1. The HSVO Simulator Environment Control Specification (SECS) Rachel Ellaway 1, David Topps 2 1 Northern Ontario School of Medicine, 2 University of Calgary MedBiquitous 2012

2. Conflict of interest I have no involvement with industry that creates a conflict of interest to disclose with respect to this workshop

3. What’s the problem? Simulation devices are unitary, unconnected, perhaps unconnectable to each other and to other technologies At most there is some connectivity through vendor tracking systems Limited ROI on simulator tech Limited applicability and scope of use Problems amplified in distributed medical education programs

4. HSVO NEP: Network enabled platform Connecting heterogeneous devices: virtual patients (OL), mannequins (Laerdal SimMan 3G), light fields (virtualised cameras), 3D visualization (RSV and Volseg), multiple data sources (CMA, Medline) Integrated NEP connects and controls devices (physical, online, distributed, helper) both for scenarios and sessions

5. Architecture edge device

6. Architecture edge device activity

7. Architecture edge device activity bus interface HSVONEP

8. Architecture HSVONEP

9. What goes over the wires? HSVO Simulator Environment Control Specification (SECS) – using XML

10. SECS Messaging HSVONEP Edge Device (simulator) Bus Interface device- specific messages SECS messages

11. Concepts Activity: a configuration of an edge device that provides discrete user or data interactions. HSVONEP: the core authoring and runtime controller and router Scenario: a template defining the workflow with edge devices and the transitions from one device to another. Session: an instance of a scenario that adds timing and specific users. One scenario can be used to create multiple sessions.

12. Scenario Rules HSVONEP holds the scenario specification as a set of rules Use these devices and these activities at each device Start with this, end with that If this happens then change devices/actions/parameters

13. SECS Actions Message FlowMessage Action(s) Initializing a Sessionauthenticate acknowledge load Running a Sessionstart pause resume getStatus reportStatus setParameter stop endSession Session IndependentgetProfile reportProfile

14. load HSVONEP tells a service to load certain configuration data for an activity. The service waits for a “start” message before it starts running the activity.

15. start HSVONEP tells a service it to start running its activity

16. pause HSVONEP tells a specified service to stop playing its activity. The activity remains paused until it receives a “resume” action.

17. resume HSVONEP tells a service to resume its activity following a “pause” action.

18. stop HSVONEP tells a service telling it to stop.

19. getStatus HSVONEP requests a “reportStatus” message outlining a service’s current state within the session. <message action=”getStatus” ID=”4565” sessionID=“123”>

20. reportStatus A service tells HSVONEP what it’s doing including listing available parameters and their current values within a specified session context. </message

21. setParameter HSVONEP tells a service instructing it to change one or more variables in an activity.

22. endSession HSVONEP tells all services in the same session to unload parameters, release licenses and resources, and to drop all threads.

23. getProfile HSVONEP tells a service to respond with a “reportStatus” message outlining its current state independent of a session.

24. reportProfile A service tells HSVONEP what it can do listing available activities and their parameters in response to a “reportProfile” message. Shock </message

25. Put it all together Scenario specifies what happens HSVONEP controls how this is run by sending SECS messages: Devices 1 and 2 load (D1 and D2) D1 starts An event triggers a rule that pauses D1 and starts D2 Another event triggers a rule that pauses D2, switches back to D1 and syncs their data

26. Use cases Integrate onscreen and physical sims Sync 2 or more mannequins Run integrated sim activities over multiple sites Connect alternative helpers such as physiological algorithms to sims Track and feedback on multi-sim performance Open model for experimentation and discovery

27. SECS in context Simple, device agnostic Open specification But simulation integration still in R&D Adoption path unclear IEEE model more complex but has more momentum including being a standard Lessons from RSS, CC etc?

28. Sim Challenge

29. but

30. And it’s a big but Almost no simulators really ready for this (lovely) architecture SimMan 3G most open and can support only a small part of the SECS spec OpenLabyrinth support but a hack – asymmetry and non-orthogonality with other devices HSVO resorted to VNC solutions - nasty and unaesthetic but much improved functionality What will simulation really interoperability look like? Is beauty truth?

31. The HSVO Simulator Environment Control Specification (SECS) Rachel Ellaway 1, David Topps 2 1 Northern Ontario School of Medicine, 2 University of Calgary MedBiquitous 2012