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Day / DateQuarterMeetingScribeNotes

Monday

 

Q1/Q2
Plenary
9:00 AM - 12:30 PM

Q3/Q4
1:30 - 5:00 PM EST

  • HL7 DEV WG

CO-CHAIR:  TODD COOPER   

CO-CHAIR: CHRIS COURVILLE

CO-CHAIR: JOHN GARGUILO

CO-CHAIR: JOHN RHOADS   

CO-CHAIR: MARTIN HURRELL

CO-CHAIR: MARTIN ROSNER

Garguilo

MEETING NOTES FROM John J. Garguilo

Monday Q1/2, 9:00 AM - 12:30 PM (Eastern Time - ET U.S.)

Q1  Plenary

Plenary Session: A Global Healthcare Ecosystem to Meet the Needs of the Next Pandemic

See <https://whova.com/portal/webapp/wgmse_202209/Agenda/2521093>

Q2 Plenary

Panel: Preparing for the Next Pandemic

See <https://whova.com/portal/webapp/wgmse_202209/Agenda/2572481>

Monday Q3, 1:30 PM - 3:00 PM (Eastern Time - ET U.S.)

Welcome, Introductions, and Agenda Review (HL7 DEV Officers)

  • ANSI Anti-Trust Policy reviewed: (Garguilo)

    Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM). 

  • Agenda Reviewed (Garguilo)
    • Minor edits made, no new topics proposed by attendees
    • Physical Activity Implementation Guide - PSS-2091 (from project proposal PSS-2069)
      • Project review - Confirmed  Thursday Q3 joint with mHealth...  
    • Gemini SES + MDI Update - PSS-1980 to be discussed Q4 Wednesday
    • Agenda approved by attendees
  • General updates / announcements (Garguilo) 

  • HL7 Co-Chair Updates (Co-Chairs)

    • Note:  HL7 International Education on Demand Site for members:  https://www.pathlms.com/hl7

    • Chief Standards Development Officer: Dan Vreeman, Deputy Chief: Diego Kaminker
    • Other new TSC members: Jean Duteau (TSC Vice-Chair), Gora Datta, Rich Geimer
  • May 2022 WG Meeting Minutes Review / Approval (Garguilo)
    • Assumed review had occurred by attendees and those interested
    • May 2022 HL7 DEV Meeting Minutes
    • Garguilo walked through meeting minutes, no further discussion occurred.
    • Motion to "approve May 2022 Meeting Minutes"
      • Approved 16-0-0, First: Todd Cooper, Second: Ken Fuchs
  • HL7 DEV Meeting Coordination / Communications (Rhoads)
    • Use of HIMSS Teams or HL7 Zulip:  The Missing "Chat" Window!
    •  ACTION:  John Rhoads  John Rhoads to work with Sarah Bell (IHE) to get resolution
    • …To include Call canceling / change notification / etc.
  • Co-Chair Elections (No Co-Chair positions presently up for nomination)
    • HL7 Device WG - Future elections of six co-chairs to fill the positions currently held by Todd Cooper, John Garguilo, Martin Hurrell, John Rhoads, Chris Courville, and Martin Rosner (all of whom may be re-elected)
    • No further discussion needed.

Break 3:00 - 3:30 PM

Monday Q4, 3:30 - 5:00 PM (Eastern Time - ET U.S.)

  • Housekeeping: Current Versions of WG documents, for discussion (Rhoads)

  • Review of Mission, Charter, SWOT - see DEV Main Page (Rhoads)

    • John Rhoads introduced and presented DEV's SWOT
    • Review of SWOT Document: 
      • John Rhoads walked through the Strengths, Weaknesses and Opportunities

      • Updates made with group's input; new document to be provided by John R.

      • Item discussed regarding potential  of adoption of Devices vs. FHIR (also a funding issue)

      • Suggested item be captured and put "in parking lot" for more elaboration

      • To be updated and soon available: Download SWOT Analysis (2019-01-17 Document)

        •  ACTION: John Rhoads to verify and post latest documents to Confluence


  • HL7 DEV Working Group 'Health Reports and the Project and Ballot Health Metrics: (Garguilo): 
    • Working Group Health Files (September '22 Interim Reports)
    • New! WG Health Metric:
      • A new metric has been added to Work Group Health measuring the number stale issues your WG has in JIRA across product families. Since this is new, it is purely informational at this time, but eventually anything in the red zone will result in an increment on your work group health. This metric will be recalculated before each report is released.

    • See links to current "HL7 WG Health" documents at end of this Agenda

Noted that Co-Chairs will attend the Q5 Co-Chair Dinner meeting - with a report out on Wednesday Q1.

  •  John Rhoads  Work with IHE Sarah Bell to resolve "MS Teams" Meeting chat issues
  •  John Rhoads Validate latest versions of WG documentation, including this session's worked-on SWOT  

Tuesday

 

Q1 - Q4
9:00 AM - 5:00 PM, ET

  • IEEE 11073 SC Leadership:

    CHAIR: KEN FUCHS   

    VICE-CHAIR: DAIDI ZHONG

    SECRETARY: STEVEN DAIN    

    emb-11073-Listserv: emb-11073-sc@LISTSERV.IEEE.ORG

  • IEEE 11073 PoCD WG Leadership:

    CHAIR: STEFAN SCHLICHTING

    VICE-CHAIR: STEVEN DAIN

    SECRETARY: KONSTANTINOS MAKRODIMITRIS

    IEEE-SA Liason to PoCD: TOM THOMPSON

    11073 PoCD Google Group: ieee-11073-pocd@googlegroups.com

MAKRODIMITRIS
/Garguilo

IEEE POCD Meeting minutes(approved) in IMEET-CENTRAL IEEE POCD WEB

MEETING NOTES FROM John J. Garguilo

IEEE-SA iMeetCentral Folder for: 11073 Point of Care Device Working Group

Start Q1 (9 AM)

Welcome, Introductions, and Agenda Review [Kosta M./Ken Fuchs]  

Welcome by Konstantinos Makrodimitris (Kosta) and Ken Fuchs (Chair Stefan Schlichting regrets for first part of meeting) to in-person and virtual attendees.

