ihe pcd rosetta update paul schluter, phd, ge healthcare ihe pcd f2f at ecri, plymouth meeting, pa...

IHE PCD Rosetta Update

Paul Schluter, PhD, GE HealthcareIHE PCD F2F at ECRI, Plymouth Meeting, PAOctober 20, 2010

IHE PCD Rosetta UpdateOctober 20, 2010

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Topics

• Overview of RTM

• New: Vendor_VMD ContainedBy (version ‘3n’)

• Next: LOINC terms for Infant Hearing Screening

• Next: RTM Ventilator (work in progress)

• Also: Begin to compile RTM for events

• Also: Specify cardinality (for event content models)

• Also: RTM for PHD devices (Continua V1.5 WAN)


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IHE PCD Rosetta Terminology Management

VendorTerms

RTM1400 rows

Harmonized

Terms

hRTM440 terms

ISO/IEEE 11073

Semantic Standards

Vendor A

Vendor B

Vendor C

HL7 V2 Messag

esHL7 V3 CDA/CC

D11073

PnP Comm

VendorSemantic

s

IHE PCD TF

Content

• Open consensus process• Observation identifiers and co-constraints• New terms incorporated into standards• hRTM used for conformance testing


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Harmonized Rosetta (hRTM)

Group REFID DIM UOM_MDC UOM_UCUM

CVS_ECG_HR MDC_ECG_HEART_RATE T-1 MDC_DIM_BEAT_PER_MIN {beat}/min {beats}/min 1/min /min

CVS_ECG_ST MDC_ECG_AMPL_ST_I ML2I-1T-3ML2I-1T-3

MDC_DIM_MILLI_VOLTMDC_DIM_MICRO_VOLTMDC_DIM_MILLI_M#

mV uV (added by scripting rule) mm# (voted “off-the-island”)

GASMON_AA_ENFL MDC_CONC_DESFL_ET L3L-3LMT-2L-2LMT-2L-2

MDC_DIM_VOL_PERCENTMDC_DIM_KILO_PASCALMDC_DIM_MMHG

%{vol} kPa mm[Hg]

Specifies for each IEEE 11073 REFID observation identifier:• the 11073 MDC and UCUM units-of-measure

- includes dimensional analysis to ensure correct ‘units-math’

• enumerated values and measurement sites• numeric codes, where appropriate

An extract from the hRTM is shown below:

Available at http://wiki.ihe.net/index.php?title=PCD_Profile_Rosetta_Terminology_Mapping

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






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New Vendor_VMD ContainedBy

Specifies VMD / CHAN OBX hierarchy above METRIC• VMD VMD required, CHAN not specified

• VMD / [CHAN] VMD required, CHAN optional [default value]

• VMD / CHAN VMD and CHAN required

• Multiple VMD / CHAN combinations may be listed

VMD is required for PCD-01

RTM now has ~30 VMDs for GE numeric parameters• CHAN also provided for NIBP episodics and infusion channels

Now awaiting input from other vendors!


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Next Support LOINC terms and mappingAdd RTM column for LOINC observation identifiers for

• Infant Hearing Screening observation IDs• Enumerated LOINC values in Enum_Values with ^LOINC• Clem McDonald’s MDC to LOINC mappings (NIST RTMMS)


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Next RTM Respiratory and VentilatorNew ventilator and gas measurement terms

New gas measurement terms incorporated into RTM ‘3m’

Current focus is ventilator mode and breath annotations

Informal collaboration between IHE PCD and IEEE 11073 and members of ASTM F2761 (ICE), IEC SC62A WG5, ISO IHTSDO,

ISO TC215 WG7 and HL7 Health Care Devices SIG,led by Norman Jones and Jan Wittenber.

Making excellent progress on ‘ventilator mode’ modelling!


