IHE PCD Rosetta Update

1. IHE PCD Rosetta Update Paul Schluter, PhD, GE Healthcare IHE PCD F2F at ECRI, Plymouth Meeting, PA October 20, 2010

2. Topics • Overview of RTM • New: Vendor_VMD  ContainedBy (version ‘3n’) • Next: LOINC terms for Infant Hearing Screening • Next: RTM Ventilator (work in progress) • Also: Begin to compile RTM for events • Also: Specify cardinality (for event content models) • Also: RTM for PHD devices (Continua V1.5 WAN)

3. IHE PCD Rosetta Terminology Management ISO/IEEE 11073Semantic Standards HL7 V2 Messages VendorTerms RTM 1400 rows HarmonizedTerms hRTM 440 terms HL7 V3 CDA/CCD 11073PnP Comm IHE PCD TF Content VendorSemantics Vendor A Vendor B Vendor C • Open consensus process • Observation identifiers and co-constraints • New terms incorporated into standards • hRTM used for conformance testing

4. Harmonized Rosetta (hRTM) • Specifies for each IEEE 11073 REFID observation identifier: • the 11073 MDC and UCUM units-of-measure • includes dimensional analysis to ensure correct ‘units-math’ • enumerated values and measurement sites • numeric codes, where appropriate • An extract from the hRTM is shown below: Available at http://wiki.ihe.net/index.php?title=PCD_Profile_Rosetta_Terminology_Mapping

5. New Vendor_VMD  ContainedBy • Specifies VMD / CHAN OBX hierarchy above METRIC • VMD VMD required, CHAN not specified • VMD / [CHAN] VMD required, CHAN optional [default value] • VMD / CHAN VMD and CHAN required • Multiple VMD / CHAN combinations may be listed • VMD is required for PCD-01 • RTM now has ~30 VMDs for GE numeric parameters • CHAN also provided for NIBP episodics and infusion channels • Now awaiting input from other vendors!

6. Next Support LOINC terms and mapping • Add RTM column for LOINC observation identifiers for • Infant Hearing Screening observation IDs • Enumerated LOINC values in Enum_Values with ^LOINC • Clem McDonald’s MDC to LOINC mappings (NIST RTMMS)

7. Next RTM Respiratory and Ventilator • New ventilator and gas measurement terms • New gas measurement terms incorporated into RTM ‘3m’ • Current focus is ventilator mode and breath annotations • Informal collaboration between IHE PCD and IEEE 11073 • and members of ASTM F2761 (ICE), IEC SC62A WG5, ISO IHTSDO,ISO TC215 WG7 and HL7 Health Care Devices SIG,led by Norman Jones and Jan Wittenber. • Making excellent progress on ‘ventilator mode’ modelling!

8. Also Event identifiers and content models • ACM Alarm Reporters should begin to compile: • Event and alarm identifiers and key properties • numeric alarm or ‘pattern’ alarm (e.g. ‘asystole’) • timepoint or interval event • physiologic and/or technical • Content models (including cardinality) • infusion pump parameters related to an event • Let’s start capturing this information!

9. Also RTM for PHD over Continua WAN • Capture Continua V1.5 WAN Guidelines for ISO/IEEE 11073 PHD (Personal Health Devices) in machine readable RTM format • Similar format to RTM … but reflects origin from ISO/IEEE 20601 and 104xx PHD specializations,as mapped to Continua WAN interface based on IHE PCD-01 TF. • Captures the following information: plusOBX-5 (ASN.1 enums), OBX-6 (units), OBX-18 (inst id) and OBX-20 (sites)

10. Additional Slides

11. Semantic Interoperability • Scenario: • Convey near real-time medical device data • from device to device or system • from device to enterprise using a gateway • enterprise document exchange • Objective: • Communicate medical device data using a single unified nomenclature and semantic model that can be rigorously defined and enforced to facilitatesafe and effective plug-and-play interoperability.

12. Related RTM and hRTM Initiatives • Respiratory and Ventilation extensions (current) • An informal collaboration between IHE PCD and 11073 MDC and members of ASTM F2761 (ICE), IEC SC62A WG5, ISO IHTSDO, ISO TC215 WG7, and HL7 HCD. See http://wiki.ihe.net/index.php?title=PCD_RTM_Ventilator • XML publication format for 11073 nomenclature extensions • 11073-10102 Annotated ECG (aECG) • 11073-10103 Implanted Device Cardiac (IDC) • Joint IHE and Continua WAN interface • RTM and RCH (Rosetta Containment Hierarchy) for IEEE Std 11073-20601 and personal health devices, as Continua deliverables for HITSP RMON SDE#2. • NIST HL7 V2 and IEEE 11073 Message Conformance Testing

13. IHE and Continua WAN (HITSP RMON SDE #2) IHE DEC: Same protocol used in two settings … Device Intermediary Device SDE #1 SDE #2: IHE DEC over WS* Home Setting EHR or Care Coordination Applications SDE #3+ Device IHE DEC over MLLP Hospital Setting Device Intermediary

14. Discussion • Unified semantics and semantic model are essential prerequisites forsafe and effective interoperability between devices and systems. • The hRTM is based on the ISO/IEEE 11073 standards and leverages and extends that work by using an open consensus process. • For each observation identifier, the hRTM specifies the units-of-measure, enumerated values, measurement sites and other co-constraints. • The hRTM rigorously defines what may be sent and informs recipients of what they may expect to receive. • The hRTM supports message conformance testing frameworks that can be used for both clinical and personal health devices.