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HL7 Healthcare Devices / IEEE 11073 Working Group Meetings - 2014.01.20 - 2014.01.24 - San Antonio, Texas 

See meeting documents posted @ ?

Monday - Q1

Participants

• John Garguilo (NIST) john.garguilo@

• Allen Hobbs (KP) Allen.Hopps@

• John Rhoads (Philips) john.rhoads@

• Paul Schluter (GE) Paul.Schluter@med.

• Stan Wiley (Draeger) stan.wiley@

• Sefan Schlichting (Draeger) stephan.ashlichting@

• Jan Wittenber (Philips) jan.wittenber@, center email??

• Todd Cooper (Center for Medical Interoperability) todd@

• Ken Fuchs (Center for Medical Interoperability) kfuchs@

• Masato Tanaka (Nihon Kohden)masato_tanaka@mb2.nkc.co.jp

Other Participants Pool (note - use for future Qs if present)

• Bill Ash (IEEE) w.ash@

• Kathryn Bennett (IEEE) k.bennett@

• Masaaki Hirai (Nihon Kohden)Masaaki_Hirai@

• Vannak Kann (VA) vannak.Kann@

• Andrzej Knafel (Roche) andrzej.knafel@

• Sadamu Takasaka (HL7 Japan) s.takasaka@

• Review of IEEE SA IP

• Review of "Declaration of Affiliation: Understanding your Disclosure Obligations"

• Review of Agenda

• Issues related to the fact that Tracy Rausch is unable to join us due to illness

• Agenda Approved

• Review Cambridge minutes (John Rhodes)

• MInutes Approved, subject to reviewing spelling and adding content based on discussion

• Review of x73 Mission and Charter

• Motion to Re-Approve passed Unanimously

Monday - Q2

Participants

• Same as Q1

• Review of HCD-DEV Decision Making Process

• Discussion of separating discussions/voting on x73 topics vs. HCD topics vs. Joint topics

• Motion that we should clearly identify x73 and/or HCD and/or other topics on the agenda, during the meeting and in the minutes in order to use the appropriate decision making rules.

• Motion voted on and approved Unanimously

• Motion that we adopt the HCD_DEV Decision Making Process

• Motion voted on and approved Unanimously

• Review of HCD_DEV SWOT

• Modified the wording concerning participation by providers/clinicians (weakness) based on the participation of the C4Mi

• Deleted weakness on v3 due to our participation in FHIR and CDA

• Added Opportunities for determining relationships with MDPnP and HL7 SOA; closer relationship with Mobile Health WG, IEEE PHD and Continua

• Motion made to approve the updated SWOT

• Motion voted on and approved Unanimously

• HL7 formed terminology authority (SKMT Glossary) -

• In the formative stages at this point

• Chartered to provide coordination and collaboration between the various terminology SDO's to reduce / remove duplication and facilitate consistency across HL7 usages

• Initial cotacts (Todd Cooper @ Healther Grain) indicated that there is interest in including device terminology

• Todd will participate in the Friday Q1 meeting of the group

• HL7 has a pilot project on conformance and certification; 

• Pilot project reported on @ San Antonio meetings

• AEGIS taking the test tooling lead and primary "risk" (e.g,. financial) responsibility

• Program to be rolled out @ HIMSS'14 in February

• Not clear exactly what is being tested 

• FHIR anticipated to be added at some point in 2014

• Devices are not currently on the map ...

• John Rhodes reviewed HL7 projects that HCD is involved in.

• ** Need to discontinue 513 and 595

• John Rhodes reviewed the WorkGroupHealth dashboard

• Dashboard does not accurately reflect WG activity, especially conference call activity since we use other services.

• Dashboard does not seem to capture our voting activity

• John was directed to bring this feedback to HL7

Monday - Q3

Participants

• Same as Q1 with the addition of:

• Bill Ash (IEEE) w.ash@

• Kathryn Bennett (IEEE) k.bennett@

• Update from IEEE (Kathryn, Bill) - see posted presentation

• P10101a needs to be sent for ballot within a month.  If not we will need to reform the ballot group.  - We intend to meet this deadline.

