PCD Event Nomenclature from Rosetta

Friday, November 12, 2010,

Manny, Monroe, John, Jeff and colleagues,

The RTM currently lists the following "event" codes as enumerated values reported by an OBX that has OBX-3=68012^MDC_ATTR_AL_COND^MDC.

MDC_EVT_STANDBY_WARN MDC_EVT_EMPTY MDC_EVT_FLUID_LINE_OCCL MDC_EVT_FLUID_LINE_AIR MDC_EVT_DOOR_POSN_ERR MDC_EVT_ADVIS_SETTINGS_CHK MDC_EVT_MALF MDC_EVT_POSN_PROB MDC_EVT_BATT_LO MDC_EVT_FLOW_LO MDC_EVT_IDLE MDC_EVT_CALLBACK MDC_EVT_VOL_INFUS_COMP MDC_EVT_VOL_INFUS_NEAR_COMP MDC_EVT_BATT_DEPL MDC_EVT_BATT_SERV MDC_EVT_EMER_STOP MDC_EVT_PWR_LOSS MDC_EVT_FLOW_STOP_OPEN MDC_EVT_CHECK_IV_SET MDC_EVT_SYRINGE_PATIENT_PRESSURE MDC_EVT_SYRINGE_PLUNGER_POSITION MDC_EVT_SYRINGE_FLANGE_POSITION MDC_EVT_SYRINGE_BARREL_CAPTURE MDC_EVT_SYRINGE_PRESSURE_DISC_POSITION MDC_EVT_SYRINGE_END_OF_TRAVEL MDC_EVT_SYRINGE_EMPTY MDC_EVT_PCA_DOOR_UNLOCKED MDC_EVT_PCA_HANDSET_DETACHED MDC_EVT_PCA_MAX_LIMIT MDC_EVT_PCA_PAUSED MDC_EVT_UNKNOWN MDC_EVT_DELAY_IMPOSSIBLE MDC_EVT_PUMP_CHAMBER_BLOCKED

But what about more complex pump events that have data? From a rigorous modeling and conformance testing standpoint, it would be significantly better to report the MDC_EVT_INFUS_START as an event identifier in OBX-3 (let's say at the dot4 METRIC level as an event identifier, for the sake of this discussion) and then report the supporting data at the dot5 FACET level. This could be easily supported in an "RTM for Events" table that could leverage the tooling that NIST will (presumably) be adding to test containment hierarchy conformance (in the near future ;-). We could also add an "Optionality" column to capture that requirement, just as we plan to capture the fact that a X73_PHD weighing scale shall report body weight and may report body mass index.

Event Name

Attribute

Optionality[

MDC_EVT_INFUS_START

MDC_DRUG_NAME_TYPE

R

MDC_CONC_DRUG

O

MDC_PUMP_MODE

R

MDC_PUMP_STAT

R

MDC_FLOW_FLUID_PUMP

R

MDC_RATE_DOSE

O

MDC_VOL_FLUID_TBI

O

MDC_VOL_FLUID_TBI_REMAIN

R

MDC_VOL_FLUID_DELIV

O

MDC_VOL_FLUID_DELIV_TOTAL_SET

O

MDC_TIME_PD_REMAIN

O

MDC_ATTR_PT_HEIGHT

O

MDC_ATTR_PT_WEIGHT

O

MDC_EVT_INFUS_STOP

MDC_DRUG_NAME_TYPE

R

MDC_CONC_DRUG

O

MDC_PUMP_MODE

R

MDC_PUMP_STAT

R

MDC_FLOW_FLUID_PUMP

O

MDC_RATE_DOSE

O

MDC_VOL_FLUID_TBI

O

MDC_VOL_FLUID_TBI_REMAIN

R

MDC_VOL_FLUID_DELIV

R

MDC_VOL_FLUID_DELIV_TOTAL_SET

R

MDC_TIME_PD_REMAIN

O

MDC_ATTR_PT_HEIGHT

O

MDC_ATTR_PT_WEIGHT

O

MDC_EVT_COMM_STATUS_ CHANGE

R

R

MDC_EVT_INFUS_COMP

MDC_DRUG_NAME_TYPE

R

MDC_CONC_DRUG

O

MDC_PUMP_MODE

R

MDC_PUMP_STAT

R

MDC_FLOW_FLUID_PUMP

O

MDC_RATE_DOSE

O

MDC_VOL_FLUID_TBI

O

MDC_VOL_FLUID_TBI_REMAIN

R

MDC_VOL_FLUID_DELIV

R

MDC_VOL_FLUID_DELIV_TOTAL_SET

R

MDC_TIME_PD_REMAIN

O

MDC_ATTR_PT_HEIGHT

O

MDC_ATTR_PT_WEIGHT

O

 _____

Table from <<Infusion Pump Event Communication JR-08232010.doc>>

We really need to represent events and alarms in a unified manner that can support rigorous modeling and conformance testing using the NIST tooling and an "RTM for Events" to capture the underlying event identifiers and supporting data (if any).

