Difference between revisions of "PCD Showcase 2009 Scenario"

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| DOR, IOC and AR for Cardinal, Hospira
 
| DOR, IOC and AR for Cardinal, Hospira
 
| Pump(s) added; PIV to be employed
 
| Pump(s) added; PIV to be employed
 +
 +
 +
Hi, I’m ______________. With Alaris Systems
 +
: Today I’d like to show you how the Alaris System contributes to patient safety.
 +
: The Alaris System uses IHE Patient Care Device messages to seamlessly communicate IV infusion and other medical device information to clinicians. The PCD-01 communicates infusion data from the pump to hospital systems, in this case GE Centricity Enterprise and  Epic EMR systems.  Just about everyone is aware of the importance of medication errors today. A few key facts to keep in mind include:
 +
: • Despite our heightened awareness of medication errors and efforts to prevent them, they continue to occur and they are costly. Preventing Medication Errors: Quality Chasm Series, Institute of Medicine, July 2006
 +
: • 61% of the most serious and costly medication errors are IV-related Communication with D.W. Bates, M.D., M.Sc. of Brigham & Women's  Hospital in Boston, October 2001
 +
: So we’ll be showing you how you can improve IV medication delivery safety.
 +
 +
: Our patient a 65 year old male is being prepped for a gastrectomy and distal transabdominal esophagectomy.
 +
: The surgery protocol calls for: 
 +
:: Dextrose 5%W 1000ml at 75mL/hr
 +
:: Propofol 100mcg/kg/min
 +
:: Morphine 100mg/D5w 100ml
 +
 +
: The pump based barcode reader provides patient, medication and pump connection confirmation. The pump based reading of solution barcodes populates the pump with initial infusion parameters:
 +
: • Scan patient id – confirming correct patient
 +
: • Scan solution
 +
: • Select medication.
 +
: • Enter program parameters.
 +
: • Confirm pump entry.
 +
: • Start infusion.
 +
: • Infusion info can be confirmed on monitor. (PCD-01 message)
 +
  
 
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=== ''Step Down Unit (SD)'' ===
 
=== ''Step Down Unit (SD)'' ===

Revision as of 20:14, 19 December 2008

Establishing Page

Patient Care Device Domain HIMSS 2009 Showcase Scenario Development

This page is provided to

facilitate development of the Showcase demonstration and its clinical story
enable the participating companies to post and refine their portion of the Showcase scenario and to develop their "script".

Companies and Systems

B Braun, Capsule, Cardinal Health, Cerner, Draeger, Epic, GE Gateway, GE Centricity Periop, GE Centricity Enterprise, Hospira VeriScan, Hospira MedNet, LiveData, Philips CIS, Philips IIC, Philips Emergin, Polycom, Surgical Information Systems

Settings and Tours

The physical structure will have four walls, which will display devices and systems that contribute to improved patient care, safety, workflow and/or productivity because of interoperability.

Three of the walls demonstrate specific devices and systems within a clinical scenario. The scenario is summarized below. Further down, each step in the scenario is described in greater detail by the company providing the device/system.

Three clinical "sites" are provided: OR, ICU, Step Down (SD). Visitors will participate in tours that start in one of these three areas and proceed to the next (OR to ICU, ICU to SD, SD to OR). Tours will rotate. Some devices/sytems participate in every tour that includes a site they participate in, while others rotate.

Docents will bring a group of visitors to the PCD structure and provide an introduction to the portion of the scenario they will see, and will seek a volunteer in the group to act as the patient for the demonstration.

Vendors will describe their contribution to interoperability, the benefits and the nature of their systems (see developing scripts, below)

Overview of the Scenario

Male patient, 65 years, BMI 32, weight 90 kg, coronary artery disease (AMI 6 months ago), moderate COPD (smoker), compensated renal insufficiency (40% GFR). Adenocarcinoma of the lower esophagus (close to the entry into the stomach), scheduled for gastrectomy and distal, transabdominal esophagectomy.


OR

Patient needs full invasive CV monitoring starting at induction.

