PCD PC&TC 2011-05-10 to 13 F2F

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This is merely a sketch to start the process -- please enter suggested topics in PCD 2011 Spring Face-to-Face Topic Suggestions

Meeting Objectives

These Springtime face-to-face meetings have a number of objectives depending on the committees involved:
  • Planning Committee: Review, plan and initiate overall PCD activities
  • Technical Committee: Review all materials slated for publication in 2011 and resolve any issues so that final editing and publication may proceed.

Some suggested topics for PCD Spring Face to Face

Planning Committee

Suggested topics may be added to PCD 2011 Spring Face-to-Face Topic Suggestions

The Roadmap - is there a disconnect between the roadmap and what participants are really prepared to do?

How much of the way we are organized serves our long-term goals and what can we do about it?

What the heck are our long-term goals, anyway?

Wednesday afternoon(?) we reserve time for Christel Anderson (and maybe me - Jon) to introduce someone from Christel’s patient informatics group and see how her/his HIMSS connections in this area might best be put to use in IHE PCD.

Publicizing PCD to users, vendors.

Recruiting users, vendors.

Setting the date for the Fall 2011 F2F

Technical Committee

Event driven processing: are EMR vendors really interested, what are the generic requirements and the infusion management requirements, should we treat Alarm Communications Management as a special case of event processing?

Asynchronous Data Query - where is it needed, when will clinical information systems be ready to play, what are the real requirements, do we need a phased approach?

Content Profiles and the mythical "volume 3"

Implementation Guides - what should be in them, how should they be organized (and who wants to work on them)

What about OIDs and use of identifying different versions of things (focus on conformance profile used in a cycle, and how subsequent cycles change [e.g., "x" --> "o" at the HL7 component level of a field]and what this means if there are not enough vendors participating as a particular actor for a later version versus an earlier version)?

Point-of-care Identity Management: what are the problems? What can (and should) we say about the solutions?

How much of Medical Equipment Management can we accomplish using existing PCD-01? How much nomenclature do we already have? What do we need to add?

Traceability in PCD-01: MDSes, VMDs, Channels, Device identifiers and metrics, and what can we and EMR vendors do to associate data with sources? Who cares now? Who will care in the future?

Modeling approaches: Clinical Workflows, ICE-PAC and HL7 Detailed Clinical Models for Medical Devices

Are manufacturers going to sign up for system -> device and device <-> device interactions?

Change Proposal Process (Ioana Singureanu)


Participants

Tuesday:

Dominick Angarra, Christel Anderson, Sam Carrillo, Anupriyo Chakravarti, Bikram Day, Al Engelbert, Ken Fuchs, John Garguilo, Chad Hays, Jack Hoffman, Khalil Maalouf, Sandra Martinez, Steve Merritt, Monroe Pattillo, John Rhoads, Jeff Rinda, Paul Schluter, Ioana Singureanu, Erin Sparnon, Richard Swim, Rob Wilder

Wednesday:

Dominick Angarra, Christel Anderson, Sam Carrillo, Anupriyo Chakravarti, Bikram Day, Al Engelbert, Ken Fuchs, John Garguilo, Chad Hays, Jack Hoffman, Brad Lunde, Khalil Maalouf, Sandra Martinez, Monroe Pattillo, John Rhoads, Paul Schluter, Ioana Singureanu, Erin Sparnon, Richard Swim, Rob Wilder, Kristina Wilson

Thursday:

Schedule & Agenda

Daily Schedule
08:00 - 08:30 Meet at Philips Emergin
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
Tuesday

2011.05.10

08:30 - 17:00 PCD Planning Committee
  • Greeting & Introductions (20 minutes)
  • Review & Approve Agenda (20 minutes)
  • IHE IP Management Process (5 minutes)
  • Review Current PCD Program:
- Roadmap Review (30 minutes)
- Schedule / Milestones Review (30 minutes)
- Break (15 minutes)
- Current Workitems (15 minutes)
- New Workitems
- Profile Supplements (30 minutes)
- White Papers (15 minutes)
  • Cycle 7 Work Item Ideas (30 minutes)


