Integrating Device Data into the Electronic Medical Record
John Zaleski - July 15, 2013
Editor's note: The following is excerpted from "Integrating Device Data into the Electronic Medical Record" by John Zaleski (Amazon.com link).
2.3 Interface StandardizationThe IEEE 1073 and 11073 standards on medical information buses (MIBs) took important steps in defining the various communication layers as well as requirements on networking and robustness. These are specifically delineated as:
1) Must withstand frequent reconfiguration due to patient and equipment movement;
2) Must support a simple plug-and-play capability; and,
3) Must provide for positive, unambiguous association between patients and devices.
MIB follows the ISO Open Systems Interconnection 7-layer Reference Model (OSI) 7-layer model which includes lower level physical device connectivity while the upper layers incorporate data encoding including the Medical Device Data Language (MDDL). A frequent misunderstanding is that devices can be seamlessly integrated with any information technology system. Historically, this has not been the case:
“The core of the so-called plug-and-play interoperability problem is this: In the absence of a communications standard that extends from the physical device connection through the application-language level, every interface between a medical device and any device or system with which it is to communicate must, at a minimum, be examined to determine what physical and logical interfaces must be developed to effect communication.”
In 2002, the IEEE announced plans to create three Health Infomatics standards:
• IEEE P1073.1.3.16: “Health Informatics-Point-of-Care Medical Device Communication-Device Specialization-Dialysis Device,” focusing on standardizing dialysis device communication with information technology.
• IEEE P1073.2.1.2: “Health Informatics-Point-of-Care Medical Device Communication-Device Specialization-Application Profiles-MIB Elements,” focusing on definitions for non-transport-specific MIB objects targeting network management and communication.
• IEEE P1073.2.3.2: Health Informatics-Point-of-Care Medical Device Communication-Device Specialization-Application Profiles-Optional Package, Symmetric Communication,” focusing on standardization of the communications interface for receiving, as clients, information from health information systems.
All three of these standards were sponsored by the IEEE Engineering in Medicine and Biology Society. Furthermore, the National Institute for Standards and Technology (NIST) has announced a collaborative effort with the IEEE 1073 Working Group to develop conformance tests and software tools to assist the medical device industry to ensure medical device communications standards are followed. It is understood that the IEEE MIB standards extend from critical care monitors, infusion devices, and mechanical ventilators to glucometers, flow meters, pulse oximeters, etc. The target objective is simplified plug-and-play mechanical, logistical, and information interoperability from the bedside.
Apart from device-level communication, many manufacturers of networked devices, to include telemetry or vitals monitors (such as those used in ICUs) and some infusion pumps, employ internal networks that provide isolated conduits for communication among devices and a central service point, typically known as Gateways. An instance of such a network is illustrated in Figure 2-11.
These Gateways typically operate on sub networks (“subnets”) that are separated physically or logically from an enterprise network as they enable the devices contained within the proprietary network to communicate unmolested. These networks support communication not only among monitors and the Gateway, but also to central nursing stations that enable alarms, notifications, and raw waveforms to be delivered rapidly. These medical subnets are, in effect, a system of medical devices within one larger medical device—the network itself.
Figure 2-11 Example of a Medical Device Gateway network topology
Device communication within the subnet is of a proprietary nature, specific to the design of the manufacturer. The manufacturer provides a mechanism for communicating with the enterprise through the Gateway. This communication is more standardized—often supporting a traditional HL7 communication interface. This interface usually provides for outbound transactions or findings in the form of either solicited or unsolicited observations and an inbound transaction containing patient identifying information, usually termed an admission, discharge and transfer, or ADT, transaction. The purpose of the inbound transaction is to associate specific patient identifying information with particular monitors. Once patient identifying data are applied to particular monitors, all outbound results and waveforms will then be electronically identified with them, thereby ensuring positive identification of results with patients—which mitigates the risk of misassociating a patient with his or her vitals data. To illustrate this point, the proprietary communication within the subnet is transmitted to the Gateway and, from there, a more standardized feed of vitals transactions are sent to the enterprise network.
Next: Medical Device Gateways
Page 1 of 3Next >
Datasheets.com Parts Search
185 million searchable parts
(please enter a part number or hit search to begin)