Connecting the clinical IT infrastructure to a service-oriented architecture of medical devices

Abstract

The new medical device communication protocol known as IEEE 11073 SDC is well-suited for the integration of (surgical) point-of-care devices, so are the established Health Level Seven (HL7) V2 and Digital Imaging and Communications in Medicine (DICOM) standards for the communication of systems in the clinical IT infrastructure (CITI). An integrated operating room (OR) and other integrated clinical environments, however, need interoperability between both domains to fully unfold their potential for improving the quality of care as well as clinical workflows. This work thus presents concepts for the propagation of clinical and administrative data to medical devices, physiologic measurements and device parameters to clinical IT systems, as well as image and multimedia content in both directions. Prototypical implementations of the derived components have proven to integrate well with systems of networked medical devices and with the CITI, effectively connecting these heterogeneous domains. Our qualitative evaluation indicates that the interoperability concepts are suitable to be integrated into clinical workflows and are expected to benefit patients and clinicians alike. The upcoming HL7 Fast Healthcare Interoperability Resources (FHIR) communication standard will likely change the domain of clinical IT significantly. A straightforward mapping to its resource model thus ensures the tenability of these concepts despite a foreseeable change in demand and requirements.

Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University Hospital

“…12 Pertaining to the requirements, a high-level architecture based on "Integrating the Healthcare Enterprise" (IHE) integration profiles was defined by Pahontu et al 13 Within OR.NET, concepts and mechanisms for both medical device-to-device communication and medical device-to-infrastructure (device to hospital IT infrastructure) communication were developed. The overall service-oriented architecture (SOA) for medical device-todevice communication described in the study of Kasparick et al 14 is based on the Device Profile for Web Services (DPWS) standard, 15 while medical device-to-infrastructure communication is presented in the study of Andersen et al 16 Five demonstration sites with different main purposes were established for presenting and evaluating the concepts and mechanisms, for both medical device-to-device and device-toinfrastructure communications, developed within OR.NET. The following sections describe the objectives of this article, the method used for setting up the demo OR at Heidelberg University Hospital as well as the evaluation method.…”

“…• HL7-Gateway and Connector IS (Connector Information Systems) for the translation and propagation of HL7 data from the hospital IT system to the OR using IEEE 11073 SDC and vice versa (detailed information can be found in the study of Andersen et al 16 ). • DICOM-Gateway for the translation and propagation of DICOM objects from hospital IT systems to the OR and vice versa and also for creating DICOM worklists from HL7 ADT/ORM messages.…”

“…This connector maps HL7 messages to IEEE 11073 SDC. The context manager groups medical devices into different sessions and sets various contexts depending on the context implementation degree supported by medical devices (detailed information on this component can be found in the studies of Kasparick et al 14 and Andersen et al 16 ).…”

“…For example, IHE PCD-01 compliant data directly emerging from Philips patient monitoring system were integrated and displayed within the hospital PDMS COPRA6. For data from Dräger patient monitoring system and anesthesia machine, we implemented an indirect data transmission according to the Device Observation Reporter (DOR) mechanism described in the studies of Kasparick et al 14 and Andersen et al 16 We implemented a component that collects all information of interest from the SDCcompliant device and performs the transformation of this information to IHE PCD-01 messages. By implementing the IHE PCD-01 transaction, we demonstrated a used case for a vendor-independent acquisition and transmission of medical device measurements to the hospital PDMS COPRA6.…”

Explorando o paradigma Publish/Subscribe e a elasticidade em níveis aplicados ao procedimento de Telemedicina

“…, patente requerida para lidar com imagens médicas usando dispositivos móveis. Bem como as transformações exigidas ao manipular imagens dessa natureza descritas emWestin et al (2016);Andersen et al (2018).…”