Patient identified on each of the 3 vendor pumps and started on 3 infusions: Dextrose 5% 1000 mL @ 75 mL/hr, propofol, 1000 mg/ 100 mL @100 mcg/kg/min and morphine 100 mg/ dextrose 5% 100 mL @ 1 mg/hr. Status of all 3 infusions is viewable on monitors via PCD01/02


Intensive Care Unit

After surgery patient remains intubated and is transferred to ICU. After initial stabilization (fluids according to CO and SvO2, low dose Dopamine), rapid weaning of the ventilator on SmartCare/PS.

Using PIV, the nurse uses BCMA to send low dose Dopamine 400 mg in Dextrose 5% 250 mL @ 2.5 mcg/kg/min) to pump to aid kidney perfusion. The infusion status is viewable on monitors via PCD01/02

The patient is extubated 12 hours after admission to ICU. Ventilator Alarms are managed, routed and displayed Discharge to SDU after 36 hours.


Step-Down Unit

On SDU patient require still monitoring of HR, BP, RR and SpO2 (RR and SpO2 due to COPD).

Antibiotic continued for 72 hours. Vancomycin 1 g in Dextrose 5% 250 mL is infused over 60 minutes via IV device. Using PIV, the nurse uses BCMA to send Vancomycin order data to pump. The infusion status is viewable on monitors via PCD01/02

Clinical Sites and Steps

The Scripts supporting the demonstration in each site are provided in the next section, below.


Operating Room (OR)

Need to add SIS

Step Company System Type Function Actor Role
1 Epic or GE, alternating Inpatient EMR or Centricity Enterprise EMR Patient ID, Admit PAM Admit patient, generate bar code and MRN; this step takes place only when tour starts in OR; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving
2 Draeger Infinity Gateway Gateway Phys Mon DOR Patient attached to physiologic monitor
3 B Braun or Cardinal or Hospira, alternating Pump Pump Pump DOR Connected to patient for drug delivery


Hi, I’m ______________. With Alaris Systems

Today I’d like to show you how the Alaris System contributes to patient safety.
The Alaris System uses IHE Patient Care Device messages to seamlessly communicate IV infusion and other medical device information to clinicians. The PCD-01 communicates infusion data from the pump to hospital systems, in this case GE Centricity Enterprise and Epic EMR systems. Just about everyone is aware of the importance of medication errors today. A few key facts to keep in mind include:
• Despite our heightened awareness of medication errors and efforts to prevent them, they continue to occur and they are costly. Preventing Medication Errors: Quality Chasm Series, Institute of Medicine, July 2006
• 61% of the most serious and costly medication errors are IV-related Communication with D.W. Bates, M.D., M.Sc. of Brigham & Women's Hospital in Boston, October 2001
So we’ll be showing you how you can improve IV medication delivery safety.
Our patient a 65 year old male is being prepped for a gastrectomy and distal transabdominal esophagectomy.
The surgery protocol calls for:
Dextrose 5%W 1000ml at 75mL/hr
Propofol 100mcg/kg/min
Morphine 100mg/D5w 100ml
The pump based barcode reader provides patient, medication and pump connection confirmation. The pump based reading of solution barcodes populates the pump with initial infusion parameters:
• Scan patient id – confirming correct patient
• Scan solution
• Select medication.
• Enter program parameters.
• Confirm pump entry.
• Start infusion.
• Infusion info can be confirmed on monitor. (PCD-01 message)


4 GE Periop Anesthesia CIS Display DOC Display data the system received consistent with the Scenario
5 LiveData OR Dashboard Dashboard Display DOC Display data the system received consistent with the Scenario
6 LiveData OR Dashboard Send Alarm Alarm AR Local workflow alarm
7 Philips Emergin Alarm Manager Receive Alarm Alarm AM Receive alarm, forward to Polycom, receive response
8 Polycom SpectraLink Clinician's Phone Alarm AC Receive alarm, respond to AM
9 Epic or GE, alternating Inpatient EMR or Centricity Enterprise EMR EMR DOC All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU
10

Intensive Care Unit (ICU)

