PCD PC&TC 2009-10-05 to 09 F2F

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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 below.

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 Clarification of HL7 copyright issues PC PCD Cochairs 2009.10.xx Open Clarification of HL7 copyright issues that may pertain to purchasers of equipment and documentation using HL7 copyrighted materials. Take issue to Domain Coordinating Committee (DCC)
2 Making the LOA optional PC Todd 2009.10.xx Open Making the LOA optional without any detail is problematic. The group asked about: what is the rationale for Item 2 and why is section E optional? Patent Disclosure Wiki Page = IHE should modify page to provide link to the disclosure and to segment the page by profile and actor. Take to DCC
3 PCD-04 default Acknowledgement ACM Monroe 2009.10.xx Open Selection to accept only the acceptor (clinician) of the alarm.


4 Detailed Profile Proposal PC John Zaleski 2009.10.xx Open Refine predicate specification in queries in SPD.


5 Ballot to Accept Work Items for Detailed Profile Proposal PC 2009.10.xx Open Manny to ballot accepting the Brief Profile Proposals as the priority efforts Cycle 5 and soliciting vendor participation.


6 Potential for RTLS in New Directions Connectathon & Showcase WG Manny 2009.10.xx Open Manny to follow up with Lisa re permission for New Directions on RTLS. Note: later in the meeting this was postponed pending research of the level of interest of the companies. This was refined later to raise the bar on inclusion of systems into New Directions
7 AAMI and HIMSS10 Demonstrations PC Manny and Steve Merritt 2009.10.xx Open Develop New Directions at HIMSS10 (Steve) and at AAMI (Manny).
8 Content Profile Management TC ? 2009.10.xx Open Ask Steve Moore how content profiles may be managed.
9 SOA PC Chad, Todd, ? ? 2009.10.xx Open Manny to follow up on stakeholder survey to learn if that will shed light on desirability. Those participating in HITSP will monitor that environment for determination of whether this is a user priority.


9 Marketing PCD, IHE PCD Cochairs Cochairs 2009.10.xx Open Cochairs to consider options.


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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
- Ken 		Status/Discussion:

Decisions/Issues:

  • Agenda updated by consensus

Action(s):

Item Topic Discussion
2 Intellectual Property Policy and Procedure
- Todd 		Status/Discussion:
  • These were described in detail by Todd. The policy is scheduled for IHE Board vote on Thursday. Todd discussed the slides Need to upload slides Todd He referred to Appendix A of the Governance document for details. Ioana asked about copyright which is covered by MOUs with the documents PCD is using. Todd noted a Wiki page for the Patent Disclosure Policy and another for the Letter of Assurance. Get links from Todd. Ken raised the question of when this LOA will be required to submit this form. The IHE Patent Disclosure Form listing potential patents that may be relevant and is to be filed as soon as the company becomes aware of the issue. The group asked about: what is the rationale for Item 2 and why is section E optional?

Decisions/Issues:

Action(s):

  • To be taken to the DCC by PCD cochairs: clarification of HL7 copyright issues that may pertain to purchasers of equipment and documentation using HL7 copyrighted materials.
  • Todd will take to DCC: Making the LOA optional without any detail is problematic. The group asked about: what is the rationale for Item 2 and why is section E optional? Patent Disclosure Wiki Page = IHE should modify page to provide link to the disclosure and to segment the page by profile and actor.


Item Topic Discussion
3 Pipeline Impedance Matching
- Todd 		Status/Discussion:
  • Steve Merritt described the committees’ obligation to evaluate and manage the work with an eye to the resources available IHE Pipeline Impedance Matching

Decisions/Issues:

Action(s):