  • Lunch


- PCD 101
- Education opportunities
- What information are we missing to educate providers?
  • Interop Showcase 2012 planning (30 minutes)
  • Break (15 minutes)
  • VA Update (Ioana/Greg)
  • Overflow discussions (90 minutes)


Wednesday Morning

2011-05-11

08:30 - 12:00 PCD Planning and Technical Committees
  • IHE IP Management Process
  • Web / wiki / FTP Review
  • Review and discuss "time" issues
  • Review and discuss ADQ requirements
  • 11:00 AM - MEM Networked Medical Device proposal (Axel and Steve to webex in)
  • Location, Dates of the Fall F2F
  • Other business
Wednesday Afternoon

2011-05-11

13:00 - 17:00 PCD Technical Committee (TC)
  • IHE IP Management Process
  • TC Welcome and Agenda Review (Garguilo/Rhoads)(10 mins)
  • Are manufacturers going to sign up for system -> device and device <-> device interactions? (Rhoads) (30 mins)
  • Asynchronous Data Query (Khalil - WebEx - John Z.) (45 mins)
- Where is it needed, when will clinical information systems be ready to play, what are the real requirements, do we need a phased approach?
Afternoon Break
  • Technical Framework Status and Review (Rhoads)(45 mins)
  • Change Proposal Process (Ioana)(Scheduled for 3:30 PM - 30+ mins)
  • How much of Medical Equipment Management can we accomplish using existing PCD-01? (Merritt/Rhoads)(30 mins)
- How much nomenclature do we already have? What do we need to add?
  • RTM Update (Schluter)(45 mins)
- How to handle restructure in TF (from Integration Profile to Appendix)
- Pointer to dynamic/living file


Thursday Morning

2011-05-12

08:30 - 12:00 PCD Technical Committee (TC)
- Cycle 6 Pre-Connectathon & Beyond... (Garguilo)
- Supporting Tool Update (Garguilo/Sandra Martinez)
- (Note preliminary Connectathon 2012 Dates @ Chicago Hyatt Grand Regency January 9th - 14th)
  • Implementation Guides (Garguilo) (15 mins)
- What should be in them, how should they be organized (and who wants to work on them)
~ Relationship to other artificts (Use Cases, Message Profiles, Message Templates, Static/Dynamic Definitions)
- Proposed Table of Contents?
  • What about OIDs and use of identifying different versions of things (Garguilo/PIV WG) (15 mins)
- Focus on conformance profile used in a cycle, and
- How subsequent cycles change [e.g., "x" --> "o" at the HL7 component level of a field]and what this means if there are not enough vendors participating as a particular actor for a later version versus an earlier version)?
Morning Break
  • Modeling approaches (Ioana Singureanu)(60 mins)
- Clinical Workflows / example from VA
- HL7 Detailed Clinical Models for Medical Devices (HL7 Ballot Item)
- ICE-PAC
  • Format for expressing event Containment and content model (Schluter) (45 mins)
  • Content Profiles and the mythical "volume 3" (Garguilo/Rhoads)(15 mins)
- What is this and what would such a volume contain?
- Is now the right time? Move to the 'Parking Lot'?
Lunch


Thursday Afternoon

2011-05-12

13:00 - 17:00 PCD TC WG Meetings
- What are the problems? What can (and should) we say about the solutions?
  • PIV Update and CP Review/Discussion (Rinda [via WebEx]/Engelbert/Lunde)(60 mins)
Afternoon Break
  • ACM Update (Patillo)(45 mins)
- Should we treat Alarm Communications Management as a special case of event processing (next Topic)?
- Move from Alarms to Event Communication?
  • Event driven processing: (30 mins)(Patillo/PIV/Others)
- Are EMR vendors really interested, what are the generic requirements and the infusion management requirements, should we treat Alarm Communications Management as a special case of event processing?


