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Use of IHE DEC Profiles for Remote Monitoring

Learn about the use of IHE DEC profiles for remote monitoring in healthcare settings. Explore how DEC profiles streamline device data communication between home and hospital settings, enabling accurate and secure patient monitoring. Discover key features such as periodic and episodic physiologic data transmission, patient ID inclusion, and support for alarms/alerts. See practical examples of PCD-01 messages for heart rate monitoring. Dive into the benefits of DEC profiles for preserving measurement context and facilitating seamless data exchange across different systems and devices.

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Use of IHE DEC Profiles for Remote Monitoring

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  1. Use of IHE DEC Profiles forRemote Monitoring Authors: Paul Schluter and Todd Cooper HITSP RMON discussion October 2, 2008

  2. IHE-DEC: Same protocol used in two settings … Device Intermediary Device Subset of IHE-DEC Home Setting EHR or Care Coordination Applications Device IHE-DEC Hospital Setting Device Intermediary

  3. IHE Device Enterprise Communication (DEC) and related Profiles (PCD, SPD, ACM). Device Observation Consumer (DOC) PCD-01 Transaction: Communicate Device Data • ISO/IEEE 11073-10101 nomenclature (does not rule out LOINC or SNOMED) • ISO/IEEE 11073 or UCUM units-of-measure • OBX-4 used for «mds.vmd.chan.metric», OBX-20 for measurement sites • Profile and simplify other aspects of HL7 V2.5 messaging • Periodic Physiologic Data: Heart Rate, Respiration rate • Episodic Physiologic Data: NIBP, Weight, Cardiac tests • Primarily structured data but facilities non structured data as well • Must include Patient ID • > 1 minute sampling rate (but could be faster) • Waveform support is simple extension • Flexible extensions with: • Alarms and alerts supported through related profile (ACM) • Subscribe to Patient Data (SPD) Profile • Security, privacy, confidentiality through related profile (ATNA) Device Observation Reporter (DOR) Device

  4. Mapping Preserves Measurement Context Overall Device or System Virtual Medical Device Channel (only as needed) A single observation

  5. PCD-01 Message Example (simple heart rate) IEEE EUI-64 MSH|^~\&|HL7^080019FFFF4F6AC0^EUI-64|MMS|||20070118133700||ORU^R01 |a4e2e3:11036b5cdbb:-|P|2.5|20070118133700||NE|AL||8859/1 PID|||6O008D^^^A^PI||DAVIDSON^DAVID^^^^^L PV1||E|3WICU^305^305 OBR|1|080019FFFF4F6AFE200701|080019FFFF4F6AC0200701|126.3.3.1^2000^MDC|||20070118133700 OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|80|/min^/min^UCUM|||||R Value ‘Heart Rate’ OBX-4 ‘/min’ UOM

  6. PCD-01 Message Example (more complex) MSH|^~\&|HL7^080019FFFF4F6AC0^EUI-64|MMS|||20070118133700||ORU^R01|a4e2e3:11036b5cdbb:-|P|2.5|20070118133700||NE|AL||8859/1 PID|||6O008D^^^A^PI||DAVIDSON^DAVID^^^^^L PV1||E|3WICU^305^305 OBR|1|080019FFFF4F6AFE200701|080019FFFF4F6AC0200701|126.3.3.1^2000^MDC|||20070118133700 OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|80|/min^/min^UCUM|||||R OBX|1|NM|147842^MDC_ECG_HEART_RATE^MDC|1.6.1.1|60|/min^/min^UCUM|||||R OBX|2|NM|131841^MDC_ECG_AMPL_ST_I^MDC|1.7.1.1|0.0|mm^mm^UCUM|||||R OBX|3|NM|131842^MDC_ECG_AMPL_ST_II^MDC|1.7.1.2|0.0|mm^mm^UCUM|||||R OBX|4|NM|131901^MDC_ECG_AMPL_ST_III^MDC|1.7.1.3|0.0|mm^mm^UCUM|||||R OBX|5|NM|131847^MDC_ECG_AMPL_ST_V5^MDC|1.7.1.4|0.0|mm^mm^UCUM|||||R OBX|6|NM|131902^MDC_ECG_AMPL_ST_AVR^MDC|1.7.1.5|0.0|mm^mm^UCUM|||||R OBX|9|NM|150035^MDC_PRESS_BLD_ART_MEAN^MDC|1.3.1.1|96|mm[Hg]^mm[Hg]^UCUM|||||R OBX|10|NM|150033^MDC_PRESS_BLD_ART_SYS^MDC|1.3.1.2|122|mm[Hg]^mm[Hg]^UCUM|||||R OBX|11|NM|150034^MDC_PRESS_BLD_ART_DIA^MDC|1.3.1.3|82|mm[Hg]^mm[Hg]^UCUM|||||R OBX|12|NM|149522^MDC_BLD_PULS_RATE_INV^MDC|1.2.1.1|60|/min^/min^UCUM|||||R OBX|13|NM|150047^MDC_PRESS_BLD_ART_PULM_MEAN^MDC|1.4.2.1|14|mm[Hg]^mm[Hg]^UCUM|||||R OBX|14|NM|150045^MDC_PRESS_BLD_ART_PULM_SYS^MDC|1.4.2.2|24|mm[Hg]^mm[Hg]^UCUM|||||R OBX|15|NM|150046^MDC_PRESS_BLD_ART_PULM_DIA^MDC|1.4.2.3|10|mm[Hg]^mm[Hg]^UCUM|||||R OBX|16|NM|151610^MDC_VENT_CO2_RESP_RATE^MDC|1.5.1.1|12|{breath}/min^{breath}/min^UCUM|||||R OBX|17|NM|151976^MDC_VENT_PRESS_AWAY_END_EXP_POS^MDC|1.5.1.2|4|cm[H20]^cm[H20]^UCUM|||||R OBX|18|NM|152008^MDC_VENT_VOL_MINUTE_AWAY^MDC|1.5.1.3|0.0|l/min^l/min^UCUM|||||R OBX|19|NM|151920^MDC_VENT_CONC_AWAY_O2_INSP^MDC|1.5.1.4|21|%^%^UCUM|||||R OBX|20|NM|151980^MDC_VENT_VOL_TIDAL^MDC|1.5.1.5|1096|ml^ml^UCUM|||||R OBX|21|NM|151957^MDC_VENT_PRESS_MAX^MDC|1.5.1.6|17|cm[H20]^cm[H20]^UCUM|||||R OBX|22|NM|151784^MDC_PRESS_RESP_PLAT^MDC|1.5.1.7|30|cm[H20]^cm[H20]^UCUM|||||R OBX|23|NM|151792^MDC_PRESS_AWAY^MDC|1.5.1.8|35|cm[H20]^cm[H20]^UCUM|||||R OBX|24|NM|151808^MDC_PRESS_AWAY_END_EXP_POS_INTRINSIC^MDC|1.5.1.9|1|cm[H20]^cm[H20]^UCUM|||||R

  7. IHE DEC (and associated) profiles • Provides a Unified Interface that -- • Supports the complete range of device data (except for high-bandwidth continuous waveforms) found in health related devices today and in the future. • Provides a consistent interface in Health Record, CareManagement Systems and Personal Health Records that is: • Secure, private • High performance even on low bandwidth links • Scalable, from a simple device intermediary (a few devices for the same patient) to multiple devices for many patients. Trivial to implement. • Straightforward mapping from proprietary and IEEE 11073 formats (uses same nomenclature as X73 Personal Health devices). • Based on proven HL7 standards that are supported by all Care Management and EHRs products today

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