Item Topic Discussion
4 Roadmap Review
- Steve Merritt 		Status/Discussion:
  • Issues raised included:
- Risk management – this refers to technologies that facilitate risk management. The spreadsheet was updated. The Roadmap details can be found at http://wiki.ihe.net/index.php?title=PCD_Roadmap and ftp://ftp.ihe.net/Patient_Care_Devices/Roadmap_and_Calendar/IHE-PCD_Roadmap-F2F-20091005.xls.
- Transactions to/from the ACM AC, and ACM AA and the AM to AR user responses are postponed. Recruiting is underway for these AC and AM vendors. Todd noted that the AR needs to inform the AM of how much data is desired from the AM when the clinician responds from the AC to the AM. Todd noted that this last part only requires a relatively minor modification to the PCD-04 transaction. This was moved to Cycle 5.
  • Question by Ioana regarding Continua and ACM. Monroe brought up question of response time requirements and the difference between needs of home health and acute care. Ken questioned including the relationship of Continua' interaction on roadmap. Paul described the need for Rosetta inclusion. Then Todd continued with discussion of IHE/Continua relationship. Continua will be in the 2010 HIMSS showcase.
  • Patient Identity Binding: Robert introduced the CP for bringing in the ITI binding. It will be added to the TC portion of the meeting.
  • Point of Care Information Management (including patient ID): will be described later. DPI was moved to a later cycle except for the WP. No one was able to recall what Point of Care to the Enterprise work item was so it was deleted.
  • Content Management: Device Specializations (RCH) was added to Cycle 5, as was Alarm Communication Terminology Mapping (RTM).

Decisions/Issues:

Action(s):

  • PCD-04 default Acknowledgement selection to accept only the acceptor (clinician) of the alarm.
Item Topic Discussion
5 Brief Profile Proposal: Multiple Parameters at a Single Point in Time
- John Zaleski 		Status/Discussion:
  • John focused on the application portion of the proposal, preferring to leave the transport concept aside. The Clinical Decision Support accomplished at the point of care requires timely (real time), synchronized data. Examples: management of a hypoglycemic patient, septic patient, especially those that are comatose and cannot communicate.
  • John described the benefits for the clinician Need to get slides His proposal is for a triggered, asynchronous query for data at the requested time. This can be a time selected by an algorithm, or clinician. A query would be initiated if data wasn’t current, was missing, etc. He noted that patient responses cannot be extrapolated from past data or interpolated from recent data points because some clinical conditions change very rapidly.
  • The proposal is to codify the transactions (see last page of the Proposal). Ruth suggested this can be an order. John suggested this can be part of an existing or standing order. Paul noted the SPD option may be used. John responded that the higher time resolution stream is not the same as a query. John Hotchkiss noted that data is often delayed in gateways and networks. Ken asked John Zaleski about acceptable latencies. He responded there are delays of perhaps a few seconds from the patient through the processing of algorithm processing time. He noted there are two groups of patients – ICU with its assorted devices, and subacute care. If the CDSS system recommends action an alert would be issued.

Decisions/Issues:

Action(s):

