VHA Medical Device Interoperability Program (MDIP)Pulse Oximetry Integration with Clinical Applications

Project Kick Off Meeting

Monday 13 February 20121300-1400 EST

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Agenda

Topics Presenter(s) Time

Roll call and introductions Leah KrynickyGreg Staudenmaier

1300-1305

Communication process & weekly call schedule Ioana Singureanu 1305-1310

Use case summary & clinician needs Sean McFarland 1310-1320

IHE process overview John Rhoads 1320-1325

Project milestones review Ioana Singureanu 1325-1330

Technical approach Ioana Singureanu 1330-1345

Engagement with subject matter experts Catherine Hoang/Ioana Singureanu

1345-1350

Follow-up actions for next meeting Ioana Singureanu 1350-1400

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Communication

• IHE PCD Pulse Oximtery Project Wiki: http://wiki.ihe.net/index.php?title=PCD_Pulse_Oximetry_Integration_with_Clinical_Applications

• Proposal and other IHE artifacts• Agendas and minutes

• MDIP Wiki: www.mdip.wikispaces.com

• Draft documents, links to appropriate PCD Pulse Oximetry pages

• Google Groups:http://groups.google.com/group/ihe-pcd-pulse-oximetry?hl=en

• Project team communication

• Weekly Meeting:• Chair/convener for the meeting• Robert’s Rules “light” used to moderate the discussion and capture decisions• Quorum requirements for binding decisions

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Weekly Call Information (WebEx)

Topic: PCD Pulse Oximetry Date: Every Monday, from Monday, February 13, 2012 to no end date Time: 1:00 pm, Eastern Standard Time (New York, GMT-05:00) Meeting Number: 923 725 881 Meeting Password: PCDmeet1

To join the online meeting (Now from mobile devices!)

1. Go to https://himss.webex.com/himss/j.php?ED=176521912&UID=0&PW=NOGRmNmM4NjI4&RT=MiMxMQ%3D%3D 2. If requested, enter your name and email address. 3. If a password is required, enter the meeting password: PCDmeet1 4. Click "Join".

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Pulse Oximetry Use Case Milestones

Task Due Date

Start development of Technical Framework Supplement Jan-March 2012

Draft Technical Framework Supplement for TC Ballot Review April, 2012

TF Supplement Ballot April-May, 2012

Complete TF Supplement for Pulse Oximetry May 29, 2012

Prepare public ballot May- June, 2012

Internal VA TC review of ballot TBD (early June)

Publish IHE PCD Supplements for Public Ballot June 5, 2012

Publish IHE PCD TF with all the supplements June 15h, 2012

Publish new Supplements for Trial Implementation August 7, 2012

VA pilot project to implement the Pulse Oximetry Supplement July - December

VA pilot project - Unit testing completed December 15, 2011

IHE Connectathon January 2, 2013

HIMSS 2013 Interoperability Showcase demonstration February 1, 2013

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IHE Process Overview

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Pulse Oximetry Use Case Summary

• Goal: Improve patient safety by making disparate systems interoperable so that clinicians can see all of the patient's pulse oximetry readings.

• Problem: The ability of exchanging pulse oximetry with enterprise information systems using the standards and terminology that are native to those system would constitute a great advantage to the provider who use those devices and accelerate the integration with enterprise systems where the documentation for medical services is completed.

• Solution: Identify a way to automatically capture these values as well as record interventions with these readings. Ideally, there should be real time feedback to the staff to be alerted to values ‐outside the acceptable ranges for intervention. Also, there should be some way to validate the readings and annotate issues affecting the reading for final placement in the EHR.

• Benefit: This will allow clinicians to make better informed decisions about the patient's treatment plan. Additionally, a comprehensive list of values can provide researchers a wide variety of data, which can lead to best practices

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Technical Approach

• Care-setting Specific workflows – ICU, OR, Step-down unit

• Continuous or periodic information exchange (device initiated) – based on the frequency allowed by the device or configured on the device manager. This type of exchange is typical in the Operating Room for anesthesia record keeping and in Intensive Care Units for clinical flowsheets. The pulse oximetry values are automatically added to the patient’s chart/medical record. The information is validated in the information system that receives the medical device information.

• User-specified information exchange – the device information is sent to the information system based on explicit user actions/request. The use may specify a set or range of measurements as relevant to the condition or treatment of the patient. These results are sent to the information site. Our analysis will determine whether the data is validated at the point of care or after the information is sent to the information system.

• Detailed analysis of clinical workflow

• Define the context of use for medical devices to enable automation and interoperability• Improve efficiency• Improve quality• Accelerate documentation

• Identify the information used by or produced during the clinical workflow

• Conetent Profile– Business workflows– Structural constaints on PCD-01 based

on info modeling/DCMs– Terminoloygy constaints and mappings

class A: Approach and Ballot Content

DCM for Medical Device Ballot Publication

Annexes

1. Business/Clinical Use Case

«structured»2. Clinical Workflow

Specifies the scope of the specification;it is revised as new requirements are identified.

3. Analysis Information Model

DCM1

(from 4. Detailed Clinical Models)

DCM2

(from 4. Detailed Clinical Models)

Clinical Scenario(s)

4. Detailed Clinical Models

+ DCM1+ DCM2

Glossary

5. Data Types

(from Detailed Clinical Model (DCM) for Medical Devices)

«flow»

«import»

«import»

«import»

basedOn

«flow»

«flow»

Technical Approach

Content Profile

Terminology Mapping

InformationRequirements

Clinical Workflow

Use Case

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Engagement with SMEs

Three steps :

Walk-through Artifact

Review/Revise Artifact

To engage effectively:• Communicate the draft to the

SMEs prior to review• Allows them to participate in a

specific topic/meeting

• Call to walk through the artifact• Level-setting and review of draft

• Revise the artifact based on the SME’s comments• Follow up with comments

Draft Artifact

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Questions

• Action items & next steps