Attendance officially kept by Kosta and IEEE-SA; attendees encouraged to log attendance on HL7 site: Log September 2022 HL7 DEVICE and IEEE 11073 WG Attendance

Slide sets and meeting materials at IEEE-SA's iMeet Central
https://development.standards.ieee.org/myproject/Public/mytools/mob/slideset.pdf
https://ieee-sa.imeetcentral.com/p2933/folder/WzIwLDEyMTEyODczXQ/WzIsNjY4ODg0NTdd/
IEEE-SA Presentations site to upload slides: https://ieee-sa.imeetcentral.com/11073pocd/folder/WzIwLDE1MDMwOTA4XQ/

IEEE Disclosures [Ken Fuchs]

Call for Potential Essential Patents Holders. Please contact IEEE WG co-chairs with just name and affiliation. 

IEEE Patent Policy - IEEE Patent Policy

IEEE-SA Copyright Policy - IEEE Copyright Policy

IEEE Meeting Conduct – IEEE Code of Conduct

IEEE Ethics Policy - IEEE Code of Ethics

11073 SC Update [Ken Fuchs]

  • Ballot to approve the resolution for extending the PAR for 10101b, approved last week, and start the SA ballot as soon as it ready.  Deadline is the end of September '22

Recently went through a set of PHD revisions and extension for those standards - 104xx

 09:15a | Agenda Review [Kosta] / Review Previous Minutes and New Members [Kosta] 

  • Kosta walked through the IEEE-SA site, and showed the structure (tabs) for this PoCD WG.
  • Kosta reviewed the May 2022 meeting minutes taken, showed suggested edits to date, and asked for folks to send any other edits.
  • No further edits suggested by attendees.  
  • Motion "to approve the IEEE-SA May 2022 meeting minutes" by Ken Fuchs, second by Javier Espina, no abstentions, no negative, passes unanimously, minutes approved (19 Attendees).
  • See IEEE-SA's iMeet site for approved and unapproved Meeting minutes

Update regarding PARs & Standards (Tom Thompson, IEEE-SA Liaison)

IEEE 11073 PARs, Projects, SDOs and Analytics
IEEE reports, dates and stats

Tom Thompson, IEEE-SA, provided the 11073 Standards update - please see slide set provided on iMeet Central Site: IEEE-SA Liaison Slide Set: Update September 2022

  • Tom noted there are several projects coming to deadlines in 2023 and suggested members have a look to determine what if anything needs to be done for that project.

  • Standards Breakdown presented.

  • Tom provided slide set providing breakout of IEEE 11073 PARs, Projects, SDOs

    • Current Projects Breakdown was provided

              

    • Noted that several above (e.g., P11073-10720) will likely need to be extended, as they are just started and in draft form… Martin K. noted that all of the projects are being worked on, although funding for projects has ended, members are committed to continue work.  2024 would be more realistic.  Tom T, noted that if group could get to Ballot Stage (forming ballot group - at least begins by Q3 by 2023) there likely wouldn't be much push back from NESCOM to continue extension… Ballot should be at least ten individuals.  Martin K. noted that it might be difficult to start the ballot by Q3 of 2023…  Thus it might take 1-2 years.  Tom suggested any time next year would be fine.

    • -10107 (External Control) has not had an progression.  Todd Cooper suggested Mod Specs would be needed prior, but Bjorn A. suggested not the case.  Bjorn suggested that group likely could get all to ballot about the same time…

    • AAMI remote control work / standards is coming from a slightly different angle...

    • Martin K. noted 10107 - regarding nomenclature - a few hundred terms to cover all aspects of work…


  • Standards and SASB Expiration Dates:

 

    • Presently (as of 16 September 2022) for PoCD

              7 Active

              6 Inactive-Reserved - can remain in this status indefinitely, unless requested to withdrawal

                  Malcolm Clarke noted the Inactive-Reserved were agreed upon to keep all in Inactive-Reserved

    • PHD standards

    • Presently (as of 16 September 2022) for PHD

              Active 15

              Inactive-Reserved - 6 - can remain in this status indefinitely, unless requested to withdrawal

              Expiring at end of  year: 7 (Note: Chart shows Dec. 2021, should show Dec. 2022)



  


  • IEEE MOUs in place:

    • HL7 - update to agreement being worked on...

    • LOINC

    • NIST - Royalty Free Agreement - will be reviewed for potentially adding additional information to be freely released as part of the new RTMMS System

        •  

          ACTION John J. Garguilo and IEEE-SA Liaison Tom Thompson to work on this before January 2023 meetings.

    • Personal Connected Health Alliance (PCHA)

IEEE reports, dates and stats

  • Schedule and upcoming meetings (e.g., NESCOM):

https://standards.ieee.org/content/dam/ieee-standards/standards/web/governance/sasb/2022calendar.pdf

Update from SDC SG (Martin Kasparick, and Bjorn Andersen, now both with Draeger)

  • PHD Update (Daidi (not present), Ray Krasinski/Philips Healthcare, Isabel Tejero/FDA)

    • Ray Krasinski provided an PHD update

      • Spirometry - specialization, fourth round

      • 10206 ACOM is now completed and in process of being published

        • ACOM spec does not ??

        • Battery status monitoring chosen (in the healthcare domain).