  • Refine predicate specification in queries in SPD.
  • Manny to ballot for accepting the Brief Profile Proposals as the priority efforts Cycle 5 and soliciting vendor participation.
Item Topic Discussion
6 Work Item Proposals: Various
- Ken, Steve Merritt, Monroe, Todd 		Status/Discussion:
  • RTLS: Ken described the focus and scope of the profile – communication from the RTLS management system and other enterprise systems. Need to get Ken’s slides Ioana suggested that this may best be accomplished in HL7 v3 and may be most efficiently handled there. Manny noted that the RTLS companies are small and that they and their customers may prefer v2. Monroe noted that another issue is whether there is a patient associated with a device.
  • MEM: Steve referred to the poster displayed at HIMS09 and the WP. He noted that Year 2 effort will focus on low hanging fruit for demonstration at HMSS11. Examples include battery management and location boundary alarms. Configuration management and operational status and monitoring is slated for Year 3. http://www.ihe.net/Technical_Framework/upload/IHE_PCD_Medical-Equipment-Management_MEM_White-Paper_V1-0_2009-09-01.pdf
  • PIB Enhancements: Trauma Patients Coming Via Ambulance Without MRNs: Robert described the situation he and Ruth are addressing. Robert indicated this will be a White Paper or CP this year.
  • ENTERPRISE ACM: Monroe submitted the proposal to ITI. This is to make the ACM profile available to other IHE domains.
  • MIDDLEWARE: Bob Stiefel submitted this request but was not available to discuss it. add link
  • QBD: Carried forward from last year. Add link to Wiki page. This will include waveform data after WCM becomes available. Ken noted that this can become very complex. He noted that there may be ITI or PCC work in this area. Todd noted that this is a requirement in HITSP use case Common Device Connectivity and falls to PCD within IHE. The time frame is not clear.
  • DEVICE SPECIALIZATION (behavioral and structural constraints): Ioana noted that device specializations have RTM in common. For those that are primarily content profiles these will largely be dependent upon resources brought by vendors. Todd later described the need for Device Specialization Content Profiles where users need to know that both data and specific clinical workflow will meet their needs. This couples with generic or specific profiles, further constraining the profile (e.g., a specific type of pump such as syringe pump). Extensive discussion followed about where these will exist, how they will be used by vendors and those specifying systems for purchase. A specific specialization may have elements from multiple profiles (e.g., DEC, ACM, MEM) and will be referred to in Integration Statements. Among those fitting this description:
  • ENERGY DELIVERY PROFILE (device specialization for electrosurgical units)
  • HEARING SCREENING DEVICE PROFILE (device specialization for newborn screening systems) – Todd will contact Lori to learn more and invite her participation this week.
  • GENERIC CONTENT PROFILE (general items for both data and devices that applies to multiple types of devices)
  • DEVICE TO PATIENT ASSOCIATION was POINT OF CARE ID MANAGEMENT Jeff described the problem, when the actor does not directly have the information to tie the patient to the device, but needs to obtain the data elsewhere to bind and unbind the patient to the device. Todd noted there are three straight forward approaches within HL7 v2 (see Wiki page PCD Brief Profile Proposal 2009 PoC ID Management.
  • VERIFICATION & VALIDATION
  • IHE: MEDICAL DEVICE TESTING IN AN HIT WORLD (WHITE PAPER): See proposal.
  • REMOTE VIEWING OF REAL-TIME ECG: To be discussed Tuesday.
  • EVENT COMMUNICATION: A communication of events that may not rise to the level of alarms or alerts Is this best accomplished in ACM or DEC or …? Is an alarm a form of event? Likely supported with 11073. Todd and Ruth speculated that there may be a model for this in another domain.
PROFILE WORK UNDERWAY OR IN THE QUEUE: Ken reminded the group that PCD Proposals Cycle 5 contains work that hasn’t begun or is in process and should be considered.
  • CONTINUA: Paul described the need for input from the PCD to engage with mapping work. A significanT issue with RTM and Rosetta Communication Hierarchy (RCH) relates to the ability of cell phones to handle this data.
  • USERS HANDBOOK: This maps workflow to be accomplished to the specification of systems by reference to profiles. Device specific profiles will result in User Handbook Appendices. Version 0.4 was referred to, <Steve posted 0.5 at http://wiki.ihe.net/index.php?title=PCD_User_Handbook on Oct. 12. Steve later provided the following:
- 1. 10-19 send to PC and TC groups for 2 week review
- 2. Incorporate comments by 11-9
- 3. 30 day review end by 12-14
- 4. Release final version 1.0 by Connectathon
- 5. Prepare Overview Presentation to go with Handbook and market out to the world (ACCE, HIMSS, AAMI, CE-IT Community, etc)>.

Decisions/Issues:

Action(s):

  • Manny to follow up with Lisa re permission for New Directions on RTLS. Note: later in the meeting this was postponed pending research of the level of interest of the companies.
  • Develop New Directions at HIMSS10 (Steve) and at AAMI (Manny).
  • Ask Steve Moore how content profiles may be managed.
Item Topic Discussion
7 Service Oriented Architecture (Part 1, Introduction)
- Todd 		Status/Discussion:

Decisions/Issues:

Action(s):

  • Manny to follow up on stakeholder survey.
  • Those participating in HITSP will monitor that environment for determination of whether this is a user priority.
Item Topic Discussion
8 Review of PCD Web/Wiki/FTP Pages
- Steve Merritt, John Rhoads 		Status/Discussion:
  • Steve Merritt and John Rhoads are reviewing. John Rhoads noted there are public domain software that may help. Ioana suggested GForge may be of use.

Decisions/Issues:

Action(s):

Item Topic Discussion
9 Marketing PCD, IHE
- <lead> 		Status/Discussion:
  • Participants believe that IHE and PCD have not been successful in getting the message out to non-affiliated vendors or healthcare organizations.

Decisions/Issues:

Action(s):

  • Cochairs to consider options.
Item Topic Discussion
10 xyz
- <lead> 		Status/Discussion:

Decisions/Issues:

Action(s):

Item Topic Discussion

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. Need to get 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.
  • John Rhoads is looking at version control, etc.