Step Company System Type Function Actor Role
1 Epic or GE Inpatient EMR or Centricity Enterprise EMR Patient ID, Admit PAM Admit patient, generate bar code and MRN; this step takes place only when tour starts in ICU; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving
2 GE or Capsule Gateway or DataCaptor Monitor & Central St or Middleware/Gateway Display DOR or DOR and AR NOTE: Patient attached to physiologic monitor; if Capsule connects unique devices it will become step 3; it may be moved to SD
3 Capsule DataCaptor Middleware Gateway DOR, AR Can be step 3 if unique devices attached
4 Philips Intellivue Clin Info Portfolio CIS Display DOC, AR Display of all data the system received consistent with the Scenario
5 B Braun and Cardinal and Hospira Pumps Pumps DOR, IOC and AR for Cardinal, Hospira Pump(s) added; PIV to be employed


Hi, I’m ______________. With Alaris Systems

Today I’d like to show you how the Alaris System contributes to patient safety.
The Alaris System uses IHE Patient Care Device messages to seamlessly communicate IV infusion and other medical device information to clinicians. The PCD-01 communicates infusion data from the pump to hospital systems, in this case GE Centricity Enterprise and Epic EMR systems. Just about everyone is aware of the importance of medication errors today. A few key facts to keep in mind include:
• Despite our heightened awareness of medication errors and efforts to prevent them, they continue to occur and they are costly. Preventing Medication Errors: Quality Chasm Series, Institute of Medicine, July 2006
• 61% of the most serious and costly medication errors are IV-related Communication with D.W. Bates, M.D., M.Sc. of Brigham & Women's Hospital in Boston, October 2001
So we’ll be showing you how you can improve IV medication delivery safety.
Our patient a 65 year old male is being prepped for a gastrectomy and distal transabdominal esophagectomy.
The surgery protocol calls for:
Dextrose 5%W 1000ml at 75mL/hr
Propofol 100mcg/kg/min
Morphine 100mg/D5w 100ml
The pump based barcode reader provides patient, medication and pump connection confirmation. The pump based reading of solution barcodes populates the pump with initial infusion parameters:
• Scan patient id – confirming correct patient
• Scan solution
• Select medication.
• Enter program parameters.
• Confirm pump entry.
• Start infusion.
• Infusion info can be confirmed on monitor. (PCD-01 message)


6 Cerner or Epic CareMobile or Inpatient EMR BCMA or EMR BCMA DOC, IOP Employ PIV
7 LiveData OR Dashboard Alarm Alarm AR Send alarm, later receive clinician acknowledgement
8 Emergin Alarm Alarm AM Receive alarm, forward to Polycom, receive response, forward to AR
9 Polycom SpectraLink Phone Alarm AC Receive alarm, respond to AM
10 Epic or GE, alternating Inpatient EMR or Centricity Enterprise EMR EMR DOC All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU


Step Down Unit (SD)

Step Company System Type Function Actor Role
1 Epic or GE Inpatient EMR or Centricity Enterprise, alternating EMR Patient ID, Admit PAM Admit patient, generate bar code and MRN; this step takes place only when tour starts in SD; otherwise previous speaker points out data will be sent, received by systems in advance of patient arriving
2 Philips Intellivue Info Ctr Monitor Phys Mon DOR, AR Obtain data, forward to EMR; for Philips, participate in ACM
3 Cerner CareAware Middleware Gateway DOR Connected to both beds (ICU, SD); need to determine what is displayed
4 Draeger Innovian Web CIS CIS DOC Display of all data the system received consistent with the Scenario
5 GE or Hospira Centricity Enterprise or VeriScan BCMA PIV IOP Employ PIV
6 B Braun and Cardinal and Hospira Pumps Pumps DOR, IOC and AR for Cardinal, Hospira Pump(s) added; PIV to be employed -- but no description if this follows ICU where this was described


