PCD Connectathon&Showcase Focused 2008-12-10 Webex

Special Meeting to address visitor/patient, caregiver and device ID

Agenda

Last Year:

• Kiosks on corners of Showcase booth where attendees could register
• ADT feed (provided John Donnelly’s group) that sent an A04 message to all registered ADT clients
• At start of tour, picked attendee from crowd that had registered at a Showcase kiosk
  • If none had registered, then backup “patient” (who was registered) was used
• Epic admitted patient into their system and printed wristband with barcoded MRN (and with MRN and name in clear text)
  • MRN was same as PID-3.1 (Patient Identifier List.ID Number) in ADT message
• Wristband was passed around so systems could either scan the barcode or type in the patient name

This year:

• Visitor Registration
• MRNs on badges?
  • Format?
• If PCD-only wristband is required:
  • Same format as last year?
    • Barcoded MRN, clear text MRN and name
  • When printed?
  • Who provides printer?
• PAM/PDQ
  • The PAM transaction for PIB option doesn't include A04 (see below)
  • Any PCD systems not supporting A04?
  • If not supporting A04, supporting PDQ?
  • Any PCD systems not supporting either A04 or PDQ?
    • Entry via keyboard only?
• Other barcodes
  • Caregiver ID
    • Responsibility of vendor of system requiring caregiver ID
  • Device ID
    • PIV will require scanning of Pump ID (pump vendor responsibility to provide barcode)
    • Need to agree on format that IOPs will be able to read
      • Code 128
      • Code 39
    • Will be tested at Connectathon as part of PIV tests
  • Medication
    • Pump vendors may optionally use barcoded medication info for OR (the only non-PIV scene)
      • If barcodes not used, can use menu sequence to select med info (either prior to start of OR scene or during)
  • Others?
• Wireless Networking
  • At the Connectathon
  • At the Showcase
  • Issues and solutions
• Timeline
  • What additional information is needed?
  • When do Steve, John Donnelly need more information?

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Information on PAM from previous email.

Here’s the ITI document for PAM:

http://wiki.ihe.net/index.php?title=Patient_Administration_Management

It looks like there are two use cases, and hence two transactions, in PAM:

• Patient Identity Management, which uses ITI-30 (Patient Identity Feed)
• Patent Encounter Management, which uses ITI-31 (Patent Encounter Management)

The PIB option calls out use of ITI-30 (Patient Identity Feed). ITI-30 has two options, “Merge” and “Link/Unlink”.

Use of the Merge option requires support for the following ADT messages:

• A28 – Create new patient
• A31 – Update patient information
• A47 – Change Patient Identifier List
• A40 – Merge two patients

Use of the Link/Unlink option requires support for the following ADT messages:

• A28 – Create new patient
• A31 – Update patient information
• A47 – Change Patient Identifier List
• A24 – Link Patient Information
• A37 – Unlink Patient Information

Note that the ADT messages in question in the action items from the Showcase Workshop (A04, A01, A02...) are not part of the PAM transaction required for PIB.

However, they are part of ITI-31. Here are the ADT messages in the “Basic Subset” for ITI-31:

• A01 – Admit inpatient
• A04 – Register outpatient
• A03 – Discharge patient
• A08 – Update patient information
• A40 – Merge patient identifier list

In conclusion, systems that support only those ADT messages required in the PIB option will not handle A04, A01, etc.

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Manny's original notes below:

Visitor/Patient ID

- PAM, PDQ testing

- PAM, PDQ reception of all HIMSS registrants - is it possible?

- Bar coding of badges (MRN alone, name alone) and human readable

- Ability of Epic, GE to read, print

- Ability of others using PIB options

- Ability to borrow printers

Device ID

- Is it necessary? For which systems?

- How can this be accomplished?

- How can we best test at the Connectathon or in a Virtual Connectathon setting?

Caregiver ID

- Is it necessary? For which systems?

- How can this be accomplished?

- How can we best test at the Connectathon or in a Virtual Connectathon setting?

Wireless Networking

- At the Connectathon

- At the Showcase

- Issues and solutions

Timeline

- What additional information is needed?

- When do Steve, John Donnelly need more information?