        • Kosta noted FDA has a program on "battery work group" (referenced Isabel Tejero)

Break 10:30-11 AM

Start Q2 (15 in person + 6 On-line (Martin K., Malcolm Clarke, Grant Forrest, Isabel Tejero, Stefan Schlichting, Jingu Choi)

Update from SDC SG (Continued)

  • Martin Kasparick subcommittee chair, introduced topic and provided information on progress of PKP standards

Bjorn provided an overview of the "Cathedral Window Diagram" (see above) and walked through the status of the included standards…

  • Started with the Key Purposes Standards

  • Device Specializations have much content, building on the PKPs and will likely have to extend to progress to ballot stage.

  • Coding System Box is left for Paul Schluter related to 10101 update (Nomenclature)

  • SDC is fairly flexible regarding code systems…

    • In addition to -10101, LOINC and SNOMED CT are primary, but not limited to these…

    • Not required, but encouraged, to use standardized terminology

  • Top box - "Profiles" - IHE SDPi profiles are the 'bindings' to the standards.

  • Noted that don't wait to implement, and start - there will (most likely) be continuous iteration and updates…

  • Question from Todd Cooper:

    • Question about ModSpecs and a consistent way to handle conformance (e.g., ICS Tables).  Bjorn suggested that likely would be similar to the Base Stds ICS tables… claimed conformity, versus "approved conformity" - this would provide structure for conformity claims (and that they can be verified…

  • Martin noted the 'yellow' part they are waiting on the PKP standards, the other standards are continuously being worked on (every two weeks)
        Note: The plan is for adding the first two PKPs (working draft) by end of year or beginning of 2023… to share w/ international community

  •    Considering joint development process with ISO…

Reference links for General Project, Issue Tracker, and Draft Document:


Vote on 1070x PAR Scope Change Proposals (Ken Fuchs)

  • 10700 Scope was modified (Ken showed document - Redline from June 2021)

  • Proposing to do the same on the other scopes (e.g., base, metric, alert, external control PKPs)

    • Ken marked up these documents and restructured the working in a similar fashion as done for the 10700

  • Proposal on the table is modify the scope to bring into alignment with BASE PKP.

  • Question if this effects the NESCOM timeline?

    • Tom Thompson noted it depends - one can't expand a scope, but can edit it if still within the original scope.  This is up to the Ballot Group… If the PAR is updated, and someone notes the change, that comment would have to be addressed for resolution…

  • For Metric, Bjorn agrees, but asked as for the Alert and External Control - is now a good time?

    • Ken responded that team (within Draeger) wants to limit this to human control…

    • This is up for discussion within working group…

  • Question as to if a vote is needed if just in the Base PKP, as those documents are still under development, and later hold a vote on Base + Alert + External Control

Update from the IDCO SG (Paul Schluter, for Craig Reister)  

  • Standard has been extended to include lots of additional content

  • Document is now fully updated to meet existing standards for Implantable Devices


  • The Standard is moving forward to ballot will soon be available to wider public for comment…

  • Presently going to ballot group (extension was filed through end of 2023).

    • Ballot group was already formed

  • Craig.reister@bsci.com  Meet on Fridays, typically 5-7 folks join

    • Sarah Bell, from IHE-DEV, can send notices to folks who ask…

    • Focus on P11073-10103R - Implanted Devices Cardiac

    • Kudos to Craig Reiser (IDCO group lead, BSCI), Paul Schluter (RTM Lead), and Michael Faughn (NIST) for help and expertise on the terminology development

Update from the 10101b (Paul Schluter)  

  • Major extension of nomenclature - approved two years ago, and now an ISO standard… new amendment is 280 pages

  • Paul noted work in conjunction of work with RTMMS (Version 2) , via NIST Royal Free Agreement with NIST + IEEE-SA

  • Work in this field is still focused on can we eliminate "false positives"…

12:00-12:30 pm

11073 Stories/Pilots and Conformity - FDA/CDRH ASCA presentation:  Simon Choi, Scott Colburn (Anil, Kosta, Stefan, Sajjad)

Scott Colburn/FDA presented the following material (several slides captured for notes):


Over 1400 Recognized standards

What is Recognition:



ASCA Program - Pilot and Volunteer program

FDA does not want to be restrictive, but understands the need to be sure technical assessors understand how to test…

https://www.fda.gov/medical-devices/standards-and-conformity-assessment-program/accreditation-scheme-conformity-assessment-asca









What would a "summary report" include and look like… to get at conformity...
5 Accreditation Bodies

Test Labs: 90 - not limited to USA

Device Compatibility
60601, 6060x

Is there plan for extension… how FDA will do this is still up for debate - developing the 17025, accreditation bodies…

Not trying to get all standards into notified bodies or additional costs to end user

Trying to more consistency and quality of testing - high quality date and declarations of conformity…

Questions Scott mentioned to consider:

  • What type of enhancements would be needed? In addition what ASCA has done to date…

  • Are the standards that are develop lend themselves to conformity

  • Trying to build regulatory ready - but understand some are

  • 60601 and compatibility… more mature so FDA thought this was a good place to start…

  • Looking to do this more collaboratively beyond FDA - with SDOs, experts, domain groups… but not there yet… but FDA would like to engage more in the future…

  • What question are we trying to solve by putting it into ASCA… what are we doing to up the ante into the 17000 series…



12:30-1:45 pm | LUNCH

Nomenclature - Continued (Paul Schluter)

11073 lifecycle from cases, development to recognition to adoption to value for patients (Kosta, Stefan, Sajjad, Todd, Ray, Isabel, Martin, All)

Attendees on-line: Anil Kochlar, Danica Marianac-Dabic, Isabel Tejero, Gregory Pappas, Stefan Schlichting

Silent ICU / Quiet Hospital / Silent Hospital / Quiet ICU

  •  Provide care where the patient is, not the medical devices

  • Alarm providers (at patient bedside) can stay silent - but signaling of alerts (e.g., to central station) to caregivers …

  • Use cases - Medium care patients… maybe wirelessly connected… usually want to see information from not only alert, but associated information on the patient that related to alert (or giving context)…

    • "Medium" - each hospital calls level of care differently…

    • E.g., one ventilator patient

  • Participated in HIMSS22 - https://www.draeger.com/Library/Content/11en_HIMSS-Showcase-SDC.pdf

Danica Marianac-Dabic

Patient Centered

How can we tap into very rich data (collected by professional societies) - and link data sources between different data sources…https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749335/

Comments from chat window via Greg Pappas (FDA)

  • WE HAVE WRITTEN A SERIES OF MANUSCRIPTS THAT DOCUMENT THE VALUE CREATED BY REAL WORLD EVIDENCE

  • THIS BUILDS ON THE WORK DANICA SHARED, ON COORDNIATED REGISTRY NETWORKS.