Hi, I’m ______________. With Alaris Systems

Today I’d like to show you how the Alaris System contributes to patient safety.
The Alaris System uses IHE Patient Care Device messages to seamlessly communicate IV infusion and other medical device information to clinicians. The PCD-01 communicates infusion data from the pump to hospital systems, in this case GE Centricity Enterprise and Epic EMR systems. Just about everyone is aware of the importance of medication errors today. A few key facts to keep in mind include:
• Despite our heightened awareness of medication errors and efforts to prevent them, they continue to occur and they are costly. Preventing Medication Errors: Quality Chasm Series, Institute of Medicine, July 2006
• 61% of the most serious and costly medication errors are IV-related Communication with D.W. Bates, M.D., M.Sc. of Brigham & Women's Hospital in Boston, October 2001
So we’ll be showing you how you can improve IV medication delivery safety.
Our patient a 65 year old male is being prepped for a gastrectomy and distal transabdominal esophagectomy.
The surgery protocol calls for:
Dextrose 5%W 1000ml at 75mL/hr
Propofol 100mcg/kg/min
Morphine 100mg/D5w 100ml
The pump based barcode reader provides patient, medication and pump connection confirmation. The pump based reading of solution barcodes populates the pump with initial infusion parameters:
• Scan patient id – confirming correct patient
• Scan solution
• Select medication.
• Enter program parameters.
• Confirm pump entry.
• Start infusion.
• Infusion info can be confirmed on monitor. (PCD-01 message)


7 LiveData Alert Manager Alarm Alarm AM Receive alarm, forward to Polycom, receive response
8 Polycom SpectraLink Phone Alarm AC Receive alarm, respond to AM
9 Epic or GE, alternating Inpatient EMR or Centricity Enterprise EMR EMR DOC All appropriate data, everywhere needed, immediately; if this is the initial site on the tour, pass on to ICU


10

Scripts

When developing your scripts, please keep in mind:

  • The intention is to promote interoperability and its benefits.
  • Indicate what your system is, and how its function is enhanced by interoperability and how interoperability improves patient care, safey, efficiency, workflow, etc.
  • For PCD, one of the primary messages that ties us together is patient safety.
  • With approximately 15 steps/vendors speaking to each tour group, you should plan on 90 - 110 seconds to deliver your message.

<Please assure that your script is properly placed by Step Number within the Scenario (see above); please include your company name, system name, and your name at the top of your document> Suggestions for changing the sequence of presentations within a specific clinical area should be discussed with the group. Feel free to use the Google Group for this purpose.

Operating Room (OR)

1

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3

B Braun, Scott Zaffrin
• Hello, my name is xxxxxxx with B. Braun Medical
• In this scenario we will be demonstrating the use of PCD01 and PCD02 transactions as defined by the IHE Patient Care Devices domain. PCD01 allows infusion data to be sent from our DoseTrac application to, in this example, GE, and LiveData. PCD02 allows for filtering of the data to make it more specific to the general need.
• The patient is in the OR, about to undergo their surgical procedure. A prophylactic antibiotic has been ordered and will be delivered by the Outlook 300/400 infusion pump.
• This model includes a wireless network card allowing infusion data to be sent to and from the pump. It also includes pump-based barcode scanning capabilities enabling Patient Matching, ensuring that the right patient is receiving the medication, and order programming to reduce errors
• The Medication is received from pharmacy with barcode segments on the IV label – these can include; (Show the IV Bag with the Barcode Label)
Patient ID
Drug name
Concentration
Dosage
Patient Weight/Height, depending on medication
• Demonstrate scanning process to program the pump
Nurse ID
Patient ID on wristband
Patient ID on bag – note that the patient matching cannot be circumvented by scanning the same Patient ID twice
Infusion order info
• The Outlook Pump is designed to send out status information every 3 seconds. This data is transferred over the hospitals wireless network and collected in our DoseTrac application.
DoseTrac is a central server application that collects and stores infusion data
DoseTrac is a Browser-based application which;
Displays real-time information from all pumps in facility
Retrospective reports for data analysis
• DoseTrac has an interface called DoseLink that forwards information to 3rd party systems using the PCD01 and PCD02 format.
Infusion data is displayed, captured, and automatically updated, as we see here, in applications such as GE, and LiveData
• Integrating infusion information with clinical systems provides caregivers with more complete information, enabling them to make better decisions and support workflow. For example, Drug and rate information can be updated in the electronic Anesthesia record without having to manually input data.