• A number of PHD PARs are waiting for action from the General Committee especially due to a need to resolve the process of harmonizing nomenclature.  PHD has received this feedback when the GC commented negatively on the PARs.

• Need to modify the PARs to recognize that nomenclature needs to be harmonized with 10101.

• Need to inform Kathryn whether agreement has been reached before 2/14

• Agreed to contine to hold co-chair status meetings every quarter

• Still need example files from Prometheus to check on use for publication

Monday - Q4

Participants

• +Christian Hay

• Continuation of IEEE status update

• Education /eHealth Strategy

• eHealth Strategy

• IEEE-SA is partnering with ICUcare to develop medical devices API for mapping devices to HIT Infrastructures.

• MOU - no cost API provided by ICUcare (PHR--> EHRs) - start w/ legacy systems into hospital infrastructure

• MOU Conflicts with other efforts (e.g., PARs in place, FHIR project) and existing IEEE practice and partners of IHE, HL7, HIMSS, etc. - see

• From Web Site: "In response to an ever growing demand for interoperability between medical devices and electronic healthcare systems such as Health Information Systems (HIS), Electronic Health Records Systems (EHRs) and Electronic Medical Records Systems (EMRs), ICUcare LLC today have announced a collaborative effort with IEEE working with its IEEE Standards Association (IEEE-SA), to develop a Universal Industry Standard/Specification and a web based Middleware Application Programming Interface (API) designed for use by healthcare professionals in mapping data from medical devices to their electronic system to the benefit of both care providers, patients and payers."

• Sponsorship / PR sales discussion (Society Sponsorship, PR & Sales)

• Mhealth WG Update (Allen Hobbs)

• FDASIA Update (Todd Cooper)

• AAMI/UL 2800 Update (Todd Cooper)

Tuesday - Q1

Participants

• John Garguilo (NIST) john.garguilo@

• Allen Hobbs (KP) Allen.Hopps@

• John Rhoads (Philips) john.rhoads@

• Paul Schluter (GE) Paul.Schluter@med.

• Stan Wiley (Draeger) stan.wiley@

• Sefan Schlichting (Draeger) stephan.ashlichting@

• Jan Wittenber (Philips) jan.wittenber@, center email??

• Todd Cooper (Center for Medical Interoperability) todd@

• Ken Fuchs (Center for Medical Interoperability) kfuchs@

• Masato Tanaka (Nihon Kohden)masato_tanaka@mb2.nkc.co.jp

• Michael Faughn (Prometheus Computing) m.faughn@

• Art Griesser (Prometheus Computing) a.griesser@

• Sergio Henriquez (Center for Medical Interoperability) senriquez@

• Introduction of participants

• Review of co-chair meeting Monday evening

• John Rhoads mentioned that we can populate the meetings tracking by just inserting the links to the WebEx or equivalent into the system.

• Todd Cooper reported that there is considerable impetus behind FHIR.  This will be further discussed later in our meeting.

• DSC meeting notes (Melva Peters):

• Motion to support IEEE and HCD leadership to draft a letter of concern over the lack of dialogue with the responsible committees, apparent disregard for the Standards Development Process and the desire to either rescind or amend the MOU to engage those committees in this process going forward.

• Motion carried with one abstention

• Motion to have a conference call between ICUcare, IEEE and IEEE 11073 committees. 

• Motion not supported

•

• Tooling update (John Garguilo)

• See presentation

Tuesday - Q2

Participants

• Same as Q1

• Tooling update continues (John Garguilo)

• Modelling update (Art Griesser)

Tuesday - Q3

Participants

• Same as Q1

• - Sergio Enriquez

• Presentation by Draeger (Stefan Schlichting)

• The reference implementation of the proposed architecture and protocols for distributed systems of medical devices in high-acuity environments is now available on Sourceforge and we are looking for your feedback.

