Difference between revisions of "PCD PC&TC 2009-10-05 to 09 F2F"

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m (Thursday 2009.10.08: partial entries)
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| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
 
:* John Rhoads led a discussion reviewing the work of the ICE-PAC WG, leading to possible work items for PCD. He noted that some of the issues in the previous discussion are relevant. Get slides/links from John Rhoads John provided an introduction to the ICE-PAC work, directed to interaction and control of devices. The ICE-PAC and PCD have collaborated to develop a detailed clinical workflow leading to requirements meeting the needs defined by Dr. Julian Goldman. The typical PCA system can lead to an overdose with serious, possibly fatal outcome. Continuous monitoring of oxygenation via SpO2 can prevent the adverse event.  
 
:* John Rhoads led a discussion reviewing the work of the ICE-PAC WG, leading to possible work items for PCD. He noted that some of the issues in the previous discussion are relevant. Get slides/links from John Rhoads John provided an introduction to the ICE-PAC work, directed to interaction and control of devices. The ICE-PAC and PCD have collaborated to develop a detailed clinical workflow leading to requirements meeting the needs defined by Dr. Julian Goldman. The typical PCA system can lead to an overdose with serious, possibly fatal outcome. Continuous monitoring of oxygenation via SpO2 can prevent the adverse event.  
The PCD approach addresses a single patient, obtaining data from multiple devices. The block diagram shows an Ice Equipment Interface, Ice Network Controller, etc. The Ice Data Logger permits retrospective analysis, especially useful to analyze an adverse event or system malfunction. The Ice Supervisor provides a clinical user interface and has the ability to provide the wider clinical environment for the patient (e.g., CDSS). The Clinical Environment Coordinator oversees multiple patients. Jan indicated the Supervisor could have multiple components such as a smart gateway, bedside device, CDSS. John Rhoads noted these are abstract actors, not necessarily specific functions/devices or interoperability. John then provided additional detail for each block in the system. ICE Top-Level Components.emf John noted that there are multiple scenarios (e.g., bedside, OR, ability to overcome interruptions. John continued, describing the detailed clinical workflow that Tracy Rausch researched at multiple hospitals.  
+
:* The PCD approach addresses a single patient, obtaining data from multiple devices. The block diagram shows an Ice Equipment Interface, Ice Network Controller, etc. The Ice Data Logger permits retrospective analysis, especially useful to analyze an adverse event or system malfunction. The Ice Supervisor provides a clinical user interface and has the ability to provide the wider clinical environment for the patient (e.g., CDSS). The Clinical Environment Coordinator oversees multiple patients. Jan indicated the Supervisor could have multiple components such as a smart gateway, bedside device, CDSS. John Rhoads noted these are abstract actors, not necessarily specific functions/devices or interoperability. John then provided additional detail for each block in the system. ICE Top-Level Components.emf John noted that there are multiple scenarios (e.g., bedside, OR, ability to overcome interruptions. John continued, describing the detailed clinical workflow that Tracy Rausch researched at multiple hospitals.  
 
+
 
:* John Rhoads introduced another example, Heparin delivery. In that example, data is obtained from multiple sources, with the Ice Controller knowing what data/systems are available for information and can provide control of the pump with the oversight of the Supervisor.  
 
:* John Rhoads introduced another example, Heparin delivery. In that example, data is obtained from multiple sources, with the Ice Controller knowing what data/systems are available for information and can provide control of the pump with the oversight of the Supervisor.  
 
 
:* The next step was integration of multiple scenarios, identifying those that are common to more than one; it hasn’t yet addressed the issue of co-morbidities. He went on to describe how systems, equipment, etc. are integrated and readiness evaluated (e.g., troubleshooting). Jan noted that the QoS block checks the system and that the patient is ready to take control of the pump. Identifying where/when troubleshooting, medical alerts were required leads to risk analysis.  
 
