PCD Brief Profile Proposal 2008 WCM

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1. Proposed Workitem: Waveform Communication Management [WCM]

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

2. The Problem

Waveform data is an important component of information coming from medical patient care devices. This information can be an important complement to assessing the current status of a patient or the status of a patient during a clinical event. As such waveform information can be provided in a number of forms:

  • waveform snapshots
    • specific forms of snapshots such as 12-lead ECG associated with a diagnostic encounter
    • general snapshots of waveforms captured during a clinical event or due to a request by a clinician
  • continuous waveforms
    • a continuous "real-time" stream of waveform data that would be used for a remote "real-time" waveform display

Independent of the form of waveform, the following information must be accommodated:

  • waveform type (e.g. ECG, Arterial Blood Pressure, CO2, etc.)
  • sampling rate
  • start time
  • event time
  • scaling (e.g. #bits/mmHg in the case of blood pressure)
  • annotations (e.g. pacer, beat-label, QRS, respiration, out-of-range, etc.)
  • status (e.g. lead-off, out-of-range, test mode, etc.)
  • filter status (e.g. low-pass, high-pass, etc.)
  • number of waveform samples
  • suggested waveform display color
  • units of measure
  • patient identification
  • clinician notes

A waveform snapshot may also include encapsulated vitals signs and event related information. The real-time waveform probably has this information as part of DEC or ACM data stream.



3. Key Use Case

  1. A patient enters the Emergency Room complaining of pressure on the chest wall. A 12-lead ECG is obtained and transmitted to the Cardiology Management System. The data is reviewed and annotated and sent via WCM to the hospital Clinical Information System as part of the patient's clinical record.
  2. A patient, post Heart Attack, is walking in his room while being monitored using a patient telemetry system. The system detects a run of ventricular beats and generates an alarm at the central nurse station. In parallel the alarm information, including a waveform snapshot, is communicated to a separate alarm communication system which send the alarm, vital signs and a waveform snapshot to a caregiver's portable device.


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.

ISO/IEEE 11073-10201

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

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

5. Discussion

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