4 GE Centricity Perioperative Anesthesia, Brian Fors

Hello, my name is XXXXXX with GE Healthcare.

In this scenario we will be demonstrating the use of PCD01 and PCD02 transactions as defined by the IHE Patient Care Devices domain. PCD01 allows data to be sent from various devices into the Centricity Perioperative Anesthesia (CPA) system. PCD02 allows for filtering of the data based on the needs specific to the consuming system.

The patient is in the OR, about to undergo their surgical procedure. The patient is connected to a physiological patient monitor, anesthesia machine and an infusion pump. CPA is acting as a device observation consumer (DOC), receiving data from all 3 devices into the anesthesia documentation system. Data from the monitor and anesthesia system is received from the Draeger Infinite gateway. Data from the infusion pump is received from the B. Braun DoseTrac application, Hospira and Cardinal systems.

The device observation reporters translate data from the proprietary data protocol for each device to a standard message structure and format. The message structure is an HL7 v2.5 message with constraints to ensure conformity across device observation reporters. Furthermore, the device data within the message is created using a standard nomenclature, the ISO/IEEE 11073 standard. This means the PCD01 transaction ensures that the data is transported in a standard message format, but also ensures the data within the message can be interpreted correctly, ensuring semantic interoperability.

Device data received from the various reports is coalesced for display within the anesthesia documentation system flowsheet in both grid and graph format. Configuration and layout of device parameters within the flowsheet can be configured based on the type of surgical procedure.

The automated charting of device data and the ease of manual charting with mechanisms such as the pre-built anesthesia scripts and touch screen dramatically reduce time spent on documentation and allow the provider to focus on caring for the patient.

When we close a case, we have a legible record with all the required elements for complete documentation. Other clinicians, like the post-op nurses, can view the anesthesia record. And the record is shared with the anesthesia department, for billing, quality initiative monitoring and outcomes research.


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Intensive Care Unit (ICU)

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3

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B Braun, Scott Zaffrin
• Hello, my name is xxxxxxx with B. Braun Medical
• In this scenario we will be demonstrating the use of PCD03 / PIV transactions as defined by the IHE Patient Care Devices domain. This transaction defines the wireless transmission of infusion data from a Bedside Medication Administration System to program the infusion device.
• We will also be demonstration PCD01 and PCD02 transactions as defined by the IHE Patient Care Devices domain. PCD01 allows infusion data to be sent from our DoseTrac application to, in this example, Cerner and Philips. PCD02 allows for filtering of the data to make it more specific to the general need.
• The patient had a successful surgical procedure and has been transferred to the ICU.
• Dopamine has been ordered for the patient.
• The order information will be sent to the Outlook 400 infusion pump via the hospital wireless network
• This model includes a wireless network card allowing infusion data to be sent to and from the pump. This ensures that the right patient is receiving the medication, and order programming to reduce errors
• The Medication order is received from the Cerner/Epic bedside medication administration system after the 5 Rights scanning process has been completed
• Demonstrate PIV to program the pump in coordination with 5 Rights scanning process
The Outlook pump receives the following data from the BCMA;
Patient ID
Drug name
Concentration
Rate or Dosage
Patient Weight/Height, depending on medication
Nurse ID
• The infusion order has been received, the Nurse validates the data and will now start the infusion.
• The Outlook Pump is also designed to send out status information every 3 seconds. This data is transferred over the hospitals wireless network and collected in our DoseTrac application.
DoseTrac is a central server application that collects and stores infusion data
DoseTrac is a Browser-based application which;
Displays real-time information from all pumps in facility
Retrospective reports for data analysis
• DoseTrac has an interface called DoseLink that forwards information to 3rd party systems using the PCD01 and PCD02 format.
Infusion data is displayed, captured, and automatically updated, as we see here, in applications such as Cerner and Philips
• Integrating infusion information with clinical systems provides caregivers with more complete information, enabling them to make better decisions and support workflow. For example, Drug and rate information can be updated in the electronic Anesthesia record without having to manually input data.