:* The next step was integration of multiple scenarios, identifying those that are common to more than one; it hasn’t yet addressed the issue of co-morbidities. He went on to describe how systems, equipment, etc. are integrated and readiness evaluated (e.g., troubleshooting). Jan noted that the QoS block checks the system and that the patient is ready to take control of the pump. Identifying where/when troubleshooting, medical alerts were required leads to risk analysis.  
 
 
:* John Hotchkiss endorsed this as a collaborative effort within PCD. He described a grant LiveData received for a rule based approach integrating alerts. This aligns data from physiologic parameters and alarms to improve patient safety, and workflow.   
 
:* John Hotchkiss endorsed this as a collaborative effort within PCD. He described a grant LiveData received for a rule based approach integrating alerts. This aligns data from physiologic parameters and alarms to improve patient safety, and workflow.   
  
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:* Robert suggested this may be handled through two WGs. Todd noted there are some components in ICE and in John Hotchkiss’ work are out of scope for PCD. E.g., the research part that Tracy is doing …
 
:* Robert suggested this may be handled through two WGs. Todd noted there are some components in ICE and in John Hotchkiss’ work are out of scope for PCD. E.g., the research part that Tracy is doing …
 
 
:* The network management piece might be a part of MEM or a spin off from that.  
 
:* The network management piece might be a part of MEM or a spin off from that.  
 
 
:* These discussions will continue in ICE-PAC and other existing WGs (e.g., DPI).  
 
:* These discussions will continue in ICE-PAC and other existing WGs (e.g., DPI).  
  
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|-
 
|-
 
| align="center" | 7
 
| align="center" | 7
| '''xyz''' <br>- <lead>
+
| '''Clinical Decision Support Systems''' <br>- <lead>
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* John Rhoads summarized the meeting. See above for an earlier summary; as a result a second summary is not included, but notes on the afternoon discussion does follow.
 +
:* Todd suggested that a CP for PCD-2 along with a WP describing its use would be a feasible approach to start. The integration issues Jan suggested will fit into DPI as additional use cases.
 +
:* Another subject was integration of devices to provide safety interlock and control, providing for a mechanism for devices to identify themselves on the network with information that describes its capabilities. This will permit a CDSS to query the devices and learn about the availability of data and ability to control the device. This led to discussion of risk and risk management, including issues like QoS.
 +
:* A brief discussion of medical equipment management as the place where the above issues would fit. Todd noted that SNMP is not presently addressed in the MEM WP. This addresses network condition and the ability to assess the condition/status of devices on the network.
 +
 
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
 
'''Action(s):'''
 
'''Action(s):'''
 +
:* Todd will provide a summary to discuss in the MEM WG.
  
 
|-
 
|-
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|-
 
|-
 
| align="center" | 8
 
| align="center" | 8
| '''xyz''' <br>- <lead>
+
| '''HL7''' <br>- Todd
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* HL7 and IHE are developing an MOU that will develop a closer working relationship, require coordination before changes are placed.
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
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|-
 
|-
 
| align="center" | 9
 
| align="center" | 9
| '''xyz''' <br>- <lead>
+
| '''RTM Process and Tools''' <br>- <lead>
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* HITSP and HL7 will be referencing our documents as the NIST tools.
 +
:* RTM management update: it is important to have each version, and to know which is the current one. Existing IEEE process has a way to gather proposed changes which are addressed three times a year. A suggestion to address this in RTM is to incorporate SourceForge in RTM for versioning.
 +
 
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
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|-
 
|-
 
| align="center" | 10
 
| align="center" | 10
| '''xyz''' <br>- <lead>
+
| '''PCD Process and Tools''' <br>- John Rhoads
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* John Rhoads is looking at version control, etc.
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
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|-
 
|-
 
| align="center" | 11
 
| align="center" | 11
| '''xyz''' <br>- <lead>
+
| '''RTLS''' <br>- <lead>
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* Monroe provided an overview of the current use of RTLS in healthcare. '''Refer to slides - needed.''' He noted that there are systems that correlate the location with the device or person. Anupriyo described use cases they are implementing. Todd noted that this had been discussed with HL7 as potentially available in v3. Ioana believes the purpose of that effort was tracking and not correlation with an event. 
 +
 