11073 to FHIR/PHR/EHR: how to integrate, map, coordinate medical device data for high quality clinical data and analytics (Kosta, Isabel, all)

Break 3:00 - 3:30 PM

Presentation on AAMI/UL 2800 (Geetha Rao)

• MOU between AAMI + UL about 10 years ago…

• Latest version release earlier this year…


Geetha noted that no action items identified regarding editions above however documentation efforts continue...

• Goal was to create a framework usable by a range of stakeholders.
• Standard written "stakeholder agnostic"

  • Multiple "use specification" for "context of use"…



"Hazardous Condition" -


PoCD WG organization, meetings & wrap-up

Logistics next WG meeting

  • IEEE-SA 11073 PoCD likely to meet again jointly at the next HL7 WG meetings scheduled for January 16-20, 2023 in Las Vegas, Nevada, USA.
  • Kosta noted the potential going forward to have (off-cycle with HL7) IEEE-SA 11073 only meetings in 2023 - TBD...

4:30 pm Closing and Adjourn [Stefan/Kosta/Steve]

Note:  Christian Haye was recognized for his fine work over many years - as he announced this would be his last HL7 WG meeting - Thanks Christian and all the best in your new endeavors (smile)

Motion "to adjourn the meeting": made by Christian Haye, second by Bjorn Anderson

Approved 16-0-0

  • CHAIR: STEFAN SCHLICHTING, PHD
  • VICE-CHAIR: STEVEN DAIN, MD
  • SECRETARY: KONSTANTINOS MAKRODIMITRIS, PHD
    • No Additional topics bought forward for (spillover meeting) this coming Friday morning Q1 meeting ( )

Kosta thanked attendees , reminded presenters to post slides.

  • CHAIR: STEFAN SCHLICHTING, PHD
  • VICE-CHAIR: STEVEN DAIN, MD
  • SECRETARY: KONSTANTINOS MAKRODIMITRIS, PHD

(Official IEEE-SA Folders)


  •  ACTION John J. Garguilo and IEEE-SA Liaison Tom Thompson to work on potential to expand MOU (report back during January 2023 meetings).
Day / DateTimeChairScribeNotes; HL7 DEV WG Meetings

Wednesday

 

Q1/Q2
9:00  AM - 12:30 PM EST

Q3/Q4
1:30 PM - 5:00 PM

  • HL7 DEV WG

CO-CHAIR:  TODD COOPER   

CO-CHAIR: CHRIS COURVILLE

CO-CHAIR: JOHN GARGUILO

CO-CHAIR: JOHN RHOADS   

CO-CHAIR: MARTIN HURRELL

CO-CHAIR: MARTIN ROSNER

Garguilo

MEETING NOTES FROM John J. Garguilo

 Room "Watertable B"

Wednesday Q1, 9 AM - 10:30 AM (Eastern Time - ET U.S.)

Meeting link (details above): https://ieeesa.webex.com/ieeesa/j.php?MTID=mb8f9c1692e7cf097593c3f60890e0e3a

Recorded Attendance: September 2022 HL7 DEVICE and IEEE 11073 WG Attendance   

  • Welcome, Introductions, and Agenda Review (HL7 Officers)

    • ANSI Anti-Trust Policy read to attendees (Garguilo): 

      Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM). 

  • Reviewed Monday Q3/4 proceedings (@Cochairs) 

    • No addiontal or changes of Agenda items (from Monday Q3)

    • Confirmed joint with O&O on Thursday Q1 with "spillover" time available on Friday Q1
    • Confirmed joint Thursday Q3 with Mobile Health WG and presentation of Laurie Whitsel from Physical Activity Alliance and the American Heart Association
  • Co-Chair Report Out (@ Cochairs)

    1. TSC 2022-09-19: WGM + Co-Chair+Dinner

    2. Report-out by Co-Chairs of Monday's Q5 meeting ...

      1. Association Management System (AMS) - Fonteva
        1. Starting Monday, October 10, the transition to the new Association Management System (AMS) begins
        2. As part of the transition, all updates and changes to the current system will be frozen. For more information on the systems that will be impacted check out the HL7 Fonteva Transition Confluence Space and the latest communication sent October 4, 2022
        3. During the freeze, the HL7 Conference Call Center will NOT be directly available to you for scheduling, updating, or canceling calls. If you need to make such changes, please contact webmaster@hl7.org during the transition. All call information will remain viewable to the community on the website throughout the transition. The Fonteva implementation will go live before October 31, 2022 at which point the Conference Call Center will be accessible for self-service updates again
        4. Thank you for your patience as we migrate to the new system. If you have questions, please contact Melva Peters at melva@hl7.org

