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

2. PC Updates

3. Alert Communication Management (ACM)
Status: Final Text, in current PCD TF, was in 2015 NA C’thon, was in 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 a
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

4. 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 b (date TBD)
Next cycle: Considering proposals for communication to device
As usual: Need more participating CMMS vendors

5. Medical Equipment Management – Location Services (LS)
Status: Trial Implementation (TI) updated, was in 2015 NA C’thon, was in 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 b (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

6. TC Updates

7. Alert Communication Management (ACM)
Passed CPs, in updated PCD TF, available in IHE 2016 NA C’thon
Change OBR ALARM^ALARM to use IEEE 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 a
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

8. 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 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 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

9. 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

10. 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 b)
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