Friday Morning

2011-05-13

08:30 - 12:00 PCD TC WG Meetings
- Action Item TC 110.
  • Test cases (development and definition) for Cycle 6 (Furst)
  • Tech Committee Overflow (First Day and half)
?? Others ??
Morning Break
  • IDCO Update (Nick Steblay and Tom Schultz via WebEx at 11 AM, Eastern)(60 mins)
- Recap and Report out from HRS Conference/Meetings (week of May 2 - 6)
- What's new or planned for cycle 6
Lunch
Friday Afternoon

2011-05-13

13:00 - 15:30 PCD Technical Committee
- MDSes, VMDs, Channels, Device identifiers and metrics, and what can we and EMR vendors do to associate data with sources?
- Who cares now? Who will care in the future?
  • Action Items Review (Rhoads/Garguilo)
  • Meeting Recap and Summary (Rhoads/Garguilo/Furst)
- Record To Dos / New Action Items
Note: Additional evening working sessions may be scheduled as needed.

Location Information

Philips Emergin
6400 Congress Avenue
Boca Raton, Florida 33487
(561) 361-6990


  • 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-Yr6-2011-12/F2F-2011May/ unless otherwise noted. Documents are available without a password.

Discussion

Discussion Summaries do not require formal approval, while minutes of meetings where votes are taken do. Participants are encouraged to review and bring up significant issues with discussion summaries of previous meetings. Votes will be taken to approve meetings where votes took place; these may be email ballots.

Tuesday Morning May 10

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

Participants introduced themselves.

Decisions/Issues: Agenda approved

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair 		Status/Discussion:

Decisions/Issues: Discussion Summary of previous meeting was deferred


Action(s):

3 Agenda Items
- As Noted 		Status/Discussion:

Webex meetings have been scheduled and the schedule and access codes have been distributed by email.

IP Patent and Disclosure

Ken summarized the IP policy and displayed the Wiki page. All present represented IHE member organizations. Discussion followed about the obligations of participants who are required to notify IHE if the work in process may be impacted by a patent.

PCD Roadmap:

Ken led discussion with reference to the PCD Roadmap Wiki page. The Roadmap was updated at the Fall 2010 F2F. He reviewed the work accomplished to date and the projections for the future. See the Roadmap for details. The original is at ftp://ftp.ihe.net/Patient_Care_Devices/Roadmap_and_Calendar/ and the updated version will be posted in that folder.
Architecture: PCD-02: the question was raised about the number of implementations required to move a supplement to TF FT. John Rhoads indicated that the requirement for three vendors on each side can be met cumulatively in multiple Connectathons. Also, WS was tested in the 2010 Korean Connectathon and thus was added to the updated Roadmap. Security was added to Cycle 7. Device Cybersecurity will be added to Device Management.
Device Enterprise Communications: Ken noted that ADQ might also be applied to the ACM AA. Monroe suggested a later discussion about removing the AA to permit ACM becoming FT since there has been insufficient interest in implementing and testing. A CP is required to remove the AA and another would be required later if it is to be added back. HL7 is considering order alarm (e.g., critical priority lab) results notification, and these are site specific. Christel noted that alarm fatigue and other issues should be a high priority for PCD and that the Smart Alarm project may address this. Manny asked how to involve other domains so that ACM meets the clinicians’ and the domains’ needs. Monroe responded that ITI was not interested in the past. Radiology has responded that they address this within DICOM, but that ACM is for system to people rather than system to system.
- Discussion of smart alarms (decision support for alarms) followed (cycle 8). This is currently out of scope due to complexity and FDA regulation. Monroe indicated that there is a demand for this. Ken noted that ADQ will accommodate these and that this project will address the requirements to support smart alarms while not specifying what the alarms will be – they will be vendor specific. Dominick asked about the application and Monroe responded by saying that this will assure the data is appropriately available, but not define the algorithms for decision making.
- AAMI will initiate an alarm safety committee and PCD should be represented. Erin will share the announcement with the PCD PC, TC.
- Data Mining (Cycle 7) was incorporated into ADQ.
Device Context Management: Device Patient Association is renamed Point of Care Identity Management (PCIM) which is about to begin work. Where and how this is accomplished has yet to be defined.
Device Order Management: CPs will be offered to PIV. With regard to PCA pumps, this will be renamed PIV for PCA pumps, Jeff noted that HL7 does not yet provide necessary elements.
Medical Equipment Management: Changes were made, moving timetables and adding a Security “Profile” to Cycle 7.
Point of Care:
- Christel encouraged PCD to make DPI a high priority and that the WP, even short of a comprehensive document, is needed now. PCD has been resource limited in completing the WP. John Garguilo noted that the FDA is struggling with this issue. Ken noted that DPI and ICE-PAC are addressing this and are addressing technical issues.
Content Management:
- WCM is available for testing and demonstration. Snippets should be tested and demonstrated in Cycle 6, Continuous in Cycle 7 and in FT in Cycle 8.
- LOINC mapping was removed; adding SNOMED or LOINC are an optional responsibility. Paul noted that others, such as the National Library of Medicine are more appropriate responsible parties.
- Extensive discussion ensued regarding RTM marketing – making its tables known to, and available for other domains and potentially expanded for terms that PCD would not use. Paul noted that RTM for PCD is a rapid way to add new terms, evaluate them and then submit to IEEE for adoption. This should be distributed as “best practice” through IHE as a level of rigor rather than required implementation since other domains use LOINC, SNOMED. Ioana endorsed this as a value set required of all IHE domains.
o ACTION ITEM: Iona will document this. PCD with Christel’s assistance will need to find a way to promulgate the message.
Coordination Efforts:
- Changes were made to the schedule.

PCD Schedule:

Steve led discussion of the schedule, noting the deadline for new supplements and CPs to be published in time to be tested in the 2012 Connectathon Cycle. Event Communication and CPs have the following deadlines: Submit new supplements due May 29, publish for public comment June 5, submit for TI July 24, publish for TI Aug. 7. CPs will be due about a month before Aug. 7. The registration window for the Connectathon and Showcase will be added to the Wiki page. Steve will update the page. There are two portions: development and deployment.


Decisions/Issues:

Action(s): Iona will document the PCD RTM as a "best practice" exemplifying the use of tight structure and rigorous definitions which produce specific coding for each element of the data. PCD with Christel’s assistance will need to find a way to promulgate the message.


Tuesday Afternoon May 10

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

PCD User Handbook:

Steve led discussion of the document and comments received. Questions were resolved.

PCD Marketing and Funding:

Discussion about the need for, and the engagement of users indicated that much of what PCD does in meetings would not be of interest. Ioana commented on how users can contribute, e.g., by identifying needs and requirements rather than active participation on a schedule. Steve added that users can help identify workflow requirements. Steve identified needs for users to identify needs and priorities, what has already been accomplished, how to participate.
- PCD 101 was conceived to help describe PCD to HIMSS’ clinical informatics membership. She holds monthly meetings and invited PCD to provide a minutes presentation. She recommended that Erin and Ioana conduct the presentation. Erin noted the introductory portion and Ken added that he would like to add some “to do” items.
- HIMSS and Alliance for Nursing Informatics (ANI) with 20 some odd member organizations that holds periodic meetings and PCD can be represented.
- Christel described the clinical informatics survey she recently conducted.
- Christel suggested PCD take advantage of the many HIMSS publications, from formal peer reviewed JHIMSS to informal.
- Anupriyo raised the question of the disparate communications required – clinicians’ different from technologists’. Christel noted the clinicians’ desire for workflow information. Ken noted that PCD develops use cases for the profiles and are not well communicated. Christel said that clinicians won’t ask for the information from PCD, so PCD needs to be proactive.
- Christel described her survey and her focus on integration into the EMR. Comments received on’the draft were described. Richard suggesting adding supply chain. Discussion addressed varying the survey for use with other audiences. Changes were suggested and the survey will be sent consistent with Erin and Ioana’s timetable.