• The folder files\framework\V1.0-Beta01\Documentation contains a whitepaper that explains the architecture and protocols:

• There is also a tutorial material available under files\examples:

• The following is a link to a YouTube video (in German) 

• Committee thanked Dr. Schlichting for his presentation

•

Tuesday - Q4

Participants

• Same as Q1

• + Barry Brown (Mortara) - Barry.Brown@

• + Andrew Norton - andrew.norton@tiscali.co.uk

• + John Walsh

• + Ellen Torrez

• Barry Brown - Extensions to ECG to support multi-hour ECG transfer

• Discussion with GAS anesthesia project (John Rhodes)

• General CDA project #513 was not making progress due to focus on project #850 for vital signs.  Recently work has re-started on #513.

• Jan Wittenber proposes starting to develop a DCM for respiration rate to use results from collaboration with TC 121.

• Still a massive amount of work to be done.  Work needs to be simplified in order to make progress.

• Using Snomed CT for vocabulary

• Would like 1 or 2 exemplar DCMs; the existing blood pressure DCM may be useful.

• Schluter asks whether a DCM is required for every parameter/observation?

• Jan agrees that what we have for aECG is a good example of what is needed.

• Need to allow both projects to run independently while synchronized

• First pass for #850 will probably not use DCMs

• Snomed - IEEE mapping project

• IHTSDO does not seem to be too anxious to renew MoU

• Kathryn Bennett had a recent discussion with Jane Miller of IHTSDO and they are asking for a higher level of granularity in the MoU concerning the goals of the MoU

• Many terms waiting for decision for quite a long time; log-jam may be clearing

• Daidi Zhong - 11073 PHD

• General feeling is that MDC_PRESS_AWAY_AVG (20723) should be used.  We do not need both AVG and MEAN.

• Don't feel we need MDC_PRESS_AWAY_WAVE and MDC_FLOW_AWAY_WAVE if these are indeed RT-SA

• Daidi requests that we contact Christoph.Fischer@mcc-med.de.  ** Jan to pick this up.

• PHD asks that the Sponsor Group support their PARs. ** Jan will communicate our desired changes to the PARs so they can make the changes before 2/14

Wednesday - Q1

Participants

• John Garguilo (NIST) john.garguilo@

• Allen Hobbs (KP) Allen.Hopps@

• John Rhoads (Philips) john.rhoads@

• Paul Schluter (GE) Paul.Schluter@med.

• Stan Wiley (Draeger) stan.wiley@

• Sefan Schlichting (Draeger) stephan.ashlichting@

• Jan Wittenber (Philips) jan.wittenber@, center email??

• Todd Cooper (Center for Medical Interoperability) todd@

• Ken Fuchs (Center for Medical Interoperability) kfuchs@

• Masato Tanaka (Nihon Kohden)masato_tanaka@mb2.nkc.co.jp

• Michael Faughn (Prometheus Computing) m.faughn@

• Art Griesser (Prometheus Computing) a.griesser@

• Sergio Henriquez (Center for Medical Interoperability) senriquez@

• Andrew Norton - andrew.norton@tiscali.co.uk

• John Walsh

• Ellen Torrez

• Questions concerning Draeger proposal

• Is Java an issue? C++ is also available.  Up to vendor to decide how to proceed and manage interoperability testing.

• Are all devices visible to all other devices.  Not necessarily, based on how it is implemented.  Usually a gateway to bridge between various logical groupings of devices.

• Need to think about how to bring this forward given currently approved work.

