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Agenda

  • Discuss proposed new resource for device alert

Attendance

Stefan Schlichting (notes), Jan-Alrik Philipsen, Stefan Karl, John Rhoad

 

Questions:

-          Q: Lifecycle of the Alarm Condition?

o   Effective time for completed Alarm Conditions.

-          Q: Single Instance of a present Alarm or also the possible Alarm Conditions that can be monitored?

o   Single Instance with versions for history, the possible Alarm Conditions and the configuration of the Alarm System are modelled in another resource

§  Duplicate the alarm limits in both

-          Q: Do we need the DeviceMetric to be referenced?

o   Open

 

Current Draft

 

{

  "resourceType" : "Alert",

  "identifier" : [{ Identifier }], // Unique identifier

  "code" : [{ CodeableConcept }], // 11703 Code for AlertCondition

  "status" : "<code>", // in-progress | completed ß Suspended, see AudibleSignal and VisualSignal

  "priority" : "<code>", //Low, Medium, High  ß Low, Medium, High, None (for information signals)

  "subject" : { Reference(Patient|Device) }, // Patient for physiological and Device if it is a technical Alarm.

  "effective" : "<dateTime|PeriodOfTime>", // The Time of presence of the Alarm Condition aka Determination Time of onset of Alarm Condition and if applicable the offset of the Alarm Condition

  "device" : { Reference(Device| DeviceMetric)}, // Device Reference for MDS, VMD, Channel and DeviceMetric for indiv. Metric (e.g. HR in a HR HIGH Alarm).

  "DerivedFrom" : [{ Reference(Observation|Device|DeviceMetric) }], // evidentiary data that is needed to interpret the condition or that is the reason why the condition is present

   {"alarmLabel" : "<string>"}   //AlertString: Display Text that may combine the alarm  concept code as well as the measurement type and potentially also bodysites

 “AudibleSignal”:” <code>” // Current state of the local audible AlertSignal that relates to the Alarm Condition with a value-set of: On, Latched, Ack, Off

  “VisualSignal”: “<code>” // Current state of the local visual AlertSignal that relates to the Alarm Condition with a value-set of: On, Latched, Ack, Off

  “remoteAudible”: {boolean}, //condition can be audible at at least one remote location (i.e., not suppressed)

  "limits": {ReferenceRange}, //Current Alert Limits that are applied in the determination of the alarm condition if applicable.

}

 

 

 

 

 

Here are the details from the discussion.

 

First iteration:

Removes: code, uses audible and latching flags

Removes: part of because FHIR supports back-referencing

Sender => renamed to Device.

 

 

{

  "resourceType" : "Alert",

  "identifier" : [{ Identifier }], // Unique identifier

  "code" : [{ CodeableConcept }], // 11703 Code for AlertCondition

  "status" : "<code>", // in-progress | completed ß Suspended, see AudibleSignal and VisualSignal

  "priority" : "<code>", //Low, Medium, High  ß Code ??? Low, Medium, High, None (for information signals)

  "rank":  [{ CodeableConcept }],  // Absolute rank of the alarm with reference to alarm system. ß Number

  "subject" : { Reference(Patient|Device) }, // Patient for physiological and Device if it is a technical Alarm.

  "effective" : "<dateTime|PeriodOfTime>", // The Time of presence of the Alarm Condition aka Determination Time of onset of Alarm Condition and if applicable the offset of the Alarm Condition

  "device" : { Reference(Device| DeviceMetric)}, // Device Reference for MDS, VMD, Channel and DeviceMetric for indiv. Metric (e.g. HR in a HR HIGH Alarm).

  "delegationReference": {Reference(Device)},

  "DerivedFrom" : [{ Reference(Observation|Device|DeviceMetric) }], // evidentiary data that is needed to interpret the condition or that is the reason why the condition is present

  "payload" : [{ // Message payload

    {"alarmLabel" : "<string>"}   //AlertString: Display Text that may combine the alarm  concept code as well as the measurement type and potentially also bodysites

  }],

  conditionMonitored: {CodeableConcept}, //on, off, monitored  //single instance of a alarm only

  conditionPresent: {boolean}, // see Status

  "EffectiveAcknowledgeTimes": "<dateTime|PeriodOfTime>", //Acknowledged timespan

 

“Signal” : [{

                Kind= Aud/Vis

                State= On, Latched, Ack, Off

]}

 

AudibleSignal: <code> // Current state of the local audible AlertSignal that relates to the Alarm Condition with a value-set of: On, Latched, Ack, Off

VisualSignal: <code> // Current state of the local visual AlertSignal that relates to the Alarm Condition with a value-set of: On, Latched, Ack, Off

 

  localAudible: {boolean}, //indicates that the condition is audible at the local system

  remoteAudible: {boolean}, //condition can be audible at at least one remote location (i.e., not suppressed)

  isLatching:{boolean}, //visible latching of the condition is allowed

  audibleLatching:{boolean}, //audio latching of the condition is allowed

  "component" : [{ // Component results: Activation, SignalGenerationDelay, Presence, Local/Remote, Slot

    "code" : { CodeableConcept }, // R!  Type of component observation (code / type)

    // value[x]: Actual component result. One of these 11:

    "valueString" : "<string>",

    "valueInteger" : <integer>,

    "valueTime" : "<time>"

  }],

  "limits": {ReferenceRange}, //Current Alert Limits that are applied in the determination of the alarm condition if applicable.

}

 

 

 

 

 

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