IHE Patient Care Device

The IHE Patient Care Device (PCD) domain was formed in 2005 to address the integration of medical devices into the healthcare enterprise, from the point-of-care to the EHR, potentially resulting in significant improvements in patient safety and quality of care. In 2006/2007 the first profile was successfully developed, tested in a Connectathon and demonstrated at HIMSS '07, exchanging information from vital signs, physiological monitors, ventilators, infusion pumps, and anesthesia workstations with enterprise applications such as clinical information systems. This enterprise-level integration is actively being extended to point-of-care integration, as well as to new workflow integration needs, such as alert communication management.

IHE PCD is sponsored by the AmericanCollege of Clinical Engineering (ACCE), the Health Information Management Systems Society (HIMSS) and the Association for the Advancement of Medical Instrumentation.

IHE PCD Profiles

IHE Patient Care Device integration profiles include:

• [ACM] Alert Communication Management enables the remote communication of point-of-care medical device alert conditions ensuring the right alert with the right priority to the right individuals with the right content (e.g., evidentiary data).  It also supports alarm escalation or confirmation based on dissemination status, such as whether the intended clinician has received and acknowledged the condition.
• [DEC] Device Enterprise Communication supports publication of information acquired from point-of-care medical devices to applications such as clinical information systems and electronic health record systems, using a consistent messaging format and device semantic content.
• [DEC-SPD] Subscribe to Patient Data provides an optional extension to the DEC profile that supports a filtering mechanism using a publish / subscribe mechanism for applications to negotiate what device data they receive based on a set of client-specified predicates.
• [IDCO] Implantable Device Cardiac Observation specifies the creation, transmission, and processing of discrete data elements and report attachments associated with cardiac device interrogations (observations) or messages.
• [IPEC] Infusion Pump Event Communication allows an infusion system to send detailed non-alarm information on to allow the tracking and logging of the whole history of an infusion operation.
•  [PIV] Point-of-care Infusion Verification supports communication of a 5-Rights validated medication delivery / infusion order from a BCMA system to an infusion pump or pump management system, thus "closing the loop."  Optionally, the [DEC] profile may be used to selectively monitor the status of the devices that have been programmed.
• [POI] Pulse Oximetry Integrationspecifies how implementers could use the existing DEC and PCD-01 transaction to exchange pulse oximetry observation sets with clinical information systems. It constrains the existing transaction to better accommodate the content of pulse oximetry measurement observation.
•  [RDQ]Retrospective Data Query  allows for patient specific, user-initiated queries of retrospective data stores of clinical data (i.e., retrospective data) for the purpose of aligning those data under a common time frame with the appropriate resolution to support clinical decision making based on the retrospective data. The RDQ is therefore patient centric and collects data from various sources (via multiple queries) to produce a comprehensive report that is meaningful to a given use case.
• [RTM] Rosetta Terminology Mapping establishes a set of tools (Excel spreadsheets & XML files) that map the proprietary semantics communicated by medical devices today to a standard representation using ISO/IEEE 11073 semantics and UCUM units of measurement.  Additionally, the Rosetta tables capture parameter co-constraints, specifying the set of units of measurement, body sites, and enumerated values that may be associated with a given parameter, thus enabling even more rigorous validation of exchanged medical device semantic content.

Each of these profiles is defined in full detail in the IHE PCD Technical Framework.

Profile and white paper development is active in the following areas:

• [DPI] Device Point-of-care Integration brings focus on device connectivity around a patient-centric point-of-care, including "first link" interfaces between devices or a device manager / supervisor system.  This activity includes initial development of a white paper, followed by a number of proposed profiles such as:  discovery and association, data reporting, symmetric (bi-directional) communication, and external control.
•  [MEM] Medical Equipment Management investigates the question of how health I.T. might support the activities of clinical engineering / biomedical engineering staff, improving quality and workflow efficiency.  Key topics include unique device identification, real-time location tracking, hardware/software configuration and patch management, battery management, and more.
• [PCIM] Point-of-care Identity Management  is an investigation of the workflows and technical means for associating the right device data with a particular patient, which is a critical patient safety requirement.
• [SA] Semantic Architecture White Paper will provide an overview of the sometimes bewildering subject of nomenclature, terminology and information models that are used to enable true semantic interoperability of patient care device information.  It will also lay the groundwork for the new terminology development that is required to fill gaps that have been identified, especially during [RTM] "Rosetta" profile development.
• [WCM] Waveform Communication Management will extend the [DEC] profile to provide a method for passing near real-time waveform data using HL7 v2 observation messages.  For example, passing wave snippets as evidentiary data in an alarm message communicated using [ACM] transactions.

PCD Planning and Technical Committees

The IHE PCD Planning and Technical Committees are responsible for developing IHE integration profiles and planning deployment activities, such as testing events and educational programs. The PCD committees are composed of users and developers of medical devices/systems and information systems. The membership of these and other IHE domain committees, along with schedules of activities, meeting agendas and minutes and working documents can be found on the IHE Wiki. The PCD wiki pages provide up-to-date information on all development activities.

The PCD Planning and Technical Committees have established Google Groups for e-mail communication. You can subscribe to these distribution lists by visiting each Group's home page or using the forms below:

Committee Co-Chairs

Planning Committee:  Kurt Elliason, Monroe Patillo

Technical Committee:  Tom Kowalczyk, John Rhoads

To Learn More

The IHE PCD welcomes your interest and invites you to join. Just send an email to paulrshermancce@gmail.com. Additional information and links to detailed descriptions and documentation for the PCD and its committees is available on IHE Wiki's PCD Domain Home Page.