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
 
'''Action(s):'''
 
'''Action(s):'''
 +
:* Manny to continue recruiting. Determine how best for them to participate in HIMSS10.
  
 
|-
 
|-
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|-
 
|-
 
| align="center" | 12
 
| align="center" | 12
| '''xyz''' <br>- <lead>
+
| '''Aggregating Comments From Experts''' <br>- Ioana
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* Ioana described issues arising from comments submitted by the VA to PCD and ITI.
 +
:* She expressed a need for domains to solicit and provide feedback when an organization collects and aggregates comments submitted in response to a call for public comments. She recommends that feedback to the individual submitter is essential. When she collects comments and submits them she will identify the submitter and believes responses to comments should not only be discussed, but also be sent to the submitter and the aggregator.
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
 
'''Action(s):'''
 
'''Action(s):'''
 +
:* Develop a cross domain process and Ken will take this to the DCC.
  
 
|-
 
|-
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|-
 
|-
 
| align="center" | 13
 
| align="center" | 13
| '''xyz''' <br>- <lead>
+
| '''Korea 2010 in Daego''' <br>- Todd
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* '''See Todd’s slides which are needed'''  Active recruiting of companies to show PHD and PCD devices is underway. It is not clear if the Japanese companies will participate. Questions include (a) approvals for the Connectathon and Showcase, and (b) IHE approval of the 2010 Connectathon as officially sanctioned. Todd added Sleep Apnea and Vital Signs home monitoring.
 +
 
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
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|-
 
|-
 
| align="center" | 14
 
| align="center" | 14
| '''xyz''' <br>- <lead>
+
| '''''' <br>- <lead>
 
| '''Status/Discussion:'''
 
| '''Status/Discussion:'''
:*
+
:* Concern is over using EUI-64 when the device in question is aggregating data from multiple devices/systems. Manufacturers have discretion in how to construct the EUI-64. The current TF text remains unchanged and the gateway’s identifier is provided. John Garguilo offered to test the validation by building a table with the 24 bit portion that is the company id portion of the identifier. The identifier is 8 hex digits with no space or hyphen for PCD. The actual device contributing data will be identified by EUI-64 or device name and serial number for legacy systems in the OBX-18. If none of these are available, manufacturers may not be able to get it from the gateway. Discussion led to a desire to provide alternatives that would be defined at system installation that provides unique identifiers.
 +
 
 
'''Decisions/Issues:'''
 
'''Decisions/Issues:'''
 
:*
 
:*
 
'''Action(s):'''
 
'''Action(s):'''
 +
:* Manny to survey participants for company IDs. Ask if they will agree to use a 64 bit identifier whether they include the company ID or not.
  
 
|-
 
|-

Revision as of 20:52, 12 October 2009


Meeting Objectives

These face-to-face meetings have a number of objectives depending on the committees involved:
  • Planning Committe: Review overall PCD activities, review and approve Cycle 5 proposals
  • Technical Committee: Review all materials slated for publication Fall 2009 and resolve any issues so that final editing and publication may proceed.


Schedule & Agenda

Daily Schedule
08:00 - 08:30 Meet at B. Braun
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
NOTE: Friday the meetings will end by 15:00.


Date Hours Committees Topics
Monday

2009.10.05

08:30 - 17:00 PCD Planning Committee
- Roadmap Review
- Schedule / Milestones Review
- Active Profiles
- Continua Coordination
- White Papers
- Users Guide
  • Cycle 5 Brief Profile Proposals PCD Proposals 2010-2011
  • Lunch
  • Cycle 5 Brief Profile Proposals
  • ITI Profile Proposal Coordination
  • SoA ...
- IHE ITI XDS.b
- HITSP: Capabilities & Service Collaborations
- HL7 SAEAF