6 Cerner, Rita Brahmbhatt

Hello, my name is X and I’m with Cerner. We are demonstrating the interoperability of our CareAware™ device connectivity architecture as defined by the IHE Patient Care Devices domain. CareAware contributes to interoperability by providing an open framework to connect medical devices to any electronic medical record (EMR). A core component of this architecture is the MDBus. The CareAware MDBus facilitates bi-directional plug-and-play connectivity that you will see in both the ICU and step down unit scenarios.

  1. In this ICU scenario CareAware, specifically the MDBus, connects an infusion pump – Hospira, B Braun, Cardinal/Alaris – to an EMR provided by Epic or GE. CareAware also connects CareMobile, a Cerner point-of-care medication device and software solution, to act as an Infusion Order Programmer (IOP), using the PCD03 transaction.
  2. The patient had a successful surgical procedure and is transferred to the ICU. Using the PIV profile, the nurse uses bar-code medication administration (BCMA) to send Dopamine to the pump to aid kidney perfusion.
  3. The role of the MDBus is to associate the patient to the pump. CareMobile, using the MDBus, utilizes patient-to-device association (P2DA) to scan the patient identifier and scan the pump. The clinician then verifies the information is correct and begins to administer the Dopamine drip.
  4. Via the PCD01 transaction, the information from the pump is communicated through the MDBus into an EMR. The nurse can view this information in the patient’s chart. Additionally, the infusion statistics from one – or many – pumps are viewed on the CareAware iAware infusion dashboard. This dashboard provides a comprehensive view of pumps for both clinicians and pharmacy to ensure IV bags are full and appropriately administered.
  5. P2DA helps to ensure the 5 Rights are conducted and medication safety is adhered to at each step. The MDBus quickly associates the patient to the device in order to save time for the nurse.
  6. In the second half of this scenario, the MDBus acts as a device observation reporter (DOR), using the PCD01 transaction. A similar procedure is followed to associate the bed with the patient.
  7. The patient identifier is scanned using the MDBus P2DA solution. The patient is now associated to the bed. Once associated, the MDBus sends data, via the PCD01 transaction, that can be used by Epic, GE or any HCIT vendor to populate an EMR.
  8. Examples of relevant bed data important to a comprehensive medical record – both for the patient and the clinician – includes, but is not limited to, weight, head rail angle, the status of the bedrail (up or down), breaks (on or off) and if the bed is elevated. This information is also key to ensuring safe care of the patient during their stay, informing clinicians of risks and changes in health status.
  9. The patient is now discharged to the step down unit after 36 hours of intubation in the ICU.


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Step Down Unit (SD)

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3 Cerner, Rita Brahmbhatt

Hello, my name is X and I’m with Cerner. We are demonstrating the interoperability of our CareAware™ device connectivity architecture as defined by the IHE Patient Care Devices domain. CareAware contributes to interoperability by providing an open framework to connect medical devices to any electronic medical record (EMR). A core component of this architecture is the MDBus. The CareAware MDBus facilitates bi-directional plug-and-play connectivity that you will see in both the ICU and step down unit scenarios.