      2. Main Website Updates...
      3. Production UTG GitLab
      4. Logical Sandbox
      5. New Ref. Implementations
      6. HL7 timeline/plan - International 3-year plan (soon to be available...)
      7. hl7.org/xprod/FHIR - 
      8. HL7 considering multi-language products (W.H.O)
      9. Unified Terminology Governance UTG/THO
        1. Considering 3 releases per year (each frozen 6 weeks prior t ballot content deadline)
      10. R5 freeze / Feb 24
      11. Graeme noted there are many many IG submitted, and asked only serious IGs should be submitted due to resources...
      12. FAST transitioned from ONC → HL7
      13. UCSD/UT FHIR Education Series available on-line (10 recorded sessions)
    3. No Action Items for HL7-DEV (other than resolving and staying on top of Workgroup Health items)

  • PHD Status update/report out - (Martin Rosner, Erik Moll, Javier Espina)

    • IEEE ACOM and BT Generic Health Sensor update (Erik Moll, Javier Espina) 

    •  "ACOM and GHS - A unified model for personal health device communication - Supported on BlueTooth LE" presented by Erik Moll (Philips Research)
    • Erik Moll presented and walked through:
      • The problem
        • Personal health devices are abundantly available in most markets and are quite often connected and come with an application running on a smart phone, a tablet or sometimes a PC.
        • In most cases Bluetooth (Low Energy) is used to connect these devices. Sometimes USB, Wi-Fi or cellular connectivity is supported.
        • For remote patient monitoring, personal health & fitness tracking and many other use cases it is desired to integrate data from such devices in one place, one service for the patient or user.
        • Today, September 2022, there is still no good, generic, interoperable standard solution for personal health device communication.
        • As a result, for each PHD dedicated software is needed in devices, apps, gateways, servers => costly!
      • The suggested Solution:
        • HL7 FHIR:
            • –The healthcare IT world is moving towards HL7 FHIR as the application-level language to achieve interoperability of healthcare data in and around the hospital.
            • Regulations in US and EU require healthcare IT systems to open up their data via a FHIR interface
            • This helps a lot but does not yet solve the PHD communication diversity and that is where ACOM comes into play.
        • IEEE 11073-10206 ACOM: 
          • ACOM stands for “Abstract Content Model”
          • ACOM defines a model based on the IEEE 11073 Domain Information Model (DIM) and nomenclature standard for medical device communication
          • ACOM objects and attributes map 1-1 to HL7 FHIR resources using JSON or XML.
          • ACOM is implemented in a binary protocol on Bluetooth LE – the Generic Health Sensor profile and service (GHS).
          • ACOM can be used by cellular IoT health sensor devices using a binary or JSON format
        • Within various working groups of IEEE, IHE and the Bluetooth SIG we developed the ACOM specification and protocols using it.
        • Todd Cooper asked how ACOM is "constrained" from POU Profile?
          • Eric responded that ACOM is constrained - stripped out attributes that are not used...
        • ACOM + FHIR
          • Build once
            • ACOM + FHIR enable a generic solution to connect sensor devices to apps, gateways and to cloud services
          • Extendable / flexible solution
            • Sensor types can be added without coding in apps / gateways / servers
            • The set of supported Observations can be extended without coding
            • Many device types / specializations are defined already in IEEE 11073 in an ACOM-compatible manner
          • Enables an end-to-end ecosystem
            • Based on one conceptual model of health devices and generated observations using a recognized nomenclature system
            • Suitable for [personal] health sensor devices at home, in the hospital and elsewhere (health & fitness, elderly care)

      • Erik presented IEEE 11073-10206 - ACOM basics (see slide 5)
      •  ACOM Observations (Slide 6)
      • ACOM Observation mapped to FHIR Observation resource (slide 7)
      • Bluetooth GHS GATT profile and service specifications:

    •  Question asked, how are you mapping compound observations? Separate Observation resources, Contained, Bundle, Observation.component etc?
      • (Response) ACOM is more in alignment with FHIR than in the past (components in FHIR <--> ACOM)
    • (Q from Todd) Payload encoding?  JSON? -
      • (Response) Erik noted experiment was done encoding in JSON (was done internally) - there was also binary encoding for time stamps, etc… noted BlueTooth is not supporting JSON - as interested in more compact encodings…
      • Erik also noted that FHIR has a large footprint/code - not sure yet if efficient to be a standard alone…
      • On Bluetooth side, binary is used; the above diagram in prototyping stage…
        Bluetooth SIG require at least 3 implementations to communicate and test using the existing test suites…
      • Next event upcoming in Miami


      • Philips ACOM/GHS prototypes - used for testing:

    • Erik's summary:
      • We introduced the IEEE Abstract Content Model for Personal Health Devices – ACOM in the context of HL7 FHIR-based healthcare systems:

      • ACOM solves a big interoperability problem and enables an ecosystem of connected personal health devices, apps, services

      • The Bluetooth SIG Generic Health Sensor service and profile specification support ACOM on top of Bluetooth LE.

      • Some details:

        • IEEE 11073-10206 - ACOM defines a generic model for personal health devices and the observations these devices can generate

        • ACOM objects in this model can easily be mapped to FHIR resources

        • The Bluetooth Generic Health Sensor service and profile are based on ACOM and are in interop testing phase in the SIG

        • ACOM and GHS enable build-once gateways to get PHD Observations into FHIR servers
          GHS demonstrators and source code are available on Android

  •  
    • Question asked about Open source and proprietary...

      • Can you explain the difference between Continua certified and ??

        • (Response) Stack did not find grounding in market due to complex state machine… took information model out of this and aligned more with FHIR and this is what ACOM would be 

    • Todd asked about a FHIR-based project out of Univ of San Francisco…

    • For next/upcoming year hope is to finish BlueTooth LE + ACOM

      • Noted that group may have to add normative text... to include timing (??)
      • Then proceed with Notice of Intent to Profile
        • Also need to figure out the IHE Profiling requirements/work;
          • After December '22 - hope to finish testing; then 1-2 months for legal review; then get Profile out...; then adoption!
          • Noted Philips plans to adopt and implement.