Tuesday

2009.10.06

08:30 - 17:00 PCD Planning and Technical Committees
  • IHE IP Management Process
  • PCD Marketing & Funding
  • Revisit Roadmap & Schedule
  • 10:45? QRPH Newborn Screen Brief WorkItem Proposal
  • Technical Framework Final Text Discussion
  • LUNCH
  • Technical Framework Final Text Discussion
  • 2010 HIMSS Showcase Discussion
  • 4 PM T-con PCD Showcase Planning


Wednesday Morning

2009.10.07

08:30 - 12:00 PCD Technical Committee (TC)
Wednesday Afternoon

2009.10.07

13:00 - 17:00 PCD TC WG Meetings

<WORKING LUNCH>

  • ADT Use Cases and Issues
- PDQ vs. PAM
- ITI-30 and ITI-31
- etc.
  • WG Breakouts
- Infusion Pump WG
- Daegu 2010 + SoA + ...
  • Technical Framework editorial WG (After hours session...)
Thursday Morning

2009.10.08

08:30 - 12:00 PCD TC WG Meetings
- Infusion Pump WG
- ICE-PAC / DPI WGs + HITSP TN905
Thursday Afternoon

2009.10.07

13:00 - 17:00 PCD Technical Committee
- Infusion Pump WG (w/ PIV)
- DPI/ICE-PAC JWGs
  • General Profile Update Reports
- WCM: TF Integration
- RTM: Process & Tools (NIST + Gforge)
- RTLS: Industry Status Update (Pattillo)
- MEM & SNMP: Network Configuration Management
- Korea 2010 Slides
  • Report: Public Review Process Discussion
  • 2010 Connectathon Issue Resolution
- EUI-64 Discussion (incl. Cycle 4 testing requirements)
- Virtual Connectathon Firewall Issues?
- Mandatory Virtual Connectathon?
- Mandatory Pre-Showcase Testing?
  • Alert: Planning & Technical Cmte Co-Chair Elections
  • Testing Strategy (continued)
  • The Question of ... Certification
Friday

2009.10.09

08:30 - 14:00 PCD Technical Committee
- Volume Organization Review (incl. Profile Optionality)
- Volume 1: Integration Profiles
- Volume 2: Transactions
- Volume 3: Semantic Content
  • SOA Discussion: WP Development? (10:00 WebEx)
  • TF Appendices: OID Usage
  • New Profile Proposal Technical Review
  • 2010 F2F Meeting Planning
  • Resolutions / Action Item Review
Note: Additional evening working sessions may be scheduled as needed.

Location Information

B. Braun
1601 Wallace Dr # 150,
Carrollton, TX 75006
(972) 245-2243


  • IMPORTANT REGISTRATION INFORMATION

Please reserve a place at the table as early as possible so that logistical planning can accommodate your attendance. Send your anticipated arrival and departure dates/times, cell phone number and hotel to Manny Furst. If you would like more information contact Manny.

Attachments / Materials

Documents related to the meeting are found at ftp://ftp.ihe.net/Patient_Care_Devices/Minutes-and-Meeting-Summaries-Yr4-2009-10/F2F-2009October5-9/ unless otherwise noted. Documents are available without a password.

Decisions Summary

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

No. Decision Date Description
1 xyz 2009.10.05
  • ...
2 xyz ...
  • ...
3 xyz ...
  • ...
4 xyz ...
  • ...
5 xyz ...
  • ...

Action Items Summary

(add newest items to the top of the list)

No. Action Item Owner Participants Due Open/Closed Description/Update
1 ... ... 2009.10.05 Open ...


Meeting Minutes

Monday 2009.10.05

Participants:

David Becker, Ruth Berge, Terry Bettis, Jon Blasingame, Anupriyo Chakravarti, Todd Cooper, Bikram Day, Allen Enebo, Al Engelbert, Robert Flanders, Ken Fuchs, John Garguilo, Colin FX Gartska, Masaaki Hirai, John Hotchkiss, Sunkee Lee, Steve Merritt, Gary Meyer, Monroe Pattillo, John Rhoads, Jeff Rinda, Paul Schluter, Ioana Singureanu, Erin Sparnon, Scott Zaffrin, Khalid Zubaidi, Manny Furst