AAMI11:

Manny provided an update. Christel will provide the handouts and will need the final version the end of the month.

HIMSS12:

Manny summarized recent discussions which indicated PCD should increase emphasis on workflow and connectivity and reduce the focus on clinical story, messages and transactions. The Showcase will have limited floor and ceiling space. One concept is to have portions similar to the PIV wall at HIMSS11 and the fourth wall which permitted in depth discussion of technical and other issues. IDCO may participate again.
Christel invited PCD members to submit proposals for presentations. Sessions include roundtables. Proposals should emphasize what participants will learn.

Board Report:

- Ken reviewed the BoD report. The latest draft is available on the PCD ftp site and will be submitted shortly.

VA Update:

- Ioana led the discussion. Attending at various times via Webex: Greg Staudenmaier, Holly Miller, Chatherine Hoang.
- IOANA’s slides are found at: on the DCM for Medical Devices Project site:

http://gforge.hl7.org/gf/project/dcmmd/docman/?subdir=257 The HL7 Ballot with all use cases can be found at ___________ . This will be discussed next week at the Health Care Devices group of IEEE.

- Ioana described the use and importance of the Domain Analysis Model (slide 2). She went on to describe each of the slides. In slide 18, Choice 3 is continuation of Choice 2.
- Device to patient association is most effective in addressing patient safety occurs when accomplished at the point of care. Each step removed from there appears to be less effective. (Slide 18).
- Patient safety and data validity issues were discussed in detail, identifying real issues that may lead to errors in associating legacy devices with patient identifiers. Paul noted that at least one demographic item must be required.
- Ioana noted that accuracy and precision were raised for the first time by clinicians, specifically for alarms, but is more general.


Decisions/Issues:

Action(s):

Action(s):

Wednesday Morning May 11

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

Decisions/Issues:

Agenda approved placeholder

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair 		Status/Discussion:

Informal review of yesterday's summaries. placeholder Decisions/Issues:

Action(s):

3 Agenda Items
- As Noted 		Status/Discussion:

Decisions/Issues:

Action(s):

4 xxx
- yyy 		Status/Discussion:

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5 yyy
- 		Status/Discussion:

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Action(s):

Wednesday Afternoon May 11

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

Decisions/Issues:

Agenda approved placeholder

Action(s):

2 Discussion Summary or Approval of Minutes (TC)
- Chair 		Status/Discussion:

Last TC Meeting placeholder

Decisions/Issues:

Action(s):

3 Agenda Items
- As Noted 		Status/Discussion:

Decisions/Issues:

Action(s):

4 xxx
- yyy 		Status/Discussion:

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Action(s):


5 yyy
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Thursday May 12

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

Decisions/Issues:

Agenda approved placeholder

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair 		Status/Discussion:

Informal review of yesterday's summaries. placeholder Decisions/Issues:

Action(s):

3 Agenda Items
- As Noted 		Status/Discussion:

Decisions/Issues:

Action(s):

4 xxx
- yyy 		Status/Discussion:

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5 yyy
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Friday May 13

Item Topic Discussion
1 Introductions & Agenda Review
- Chair 		Status/Discussion:

Decisions/Issues:

Agenda approved placeholder

Action(s):

2 Discussion Summary or Approval of Minutes
- Chair 		Status/Discussion:

Informal review of yesterday's summaries. placeholder Decisions/Issues:

Action(s):

3 Agenda Items
- As Noted 		Status/Discussion:

Decisions/Issues:

Action(s):

4 xxx
- yyy 		Status/Discussion:

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5 yyy
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Decisions Summary

Next Meeting

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