Transcript POC Overview - CodeConcept

Point-of-Care Overview
Gliwice
November 17th, 2008
Agenda

POC Basics

Connectivity System Components

POC Interfaces

Device Messaging Layer

Observation Reporting Interface
POS Basics
What is POS?
• Point-of-Care testing is defined as various testing
conducted near the site of patient care.
• It incorporates different environments, including
hospital based testing, near-patient testing,
physician’s-office testing, and patient self testing.
POS Basics
POC Connectivity
• Allow seamless multi-vendor interoperability and
communication between point-of-care devices, data
concentrators, and clinical information systems.
• Provide framework for engineers to design devices,
workstations and interface for multiple types and
brands of POC devices to communicate bidirectionally with access points, data concentrators,
and laboratory information systems from variety of
vendors.
POS Basics
What is POC Standard?
• The core of the standard is a group of specifications
developed by the Connectivity Industry Consortium
(CIC).
• Describes the attributes of an access point; the
communication protocols between the device and
access point; communication between a data
manager and clinical information system.
POS Basics
Evolution of POC standards
Cooperative effort of: providers, manufacturers,
representatives of:
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CIC
NCCLS
HL7
IEEE
CAP
FDA
JCCLS
IFCC
Agenda

POC Basics

Connectivity System Components

POC Interfaces

Device Messaging Layer

Observation Reporting Interface
Connectivity System Components
Point-of-Care Device
• Hand-held devices; test modules that are part of the other
instrumentation (patient monitor, for example); or small,
bench-top analyzers
Connectivity System Components
Access Point
• Allow to communicate with an Observation Reviewer to
report results and exchange information
Connectivity System Components
The Observation Reviewer (POC Data Manager)
• The primary role of an Observation Reviewer is to host one
or more services to which point-of-care diagnostic devices
connect.
• Services hosted by an Observation Reviewer may exchange
data with existing information systems that already exist in
the hospital laboratory
Connectivity System Components
The Observation Recipient (LIS, CDR, or EMR)
• In many cases, the final resting place of a point-of-care
diagnostic test observation is inside an Observation
Recipient system
• Typically, LIS or Clinical Data Repository (CDR) systems fill
the role of Observation Recipient
Connectivity System Components
Device Interface
• Governs the flow of information between devices and
Observation Reviewers
Observation Reporting Interface (EDI interface)
• Describes messaging between Observation Reviewers and
Observation Recipients
Agenda

POC Basics

Connectivity System Components

POC Interfaces

Device Messaging Layer

Observation Reporting Interface
POS Interfaces
DML
• Device Messaging Layer specification describes the dialog
between a device and Observation Reviewer
POS Interfaces
The DML allows bidirectional data exchange concerning the following
topics:
I.
Device Status
II. Observations
1. Patient Tests
2. Calibration Tests
3. Quality Tests
i.
Liquid QC
ii. Electronic QC
iii. Calibration Verification
iv. Proficiency Test
III. Device Events
IV. Update Lists
1. Operator List
2. Patient List
V. Directives
1. Basic (e.g., Lockout, Goto Standby)
2. Complex (e.g., Set Time)
3. Vendor-specific
VI. Vendor-specific Data
POS Interfaces
DAP
• Device Access Point specification defines a law cost, flexible
means to reliably communicate messages between POC
Device and Observation Reviewer
POS Interfaces
DAP and DML interfaces are layered on top one
another in the OSI model
DML
DAP
POS Interfaces
• Observation Reporting Interface – facilities the
communication of test results and orders information
between Observation Reviewers and Observation Recipients
• The interface provides bidirectional flow between these
services
Agenda

POC Basics

Connectivity System Components

POC Interfaces

Device Messaging Layer

Observation Reporting Interface
Device Messaging Layer
Message Flow
• In general, the communication between the Device and
Observation Reviewer can be described at a high – level in
terms of dialog between two actors
• Example: Scheme of base profile message flow
Device Messaging Layer
Message Encoding
• POC Device Messaging Layer’s messages leverage the XML
encoding rules defined in HL7 version 3
• Example: Simple Glucose Messages
Device Messaging Layer
Message Encoding
Agenda

POC Basics

Connectivity System Components

POC Interfaces

Device Messaging Layer

Observation Reporting Interface
Observation Reporting Interface
• EDI employs existing HL7 messages, segments, and fields
in order to communicate test results and ordering
information
• Four new triggers (as compared to HL7 v2.4) are defined for
HL7 ORU message
• As long as the final implementation uses the messages and
fields defined in POCT1 specification (ORU^R30,
ORU^R31, ORU^R32, ACK^R33), the resulting interface is
compliant with the POCT1 Observation Reporting Interface
specification
Observation Reporting Interface
• Individual institutions or deployments may have additional
requirements beyond addressed by POCT1 specification
• Message fields not defined for use by POCT1 specification
may be used to support these site-specific requirements
Observation Reporting Interface
Message Example
• Sample message exchange, preordered test with singlevalued result
• ORU^32 – Observation result message from POCT1DMSOBSREV to POCT1LIS-OBSRCPT sent 6/10/00 1:03:55
Observation Reporting Interface
ORU^30
Unordered Observation – Place Order
• One example of this use case occurs when a doctor verbally
instructs a nurse to perform a test
• To allow the Observation Reviewers correlate every result
with its associated order, the Observation Recipient will
return the newly created Order ID in the application-level
acknowledgement to this ORU^30 message
Observation Reporting Interface
ORU^31
New Observation – Search for an Order
• In this case, the Observation Reviewers does not know if an
order has been placed
• This trigger instructs the Observation Recipient to search
for an existing order for the associated results
Observation Reporting Interface
ORU^32
Preordered Observation
• In this case order information is provided by either of the
following schemes:
 The user enters an accession number at the POC Device
when performing test
 If the Device doesn’t support that input capability or the
accession number isn’t known at the point-of-care, the
Observation Reviewer (e.g., POC Data Manager)
retrospectively determines the appropriate order to
match to the test result
Many thanks for your
attention!
Iwona Machowska
Marketing & New Business Manager
Tel. +48 600 375 376
Email: [email protected]
Ul. Toszecka 101/222
44-100 Gliwice, Poland
Tel. 48 32 23 00 290
www.codeconcept.pl