    • Jacob tried to map the 'complicated pregnancies' use case to FHIR;
      • Noted a very complex use case to address… not aware of all FHIR constructs available
    • COVID-19 use case:

      • Holter monitoring: can't yet share details, but in some cases Holter monitor can be connected and do a live streaming - also looking to do a large roll out...

    • Live Spirometry flow, so not to wait the 6+ seconds to do a live flow…(waveforms)...
    • Two issues:
      • 1. Complex nature of date (mapped to IEEE, and in particular to FHIR) - lacking more complex data types, as well as some quality enumerations… e.g., when leads are not connected properly - there is noise ratio
        • --should have some attempt to get a consistent  way to do this in FHIR


      • 2. Live Streaming - more generic way to do this w FHIR payloads - send data to server, viewer that pulls date from server in real time or near real time/recoding while being made…


    • Todd Cooper noted is useful in Zulip to capture the use cases…
    • Paul Schluter commented that work was done regarding waveforms… reasonable for real time monitors - including beat to beat etc. (this was done in HL7 V2)…  Can be easily persisted as a binary data set (V2 can be trivially mapped to be looked at retrospectively later on…)
    • Mikael Rinnetmaki (Finland) - added comments around timing intervals - e.g., medication requests…
      Once you do this you end up with a bundle around 20-30K which are sent to server, and then accessed (this takes 20 - 30 minutes - which has big consequences…) - now becomes 30 minutes back which is obviously not ideal…  Could a sample bundle be published as a FHIR resource to highlight this issue… 
      Sample data is available, but not yet on the explanatory text…  this could be discussed on one of the weekly Monday or Wednesday 9 am Eastern US meetings… where do pieces fit and try to coordinate this…
    • Suggested to coordinate via Zulip…
      Slides to be sent at later time… perhaps when more details written about the use cases… Jacob agreed to send once available…
    • EEE EMBS Standards referenced
      • IEEE 1752 noted...


  • Break from 10:30 AM - 11:00 AM ET

    Wednesday Q2, 11:00 AM - 12:30 PM (ET U.S.) Room "Watertable B"

    Recorded Attendance: September 2022 HL7 DEVICE and IEEE 11073 WG Attendance   

  • DoF:  PoCD – Device Settings Reporting / Snapshot Reporting (Elliot Silver )

    • Discussion on the challenges or (several) ways of recording a setting -Device Metric 

    • There are gaps - 
      •  ACTION Elliot Silver Begin to capture the use cases identifying (and ultimately addressing) such gaps...Type your task here, using "@" to assign to a user and "//" to select a due date

(NIST) Tooling & Testing (Michael Faughn , John J. Garguilo )

    • See Slide set: NIST_HL7_IEEE_Update_Baltimore_9_21-2022.pdf
    • Garguilo provided V2 Tooling updates - used for IHE-DEV (PCD Program) at IHE Connectathons last week in Atlanta and Montreux provided

    • Garguilo provided Connectathon 2022 Test Report Out (Atlanta and Montreux)

      • IHE-DEV (PCD Program): 14 Organizations, 22 Applications, 6 Integration Profiles (New: PCIM!), 150 Test Instances Verified
    • RTMMS new version release update and progress reported (Michael Faugh)

      • Michael Faughn indicated new RTMMS targeted for later part of Oct 2022
      • Mailing will occur to all those who presently have an account (on existing rtmms.nist.gov tool) - Please stay tuned!
      • Users will be required to check-in and create a new account on new RTMMS 
      • Michael provided a status update on other V2 ongoing work including his work on V2+ and as a member of UTG - Terminology Management  Group
  • PoCD and PHD IG Publication topics/issues/other  (John Rhoads , Martin Rosner )

    • PoCD IG (Rhodes + Stefan Karl)

    • State of affairs - held up need of implementations + testing - presently not enough
    • Underlying Technical Structure in good shape
    • Associated Terminology identified
    • Increasing elaboration of terminology is ongoing and needed/necessary (out of FHIR → Terminology Authority
    • John Rhoads provided/noted IG reference to current build on FHIR site (search "FHIR PoCD" - https://hl7.org/fhir/uv/pocd/2021sep/index.html and http://build.fhir.org/ig/HL7/uv-pocd/)
    • PHD IG (Marin Rosner)

    • Martin Rosner provided brief report out, no new items to note from last meeting.

Lunch Break from 12:30 PM - 1:45 PM ET

Wednesday Q3 Room "Watertable B"

From the 2019-09 HL7 WGM   (here is the presentation) & 2019-10 IHE Devices meetings:  

      • Use Cases - both that are distinct to a specific use context and that involve two or three and require cross-context coordination
      • Use Contexts - are the (3) suggested appropriate or should there be a further breakdown? Architectures?
      • Ecosystem – Intra & Inter Context Providers / Consumers (e.g., EHR consumers of PoC device content)
      • Risk => Criticality => Regulatedness:  Clearly this is involved in all three use contexts, but at different levels?
      • Quality – including process requirements (e.g., ISO 13485)
      • User - professional clinician to personal grandpa or family caregiver
      • Technology - esp. with the advent of Medical IoT & Clinical IoT and Io<everything>T, mobile FHIR-based, AI/ML MD ... EMBS SC initiatives?  Etc.