• Need to discuss whether optimizations being proposed are required or just suggestions

• Further discussion on Thursday and DPI T-con

• 11073-10101a Amendment

•

Wednesday - Q2

Participants

• Same as Q1

• - Andrew Norton; John Walsh; Ellen Torrez

• + Ewout Kraemer e.levamer@

• + Joon Hyun Song  jhsong@

• + Dangil Jeong - 

• + Michael Donnelly (EPIC) michael.donnelly@

• + Sadrata Parioni (Cerner) - 

• + Brad Arndt (Cerner) brad.arnt@

• + Gaby Jewell (Cerner) Gjewell@

• + D Youn Lee (Korea)

• FHIR Discussion (Ewout Kramer)

• Review of FHIR Device Observation Resource

• Revice of FHIR Device Resource

• NOTE:  Other device-related resources (e.g., DeviceLog) were taken off the table and the two above revised per 2013-09 Cambridge WGM ballot resolutions

• Recently, the documentation for the above two resources was updated ... but more information is needed.

• For May FHIR Connectathon

• Want to expand on the Devices Use Cases

• Google "fhir connectathon 5" to get link to 2014-01 event

• Track #3 was intended to include devices; however, the specifications were not in place in time to advance this with a broader group of participants

• For 2014-05 FHIR Connectathon, refer to the 2014-01 Tracks / scenarios to see the level of information that is needed.

• MEDICAL DEVICE INTEROPERABILITY TESTING will be included as part of the FHIR Connectathons; this will provide opportunity to prototype and test emerging "from the device interface" standards + to link those to FHIR resources

• Discussion of what should be done next.  Remote Control?  Alerts?  Remote Setting (of limits)?

• Do we need a special Medical Device Alert or just reuse the existing Alert resource?  

• NOTE: That due to the high patient safety issues associated with medical device alerts and the delivery requirements (often enforced by standards and regulatory authorities), separate components are often defined to ensure the needed reliability, latency and other QoS requirements.  For example, in IHE PCD a ORU message is used but a specific trigger was allocated to indicate the special nature of the message.

• For the Remote Setting we could base this on the 11073 Limit Alert Setting.

• We committed to prototyping both an MD Alert Resource as well as an MD Control for the next Connectathon.

• ** Need to make a New Resource Proposal to the FMG (FHIR Management Group). See wiki.index.php?title=Template:FHIR_Resource_Proposal

• Issue brought up concerning the return path requirement for Alerts, i.e. an acknowledgement of the Alert back to the device that sent it.

• TBD how best to accomplish this

• Single HL7 PSS to cover both activities

• Four types of conversations are envisioned (and thus driving the need for associated resources):

• Device reporter => server => client  [today's resources]

• MD Alert => server / alert manager => end clients

• MD Control Resource SCT (Snomed CT) Mapping

• Need to extend the MoU with IHTSDO

• Thought is to focus on a few specific areas

• Andrew Norton volunteers to work on respiratory measurements and settings.  There are already quite many in Snomed.

• Snomed only deals with information directly about a patient.  So device status related terms (technical) are out of scope.

• Specifically IEEE should suggest the following work with IHTSDO:

• Patient related respiratory terms

• Update hemodynamic terms already mapped

• Harmonized Rosetta patient related termset

• Establish a construct for generailzing and maintaining this process with Snomed and other terminologies.  

• Also terminology consistency and ability to traverse across different terminologies and end up at the same place.

• Kathryn to update the MoU with the above bullets and review within IEEE

• Todd and Andrew to double-check with Jane Millar of IHTSDO to make sure we are on the right track

• Pump Terminology Update

• Motion to reform the ballot group for 10101a approved

• Target to finish 10101a by the end of February

Thursday - Q1

Participants

• John Garguilo (NIST) john.garguilo@

• Allen Hobbs (KP) Allen.Hopps@

• John Rhoads (Philips) john.rhoads@

• Paul Schluter (GE) Paul.Schluter@med.

• Stan Wiley (Draeger) stan.wiley@

• Sefan Schlichting (Draeger) stephan.ashlichting@

• Jan Wittenber (Philips) jan.wittenber@, center email??