Decisions/Issues:

Action(s):

Item Topic Discussion
10 RTLS
- <lead> 		Status/Discussion:
  • Monroe provided an overview of the current use of RTLS in healthcare. Slides are available at ftp://ftp.ihe.net/Patient_Care_Devices/Minutes-and-Meeting-Summaries-Yr4-2009-10/F2F-2009October5-9/. 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
11 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
12 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
13 EUI-64
- <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
14 Virtual Connectathon and Showcase: Firewall Issues
- Manny 		Status/Discussion:
  • Some people with firewall issues may be able to arrange for specific port/ip addresses to be able to connect. Others will have to rely upon emailed attachments or uploaded to the ftp site of messages tested on the MWB. Sending and receiving companies will review the results and notify the project manager that they agree the data sent matches the data received and any associate requirements are met. Companies may elect to post a display/table along with the messages.

Decisions/Issues:

  • Will be mandatory, with the process above to avoid firewall issues.

Action(s):

  • Manny to survey to learn which companies have firewall issues.
15 Virtual Showcase
- Manny 		Status/Discussion:
  • Discussion revealed that PCD does not need a Virtual Showcase this year. Pre-Connectathon Testing with MWB and NIST Tools and Connectathon Testing with parameters/data that are likely to be used in the Showcase during the Connectathon should be sufficient.

Decisions/Issues:

  • PCD does not need a Virtual Showcase this year due to its size and ability to test systems and parameters/data that is likely to be used in the Showcase during the Connectathon.

Action(s):

Item Topic Discussion
16 '
- <lead> 		Status/Discussion:
  • Lisa is encouraging PCD to move the election cycle such that new cochairs take office on September 1 to provide continuity with new profile development.

Decisions/Issues:

Decision

  • The consensus is to change the date and to leave it to the cochairs to determine if they prefer the PCD will hold elections and those elected will have shorter terms, or if they prefer to remain in office until the later election cycle.

Action(s):

  • Cochairs to make the decision and communicate with Lisa.
Item Topic Discussion
17 NIST Testing Strategy
- John Garguilo 		Status/Discussion:
1. Instance Testing
a. Conformance with HL7 2.x or CDA
b. Virtual and Pre-Connectathon
2. Isolated System Testing
a. Includes Instance Testing
b. Protocol Conformance
c. Functional Behavior Conformance
3. Peer-to-Peer System Testing
a. Includes Isolated System Testing
b. Interoperability Testing
i. Test complete application environment
ii. … see slides for more information
  • Gary asked if passing the NIST tool could substitute for Kudu Connectathon testing.

Decisions/Issues:

  • The consensus was that the tool will be used in the Connectathon as well as in Pre-Connectathon testing.

Action(s):

Item Topic Discussion
18 Certification
- <lead> 		Status/Discussion:
  • Marketing, engineering and users are reportedly in favor of certification. Anupriyo noted that CCHIT provides certification of ITI, but not elements of concern to PCD. Connectathon testing will no longer be a prerequisite for CCHIT. It may be that CCHIT will certify PCD message types. There was general agreement that certification is desirable.

Decisions/Issues:

Action(s):

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

Decisions/Issues:

Action(s):

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

Decisions/Issues:

Action(s):

Item Topic Discussion
21 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

The following joined the SoA discussion via Webex: Mark Arratoon (GE), Chad Hays, Sarah Hopkins, Sandy Weininger, Cheng Zhu (NextGen)


Item Topic Discussion
1 Agenda Review, IP
- Todd 		Status/Discussion:
  • Todd reviewed the agenda for the day. All except some who joined the specific SoA were aware of the IP issues. The SoA discussion did not include IP issues.

Decisions/Issues:

  • Any changes were made by consensus.

Action(s):

Item Topic Discussion
2 Showcase Continued
- Manny 		Status/Discussion:
  • ACM AM to AR actor – there are two systems available to test at the Connectathon if Ascom is able to provide a system. Live Data is able to implement and test.

Decisions/Issues:

Action(s):

  • Monroe asked Rob Wilder of AmcomSoft if they are able to do so. Rob Wilder will explore the possibility.
Item Topic Discussion
3 TI Version of Technical Framework
- Todd 		Status/Discussion:
  • Todd led discussion on the organization and content of the update. The PDF need to provide link provides the updated structure and organization.
  • The TF TI version to be released for PCD comment will be technically complete. The Final Text version will contain additional editorial material provided in a CP. This includes architectural considerations, ICE references.