-Consider RWE needs of FDA and others @ AI / ML MDs ... melding a few of the above aspects

      • Architecture – Is there a clear delineation between device subsystems that allow for "containment" of critical (high risk) functions to one system component (e.g., the dialysis subsystem with SiMD) and other elements, such as education or user interface to software applications (general health software & SaMD) that are running on a general purpose platform?  
      • Communication Devices:
      • e.g., mobile "device" - "device used in a clinical setting" but not a regulated medical device (at ACM:  Edge devices / end-point communication devices) 
      • Google Glass ... VR / MR / AR technology
      • Note:  in ACM a "dashboard" can be an endpoint "device"
      • Connected vs. Disconnected (not connectable)
      • HIT Infrastructure "devices" vs. health / medical purpose (sensor/actuator/intelligence) "device"
      • Including ID & location devices (e.g., RFID)
      • Cameras ...
      • e.g., for patient assessment in an isolation room


  • Martin Hurrell suggested to first make a general list that "everything people might consider to be a device, and that people are interested in:…  but something like a multi-lumen catheter is of interest..
    • Write down as many "real" devices that we can
    • Try to define a series of constructs in which could be used to define - such as can a device communicated, etc…
    • Look at tirade of these devices to say in what way are these devices alike, but others do not…
    • Constrain it "medical devices"
    • Potentially look at multiple set of devices…
    • OO has a much broader space (beyond Med Devs) - this may hinder the need for this quickly…
      • Perhaps find out what O&O considerations / exemplars are?
    • Importance is high
    • Timing: hard to say how long this would take…hard to say??
    • Goal would be to make a significant improvement on where we are now…


ACTION: @Todd Cooper and @Martin Hurrell: Re-start the Technical Report process for "What is a Device?"

Todd Cooper started a new project (ID: PSS-2120): Added to O&O Agenda for Thursday's Q1 discussion.

Wednesday Q4 Room "Watertable B"

  • ( John Rhoads Todd Cooper )  DeviceAlert project:  

    1. Considered leveraging the "What is a 'Device'?" metamodel mentioned previously to explain what is unique about the alerting devices & DEVAL space but without having to include the whole topic (again, linkable article)
    2. DISCUSS:  (John Donnelly , not attending meeting ) Alert Policy 
      1. Should the DeviceAlert project also include something around a care provider's "alert policy"?
      2. By analogy, security experts who see "risk management" as 100% a security issue, always talk about managing security policies 
      3. Medical device alerting includes similar policies; however, they are never formalized (via standards) and are definitely not computable
      4. This is a similar concern to the ISO/IEC JWG7 "SES" concern and is tied in with requirements from 60601-1-8, 11073-10702, and similar standards
      5. Alert management systems (DIS / DAS / cDAS etc.) all include support for configuring in accordance with implementation environment polices, e.g., around escalation BUT ...
      6. Is there value in making this COMPUTABLE (as is the case with security infrastructure) and if so, how?
  •  ACTION: John Donnelly John Donnelly to provide use cases around Alert Policy


    1. Reference Confluence page/site: "What is a Device"?
    2. Review general "heads up" content proposed for the updated Device resource description
    3. Review the content being added to the SDPi 1.0 TF-1 front matter related to the scope of the IHE DEV TF (this will be the first version of the broadened IHE domain (vs. PCD only)
    4. Discuss whether and who and where to include and publish the broader question of "What is a 'Device'?" material 
      1. Consider Martin's work around establishing a metamodel w/ attributes, looking for "clusters" and leveraging that to address some common uses of the term:  device 
      2. Link in the previous material from Paper: What is a device? confluence page
      3. Determine the best place to publish this article - for example as an article in the FHIR space similar to workflow and other topics (and linkable from the device-related resources!)
      4. A previous project proposal (pre PSS) was floated for this topic but never fully advanced .. should it be now?
      5. All in favor of Dr. Martin Hurrell being the Editor-in-Chief, raise your hand!  (you cannot vote, Martin ...)
        1. Martin Hurrell asked to defer his taking this item on... 
      6. Is this a Gemini (joint IHE-HL7 article) and should fly under that flag?  Or simply an HL7 internal paper?  (it will be used / leveraged in the IHE DEV TF-1 discussion)

Adjourn IHE-DEV Wednesday 


Day / DateTimeChairScribe

Notes

Thursday

 

Q1/Q2

9:00 AM - 12:30 PM

Q3/Q4
1:30 PM - 5:00 PM



CO-CHAIR:  TODD COOPER   

CO-CHAIR: CHRIS COURVILLE

CO-CHAIR: JOHN GARGUILO

CO-CHAIR: JOHN RHOADS

CO-CHAIR: MARTIN HURRELL

CO-CHAIR: MARTIN ROSNER

Garguilo

Thursday Q1 (9:00 - 10:30 AM ET)

Recorded Attendance: September 2022 HL7 DEVICE and IEEE 11073 WG Attendance   

  • Welcome and Introductions (new attendees)

  • Introductions: 13 Attendees;  new attendees for Q1 Grant Forrest, Dr. Cheryl Lohman, "SV"(?)

Garguilo read ANSI Anti-Trust Policy: 

Professional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM). 

  • NO MEETING - DEV at O&O

  • Q1  Joint at Orders and Observation WG + BR&R (Device Scope Technical Paper); room "Pride of Baltimore" 

From O&O Agenda:

Break from 10:30 AM - 11:00 AM ET

Thursday Q2 (11:00 AM - 12:30 PM ET)

  • Anesthesia WG Topic

      • Allocate: partial Quarter

      • Intra-procedural Anesthesia FHIR IG Work

  • Nomenclature - RTM status update (Paul Schluter)

    • Paul Schluter to provide Nomenclature update - RTM + on 10101b progress (and milestone!)