Item Topic Discussion
1 Introductions, Agenda Review and Modification
- Todd
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
2 Intellectuarl Property Policy and Procedure
- Todd
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
3 Pipeline Impedance Matching
- Todd
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
4 Roadmap Review
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
5 Brief Profile Proposal: Multiple Parameters at a Single Point in Time
- John Zaleski
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
6 Work Item Proposals: Various
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
7 Service Oriented Architecture (Part 1, Introduction)
- Todd
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
8 Review of PCD Web/Wiki/FTP Pages
- Steve Merritt, John Rhoads
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
9 Marketing PCD, IHE
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):


Tuesday 2009.10.06

Participants:

David Becker, Ruth Berge, Terry Bettis, Jon Blasingame, Anupriyo Chakravarti, Todd Cooper, Bikram Day, Allen Enebo, Al Engelbert, Robert Flanders, Ken Fuchs, John Garguilo, Colin FX Gartska, Chad Hays, Masaaki Hirai, John Hotchkiss, Sunkee Lee, Steve Merritt, Gary Meyer, Monroe Pattillo, John Rhoads, Jeff Rinda, Paul Schluter, Ioana Singureanu, Erin Sparnon, Scott Zaffrin, Khalid Zubaidi, Manny Furst

Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
2 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
3 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
4 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
5 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
6 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
7 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
8 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
9 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
10 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
11 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
12 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
13 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
14 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
15 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):


Wednesday 2009.10.07

Participants:

Ruth Berge, Terry Bettis, Jon Blasingame, Anupriyo Chakravarti, Todd Cooper, Bikram Day, Allen Enebo, Al Engelbert, Robert Flanders, Ken Fuchs, John Garguilo, Colin FX Gartska, Masaaki Hirai, Chad Hays, John Hotchkiss, Sunkee Lee, Gary Meyer, Monroe Pattillo, John Rhoads, Jeff Rinda, Ioana Singureanu, Erin Sparnon, Kristina Wilson, Scott Zaffrin, Khalid Zubaidi, Manny Furst


Item Topic Discussion
1 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
2 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
3 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
4 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
5 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
6 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
7 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
8 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
9 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
10 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
11 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
12 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
13 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
14 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion
15 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):


Thursday 2009.10.08

Participants:

David Becker, Ruth Berge, Jon Blasingame, Anupriyo Chakravarti, Todd Cooper, Bikram Day, Al Engelbert, Robert Flanders, Ken Fuchs, John Garguilo, Colin FX Gartska, Kai Hassing (Webex), Chad Hays, John Hotchkiss (Webex), Sunkee Lee, Gary Meyer, Monroe Pattillo, John Rhoads, Jeff Rinda, Ioana Singureanu, Greg Staudenmaier (Webex), Sandy Weininger (Webex), Kristina Wilson, Jan Wittenber (Webex), Scott Zaffrin, John Zaleski (Webex), Khalid Zubaidi, Manny Furst

Item Topic Discussion
1 Agenda Review, IP Announcement
- Todd
Status/Discussion:
  • Todd reviewed and updated the agenda.
  • There was no need to repeat the IP notice as participants were present earlier in the week.
  • There was a simultaneous Breakout session for the Pump WG.

Decisions/Issues:

Action(s):


