IHE PCD 2015 Fall F2F Profile PC and TC Updates ACM, MEMDMC, MEMLS Monroe Pattillo – PHI, LLC

PC Updates

Alert Communication Management (ACM) Status: Final Text, in current PCD TF, was in 2015 NA C’thon, was in 2015 HIMSS Annual Interoperability Showcase, was in 2015 HIMSS Showcase at AAMI, plan is for same demonstrations next cycle Technical details during TC portion of presentation Several CPs passed, a couple still in development, 1 expected before C’thon Updated PCD TF contains all ACM CPs passed as of PCD TF publication ACM alert containment MDCs updated to reflect IEEE 11073-10101a Related Work: IHE ITI mACM (AR–AM FHIR based, AM–AC WCTP) Next cycle: Resume work on list of alerts and their containments Desired: Demonstrations of alerts containing device cached LS data and alerts from CMMS systems and alerts from LS systems As usual: Need more participating AC vendors

Medical Equipment Management – Device Management Communication (MEMDMC) Status: Trial Implementation (TI) updated, was in 2015 NA C’thon, was in 2015 HIMSS Interoperability Showcase, was in 2015 HIMSS Showcase at AAMI, plan is for same testing and demonstrations next cycle Technical details during TC portion of presentation Several CPs passed, none currently in process Produced updated version of TI including all passed CPs Drafted REFID/MDC inputs for IEEE 11073-10101b (date TBD) Next cycle: Considering proposals for communication to device As usual: Need more participating CMMS vendors

Medical Equipment Management – Location Services (LS) Status: Trial Implementation (TI) updated, was in 2015 NA C’thon, was in 2015 HIMSS Interoperability Showcase, was in 2015 HIMSS Showcase at AAMI, plan is for same testing and demonstrations next cycle Technical details during TC portion of presentation Several CPs passed, none currently in process Produced updated version of TI including all passed CPs Drafted REFID/MDC inputs for IEEE 11073-10101b (date TBD) Promotion: IHE Profile Spotlight Next cycle: Promote profile comparative effectiveness vs proprietary Related Works: IEEE p1847 LS for Healthcare As usual: Need more participating LS vendors

TC Updates

Alert Communication Management (ACM) Passed CPs, in updated PCD TF, available in IHE 2016 NA C’thon Change OBR ALARM^ALARM to use IEEE 11073-10101 MDC/REFID Change OBR result status to F Resurrect optional PCD-05 Resurrect optional Recipients in PCD-04 Resurrect WCM options for PCD-04 and PCD-06 CP to align ACM containment MDCs with IEEE 11073-10101a Highly likely to pass, but not in PCD TF (after cutoff) Will be at IHE 2016 NA C’thon (and in NIST Test Tools) Utilizes first ever OID update to MSH-21 to identify change in containment content CPs in process, not yet ready for balloting Identify physio alarms as alerts in OBR not exceeded limit – Needs discussion HL7 2.8 OBR Print/Display component for AR to pass additional alert text to AM Add FHIR variant of PCD-04 to align with ITI mACM Add FHIR variant of PCD-05 to align with ITI mACM

Alert Communication Management (ACM) cont Discussion: Currently no ACM profile documented mechanism in Repot Alert PCD-04 basic containment for communication of any items in IEEE 11073-10201 Alert Status Alert-Flags, specifically state of local-audible Some alerts (technical alarms, advisories) may be communicated to clinician (AC) without producing alert originating device local audio annunciation, even though local audio is enabled IEC 60601-1-8 6.3.3 Auditory Alarm Signals, Table 3 Note d – auditory component generation of LOW PRIORITY ALARM CONDITION optional State of, particularly absence of, device local audio in presence of an active alert should be included in ACM’s PCD-04 basic containment otherwise decision-making for alert fatigue management and retrospective analysis not empowered Alert instance specific state of device local audio at time alert is sent from AR to AM – distinctly different from what ACM currently communicates which is device operator manually asserted control of alert local audio as indicated in ACM Alarm Inactivation State audio-paused and audio-off which communicate using the name of the negative of the audio enables Currently no values in Alert Flags, in which local-audible is defined, communicated in ACM basic containment – need new basic containment OBX MDC/REFID communicating Alert Flags Currently no MDC/REFID for communication of state of local-audible (a Boolean) in OBX-5 – local-audible implies audio for alert is annunciating, how do we indicate local-silent? Implementation would result in ACM CP, small number of MDC/REFID additions to 11073-10101

Medical Equipment Management – Device Management Communication (MEMDMC) TI housekeeping updates More clearly indicate use case distinction between observations included in messages of other profiles (DEC, ACM, IPEC) and DMC profile specific observations and alerts in PCD-15 messages Passed Change Proposals, in updated TI, available in IHE 2016 NA C’thon Move equipment name from OBX-18 to OBX-5 Indicate OBX-11 Result Status as F, not R Next cycle: Reviewing proposals for communication to devices

Medical Equipment Management – Location Services (LS) TI housekeeping updates More clearly indicated use case distinction between observations included in messages of other profiles (DEC, ACM, IPEC) and LS profile specific observations and alerts in PCD-16 messages Clarified presence of PRT segment Added coverage of base associated with based + relative offset LS observations Added use of HL7 Extended Address (XAD) datatype for OBX-2 for postal addresses Add opt indication of accuracy to relative offset LS observations Roll up of all triggers and associated attributes (prep for inclusion in IEEE 11073-10101b) Passed Change Proposals, in updated TI, available in IHE 2016 NA C’thon Move equipment name from OBX-18 to OBX-5 Indicate OBX-11 Result Status as F, not R Investigated DARPA work on use of GPS satellite reception fix based waypoint followed by inertial navigation based observations using GPS elements (already supported by MEMLS) Related Works: IEEE p1847 LS for Healthcare