  1. In this step down scenario, the CareAware MDBus acts as a device observation reporter (DOR) with the <vendor name> bed. CareMobile, a Cerner point-of-care medication device and software solution, acts as the infusion order programmer (IOP) brokering information between the pump and the electronic medical record (EMR).
  2. The patient is transferred from the ICU to the step down unit for continued monitoring of antibiotics for 72 hours. Using the PIV profile, the nurse uses BCMA to send a Vancomycin order to the pump. P2DA via the MDBus associates the patient identifier to the pump using simple scanning. The MDBus sends the Vancomycin order to the pump.
  3. Once the pump receives the order, it will program itself. The pump acknowledges it has received the order, programs accordingly and reports back to the clinician via the MDBus. This process ensures real-time order updates and facilitates 5 Rights checking.
  4. As the Vancomycin is administered, the MDBus receives status updates via the PCD01 transaction. These updates publish to the CareAware iAware dashboard. This dashboard displays the infusion statistics from one – or many – pumps in a single view. A comprehensive view enables clinicians and the pharmacy to ensure IV bags are full and appropriately administered and refilled.
  5. P2DA helps to ensure the 5 Rights are conducted and medication safety is adhered to at each step. The MDBus quickly associates the patient to the device in order to save time for the nurse.
  6. Next the MDBus acts as a DOR between the bed and the EMR. A similar procedure is followed to associate the bed with the patient.
  7. The patient identifier is scanned using the MDBus P2DA solution. The patient is now associated to the bed. Once associated, the MDBus sends data, via the PCD01 transaction, that can be used by Epic, GE or any HCIT vendor to populate an EMR.
  8. Examples of relevant bed data important to a comprehensive medical record – both for the patient and the clinician – includes, but is not limited to, weight, head rail angle, the status of the bedrail (up or down), breaks (on or off) and if the bed is elevated. This information is also key to ensuring safe care of the patient during their stay, informing clinicians of risks and changes in health status.
  9. The patient is now discharged to go home with a complete medical record. The nurse, having had the ability to quickly associate the patient to any device – IV and bed in this scenario – is able to provide safer, direct care with less manual charting.


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6

• Hello, my name is xxxxxxx with B. Braun Medical
• In this scenario we will be demonstrating the use of PCD03 / PIV transactions as defined by the IHE Patient Care Devices domain. This transaction defines the wireless transmission of infusion data from a Bedside Medication Administration System to program the infusion device.
• We will also be demonstration PCD01 and PCD02 transactions as defined by the IHE Patient Care Devices domain. PCD01 allows infusion data to be sent from our DoseTrac application to, in this example, Draeger and Hospira. PCD02 allows for filtering of the data to make it more specific to the general need.
• The patient survived their ICU experience and has been transferred to Step Down Unit.
• Antibiotic XX has been ordered for the patient
• The order information will be sent to the Outlook 400 infusion pump via the hospital wireless network
• This model includes a wireless network card allowing infusion data to be sent to and from the pump. This ensures that the right patient is receiving the medication, and order programming to reduce errors
• The Medication order is received from the GE/Hospira bedside medication administration system after the 5 Rights scanning process has been completed
• Demonstrate PIV to program the pump in coordination with 5 Rights scanning process
The Outlook pump receives the following data from the BCMA;
Patient ID
Drug name
Concentration
Rate or Dosage
Patient Weight/Height, depending on medication
Nurse ID
• The infusion order has been received, the Nurse validates the data and will now start the infusion.
• The Outlook Pump is also designed to send out status information every 3 seconds. This data is transferred over the hospitals wireless network and collected in our DoseTrac application.
DoseTrac is a central server application that collects and stores infusion data
DoseTrac is a Browser-based application which;
Displays real-time information from all pumps in facility
Retrospective reports for data analysis
• DoseTrac has an interface called DoseLink that forwards information to 3rd party systems using the PCD01 and PCD02 format.
Infusion data is displayed, captured, and automatically updated, as we see here, in applications such as Draeger and Hospira
• Integrating infusion information with clinical systems provides caregivers with more complete information, enabling them to make better decisions and support workflow. For example, Drug and rate information can be updated in the electronic Anesthesia record without having to manually input data.

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Parameters and Data

Operating Room

Following are typical parameters that would be received from devices in the OR and captured in the anesthesia documentation system.

  • Patient Monitor
Heart Rate
Non-invasive BP Systolic
Non-invasive BP Diastolic
Non-invasive BP Mean
Temp
% SpO2
SvO2
Invasive BP
Inspired CO2
Expired CO2
Inspired CO2 %
CO2 Resp Rate
  • Anesthesia System
Peak Pressure
PEEP
Plateau Pressure
Inspired Tidal Volume
Expired Tidal Volume
Flow Resp Rate
  • Infusion Pump
Drug name
Drug concentration
Dose rate
Fluid flow rate

Intensive Care

Step Down

Links

http://wiki.ihe.net/index.php?title=PCD_Connectathon%26Showcase_WG_2008-9

http://wiki.ihe.net/index.php?title=IHE_PCD_2009_Showcase