IHE PCD Integration Pro-files

: PCD-01 Transaction

경북대학교 전자전기컴퓨터학부Device Software Lab.

이성기 도형호

용어Integration Profiles

Describe clinical information management use cases and specify how to use existing standards (ISO/IEEE, HL7, DI-COM, etc,...) to address them.

Systems that implement integration profiles solve inter-operability problems.

Technical FrameworksDocuments that specify the Integration Profiles and the

associated systems (actors) and transactions.

용어Actor

Information systems or components of information sys-tems that produce, manage, or act on categories of in-formation required by operational activities in the enter-prise.

Transaction Interactions between actors that communicate the re-

quired information through standards-based messages

Integration Profiles (PCD Do-main)

Profile Status Date

DEC (Device Enterprise Communication) Trial Implementation 2006-08-15

RTM (Rosetta Terminology Mapping) Trial Implementation 2008-08-22

ACM (Alarm Communication Management) Trial Implementation 2008-08-22

PIV (Point of Care Infusion Verification) Trial Implementation 2008-12-17

IDCO (Implantable Device Cardiac Observa-tions)

Trial Implementation 2009-08-24

MEM (Medical Equipment Management) Development (Cycle 4 whitepaper)

---

DPI (Device Point of Care Integration) Development (Cycle 4 whitepaper)

---

WCM (Waveform Communication Management) Development (Cycle 4) ---

Transactions (PCD Domain)ID Transaction Title Profile Source Actor Receiving Actor Notes

PCD-01 Communicate PCD Data DEC Device Observation Reporter (DOR)

Device Observation Consumer (DOC)

PCD-02 Subscribe to PCD Data SPD Device Observation Consumer (DOC)

Device Observation Filter (DOF)

PCD-03 Communicate Infusion Order

PIV Infusion Order Programmer (IOP)

Infusion Order Consumer (IOC)

PCD-04 Report Alarm ACM Alarm Reporter (AR) Alarm Manager (AM) For-merly ACM-01

PCD-05 Report Alarm Status ACM Alarm Manager (AM) Alarm Reporter (AR) For-merly ACM-02

PCD-06 Disseminate Alarm ACM Alarm Manager (AM) Alarm Communicator (AC) For-merly ACM-03

PCD-07 Report Dissemination Alarm Status

ACM Alarm Communicator (AC)

Alarm Manager (AM) For-merly ACM-04

PCD-08 Subscribe to Alarm ACM Alarm Archiver (AA) Alarm Manager (AM) For-merly ACM-06

PCD-09 Communicate IDC Observation

IDCO Device Observation Reporter (DOR)

Device Observation Consumer (DOC)

PCD-01 개요

PCD-01: Communicate PCD Data

Used to communicate PCD DataUsed by the DOR(Device Observation Re-

porter), DOF(Device Observation Filter) and DOC(Device Observation Consumer) actors

Communicate PCD Data From DOR to DOF or DOCFrom DOF to DOC

Use Case Roles

DOR: Sends PCD Data to DOF or DOCDOF: Receives PCD Data from DOR and sends

PCD Data to DOC based on defined filter pred-icates

DOC: Receives PCD Data form DOR and/or DOF

DEC Integration Profile

DEC Interactions

With filteringNo filtering

의료기기 데이터 흐름도

Manager/Gateway

Recv

Send

Blood pres-sure moni-

tor

Glucosemeter

Body Com-position Analyzer

LAB Devices

DeviceInterface

11073Server Sys-

tems(HIS,

CDR,LIS)

HL7 msg(ORU_R01)

ObservationReportingInterface

X73 to HL7

ORU_R01 Message 분석

ORU_R01 정의 (1)Segment Meaning Optionality Cardinality HL7 Chapter

MSH Message Header R [1..1] 2

[{SFT}] Software Segment X [0..0] 2

{ ---PATIENT_RESULT_begin

[ ---PATIENT begin

PID Patient Identification R [1..1] 3

[PD1] Additional Demographics X [0..0] 3

[{NTE}] Notes and Comments X [0..0] 2

[{NK1}] Next of Kin/Associated Parties X [0..0] 3

[ ---VISIT begin

PV1 Patient Visit O [0..1] 3

[PV2] Patient Visit – Additional Info X [0..0] 3

] ---VISIT end

] ---PATIENT end

{ ---ORDER_OBSERVATION begin

ORU_R01 정의 (2)Segment Meaning Optionality Cardinality HL7 Chapter [ORC] Order Common X [0..0] 4 ORB Observation Request R [1..1] 7

