HL7

Eric Poiseau, INRIA

IHE Europe Technical Project Manager

MEDICAL

DEVICES
 Clinical Interfaces: Cost vs Quantity

Source : http://www.corepointhealth.com/whitepapers/evolution-hl7

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 The problem of non standard interfaces

B
4 systems, 6 interfaces

A C
B

D C
A

D 5 systems,
E 10 interfaces

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 Case of standardised interfaces

4 systems, 6 interfaces

A C
B

A C

5 systems,
5 interfaces
E D

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 HL7 Logo HERE

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 Why Health Level “Seven”

Source: http://en.wikipedia.org/wiki/OSI_model
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 The HL7v2.x Standard

 15 chapter

 4 appendices !

 Thousands of pages of specifications

 Different transport mechanism (MLLP, FTP…)

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 First Fresenius Kabi device
including HL7

Drug or Solution Name

Dose Rate
Concentration
Volumes
Alarms
Pre-alarms

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 In order to implement standardized interfaces, Fresenius Kabi has chosen
to use the IHE technical specifications.

FebCopyright
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2014
 IHE : Integrating the Healthcare Enterprise

 IHE provides technical specifications to vendors showing in detail how to

apply existing standards such as HL7 or DICOM (?) to a specific use cases
including clinical data management. For a seamless medical device
integration in the IT environment.

 It gives vendors a tested, uniform guide for implementation of the

responsibilities ? of the use case, and

 It gives healthcare providers a specific identifier to use in purchasing

specifications.

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 IHE : Integrating the Healthcare Enterprise

 Using IHE, the vendors can implement standard based interfaces and
ensure a plug and play interoperability for the Medical devices.

 Users, on the other side do not need to reinvent the wheel when writing
“requests for proposals” . By specifying IHE profile in their RFP, they use a
language that is clearly understood by their providers avoiding surprises.

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 IHE PCD

 In the field of patient care devices, IHE specifies use cases for the
interoperability of Medical Devices like:
– Infusion pumps
– Patient Monitors,
– Ventilators,
– Anaesthesia machine
– The Mission is to enable reliable, “Functionally Interoperable” solutions

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 IHE Connectathon

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IHE defines numerous profiles to respond to specific
interoperatibility use cases. In particular, Fresenius Kabi uses
 Device Enterprise Communication (DEC)
 Alert Communication Management (ACM)
 Consistent time (CT)
 Rosetta Terminology Mapping (RTM)

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 The alarm communication management (ACM) profile enables integrating
infusion alarms from an infusion pump to an alarm management and
reporting system, for example. The alarm receiver can send a notification
to the appropriate persons, typically through phone or other portable
devices, enabling a faster response from the clinical staff.

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 The Device Enterprise communication profile allows integrating for
example infusion data from a pump to the electronic medical record (EMR)
for a better traceability, automatic documentation, to avoid transcription
errors thus saving nurses’ time.

Time: accurately time stamped enables reducing synchronization errors

and interpretation errors.

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Illustration

EMR

19
 Rosetta Terminology

 Codes from medical device

manufacturer:
– BBraun
– Draeger
– GE
– Mindray
– Nuvon
– Philips
– Siemens
– Spacelabs
– Viasys
– WelchAllyn
– …

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 How to find a product

 Exemple of use of
the product-registry

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 Conclusion

 With the implementation of the HL7 standard following the IHE PCD DEC
profile recommendations Fresenius Kabi addresses the following
challenges:
– Patient Care and Safety
– Electronic Health Record integration
– Availability of device data in the flow of care
– Quality and efficient workflow
– Having a heterogeneous infrastructure
– Connecting Point-of-care devices

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 Links to further information

 Available through different ways

– IHE website
• http://www.ihe.net/Technical_Framework

• Current versions, Supplements

• PDF files to download

– IHE FTP
• ftp://ftp.ihe.net/

• Current and old versions of TF (doc and pdf)

• Implementation material and change proposals

– HL7 website
• http://www.hl7.org

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