Item Topic Discussion
2 Multiparameter Data Synchronization
- John Zaleski
Status/Discussion:
  • John Zaleski referred to his slides and used the example of managing spontaneous breathing trials in preparation as a predictor for managing the discontinuation from mechanical ventilation of coronary artery bypass grafting (CABG) patients. It illustrates the need to access critical data simultaneously (see slides presented earlier in the week). Yet, bandwidth and other requirements make continuous high resolution data acquisition unreasonable. Some data arrive synchronously, some episodically. John Zaleski noted that data are obtained from multiple ISs and used by the clinician in making decisions. Jan noted that many devices likely require multiple physician’s orders to take into account. John suggested that every major change would initiate acquisition of the required selection of data. The key is to provide the capability to retrieve information necessary to specific clinical decision making at the time of need, and to retrieve this new information to update potentially latent, missing or obsolete data. Jan noted that there are also multiple clinicians involved, and this is analogous to the medical home concept where multiple clinicians need to coordinate and collaborate. Addressing this with context awareness is also necessary. The data required changes as the context evolves. Ken noted that this discussion is continuing in the TC and the technical requirements should be addressed today. John Rhoads summarized by saying the scope addresses the high level request issues and the CDSS’s need for data, leaving the lower level distinctions for context can be deferred. Jan suggested that another function can be used to select the data required based upon context for the clinical situation; it would know what sources were available at the time and what data should be collected in order to meet the needs of specific clinical decision support methods at the time required. John Rhoads noted that the current SPD option assumes knowledge of what is available, but doesn’t actively seek knowledge of the inventory. Jan noted that the amount of data available (e.g., ventilator data) is large and selection of appropriate data is desired. While this may require a new actor, an incremental approach would match the available data to the need. Other complexities are related to the number of data sources and potential overlap with conflicting data, selecting among the available parameters when several address the same underlying issues, QoS, device alerts/alarms, and proprietary device algorithms.

Decisions/Issues:

Action(s):

Item Topic Discussion
3 ICE-PAC
- <lead>
Status/Discussion:
  • John Rhoads led a discussion reviewing the work of the ICE-PAC WG, leading to possible work items for PCD. He noted that some of the issues in the previous discussion are relevant. Get slides/links from John Rhoads John provided an introduction to the ICE-PAC work, directed to interaction and control of devices. The ICE-PAC and PCD have collaborated to develop a detailed clinical workflow leading to requirements meeting the needs defined by Dr. Julian Goldman. The typical PCA system can lead to an overdose with serious, possibly fatal outcome. Continuous monitoring of oxygenation via SpO2 can prevent the adverse event.
  • The PCD approach addresses a single patient, obtaining data from multiple devices. The block diagram shows an Ice Equipment Interface, Ice Network Controller, etc. The Ice Data Logger permits retrospective analysis, especially useful to analyze an adverse event or system malfunction. The Ice Supervisor provides a clinical user interface and has the ability to provide the wider clinical environment for the patient (e.g., CDSS). The Clinical Environment Coordinator oversees multiple patients. Jan indicated the Supervisor could have multiple components such as a smart gateway, bedside device, CDSS. John Rhoads noted these are abstract actors, not necessarily specific functions/devices or interoperability. John then provided additional detail for each block in the system. ICE Top-Level Components.emf John noted that there are multiple scenarios (e.g., bedside, OR, ability to overcome interruptions. John continued, describing the detailed clinical workflow that Tracy Rausch researched at multiple hospitals.
  • John Rhoads introduced another example, Heparin delivery. In that example, data is obtained from multiple sources, with the Ice Controller knowing what data/systems are available for information and can provide control of the pump with the oversight of the Supervisor.
  • The next step was integration of multiple scenarios, identifying those that are common to more than one; it hasn’t yet addressed the issue of co-morbidities. He went on to describe how systems, equipment, etc. are integrated and readiness evaluated (e.g., troubleshooting). Jan noted that the QoS block checks the system and that the patient is ready to take control of the pump. Identifying where/when troubleshooting, medical alerts were required leads to risk analysis.
  • John Hotchkiss endorsed this as a collaborative effort within PCD. He described a grant LiveData received for a rule based approach integrating alerts. This aligns data from physiologic parameters and alarms to improve patient safety, and workflow.

Decisions/Issues:

Action(s):

Item Topic Discussion
4 Technical Framework
- Todd
Status/Discussion:
  • Todd addressed the need to identify gaps in the TF that need to be addressed in order to accommodate new work or existing work. For example, network configuration management to identify network configuration, device connections and status. This may be factored into the User Manual as well. Jan noted that performance monitoring, including network and system QoS, are essential to assure performance of the systems and of the algorithms.
  • MISSING SUBJECT INFORMATION
  • Robert suggested this may be handled through two WGs. Todd noted there are some components in ICE and in John Hotchkiss’ work are out of scope for PCD. E.g., the research part that Tracy is doing …
  • The network management piece might be a part of MEM or a spin off from that.
  • These discussions will continue in ICE-PAC and other existing WGs (e.g., DPI).

