IEEE 11073 Nomenclature Status IEEE 11073 GC at HL7, New Orleans Tuesday, January 30, 2018 Paul Schluter Center for Medical Interoperability

Topics IEEE P11073-10101b – New Observation Identifiers IEEE P11073-10101b – Events, Alerts and par-src-evt 3-tuples IEEE P11073-10103a – IDC Notifications and other extensions Additional UOM_MDC and UOM_UCUM for hRTM2a PHD vs RTMMS Code Conflict Detection Provisional MDC_ATTR and MDC_EVT for WCM and MEM-LS Terminology Coordination with other groups

IEEE P11073-10101b Observation Identifiers Extends ISO/IEEE Std 11073-10101:2004 and -10101a-2015: Initial Proposal REFIDS Definitions UoM Enums WG Appr Codes N/A 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) Event and Alert Identifiers (in progress) Dialysis Surgical and OR devices (by OR.NET at http://www.ornet.org/) Hemodynamic parameters using transpulmonary thermodilution and pulse contour analysis Note: 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 has been extended to support the IHE PCD Rosetta for Events and Alerts and ACM. This work extends the existing -10101:2004 nomenclature with contributions from GE, Philips, Dräger and others. Events and alerts will be included in IEEE P11073-10101b , based on earlier discussions. Physiologic events and alerts – largely done, with par-src-evt 3-tuples. Technical events and alerts – 800+ proposed and existing REFIDs and definitions based on GE, Philips and -10101:2004 standard, with more terms from Dräger and other vendors. Preliminary par-src-evt 3-tuples for ecg, ecgResp, nbp, spO2, temp, ip, eeg, bis and entropy with proposed definitions - phys-tech.2d.2017-10-31T20.ecg-ecgResp-nbp-spO2-temp-ip-eeg-bis-entropy.xlsx Preliminary par-psrc-evt 3-tuples for resp, spiro, gasMonCO2 and gasMon with definitions has been completed; ventilators and anesthesia are next.

IEEE P11073-10101b par-src-evt 3-tuples description remarks ecg-phys MDC_ECG_HEART_RATE MDC_EVT_LO MDC_EVT_HI Heart rate limit exceeded + reuse of existing numeric identifiers + additional lo|high variants MDC_ECG_V_P_C_CNT «VMD» MDC_EVT_ECG_V_P_C_RonT R-on-T PVC ’named’ event/alert fully identifies – src is largely arbitrary and redundant ecg-tech MDC_ECG_LEAD_RA MDC_ECG_LEAD_* MDC_EVT_LEAD_DISCONN Lead disconnected + src and evt convey useful information vent-tech Estimated leak flow rate ? «VMD» MDC_EVT_VENT_PAT_CIRCUIT_DISCONN Patient circuit disconnected ’named’ event/alert fully identifies – src is unnecessary Comments: 1. par-src-evt representation works reasonably well (par is typically required in most protocols). 2. src identifier is not consistently obvious if evt is already a strong standalone semantic concept. Recommendations: IEEE P11073-10101b (or RTMMS) shall provide a full description with each par-src-evt 3-tuple. Alternatively stated, one or more valid src values shall be specified with each event/alert term-row. This is consistent with how many user and service manuals are written and would facilitate direct conversion of on-the-wire par-src-evt 3-tuples to text messages that could be displayed on the device.

IEEE P11073-10103a Implanted Devices Cardiac Extends IEEE P11073-10103:2012 Implanted Devices Cardiac New IDC term codes, extending IEEE P11073-10103:2012. Notifications (‘alerts’) are largely complete with the definition of 14 standardized notification categories that convey publically- disclosed vendor-specific notifications. [This reflects the sometimes significant differences in the underlying vendor design of these devices.] Several dozen new terms and term-sets have been reviewed by the Heart Rhythm Society (HRS) and will be included in the standard. The IDCO WG meets weekly on Fridays at 10:00 AM Central (US).

Extras Additional UOM_MDC and UOM_UCUM for hRTM2a Added to support vendor requests. PHD vs RTMMS Code Conflict Detection Semi-automatic identification of numeric code conflicts. Provisional MDC_ATTR and MDC_EVT terms for WCM and MEM-LS WCM and MEM-LS have numeric identifier codes, assigned as ‘provisional’ terms, described in the next presentation. Codes were used for data interchange at 2018 IHE NA Connectathon! Provisional MDC_OBS for WCM (Observation Set IDs for OBR-4) MDC_OBS_WAVE_CTS continuous waveform (part of) MDC_OBS_WAVE_NONCTS non-continuous waveform snippet