PCD Brief Profile Proposal 2009 PoC ID Management

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Proposed Workitem: Point-of-Care Identity Management

  • Proposal Editor: Todd Cooper / Khalid Zubaidi
  • Editor: TBD
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: Patient Care Devices (PCD)


The Problem

Patient Care Devices (PCD) hold valuable information about the treatment being delivered to patients. Device Observation Reporters (DOR) publishes this valuable information to Device Observation Consumers (DOC) that use this valuable data to complete the medical record documentation for patients. However, this data published by the DOR requires a patient identifier be available either within the message or through a separate mapping function maintained by the DOR. In some cases, this data, if associated with the wrong patient, may result in incorrect documentation, increasing the potential of documentation errors or even mistreatment.

Currently, IHE PCD group assumes the device has been assigned the correct patient identifier. A typical process involves manual assignment of patient identifier to the device. This manual assignment process can be inconsistent and can lead to manual data entry errors. With the emerging adoption of Bar-Coding Medication Administration (BCMA) and Bar-Coding at the Point of Care (BPOC) systems, there is an opportunity in automating this process. The medication administration workflow being proposed by these systems includes a positive patient identification step. Although the PIV profile supports this assignment as a part of populating infusion parameters, this profile does not cover all user needs in assigning patient identifiers outside of an infusion administration workflow.

I propose that we include an optional patient association transaction that would complete the needs around the patient to device association.


Key Use Cases

<Feel free to add a second use case scenario demonstrating how it “should” work. Try to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>


Standards & Systems

A number of technical approaches have been suggested; however, given the general HL7 ver 2.x foundation for most of the PCD enterprise-related profile components, most of the proposals have centered around leveraging either current or closely related technical approaches:

<HL7 v2 R30> <hl7 V2 ADT - encounter paradigm> <HL7 v2 Ch. 10 approach - scheduling & resource allocation> <CCoM>

Additional Considerations

  1. This technical framework should be applicable to multiple implementation technologies, such as barcodes, RF-ID tags, RTLS systems, ultrasound solutions, etc.
  2. Other IHE domains, especially ITI, may be interested in working on this jointly.
  3. Other non-IHE coordination - other standards-based organizations may also be very interested in partnering with IHE PCD in the development of this profile, including AAMI.


Discussion

Technological Risks

An assessment needs to be made regarding technologies currently in use to determine the best technologies for the profile developer's initial focus. Note: When this area was first assessed by PCD in the 2005 time frame, there was so little standardization that it was deemed best to defer working on this area to a future date.