[{NTE}] Notes and Comments O [0..1] 2 [{ ---TIMIMG_QTY begin

TQ1 Timing/Quantity O [0..1] 4 [{TQ2}] Timing/Quantity Order Sequence X [0..0] 4

}] ---TIMING_QTY end [CTD] Contact Data X [0..0] 11

[{ ---OBSERVATION begin OBX Observation Result R [1..1] 7

[{NTE}] Note and comments }] ---OBSERVATION end

[{FT1}] Financial Transaction X [0..0] 6 [{CTI}] Clinical Trial Identification X [0..0] 7

[{ ---SPECIMEN begin SPM Specimen X [0..0] 7

[{OBX}] Observation related to Specimen X [0..0] 7 }] ---SPECIMEN end } ---ORDER_OBSERVATION end } ---PATIENT_RESULT end

[DSC] Continuation Pointer X [0..0] 2

ORU_R01 필수 Segment

MSH Message Header Segment

PID Patient Identification Segment

OBR Observation Request Segment

OBX Observation Result Segment

MSH SegmentSEQ LEN DT

OptionalityELEMENT NAME

HL7 IHE PCD1 1 ST R R Field Separator2 4 ST R R Encoding Characters3 227 HD O R Sending Application4 227 HD O RE Sending Facility5 227 HD O RE Receiving Application6 227 HD O RE Receiving Facility7 26 TS R R Date/Time Of Message8 40 ST O X Security

9 15 MSG R R Message Type

10 20 ST R R Message Control ID11 3 PT R R Processing ID12 60 VID R R Version ID13 15 NM O RE Sequence Number14 180 ST O X Continuation Pointer15 2 ID O R Accept Acknowledgment Type16 2 ID O R Application Acknowledgment Type17 3 ID O RE Country Code18 16 ID O RE Character Set19 250 CE O RE Principal Language Of Message

20 20 ID O X Alternate Character Set Handling Scheme

21 427 EI O R Message Profile Identifier

PID Segment (1)SEQ LEN DT

OptionalityELEMENT NAME

HL7 IHE PCD

1 4 SI O X Set ID - PID

2 20 CX B X Patient ID

3 250 CX R R Patient Identifier List

4 20 CX B X Alternate Patient ID - PID

5 250 XPN R R Patient Name

6 250 XPN O RE Mother’s Maiden Name

7 26 TS O RE Date/Time of Birth

8 1 IS O RE Administrative Sex

9 250 XPN B X Patient Alias

10 250 CE O RE Race

11 250 XAD O RE Patient Address

12 4 IS B RE County Code

13 250 XTN O RE Phone Number - Home

14 250 XTN O X Phone Number - Business

15 250 CE O RE Primary Language

16 250 CE O RE Marital Status

17 250 CE O RE Religion

18 250 CX O RE Patient Account Number

PID Segment (2)SEQ LEN DT

OptionalityELEMENT NAME

HL7 IHE PCD TF19 16 ST B X SSN Number - Patient20 25 DLN B RE Driver's License Number - Patient21 250 CX O RE Mother's Identifier22 250 CE O RE Ethnic Group23 250 ST O RE Birth Place24 1 ID O RE Multiple Birth Indicator25 2 NM O RE Birth Order26 250 CE O RE Citizenship27 250 CE O RE Veterans Military Status28 250 CE B RE Nationality 29 26 TS O RE Patient Death Date and Time30 1 ID O RE Patient Death Indicator31 1 ID O RE Identity Unknown Indicator32 20 IS O RE Identity Reliability Code33 26 TS O RE Last Update Date/Time34 241 HD O RE Last Update Facility35 250 CE C RE Species Code36 250 CE C C Breed Code37 80 ST O C Strain38 250 CE O RE Production Class Code39 250 CWE O RE Tribal Citizenship

