IEEE P11073-10101a Update HL7 DEV SIG and IEEE 11073 GC Meetings, San Antonio Thursday Q2, January 22, 2015 Paul Schluter, GE Healthcare Jan Wittenber and Todd Cooper, C4MI 1 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 IEEE P11073-10101a-D0.1k Term Status Subset Owner Status Resp, Vent, Anesth Paul Completed Other Parameters Paul Completed ACM Attrs & Enums Paul, Monroe Completed WCM Attrs & Enums Paul, Ken Defer to -10101b (use aECG, Capsule-Epic demo) Infusion Terms Todd, Jeff Defer to -10101b (not done) Units NIST, Paul Completed MDS/VMD/CHAN Paul PHD (Personal Health Daidi/Michael, Devices) Paul and Jan Compleded Completed: includes new PHD MDC_PART_DIM and MDC_PART_SCADA terms Draft -10101a standard ready for balloting this month! Reconciliation of vent terms with ISO/CD 19223 (ISO/TC121/SC4) completed Informal approval to defer infusion terms and enumerations to -10101b Includes over 450+ new terms and enumerations (excluding infusion pumps) 2 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 Respiratory, ventilator and anesthesia terms, and collaboration with ISO/CD 19223 • Numeric parameters based on subset of inflation or breath types: TV, MV, breath rate ... to support precise definitions of ‘spontaneous’ and ‘mandatory’ (using _BTSD_P,S,Z,A,C). • Extended gas measurement sites, internal as well as external • Anesthesia ventilation and breathing circuits • Unambiguous use of _SETTING über-discriminator • Reference ID structure and construction guidelines • Term normalization by various body weights: - ‘total’ (TBW, actual, default) - ‘ideal’ IBW = ‘predicted’ PBW (Devine, 1974) - ‘adjusted’ ABW 3 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 ISO/CD 19223: Add fifth breath type Illustration of difference between current-practice terminology and the draft ISO terminology Spon (ISO) Mand (current) Assisted Spon & Mand (ISO) Mand (current) Synch’d Assisted Spon (ISO) Spon (current) Supported Inspiratory Breath Unassisted Spon (ISO) Spon (current) Mand (ISO) Controlled Mand (current) In ISO terminology a mandatory delivery is a function of the ventilator whereas a spontaneous breath is an independent patient function: they are not alternatives. In the pursuit of simplicity, the currently used terminology employs both terms in the context of ventilator settings, thereby making them convenient alternatives. As ventilator technology has developed this has become a source of confusion because the term ‘spontaneous’ can be used in the same sentence with two different meanings: either a ventilator setting or a patient action. Natural language only recognises a ‘spontaneous breath’ as a patient action. NSJ Iss1: 16/10/2015 4 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 Explore the documents ... • IEEE P11073-10101a Nomenclature Amendment/Extension • • IEEE_11073-10101a-D0.1j_pss.2015-01-01T19.clean.pdf (distributed) IEEE_11073-10101a-D0.1k_pss.2015-01-17T20.pdf (current) • ISO/CD 19223 (ISO restricted distribution) • • NSJ rev 2 N283-ISO_CD_19223_(E) Revised during Incheon_MD.pdf IsoSettings.2f.2015-01-17T20.abbr.xlsx 5 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 IEEE P11073-10101a Collaborations • IEEE 11073 and IHE PCD Rosetta • ISO/TC121/SC4 (ISO/CD 19223 working group) • • • Dr. Norman Jones (Technical chair, ISO 19223) Dr. Steven Dain (Chair ISO 19223, anesthesiologist, editor for IEC 60601-1-8 Ed 1) Dr. John Walsh (anesthesiologist at Partners) • HL7 GAS SIG • Dr. John Walsh (HL7 GAS SIG chair, anesthesiologist at Partners) • VA • Dr. Loren Stevenson, Greg Staudenmaier, Ioana Singureanu and others • NIH/NLM/LHC and Regenstrief (Mapping IEEE 11073 to LOINC) • Drs. Clem McDonald, MD, and Swapna Abhankar, MD • GE HC LSS (CS2V2 Aisys/Avance, Carescape R860) • Andreas Tzanetakis, Robert Tham, Mike Krajnak 6 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 Ready for balloting ... IEEE P11073-10101a-D0.1k is ready for balloting ... • Add any changes from ‘short list’ and IEEE 11073 GC discussions • Submit draft for IEEE Mandatory Editorial Coordination (MEC) review next week (without infusion content). • Motion to start balloting at today’s meeting ... 7 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 IEEE P11073-10101a Annex A Annex A (normative) Nomenclature Semantics A.1 Nomenclature, data dictionary, and code extensions for vital signs devices A.2 Terminology and code extensions for units of measurement A.3 Nomenclature and code extensions for hemodynamic monitoring measurements A.4 Nomenclature and code extensions for respiratory, ventilator and anesthesia measurements A.5 Nomenclature and code extensions for fluid chemistry measurements A.6 Nomenclature and code extensions for infusion pumps A.7 Nomenclature and code extensions for neurological monitoring measurements A.8 Nomenclature and code extensions for miscellaneous measurements A.9 Nomenclature and code extensions for infant incubator and warmer microenvironments A.10 Nomenclature and code extensions for personal health devices A.11 Nomenclature and code extensions for electrode sites for electroencephalography A.12 Information attributes to support IHE PCD Alert Communication Management A.13 Infrastructure attributes to support Continua WAN and IHE PCD DEC A.14 Information attributes to support Continua WAN A.15 Information attributes to support IHE PCD DEC and Continua WAN timekeeping 12 13 17 22 24 63 64 65 67 69 70 73 74 74 75 76 8 HL7 DEV SIG and IEEE 11073 GC 2015-01-22 IEEE P11073-10101a Annexes B-G Annex B (normative) Expanded terms and numeric codes 79 B.1 Overview 79 B.2 Expanded terms and numeric codes 79 Annex C (informative) Schema and XML for nomenclature extensions 80 Annex D (informative) Breaths and Inflations 81 Annex E (informative) Respiratory, Ventilator and Anesthesia Reference ID Naming Conventions 82 Annex F (informative) Anesthesia Ventilation and Breathing Circuits 84 F.1 Bellows driven on expiratory side 86 F.2 Piston driven on inspiratory side 87 F.3 Mapleson circuits 88 Annex G (informative) Bibliography 89 9 HL7 DEV SIG and IEEE 11073 GC 2015-01-22