    • Nomenclature work

Thursday Q3 (1:45 - 3:00 PM) Room "Watertable B"

12 In-person 5 on-line
  • Joint with Mobile Health WG (Matt Graham/Gora Datta/Nathan Botts/Frank Ploeg - Mobile Health Co-Chairs)

    • Welcome & Introductions (Mobile Health WG Agenda

    • General mHealth WG Updates w/ report out and status of on-going projects (Graham/Datta)
    • Matt and Gora walked through Mobile Health Slide set providing updates on projects: 2022 Sept Mobile Health Project Updates.pptx
    • PSS Updates (e.g.,  "Unique Mobile Health App Identifier") (Datta)
    • CMAFF
      • STU-2 - publishing soon!
    • SHIFT
      • In process of publishing technical paper (likely Oct/Nov '22??) - would include a collecting of things/activities  pulled together...
      • CDC referenced...
    • UMHAI - PSS-1867
      • Plan is to release draft next year
      • Static and dynamic IDs - some devices
      • How would it get managed?  need to be unique!
        • centralized registry - how centralized??
        • Security managed??
        • Maybe similar to IP addressess?
    • Others...
  • 2:30 PM Meeting Session w/  Physical Activity Alliance and the American Heart Association - continuation as they jump into the HL7 FHIR standards development world

    • Laurie Whitsel (Laurie.Whitsel@heart.org) and Maria Isler (Maria.Isler@heart.org) are the project sponsors. 
      Project Proposal for an IG defining standards for physical activity measurement and enhancement. 
    • PSS-2091 Physical Activity Implementation Guide Update (Laurie Whitsel)
    • Overview/presentation of work and proposal: PAA - HL7 Slide Decks - FInal.pptx
    • Specifically, the project is looking at being able to capture measures related to physical activity level.  This may well involve leveraging real-time device information such as step counts or heart rate monitor information.

    • Laure asked to please think about if/how the HC Devices work group might like to be involved. 
      • Also reaching out to PC, FM, OO, MH, CIC, and the Gravity project
    • PAA will continue to meet with DEV as part of the Q3 joint meetings with Mobile Health moving forward (and at January 2023 WG meetings)

Thursday Q4 (3:30 - 5:00 PM) Room "Watertable B"

  • Open Discussion / Topics Arising from this week... (Co-Chairs)

    • IEEE POCD 11073 additional topics - none brought forward by attendees 
    • Interoperability standards success stories/Pilots and Conformity updates around the globe
    • Joint Standards Workgroup (Konstantinos Makrodimitris) Meetings - Planning 2022-2023
      • Considerations about future IEEE-SA PoCD WG 2023 Meetings (hosted by FDA)
    • Regulatory map/coordination on interoperability 
    • Encouraged attendees to propose HL7 DEV Topics for next meeting...never too early to get them on the table (smile)
  • Action Items overview going forward from September 2022(HL7/IEEE/ISO) and coordination with other SDOs

    • Action Items Review (deferred to once meeting minutes completed)

  • Planning January 16-20 '23 WGM (Co-Chairs)

    • HL7 announced it will likely be a live event  in Las Vegas/Henderson, Nevada

    • Feedback from these/September '22 meetings

    • Objectives / Core Topics for January '23 (incl. joint sessions)

      • NOTE: we have been offered a full Quarter with OO - continuing to assume Thursday Q1 works best for DEV(?)
        • Attendees agreed
    • HL7  Room Reservation for January 2023 Meetings (Garguilo)

      •  John J. Garguilo (Completed ) ACTION: Garguilo to reserve rooms and schedule joint quarters - needs to be completed by next week.. .To include full Q with O&O and DEV (OO hosting); Q3 Thursday with Mobile Health WG and Physical Activity Alliance

Meeting Adjournment (Co-Chairs)

  • Many Thanks to our thoughtful presenters, attentive attendees, and a VERY Informative work of week!
    • Co Chairs thanked participants and presenters for their engagement, enlightening and very informative sessions throughout the week and contributions to the HL7 DEV WG :-)
    • Attendees reminded to review these meeting minutes and post all presentations to DEV's Confluence File Storage Area within Working Group Materials Folder (or send to John J. Garguilo 
  • Be well and thanks for your attendance and work as we move DEV forward :-)
  • Hope to see everyone in Las Vegas, Nevada in January 2023!
  • HL7 DEV September 2022 (Baltimore) Meeting Adjourned at 4:45 PM, Thursday September 23, 2022
  • Meeting Adjournment (Co-Chairs)

DayTimeChairScribeNotes

Friday

 

Q1
9:00 AM - 10:30 AM

CO-CHAIR:  TODD COOPER   

CO-CHAIR: CHRIS COURVILLE

CO-CHAIR: JOHN GARGUILO

CO-CHAIR: JOHN RHOADS   

CO-CHAIR: MARTIN HURRELL

CO-CHAIR: JOHN WALSH

CO-CHAIR: MARTIN ROSNER

O&O

NOTE: No Q1 DEV Meeting - Joint at O&O

Friday Q1 (9:00 AM - 10:30 AM ET)

No WebEx available in O&O Meeting Room

 

Friday

Q1 at O&O

9:00 AM –10:30 AM

Break10:30 - 11:00 AM

 O&O Room: "James"

Note: Joint DEV at O&O (Joint) - Members welcomed to join Joint O&O and FHIR-I WG Sessions in Q1
(No official DEV Meeting)

  • Device Overflow from Thurs Q1 with DEV group
  • JIRAs (recommendations/dispositions) with those who are present
  • Adminstriva - time permitting (else co-chairs can do that off-line?)
  • Note: Refer to O&O meeting minutes for proceeding details

Current Versions of WG documents, for discussion (To Do: John Rhoads please validate for latest versions...)

https://www.hl7.org/documentcenter/public/wg/healthcaredevices/Default_HL7_WG_DMP_2018.pdf

Default_HL7_WG_DMP_2019_V5.2_Clean.docx

https://www.hl7.org/documentcenter/public/wg/healthcaredevices/HL7 DEVICES - 3-year plan 2021 - 2024.docx

https://www.hl7.org/documentcenter/public/wg/healthcaredevices/HCD_DEV_SWOT_Analysis_2019-01-17.doc

https://www.hl7.org/documentcenter/public/wg/healthcaredevices/HCD_WG_Mission_And_Charter_2019-01_17.docx





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