OBR Segment

SEQ LEN DTOptionality

ELEMENT NAMEHL7 IHE PCD

1 4 SI O R Set ID ‑ OBR

2 22 EI C R Placer Order Number

3 22 EI C R Filler Order Number

4 250 CE R R Universal Service Identifier

5 2 ID X X Priority – OBR

6 26 TS X X Requested Date/Time

7 26 TS C RE Observation Date/Time

OBX SegmentSEQ LEN DT

OptionalityELEMENT NAME

HL7 IHE PCD TF

1 4 SI O R Set ID – OBX

2 2 ID C C Value Type

3 250 CE R R Observation Identifier

4 20 ST C R Observation Sub-ID

5 99999 varies C C Observation Value

6 250 CE O C Units

7 60 ST O CE References Range

8 5 IS O CE Abnormal Flags

9 5 NM O X Probability

10 2 ID O CE Nature of Abnormal Test

11 1 ID R R Observation Result Status

12 26 TS O X Effective Date of Reference Range

13 20 ST O X User Defined Access Checks

14 26 TS O RE Date/Time of the Observation

15 250 CE O RE Producer's ID

16 250 XCN O RE Responsible Observer

17 250 CE O RE Observation Method

18 22 EI O RE Equipment Instance Identifier

19 26 TS O CE Date/Time of the Analysis

20 705 CWE X RE Observation Site

ORU_R01 Message 매핑

MSH SegmentHL7 메시지의 메타데이터 (metadata) 를 포함하고

있는 세그먼트의료기기에서 전송되는 데이터와 직접적인 연관

없음

PID SegmentPID 의 필수 필드

PID-3: Patient Identifier ListPID-5: Patient Name

PID 의 필수 필드 입력 방법11073-90101(PoCT1:Analytical instrument –Point of Care Test)

PID 세그먼트에 해당하는 데이터 전송11073-20601(PHD: Personal Health Device)

PID 세그먼트에 해당하는 데이터 전송하지 않음비표준 의료기기 (Non 11073)

기기에 따라서 PID 세그먼트에 해당하는 데이터 전송하는 경우와 전송하지 않는 경우로 나뉘어 짐

의료기기에서 PID 세그먼트에 해당하는 데이터가 전송되는 경우에는 HL7 메시지에 그대로 적용 , 전송되지 않는 경우에는 사용자가 반드시 입력해주어야 함

OBR SegmentOBR 의 필수 필드

OBR-1: Set IDOBR-2: Placer Order Number(conditional)OBR-3: Filler Order Number(conditional)

PCD TF does not use the ORC, the OBR-2 & 3 must be valued

OBR-4: Universal Service IdentifierOBR 의 필수 필드 입력 방법

OBR-4 대부분 전송되는 항목 ( 표준 , 비표준 ) 입력 되지 않을 경우 , 사용자가 반드시 입력 코드값 입력 - CE(Coded Entry) 타입

OBX SegmentOBX 의 필수 필드

OBX-1: Set ID OBX-2: Value Type(conditional)

Must be value if OBX-11 is not X OBX-3: Observation Identifier OBX-4: Observation Sub-ID

Multiple OBX segments OBX-5: Observation Value(conditional) & OBX-6: Units(conditional) or OBX-8: Abnormal flag OBX-11: Observation Result Status

OBX 의 필수 필드 입력 방법 OBX-3, OBX-6

대부분 전송되는 항목 ( 표준 , 비표준 ) 입력 되지 않을 경우 , 사용자가 반드시 입력 코드값 입력 - CE(Coded Entry) 타입

용어 코드 및 매핑MDC(ISO/IEEE 11073-10101:Nomenclature) 사용

의료기기 : 11073 기반HL7 메시지에 그대로 적용

LOINC(Logical Observation Identifiers, Names and Codes) 사용 의료기기HL7 메시지에 그대로 적용

Other code system & Company proprietary code 사용 의료 기기MDC 매핑 시도LOINC 매핑 시도HL7 메시지에 그대로 적용 : 반드시 coding system 을

입력

MDC 코드 매핑

Term code for MDC_DIM_PULS_PER_MIN

Dimension Unit of mea-surement Symbol Reference ID Code

special vital signs rates Puls per minute puls min–1 MDC_DIM_PULS_PER_MIN 2752

Partition code for MDC_DIM_PULS_PERS_MIN

Partition number Nomenclature category

4 Dimensions(Unit of measurement)

Expression for MDC code

4 X 65536 + 2752 = 264896 (Partition code X 216 + Term code)

Example of HL7 message adopted the MDC code

… | 264896 ^ MDC_DIM_PULS_PER_MIN ^ MDC | …

HL7 Message 예 (Weighing Scale)

MSH|^~\&|hhdoORI^ACDE48234567ABCD^UUID||||

20090901100030-0400||ORU^R01^ORU_R01|MS-

GID123456789|P|2.5|||NE|AL|||||IHEPCDORU-

R01_09^HL7^2.16.840.1.113883.9.n.m^HL7

PID|||ID12345^^^KNUH^PI||Hong^Gildong^^^^^L

OBR|1|AB12345^Daegu-uHealthCenter|

CD12345^Daegu-uSilverCenter|

188736^MDC_MASS_BODY_ACTUAL^MDC

OBX|1|NM|188736^MDC_MASS_BODY_ACTUAL^MDC|

1.1.1.1|75.4| 188716^MDC_DIM_KILO_G^MDC|||||R