PCIM Update - Face to Face Fall 2024�Piscataway, New Jersey

PCIM Purpose

• Device-Patient Association Source of Truth
• Accuracy - Patient and location information stamped on device data increases safety and efficiency
• Efficiency - Clinicians don’t want to (or have time) to search, select patients on all device displays!
• Many device vendors don’t provide UI implementations for selecting patients
• Interoperable interfaces facilitate plug and play system participation

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PCIM Status

• Version 2.1 Trial Implementation Published – 7/1/2024
• Foundational cleanup, deprecates PCD-17/18 introduces DEV-51 & 52, removes PCD-20
• Two CPs ready for review and balloting
• CP-DEV-012 - Association Instance Unique Identifier
• CP-DEV-013 - Require PRT-4.2 Text and PRT-4.3 Name of Coding System Fields to be populated
• New CP for Retrospective Search Capabilities in FHIR Initiated
• AsciiDoc authoring process
• All work done at https://github.com/IHE/DEV.PCIM

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PCIM Timeline

PCIM Actor & Transaction Diagram

PCIM – Incorrect Association Remediation

• “Wrong” association signaling and required behavior
• Provision for “Correcting” or updating some associations

PCIM – Human Error - Wrong Association Performed

Description

Practitioner mistakenly associates the wrong device with the wrong patient (not paying close attention to confirmation in HMI, scanning the incorrect tag for various reasons, etc.)

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What Happened

Verified association was sent to consumers. Medical devices, gateways, etc begin stamping data with the ”wrong” patient.

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Practitioner(s) catch problem, how do they remediate this?

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Possible Resolution Flow

DPAM HMI must provide a UX to mark association as “Wrong”.

Optionally, DPAR may send a DEV-51 marked as “Wrong” to DPAM.

DPAM must send DEV-52 marked as “Wrong” to subscribed DPACs

Should DPAM be required to send an Alert? (Ensure practitioners are aware the data has been sent for the wrong patient for the known time period and that care should be analyzed accordingly)

DPAC must immediately unassociate device patient logical association.

Should DPAC be required to send a Alert? (Ensure practitioners are aware the data has been sent for the wrong patient for the known time period and that care should be analyzed accordingly)

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PCIM – Human Error - Correctable association

What is a Correctable Association?

Start time and End Time for RO or AUT participants.

Correcting patient is not allowed, that is a W followed by new association.

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Possible Resolution Flow

DPAM must provide a UX to correct the times that are “correctable”

DPAM must send DEV-52 marked as “Corrected” to subscribed DPAC.

Optionally, DPAR may send a DEV-51 marked as “Corrected” to DPAM.

DPAC should do what it deems necessary with correction message.

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PCIM FHIR Search Capabilities

• Use case for HL7v2 real-time association state communication consumers
• Simplified, safe efficient approach to associating patients to devices
• Consumers such as medical devices or gateways that communicate patient data benefit as well as downstream sytems/users
• Stamp patient data on all observations
• Stamp patient data on all alerts
• Show patient identifier in UX of management system or display (can be small) of medical device

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• Use cases for device patient search consumers
• Billing system (e.g. ventilator usage reports by patient)
• Fleet management (e.g what devices are in use, or which ones are available?)

PCIM FHIR Search Actors and Transactions

• Single Consumer (DPAC) Actor
• Optional DEV-52 (real-time push with current state)
• Optional DEV-19 (filter criteria)
• Optional DEV-5X (FHIR search)
• May support HL7v2 or FHIR or both
• Separate Consumer Actors
• DPARC for real-time with optional filtering
• DPASC for FHIR search
• A single DPAC implementation could support both actors
• Manager MUST support HL7v2 & FHIR?

PCIM FHIR Search Parameters

• Device
• Device Association Identifier
• Operator
• Person
• Practitioner
• Patient
• Patient
• Status
• Time period? (start or end or both)
• Location