Participants

Anupriyo Charkravarti, Chad, Ruth Berge, Rita Brahmbhatt, Al Engelbert, Robert Flanders, Brian Fors, Ken Fuchs, Colin FX Gartska, Monroe Pattillo, Steve Moore, John Rhoads, Jeff Rinda, Scott Zaffrin, Manny Furst

Discussion

The special meeting addressed several issues:

• Providing Patient Care Device domain (PCD) systems with visitor/patient. It is necessary to associate patient data with the patient – the same volunteer patient from the tour group – and to carry that patient through the two clinical sites (walls) for each tour. However, some PCD systems are unable to access ADT in the Connectathon or Showcase environment. This makes it necessary to provide a mechanism to assure all systems provide reliable and consistent identification.
• Drug, caregiver and device identification.
• IOPs that need an RDE order.

Attending:

Anupriyo Charkravarti, Chad, Ruth Berge, Rita Brahmbhatt, Al Engelbert, Robert Flanders, Brian Fors, Ken Fuchs, Colin FX Gartska, Monroe Pattillo, Steve Moore, John Rhoads, Jeff Rinda, Scott Zaffrin, Manny Furst

Additional questions (please add any others you can think of)

• If the MRN is not provided on the visitor badge, will the visitor name be sufficient?
• How best to communicate to Epic/GE at the end of a tour that the medical record system can “discharge” the patient to free the existing bed for the next tour.
• Will multiple printed copies of patient ID be required or useful (e.g., for pumps to demo bar coding of patient and IV bag, or to pass to the second clinical site)?

Patient Identification

• Epic EMR and GE Enterprise are able to access the Connectathon and the Showcase ADT systems. Epic will query (PDQ) and GE will us PAM. They will print the information required by other PCD systems.

• It is not clear if the ADT system will hold all HIMSS09 conference registrants or just those registering for the Showcase. Neither Epic nor GE sees this as an obstacle.

• John Donnelly is seeking to learn if the visitor badge will have a bar code and human readable MRN. It will have a human readable name.
• Steve will provide a global id and Epic and GE will provide local IDs for PCD vendors. GE will store all (PAM), Epic will query Initiate (PDQ). Epic and GE will print the information for use by the other PCD systems.
• All systems can use an A04 except Hospira’s Veriscan. GE and Epic will provide A04.
• RDE will also be provided by Steve Moore (see IOP RDE, below).

The visitors experience will look like this (subject to refinement):

1. Visitors on a tour come to one of the three sites (walls).

2. The experience starts with a visitor volunteering to play the role of “patient” and offering his/her badge.

3. GE or Epic (the two systems alternate) use the bar code or human readable MRN to find the patient in the ADT system.

a. Epic uses PDQ, GE uses PAM

b. If the MRN is not provided, will the visitor name be sufficient?

4. GE or Epic uses the ADT information to print the following information for use by the other PCD systems:

a. Patient Name, Medical Record Number, DOB, Sex, Location, all human readable

b. Bar coded MRN – code 39 or other TBD

5. The paper visitor/patient ID is passed to all vendors

a. Those that have access to the ADT system will scan or enter via keyboard the information required to associate the patient with the data

b. Those who do not have access to ADT will manually associate the patient and data

6. At the completion of the tour, the vendor will remove the patient from its system

a. The patient must be removed because there are only two patient locations for each site (wall).

b. The tour must be completed before the Epic or GE Enterprise system can remove the patient.

Patient Location

Patients/visitors on a tour will visit two out of the three sites. Tours will start in sequential locations to provide all sites with equal visibility (i.e., tours start in OR, ICU, SD). If tour groups are large, they may be broken into two to provide visitors with a better experience.

Patient location will be specified. The suggestion is:

Starts in OR, room OR1; goes to ICU, room 2222 bed 1

Starts in ICU, room 1111 bed 1; goes to Step Down (SD) 4442 bed 2

Starts in SD, room 3331 bed 1; goes to OR, room OR 2

Caregiver and Device Identification

There was agreement that systems needing this information will provide it to those who need it.

Drug Identification Jeff will provide the drug library for the tests and demonstrations. Bar code or other identification on IV fluid will be the responsibility of the IOCs.

IOP RDE

• Ruth will send Steve sample RDE messages.
• Steve will arrange to have RDE messages provided along with the ADT messages.
• Epic and GE Centricity Enterprise will send RDE messages to the IOPs.

Return to main WG page which has links to individual meeting pages

Return to main PCD Connectathon/Showcase WG page: PCD_Connectathon&Showcase_WG_2008-9