Decisions/Issues:

Action(s):

  • Ruth will check status of ITI HL7 ACK text. This relates to PCD-03.
Item Topic Discussion
4 SoA Continued
- Chad Hays 		Status/Discussion:
  • The following joined via Webex: Mark Arratoon (GE), Chad Hays, Sarah Hopkins, Sandy Weininger, Cheng Zhu
  • Todd led the discussion of SoA and how it may be used by PCD. Need to get document, add link
  • ITI has white paper (referenced by Todd) 9/28/09 posted and out for public comment. Todd provided IHE ITI TF web link get link
  • Also referenced HITSP framework …this shows need to integrate SOA concepts in standards
  • Also HL7 SAEAF, service aware enterprise aware framework, has conceptual, platform independent and platform specific views.
  • Chad recommended that SoA will reduce future issues for PCD. Mark Arratoon agreed, adding that the industry is moving in this direct. Chad believes this will add value immediately and appeal to vendors interested in IHE. Mark noted that there are existing standards that can be leveraged to facilitate interoperability. Todd conducted an informal poll of device vendors and did not find a high level of interest. He asked if SoA implies web based platform or rather a platform independent architecture - for Chad, Mark. Mark responded that he is referring to the latter. John Rhoads noted that and while not necessarily the best approach it is the direction. Mark indicated that SoA hides some of the complexities of the message process and therefore is more flexible, and also permits additional services. For example, SPD query would not be required to provide a filter. Anupriyo offered a different point of view – PCD deals with data while SoA is about services; for example, a DOR becomes a service consumer. The focus will shift to the consumer. Mark responded that there are two aspects: services and service bus (integration engine) provide service provision as well as messages and filters and the ability to convert messages to XML – doing work on the bus. He believes that the messaging engine facilitates data communication. Chad added that this is a robust communication service.
  • Ken suggested that SoA may be useful in DPI, and asked if it would be robust at high data rates and the ability of PCD to find the resources to accomplish the additional work required.
  • With regard to pipeline impedance matching, Todd asked if users and vendors see SoA as a high priority. In the short term, HITSP will be discussing how SoA fits device connectivity. He suggested that PCD develop a WP on the subject; this will provide an opportunity to research the issue. Chad supported this approach. Todd noted that this may attract the attention of other domains, announce this to DCC, and others may join the discussion. John Rhoads suggested that this be approached more informally than other WP activities.

Decisions/Issues:

Action(s):

  • Chad, Mark, John Rhoads will develop a Brief Proposal for ballot next week. Chad will provide the Brief Work Item Proposal on Monday for submission for PCD ballot.
  • Manny to provide ballot for Profiles.
Item Topic Discussion
5 WCM Profile Continued
- Ken 		Status/Discussion:
  • Ken described components of the WCM content profile and these produced additional items in the TF structure and implications for future work. Robert noted that work can begin shortly on the Supplement. Ken wondered about the structure of a Content Profile.

Decisions/Issues:

Action(s):

Item Topic Discussion
6 OID
- <lead> 		Status/Discussion:
  • The IHE Wiki pageOID Registries is a useful reference. John Rhoads noted that the IEEE’s approach does not encode much in an OID. IEEE has tutorials “IEEE Registration Authorities” with a link to the way IEEE manages OIDs. John Rhoads provided a Wiki page PCD OID Management, as does ITI. PCD has an OID root. PCD will assign OIDs to entities, documents other than profiles as well as assignment to profiles. An SNMP data address is an OID. PCD can use OIDs for template IDs and coding systems as HL7 v3 does. E.g., the coding system for WCM (perhaps as a subset of RTM) would have an OID. Get links from Todd and post

Decisions/Issues:

Action(s):

Item Topic Discussion
7 Next F2F
- Todd 		Status/Discussion:
  • PCD will look at April, and first learn when and where other domains meet so that we can send liaisons to the others, esp. ITI, PCC, QRPH.

Decisions/Issues:

  • Manny to research dates and availability of meeting rooms.

Action(s):

Item Topic Discussion
8 Wrap Up
- Todd 		Status/Discussion:

Decisions/Issues:

Action(s):

  • Manny will post discussion notes and Action Item list. The action items will be reviewed at Wednesday’s joint PC, TC meeting. The following meeting will be a PC meeting and the one following that one will be a TC meeting.
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):


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

PCD Home

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