ACM Profile Presentation to IHE PCD IDCO WG

1. ACM Profile Presentationto IHE PCD IDCO WG by Monroe Pattillo IHE PCD Planning Committee Co-Chair Practical Health Interoperability, LLC

2. Overview ACM is the Alert Communication Management IHE PCD profile Purpose is people notifications based upon HL7 v2.x messages originating from devices, gateways, and applications Work started in 2008, ACM has been at 6 NA Connectathons Profile at Final Text as of IHE PCD Technical Frameworkv3.0 Name change 2013, added advisories, widened applicability IEEE 11073-10101a adds MDC/REFIDs, containment attributes

3. Per information in IEEE 11073 Domain Information Model What is an Alert? ALERT ALARM EVENT ADVISORY Physiological Technical Unlike an Alarm, an Advisory has no presumption of patient life safety or time critical response IHE PCD identifies Alerts as resulting in notifications to people and Events as something that goes between systems and not to people ACM includes support for Advisories for Nurse Call Systems, Workflow and Materials Management Systems, and Early Warning Systems

4. Expectations of ACM Move away from proprietary interfaces for people notifications Originators don’t want to change if notification backend changes Include clinical, routing, and retrospective relevant information PID, PV1, source, priority, type, phase, ID/child ID, device ID, timestamp Abstract originators from notification mapping to people Originators don’t need to understand shift/group management Abstract originators from people to destination management Originators don’t need to track people’s destination preferences Abstract originators & managers from notification device protocols, OS, GUIs Originators and managers don’t need to change with every new device fad Standardize management of notification delivery status and user responses And communication systems don’t want to be medical devices

5. ACM Actors and Roles ORIGINATOR Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) Gathers and packages pertinent data Notification text to destination protocol mapping performed here Alert source & type to staff to device mapping performed in here Status Submitted Delivered Not Delivered Read Responses Accept Reject Alert data to notification text mapping performed here

6. Protocol HL7 v2.x Protocol WCTP ACM Actors, Transactions, & Protocols ORIGINATOR PCD-06 Disseminate Alert PCD-04 Report Alert Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) PCD-07 Report Dissemination Alert Status

7. ACM Sources and Destinations ORIGINATOR PCD-06 Disseminate Alert Sources Destinations PCD-04 Report Alert Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) Wired or Wireless Devices, Gateways Desktop or Mobile PCD-07 Report Dissemination Alert Status Infrastructure Local or Public Pagers 1/2-way, PBX Phones, Voice Badges, Smart Phones, Tablets, Laptops, Desktops

8. Protocol HL7 v2.x Protocol WCTP ACM Protocol Transactions ORIGINATOR PCD-06 Disseminate Alert wctp-SubmitRequest PCD-04 Report Alert Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) PIN, Text PCD-07 Report Dissemination Alert Status ORU^R40 ^ORU_R40 wctp-StatusInfo MSH PID PV1 OBR OBXs

9. Protocol HL7 v2.x Protocol WCTP ACM Actors and Transactions ORIGINATOR PCD-06 Disseminate Alert Sources Destinations PCD-04 Report Alert Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) Wired or Wireless PIN, Text Devices, Gateways Desktop or Mobile PCD-07 Report Dissemination Alert Status ORU^R40 ^ORU_R40 Gathers and packages pertinent data Notification text to destination protocol mapping performed here Alert source & type to staff to device mapping performed in here Infrastructure Local or Public MSH PID PV1 OBR OBXs Status Submitted Delivered Not Delivered Read Responses Accept Reject Pagers 1/2-way, PBX Phones, Voice Badges, Smart Phones, Tablets, Laptops, Desktops Alert data to notification text mapping performed here

10. Alert Reporter (AR) Alert Manager (AM) Alert Communicator (AC) Communication Device (actor out of scope) Transaction Timing A single PCD-04 can result in many PCD-06 (groups, people with multiple devices) PCD-04 Report Alert WCTP A single PCD-06 can result in many PCD-07 (received, delivered, read, accept) for each PCD-06 (protocol out of scope) HL7 ACK PCD-06 Disseminate Alert HL7 v2.x Send text messages to devices Due to overheads and people response times, arrival time for last PCD-07 is indeterminate, could be seconds to minutes to never Receive delivery status updates and user replies from devices PCD-07 Report Dissemination Alert Status

11. Attributes

12. Enumerations

13. Benefits to IDCO WG for use of ACM IDCO notification actor only has to learn how to send PCD-04 (an HL7 v2.x message) IDCO actor vendor does not have to develop code to manage alert to people assignments, shift changes, assignment groups, people to device assignments, or on/off duty or breaks IDCO actor vendor does not have to develop code for communication device protocols or deal with device GUIs, display sizes, menus, fonts, buttons, stylus, or O/S types (Apple vs Android vs Win Mobile) Day one ability to deliver notifications to Philips IEM (fka Emergin), USA Mobility AMCOM, iSirona NANT, and Cerner iBus with no changes to IDCO actor implementations beyond ability to send PCD-04, and likely more systems that can receive HL7 v2, but aren’t IHE members, or don’t participate in IHE Connectathons (check with Extension and Connexall) IDCO notifications become an easy addition to existing ACM AM/AC actor deployments Supports communication back ends supported by AM and AC systems ACM supported WCTP AM to AC (AMCOM, Vocera, Cardiopulmonary) There are others quite likely (AM and AC vendor specific) Day-one potential to transparently support a variety of notification devices Pagers, Badges, PBX Phones, Smart Phones, Tablets, Desktop Computers Operating environments: Apple, Android, Windows Mobile IHE Certification potential – IHE-USA/ICSA Labs Certification program includes ACM

14. Q&A

15. For More Information ACM WG Google Group ihe-pcd-ACM@googlegroups.com WebEx sessions Thursdays 4-5 PM ET IHE PCD Planning Committee Co-Chairs Monroe Pattillo, PHI, LLC Greg Staudenmaier, VA IHE PCD Technical Committee Co-Chairs John Garguilo, NIST Jeff McGeath, Iatric Systems, Inc. IHE PCD Secretariat Paul Sherman pcd@accenet.org Connectathon Results – http://connectathon-results.ihe.net Folder containing PCD list of Commercially Available solutions ftp://ftp.ihe.net/Patient_Care_Devices/Deployment/Commercially_Available_PCD_Systems/