Decisions/Issues:

Action(s):

  • Schedule the alternate weeks in the ICE-PAC WG meetings to devote to PAC. <This has been accomplished and won't be added to the open items list>
Item Topic Discussion
5 IHE International Board Meeting
- Todd
Status/Discussion:
  • Membership Update: Covidien Energy Based Devices was approved for membership. There was some confusion about the relationship between CareFusion and Cardinal so a decision was delayed. Several organizations have not submitted their IP declaration so they are in the process.

Decisions/Issues:

  • Laboratory Domain: Presently inactive. There are two potential sponsors.
  • IP: The IP Policy was adopted.
  • Incorporation: State of Illinois has granted incorporation. The IRS has not yet acted.
  • PCD Board Report: Still listed as a draft.

Action(s):

  • Todd will follow up on the pending applications.
  • Ken will resolve the issues with the Board Report, obtain final status.
Item Topic Discussion
6 Pump Breakout
- Jeff Rinda
Status/Discussion:
  • Jeff summarized the meeting.
  • Decision to remove DOR as a grouped actor from PIV from the Supplement. A note will indicate that it can be used. The grouping will not be tested at the Connectathon.
  • The existing CPs will be included in the TF revision.
  • Event information is a complex issue. Discussion revealed three options:
1. Leverage PCD-01
2. Extend ACM-04 for general event reporting
3. Establish a new transaction
A decision was not reached. Todd suggested that depending upon the application, perhaps both PCD-01 and ACM-04 would be used.
  • Changes required to support syringe pumps are minimal and items will be submitted for inclusion in RTM.
  • Workflow issues can produce differences between the programmer and pump – e.g., clinicians that set the amount to be infused lower than the amount available; the pump doesn’t know how much is available, remaining.
  • More work is required on PCA pumps.
  • Khalid described the need to bind the device to the patient and consideration of an ADT message, but this does not seem to be appropriate. This is in follow up to Todd’s CP, with messages from a CIS to the pump. Currently, the patient is bound at the device. Both would be available for binding the patient to the pump. There is a time element to this binding. SIU was suggested for consideration.
  • Todd described concerns relating to RTM as robust for pumps given historical documentation that is not complete.

Decisions/Issues:

Action(s):

Item Topic Discussion
7 Clinical Decision Support Systems
- <lead>
Status/Discussion:
  • John Rhoads summarized the meeting. See above for an earlier summary; as a result a second summary is not included, but notes on the afternoon discussion does follow.
  • Todd suggested that a CP for PCD-2 along with a WP describing its use would be a feasible approach to start. The integration issues Jan suggested will fit into DPI as additional use cases.
  • Another subject was integration of devices to provide safety interlock and control, providing for a mechanism for devices to identify themselves on the network with information that describes its capabilities. This will permit a CDSS to query the devices and learn about the availability of data and ability to control the device. This led to discussion of risk and risk management, including issues like QoS.
  • A brief discussion of medical equipment management as the place where the above issues would fit. Todd noted that SNMP is not presently addressed in the MEM WP. This addresses network condition and the ability to assess the condition/status of devices on the network.

Decisions/Issues:

Action(s):

  • Todd will provide a summary to discuss in the MEM WG.
Item Topic Discussion
8 HL7
- Todd
Status/Discussion:
  • HL7 and IHE are developing an MOU that will develop a closer working relationship, require coordination before changes are placed.

Decisions/Issues:

Action(s):

Item Topic Discussion
9 RTM Process and Tools
- <lead>
Status/Discussion:
  • HITSP and HL7 will be referencing our documents as the NIST tools.
  • RTM management update: it is important to have each version, and to know which is the current one. Existing IEEE process has a way to gather proposed changes which are addressed three times a year. A suggestion to address this in RTM is to incorporate SourceForge in RTM for versioning.

