reconfiguration
- Events leading to handoffs:
o Device Failure ("hot swapping")
o Change in care context (equipment stays in context)
o Change in patient condition requiring more sophisticated equipment
o Wired-to-wireless transitions
o Co-existence of comm technologies: wired + telemetry + wireless Pumps
- Simple: change device w/ same make & model (risk management strategy!); proposal includes change between makes & models
- Synchronization must include clinical context/intent and not just blind settings

DPI: Can we focus on semantic interop first? no need both SI + technical interoperability - PnP

- Note: Neither DPI nor ICE framework mandate a non-intermediary architecture (e.g., manager w/ agents)
- Multi-protocol support? Yes, but for example, an x-ray machine typically has two ports. One for exchanging imaging information using DICOM, and another service port that can be used for synchronization services.
- Briefly reviewed ICE-PAC work to date, focusing on infusion pump & ventilator work flow
- Project proposal: Device configuration transfer during patient transfer "handoffs"; semantics would focus on settings, technical interoperability would focus on DPI & facilitation of automated configuration / reconfiguration
- Events leading to handoffs:
o Device Failure ("hot swapping")
o Change in care context (equipment stays in context)
o Change in patient condition requiring more sophisticated equipment
o Wired-to-wireless transitions
o Co-existence of comm technologies: wired + telemetry + wireless Pumps
- Simple: change device w/ same make & model (risk management strategy!); proposal includes change between makes & models
- Synchronization must include clinical context/intent and not just blind settings

DPI: Can we focus on semantic interop first? no need both SI + technical interoperability - PnP

- Note: Neither DPI nor ICE framework mandate a non-intermediary architecture (e.g., manager w/ agents)
- Multi-protocol support? Yes, but for example, an x-ray machine typically has two ports. One for exchanging imaging information using DICOM, and another service port that can be used for synchronization services.
- Briefly reviewed ICE-PAC work to date, focusing on infusion pump & ventilator work flow
- Project proposal: Device configuration transfer during patient transfer "handoffs"; semantics would focus on settings, technical interoperability would focus on DPI & facilitation of automated configuration / reconfiguration
- Events leading to handoffs:
o Device Failure ("hot swapping")
o Change in care context (equipment stays in context)
o Change in patient condition requiring more sophisticated equipment
o Wired-to-wireless transitions
o Co-existence of comm technologies: wired + telemetry + wireless Pumps
- Simple: change device w/ same make & model (risk management strategy!); proposal includes change between makes & models
- Synchronization must include clinical context/intent and not just blind settings

Decisions/Issues:

Action(s):

4 ICE-PAC Project Proposal Status/Discussion:
  • Project Proposal
- Next step: Draft a project plan targeting (a) specification development over the summer, (b) prototyping in the fall / early winter, (c) demonstration testing event, (d) public demonstration during HIMSS '11 (end of February in Orlando)
- Companies: DocBox, Philips, Draeger, Baxter, Nuvon
- End Users (?): KP, Sutter Health, CIMIT, ...
- NIST: Will engage as appropriate depending on the project's testing requirements
- ACTION: Jon B. will recruit & organize
- Meetings:
o Use Thursday A.M. DPI session to work on project specifics
o Use every other Monday (noon Pacific) to cover general project requirement & planning (esp. clinical participants
o Note: the alternating Monday WebEx sessions will be normal ICE-PAC discussions, currently focused on respiratory / vent workflow

Decisions/Issues:

Action(s):

XX Item Status/Discussion:

Decisions/Issues:

Action(s):

Next Meeting

The next meetings are: The Planning Committee will hold a webinar meeting May 12, 2010 PCD PC 2010-05-12 Webex

The Technical Committee will hold a webinar meeting May 19 PCD TC 2010-05-19 Webex


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