Raymond Peter Zambuto, CCE, FASHE, FHIMSS, FACCE President, Technology in Medicine, Inc. Co-Chair IHE Patient Care Devices Domain Emanuel Furst, PhD, CCE.

Raymond Peter Zambuto, CCE, FASHE, FHIMSS, FACCE President, Technology in Medicine, Inc.Co-Chair IHE Patient Care Devices DomainEmanuel Furst, PhD, CCEPresident, Improvement Technologies, LLCTechnical Project Manager, IHE Patient Care Devices Domain

IHE Patient Care Devices DomainIHE Patient Care Devices DomainA Roadmap to InteroperabilityA Roadmap to Interoperability

• History– 1998 – HIMSS and RSNA form IHE Initiative

– 2001 – HIMSS IHE Road Show

– 2003 – ACCE and IHE begin Task Force for IHE Education to CE Community

– 2005 – IHE-PCD Launched

– 2007 – First Public Demonstration of Medical Device Interoperability

+

IHE-PCD is a Collaborative Effort

• Survey of all IHE Users Survey of all IHE Users

• Over 50% of those Over 50% of those surveyed said patient surveyed said patient care devices should be care devices should be the next area developed the next area developed for IHE for IHE

HIMSS 2005 Annual Survey Results

IHE PCD Formed in September 2005

• IHE Charter - The Patient Care Devices Domain is concerned with Use Cases in which at least one actor is a regulated patient care device. The PCD coordinates with other IHE clinical specialty based domains such as medical imaging.

• Current membership is approximately 200 and growing.

Device Enterprise Communication Profile – 2006-7

Provides the ability of a device to send physiological data directly, or through a gateway. Sampled data from continuous parameters (heart rate, blood pressure, SpO2) or intermittent parameters such as NIBP are included.

HIMSS Showcase Feb. 2007

The PCD display generated a great deal of interest as six companies demonstrated the ability to transfer physiologic data.

IHE PCD 2007 Interoperability Showcase Demonstration

IHE PCD 2007 Interoperability Showcase Demonstration

IHE PCD 2007 Interoperability Showcase Demonstration

IHE PCD 2007 Interoperability Showcase Demonstration

Connectathon

Recruit

Resources

Set Priorities

Develop Technical Framework

Process for Current Cycle (2007-8)

2006 Survey Call for Short Proposals

“Vetting” by Planning and Technical Committees

Interoperability Showcase Demonstration

Respondent Demographics171 Individual Responses

0 10 20 30 40 50 60 70 80

Vendor

Hospital based Clinical Engineer

Other

Other Hospital Based I.T. Professional

User of Medical Devices / Caregiver

Hospital Department Head

Hospital CIO

Regulator - Government or Other

Purchaser / Materials Mgr.

= Hospital Based

Relationship of Clinical Engineering and IT

*26 of the 103 Non-Vendor Respondents do not work in hospitals

0 5 10 15 20 25 30 35 40 45

Do not know

C E i s Outsour ced

Do not cr oss paths

C E and I T ar e separ ate -

wor k c l osel y

C E i s P ar t of I T

Importance of Interoperability - Hospital Respondents

0 5 10 15 20 25 30 35 40

Not a P r i or i ty

P r ef er i nter oper abl e devi ces but not

r equi r ed

Movi ng to compl i ance - wi l l i ng to pay a

pr emi um f or i nter oper abi l i ty

I HE compl i ance i s a r equi r ement f or

pur chase i f i t i s avai l abl e

What are the priority devices for interoperability?

= Users= Vendors

0 10 20 30 40 50 60 70 80

Dialysis (acute / chronic)

Intra-Aortic Balloon Pumps

Infusion Pumps

Anesthesia Systems

Ventilators

Physiological Waveform Monitors

Vital Signs Reporting Devices

Percent of respondents that consider it important

Short Proposals Submitted for 2007

Version Author/ Champion

Profile File Name No. Name

Patient ID 4.11 Ray Zambuto

RealTimeClinicalDataManagementStorageAndRetrieval 1.0 Jack Harrington

CrossEnterpriseSharingofPatientCareDeviceData-Synchronous 1.0 Jack Harrington

IHE-ECG-Workflow 1.0 Jack Harrington

InfusionPumpIntegrationToBPOC 1.0 Scott Zaffrin

PoCRealTimePnPDeviceIntegration 1.0 Todd Cooper

SmallDataElementExchange 1.1Karen Witten, Beth

Hurter

HomeTelehealth 1.1Vern Williams, Jim

McCain

Alarm Interoperability 1.0Elliot Sloane, Tobey

Clark

PCAInfusionSafety 1.0Julian M. Goldman,

MD

PCD-02Query 1.0 Paul Schluter

Proposals Adopted for 2007*

Author/ Champion

Profile File Name Name

Patient ID Ray Zambuto

PCD-02Query Paul Schluter

PoCRealTimePnPDeviceIntegration Todd Cooper

HomeTelehealthVern Williams, Jim

McCain

* Based on resource limitations. Additional work can be added if author/champion demonstrates sufficient additional resources

Subscribe to Patient Data 2007

An optional publish/ subscribe mechanism for applications to negotiate which PCD messages are communicated to a given application based on negotiated predicates (i.e., filter by patient, parameter or certain other characteristics)

Patient Identity Binding 2007

Automates the entry of patient identification to Patient Care Device systems, providing the potential for improving throughput, reducing errors, and increasing safety and increasing device and drug effectiveness.

Point of Care Plug and Play 2007

This profile should be available for public comment by the end of July.

Roadmap for 2008 and Beyond

Profile Family Year 1 Year 2 Year 3 Year 4 Year 5

Patient Identification Binding

Cross Enterprise Sharing of Synchronous Patient Data

Device control paramaters, interlocks, alarm controls, authentication

PCD-02 Patient Data Publish and Subscribe Query

Real Time Clinical Data Management, Storage and Retrieval

Point of Care Real Time PnP Device Integration

Device Interrogation, Identification, Location

Device-Device interaction Device-Device Control

Transport - pre hospital, waveforms, AED, telephonic

Wellness, smart home dataOutside the home - e.g. fitness

Alarm Interoperability - Alarm Information

Alarm Control

PCA Infusion Safety Smart Alarm Applications Smart Alarm Applications

IHE ECG WorkflowSmall Data Element Exchange

Infrastructure Export of PCD Data (DEC)

Inter-Device

Home Telehealth

Cross Domain

Work Flows

Applications

• The ability to influence the Technical Framework (public comment period just beginning for the Supplements)

• A year’s marketing advantage over those who don’t participate

• Participation in the Jan. 2007 Connectathon and the Feb. 2007 HIMSS Showcase with other PCD systems

Participation in 2007 Provides