Decisions/Issues:

Action(s):

Item Topic Discussion
10 PCD Process and Tools
- John Rhoads
Status/Discussion:
  • John Rhoads is looking at version control, etc.

Decisions/Issues:

Action(s):

Item Topic Discussion
11 RTLS
- <lead>
Status/Discussion:
  • Monroe provided an overview of the current use of RTLS in healthcare. Refer to slides - needed. He noted that there are systems that correlate the location with the device or person. Anupriyo described use cases they are implementing. Todd noted that this had been discussed with HL7 as potentially available in v3. Ioana believes the purpose of that effort was tracking and not correlation with an event.

Decisions/Issues:

Action(s):

  • Manny to continue recruiting. Determine how best for them to participate in HIMSS10.
Item Topic Discussion
12 Aggregating Comments From Experts
- Ioana
Status/Discussion:
  • Ioana described issues arising from comments submitted by the VA to PCD and ITI.
  • She expressed a need for domains to solicit and provide feedback when an organization collects and aggregates comments submitted in response to a call for public comments. She recommends that feedback to the individual submitter is essential. When she collects comments and submits them she will identify the submitter and believes responses to comments should not only be discussed, but also be sent to the submitter and the aggregator.

Decisions/Issues:

Action(s):

  • Develop a cross domain process and Ken will take this to the DCC.
Item Topic Discussion
13 Korea 2010 in Daego
- Todd
Status/Discussion:
  • See Todd’s slides which are needed Active recruiting of companies to show PHD and PCD devices is underway. It is not clear if the Japanese companies will participate. Questions include (a) approvals for the Connectathon and Showcase, and (b) IHE approval of the 2010 Connectathon as officially sanctioned. Todd added Sleep Apnea and Vital Signs home monitoring.

Decisions/Issues:

Action(s):

Item Topic Discussion
14 '
- <lead>
Status/Discussion:
  • Concern is over using EUI-64 when the device in question is aggregating data from multiple devices/systems. Manufacturers have discretion in how to construct the EUI-64. The current TF text remains unchanged and the gateway’s identifier is provided. John Garguilo offered to test the validation by building a table with the 24 bit portion that is the company id portion of the identifier. The identifier is 8 hex digits with no space or hyphen for PCD. The actual device contributing data will be identified by EUI-64 or device name and serial number for legacy systems in the OBX-18. If none of these are available, manufacturers may not be able to get it from the gateway. Discussion led to a desire to provide alternatives that would be defined at system installation that provides unique identifiers.

Decisions/Issues:

Action(s):

  • Manny to survey participants for company IDs. Ask if they will agree to use a 64 bit identifier whether they include the company ID or not.
Item Topic Discussion
15 xyz
- <lead>
Status/Discussion:

Decisions/Issues:

Action(s):


Friday 2009.10.09

Participants:

Ruth Berge, Jon Blasingame, Anupriyo Chakravarti, Todd Cooper, Bikram Day, Al Engelbert, Robert Flanders, Ken Fuchs, John Garguilo, Colin FX Gartska, Sunkee Lee, Gary Meyer, Monroe Pattillo, John Rhoads, Ioana Singureanu, Manny Furst

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1 xyz
- <lead>
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2 xyz
- <lead>
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3 xyz
- <lead>
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4 xyz
- <lead>
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5 xyz
- <lead>
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6 xyz
- <lead>
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7 xyz
- <lead>
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8 xyz
- <lead>
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9 xyz
- <lead>
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10 xyz
- <lead>
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11 xyz
- <lead>
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12 xyz
- <lead>
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13 xyz
- <lead>
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14 xyz
- <lead>
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15 xyz
- <lead>
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Next Meeting

The next meetings are: A joint PC and TC meeting on October 14, 2009 PCD PC&TC 2009-10-14 Webex

PC meeting October 21, 2009 PCD PC 2009-10-21 Webex

TC October 28, 2009 PCD TC 2009-10-28 Webex

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