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Also Event identifiers and content modelsACM Alarm Reporters should begin to compile:

Event and alarm identifiers and key properties• numeric alarm or ‘pattern’ alarm (e.g. ‘asystole’)

• timepoint or interval event

• physiologic and/or technical

Content models (including cardinality)• infusion pump parameters related to an event

Let’s start capturing this information!


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Also RTM for PHD over Continua WANCapture Continua V1.5 WAN Guidelines for ISO/IEEE 11073 PHD (Personal Health Devices) in machine readable RTM format

Similar format to RTM… but reflects origin from ISO/IEEE 20601 and 104xx PHD specializations,

as mapped to Continua WAN interface based on IHE PCD-01 TF.

Captures the following information:REFID OBX-2 OBX-3 OBX-4

MDC_DEV_SPEC_PROFILE_BLD 528391^MDC_DEV_SPEC_PROFILE_BP^MDC 1

.. MDC_PRESS_BLD_NONINV 150020^MDC_PRESS_BLD_NONINV^MDC 1.0.1

... MDC_PRESS_BLD_NONINV_SYS NM 150021^MDC_PRESS_BLD_NONINV_SYS^MDC 1.0.1.1

... MDC_PRESS_BLD_NONINV_DIA NM 150022^MDC_PRESS_BLD_NONINV_DIA^MDC 1.0.1.2

... MDC_PRESS_BLD_NONINV_MEAN NM 150023^MDC_PRESS_BLD_NONINV_MEAN^MDC 1.0.1.3

... MDC_PULS_RATE_NON_INV NM 149546^MDC_PULS_RATE_NON_INV^MDC 1.0.0.1

plus OBX-5 (ASN.1 enums), OBX-6 (units), OBX-18 (inst id) and OBX-20 (sites)

Additional Slides


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Semantic Interoperability

Scenario:Convey near real-time medical device data- from device to device or system- from device to enterprise using a gateway- enterprise document exchange

Objective:Communicate medical device data using a single unified nomenclature and semantic model that can be rigorously defined and enforced to facilitatesafe and effective plug-and-play interoperability.


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Related RTM and hRTM Initiatives• Respiratory and Ventilation extensions (current)

- An informal collaboration between IHE PCD and 11073 MDC and members of ASTM F2761 (ICE), IEC SC62A WG5, ISO IHTSDO, ISO TC215 WG7, and HL7 HCD.

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

• XML publication format for 11073 nomenclature extensions- 11073-10102 Annotated ECG (aECG)

- 11073-10103 Implanted Device Cardiac (IDC)

• Joint IHE and Continua WAN interface- RTM and RCH (Rosetta Containment Hierarchy) for IEEE Std 11073-

20601 and personal health devices, as Continua deliverables for HITSP RMON SDE#2.

• NIST HL7 V2 and IEEE 11073 Message Conformance Testing


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DeviceDevice

Intermediary

Device

EHR or Care Coordination Applications

Home Setting

Hospital SettingDevice

Intermediary

IHE DEC over MLLP

SDE #2: IHE DEC over WS*

IHE and Continua WAN (HITSP RMON SDE #2)

IHE DEC: Same protocol used in two settings …SDE #1

SDE #3+


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Discussion• Unified semantics and semantic model are essential prerequisites

forsafe and effective interoperability between devices and systems.

• The hRTM is based on the ISO/IEEE 11073 standards and leverages and extends that work by using an open consensus process.

• For each observation identifier, the hRTM specifies the units-of-measure, enumerated values, measurement sites and other co-constraints.

• The hRTM rigorously defines what may be sent and informs recipients of what they may expect to receive.

• The hRTM supports message conformance testing frameworks that can be used for both clinical and personal health devices.

ihe pcd rosetta update paul schluter, phd, ge healthcare ihe pcd f2f at ecri, plymouth meeting, pa...

Documents

new vendor

terms hrtm

ge healthcare ihe pcd

volt mdc

support loinc terms

ventilator new ventilator

rtm ventilator work

rtm column