Best regards,

Paul Schluter

office: (414) 362-3610 cell: (414) 702-2026

 _____

From: Manny Furst [1] Sent: Friday, November 12, 2010 5:11 PM To: Schluter, Paul (GE Healthcare); 'Pattillo, Monroe' Cc: 'John Garguilo'; 'Martinez, Sandra'; 'Rinda, Jeffrey E.' Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

For this year, only, if the AR providers developing the demonstration voluntarily provide text, as Paul suggests, and the AM and AC providers voluntarily support these few parameters, we’ll consider this frosting on the cake. What do you think of defining the bare outlines of the participating systems before Thanksgiving and then see who wants to play. There would be no inference that the text will be used any other time.

Thanks,

Manny

From: Schluter, Paul (GE Healthcare) [2] Sent: Friday, November 12, 2010 3:42 PM To: Manny Furst; Pattillo, Monroe Cc: John Garguilo; Martinez, Sandra; Rinda, Jeffrey E.; Paul.Schluter@med.ge.com Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

Monroe,

Assuming that these are your top-level event identifiers that go in OBX-3, then it should be in the form:

123456^MDC_EVT_FLUID_LINE_OCCL^MDC

which would be consistent with how numeric observations are identified by OBX-3. If you want to include a text string value, perhaps that could be sent in OBX-5 as type 'ST'.

Also keep in mind that for many events we will also want to support numeric values to support the event identifier, e.g. drug name, concentration, etc., which would presumably be sent as "descendant" OBXs (using our dotted notation). This would allow rigorous modeling and validation, with the "observation hiearchy" captured in the RTM Events table(s).

Best regards,

Paul

 _____

From: Manny Furst [3] Sent: Friday, November 12, 2010 4:33 PM To: 'Pattillo, Monroe' Cc: 'John Garguilo'; 'Martinez, Sandra'; 'Rinda, Jeffrey E.'; Schluter, Paul (GE Healthcare) Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

This looks like a good idea, and may require some flexibility (e.g., one vendor would like to add something to make the message more specific). What if we try this for the demonstration, with whoever wants to participate?

I’ll add this to the agenda and we can learn what others think.

I’m copying Paul to learn if he sees something in this.

Manny

From: Pattillo, Monroe [4] Sent: Friday, November 12, 2010 10:03 AM To: Manny Furst Cc: 'John Garguilo'; 'Martinez, Sandra'; 'Rinda, Jeffrey E.' Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

Manny,

These are good for OBX-3-1 Observation Identifier - Identifier component values for infusion pumps, and are good for system to system communication, but it would be meaningful to ACM AM actors for AR actors to also come up with content to assist the ACM effort to integration ACM into RTM by coming up with OBX-3-2 Observation Identifier – Text component values which ACM AM actors use to tell people on communication devices what is going on in rapidly understandable words…

OBX-3-1 OBX-3-2 OBX-3-3

Identifier Text Name of Coding System

MDC_EVT_FLUID_LINE_OCCL Occlusion MDC

MDC_EVT_DOOR_POSN_ERR Door Position MDC

The IHE PCD TF volume 2 shows the Text component of OBX-3 as required with a cardinality of 1..1, so something needs to be there.

If this is acceptable then we’re good on pumps. Now we need Text component values for all alarms from all other AR types and vendors that already participate in Showcase – patient monitors, bed systems, workflow systems, etc.

Regards,

Monroe

Monroe Pattillo

Product Manager

6400 Congress Ave, Ste 1050

Boca Raton, FL 33487

Tel: 561.886.3108

 _____

From: Manny Furst [5] Sent: Friday, November 12, 2010 10:23 AM To: 'Rinda, Jeffrey E.'; Pattillo, Monroe Cc: 'John Garguilo'; 'Martinez, Sandra' Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

Thanks, Jeff,

If this is acceptable to John and Sandra I’ll issue a revision, indicating that participants can test with either or both for the pump portion of the ACM test, and blood pressure (and possibly heart rate as an option for a system that won’t include bp).

Thanks, all,

Manny

From: Rinda, Jeffrey E. [6] Sent: Friday, November 12, 2010 8:05 AM To: Manny Furst; 'Pattillo, Monroe' Cc: 'John Garguilo'; 'Martinez, Sandra' Subject: RE: PCD ACM Test for Pumps - what parameter and value would be useful

Vendors differ in how easy these are to generate on demand, so I think we need two scenarios, either one of which meets the test requirement).

Occlusion

Door Open

MDC_EVT_FLUID_LINE_OCCL

MDC_EVT_DOOR_POSN_ERR

 _____

From: Manny Furst [7] Sent: Thursday, November 11, 2010 12:58 PM To: Rinda, Jeffrey E.; 'Pattillo, Monroe' Cc: 'John Garguilo'; 'Martinez, Sandra' Subject: PCD ACM Test for Pumps - what parameter and value would be useful

Good afternoon,

I’m revising the Pre-Connectathon test and would like to include a NIST tool test for pumps, just one parameter and value (e.g., occlusion). What parameter, value would make sense as the demonstrations currently, vaguely develop, and does RTM table support it?

Thanks,

Manny

PCD Event Nomenclature from Rosetta

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