• Todd Cooper (Center for Medical Interoperability) todd@

• Ken Fuchs (Center for Medical Interoperability) kfuchs@

• Masato Tanaka (Nihon Kohden)masato_tanaka@mb2.nkc.co.jp

• Michael Faughn (Prometheus Computing) m.faughn@

• Art Griesser (Prometheus Computing) a.griesser@

• Lura Daussat (OZ Systems), ldaussat@oz-

• Satoshi Koboyashi (Fukuda Japan) satoshi.Kobayashi@fukuda.co.jp

• Lura Daussat:

• Review and approval of Implementation Guide concerning EHDI

• Approved with the proviso that any effects on PCD-01 be evaluated.

• Review and approval of Implementation Guide concerning CCHD

• Approved with the proviso that any effects on PCD-01 be evaluated.

• Review of 10201 Tooling (Michael Faughn, Art Griesser)

• Tooling could also be used to define FHIR resources for devices

Thursday - Q2

Participants

• same as Q1

• - Lura Daussat

• Jan Wittenber

• review of UL architecture (see x73_PoC_Topo_jw2)

• review of current 20401 CNS draft document

•

Thursday - Q3

Participants

• Same as Q1

• - Lura Daussat

• +Paul Spadafora (Center for Medical Interoperability) pjspadafora@

• +Mathew Graham (Mayo Clinic) graham.mathew@

• ACSE Discussion (Paul Spadafora)

• See presentation on 20101 - harmonization investigation of 20101 with 20601

• **Todd Cooper action item: Add to the 11073-20101 revision spreadsheet:

• Deprecate expedited messaging service

• Deprecate coalescence messaging service

• Stan Wiley mentioned that the mechanisms used in the 802.11ai (Fast Roaming) approach may be applicable in this case as well.

• Need to review how the manager "catches up" (Paul calls it "in-sync") with the agent when re-associated

• Presentation is assumed to be MDER.  Semantics in Connect Indication can allow other presentation alternatives.  PHD does not have a CI.

• ** Paul SP and Jan to look at a way of have a common (with PHD, HL7 and PoC) connection phase prior to the Association Phase.

• WCM Attributes Review (Paul Schluter)

•

Thursday - Q4

Participants

• Same as Q1

• - Lura Daussat; John Rhodes; Michael Faughn; Art Griesser

• + Mathew Graham (Mayo Clinic) graham.mathew@

• + Harry Rhodes (AHIMA) harry.rhodes@

• + Andrew Brown (Ecosolutions) andy.brown@

• + Michael Steine (?) michael.steine@

• + Christina Hay (GS1)

• + Ilkon Kim (Korea) ikki,@icnu.ac.rr

• + Masaki Hirai (Nihon-Kohden Japan) Masaaki_Hirai@mb1.nkc.co.jp

• Mobile Health (Allen Hobbs) (see slide set) 

• Discussion concerning shared Use Cases 

• Holter Monitor (pre-annual physical) use case

• Glucometer (Diabetes Management) use case

• Comment that there are implementations using Continua devices and architecture that implement the use case.

• Discussion concerning automobile telematics and mobile health

• Third Use Case for mobile intelligent automobile/emergency vehicle

• Goal is to have a draft proposal for next meeting

• Jan W asks for analysis concerning what is especially required for "mobile" use cases vs. our typical use cases.

• Review current state-of-the-art in Continua, ISO, etc.

• Define requirements

• Connect with FHIR

•

• UDI (Christian Hay)

• Update on status of GS1 and UDI coding for HL7.

• Long discussion on the availability of parentheses in the code.

• CNS Harmonization Project (Classic and Draeger proposal) - Jan Wittenber

• See file x73_CNS_Harmonization_Proj_Summary_jw1.jpg

• Look at scopes for different solutions and see if they overlap or not

• If overlap then try to harmonize; if not then stay somewhat independent

• Motion made to accept this proposal as a project; motion approved with the proviso that MDPnP be contacted to see if they also would like to participate.

•

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