IEEE 11073 Nomenclature Status IEEE 11073 GC at HL7, San Antonio, TX Tuesday Q2 – January 17, 2016 Paul Schluter, GE Healthcare

Topics IEEE Std 11073-10101 and NIST RTMMS Update IEEE P11073-10101b – new observation terminology IEEE P11073-10101b – events and alerts IEEE P11073-10103a – IDC extensions NIST RTMMS – new terminology process to accelerate MDC numeric code assignments PHD, PCHA/Continua Terminology in NIST RTMMS

IEEE Std 11073-10101a and NIST RTMMS update NIST RTMMS has been updated with -10101a nomenclature. Co-constraints (units, enums and sites) for -10101a terms have been uploaded to NIST RTMMS and are now available. The second-generation harmonized Rosetta, hRTM2, combines the ‘old’ 10101 and ‘new’ 10101a terms and co-constraints, and use -10102 aECG lead offsets  65. hRTM2exp.3j.x3j.2016-09-16T16.expALL.html (hRTM2 html) Co-constraints for several PHD devices (NBP, SpO2, Glu, Coag) have been added, based on the published -20601 PHD and -104xx device specializations. PHD-nibp-spo2-glu-inr.1e.x3g.2016-05-24T12.html

IEEE P11073-10101b [PAR approved] Extends ISO/IEEE Std 11073-10101:2004 and -10101a-2015: Initial Proposal REFIDS Defn’s UoM Enums WG Appr Codes Infusion pumps and infusion events (IHE PCD PIV and IPEC) Ventilator mode, high-frequency ventilation, annotations NMT Neuromuscular transmission (level of neuromuscular block) * Finalize the WCM waveform attributes Ventilator E:I ratio, Ipart, Epart and other terms IHE PCD Device Management Control (DMC) IHE PCD Real-Time Location Services (LS) Generalized Signal Quality Index Dialysis Surgical and OR devices (by OR.NET at http://www.ornet.org/) Hemodynamic parameters using transpulmonary thermodilution and pulse contour analysis 1. IEEE-SA staff has already merged -10101:2004 and -10101a-2015 into a single document. 2. Inclusion of new terms in draft standard is contingent on timely completion.

IEEE P11073-10101b [Events and Alerts] The existing list of ISO/IEEE 11073-10101:2004 MDC_EVT_ identifiers will be extended to support the IHE PCD Rosetta for Events and Alerts and other requests. These will be included in IEEE P11073-10101b , based on discussion last year. Will cover physiologic alerts and essential technical events and alerts (see companion presentation).

IEEE P11073-10103a [PAR approved] Extends IEEE P11073-10103:2012 Implanted Devices Cardiac New IDC term codes, extending IEEE P11073-10103:2012 Considering EGM waveforms. New terms were presented and discussed at the Heart Rhythm Society (HRS) meeting in San Francisco See presentation: IDC Nomenclature Status 20-Sep-2016.ppt

IEEE 11073 and NIST RTMMS Terminology Process IEEE 11073 GC at HL7, San Antonio, TX Tuesday Q2 – January 17, 2016

New Term REFID and Code Assignments Background for this discussion, motivated by the desirability of assigning numeric codes at the earliest possible time. Use the NIST RTMMS as the authoritative numeric code validator (and generator) for new terms to guarantee non-overlap between multiple organizations, e.g. IEEE 11073 PoCD, IEEE 11073 PHD, IHE PCD Rosetta, PCHA/Continua, MDPnP, OR.NET and others. If the assigned Reference ID, Disc, Part::Code is discarded during balloting, it is retired as a “zombie term” and cannot be re-used. Terms that are assigned codes must have complete definitions, UoMs, enum values and other information when they are submitted as an Excel worksheet, formatted exactly as it would appear in the published standard. Is this a good idea? Yes, if we can keep the number of “zombie terms” to a small number (e.g. < 1 to 3% of new terms defined). No, we could end up with a ‘free-for-all’ if this is uncontrolled without any degree of editorial review and curation.

Code and Term Assignment Process  Proposed 0^MDCX terms that have not been approved by a recognized working group, let alone by the larger IEEE 11073 community.  Provisional terms that have been approved by a recognized working group (e.g. IEEE 11073 PoCD, PHD, IHE PCD Rosetta, PCHA/Continua, MDPnP, OR.NET and others) may have numeric codes assigned to them prior to IEEE balloting. The status of each term (proposed, provisional, published) will be maintained on the NIST RTMMS.  Published terms are those that have been balloted, approved and published as an IEEE 11073 standard. Note: If a provisional term is rejected during IEEE balloting, the { Reference ID, Disc, Part::Code } 3-tuple will be retired as a “zombie term” and the Part::Code shall not deployed in messages nor recycled for use with another term in the future (enforced by NIST test tools). Proposed and provisional terms are subject to change and are not final until published in an IEEE 11073 standard. CF_CODE10^REFID RTMMS Status Meaning 0^MDCX_term  Proposed Proposed term nnnnn^MDC_term  Provisional Assigned numeric code (could become zombie)  Published IEEE 11073 Balloted, Approved and Published

Additional Required NIST RTMMS Capabilities Clearly indicate { proposed, provisional, published, zombie } status for all terms. Maintain list of { published ∪ provisional ∪ zombie } terms, from which new provisional REFIDs and Part::Codes shall not be drawn.