Point-of-Care Identity Management IHE Integrating the Healthcare Enterprise Patient care device Point-of-Care Identity Management John Rhoads Philips Healthcare

Assumptions Device-Patient Association needs to be validated by a person. Automated identification is not reliable enough for life-critical activities like establishing a data stream from from a device to a flowsheet, or preloading order details for an infusion. Therefore provision must be made at the point of care for human validation to be done, and for the results to be communicated to the systems concerned.

Assumptions, contd. Different systems at the point-of-care and in healthcare enterprise systems rely on accurate association of devices with patients. It is needed for correctly linking observations with patient identities, and for being sure that information communicated to peripheral devices (for example setting alarm limits) is targeted correctly. Notification transactions suited to both enterprise systems and devices are needed.

Assumptions, contd. It is desirable that messages and protocols allow different equipment arrangements and topologies to be accommodated. For example, the transactions should support very simple devices separate from the medical devices at the point-of-care that simply read barcodes and present a small display where the clinician can see the name, date of birth, and gender of the proposed patient as well as a medical device with validation capabilities integrated in its design.

Assumptions, contd. It is desirable that the communications be based on appropriate standards rather than proprietary methods. IHE PCD profiles provide a base that needs little extension to support

General message form Basically an ORU R01 with added participation segments (PRT) for devices (and attesting clinician) “this device (or these devices) are participating in observations on this patient” MSH PID PV1 OBR PRT OBX

PRT segment SEQ LEN DT OPT RP/# TBL# ELEMENT NAME 1 1..4 EI C N Participation Instance ID 2 2..2 ID R 287 Action Code 3 CWE O Action Reason 4 CWE R 912 Participation 5 XCN C Y Participation Person 6 CWE C Participation Person Provider Type 7 CWE C 406 Participant Organization Unit Type 8 XON C Y Participation Organization 9 PL C Y Participant Location 10 EI C Y Participation Device 11 DTM O Participation Begin Date/Time (arrival time) 12 DTM O Participation End Date/Time (departure time) 13 CWE O Participation Qualitative Duration 14 XAD C Y Participation Address 15 XTN O Y Participant Telecommunication Address