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Learn how to record and monitor patient vital signs during surgery. Understand the setup and recording process for anesthetic vital signs. Explore the integration of 11073 standard into CDA documents for accurate data representation.
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11073 in CDA Representing anaesthetic vital sign data in a CDA document, using the 11073 standard • Martin Hurrell Alan Nicol
Acknowledgements In no particular order thanks to: Terri Monk (IOTA & HL7 Anesthesiology WG)) John Rhoads and Jan Wittenber (HL7 Healthcare Devices WG)
Anaesthetic vital signs use case (Setup) Vital Signs Monitoring Setup Connect the various probes and measurement devices to a patient so that their physiological values can be measured and recorded during an intra-operative procedure. Scenario A blood pressure cuff is placed on the left upper arm of the patient and connected to the patient monitors non-Invasive blood pressure module. The non-invasive blood pressure module uses a sphygmomanometric technique to measure systolic and diastolic blood pressure. Blood pressure values are typically measured in millimetres of Mercury (mmHg). Actors Patient: A person who is the recipient of healthcare services. Patient Monitor: an electronic medical device that measures and displays a patient's vital signs
Anaesthetic vital signs use case (Recording) Vital Signs Monitoring Recording The context is the measurement and storage of physiological values from a patient during a surgical procedure under anaesthesia. In the following example the values recorded are the patient’s non-invasive blood pressures. Scenario Monitoring starts and the first set of values of the Systolic, Mean and Diastolic blood pressures are collected after an initial interval of 5 minutes and at 5 minute intervals thereafter. Actors Patient: A person who is the recipient of healthcare services. Patient Monitor: an electronic medical device that measures and displays a patient's vital signs
11073 Dim Patient monitor/Blood Pressure Module
11073 Dim Patient monitor/Blood Pressure Module Non-Invasive Blood Pressure
11073 Dim Patient monitor/Blood Pressure Module Non-Invasive Blood Pressure Blood Pressure Measurement
11073 to HL7 R-MIM VMD (Patient Monitor)
11073 to HL7 R-MIM Channel (Non-Invasive Blood Pressure) VMD (Patient Monitor)
11073 to HL7 R-MIM Channel (Non-Invasive Blood Pressure) Metric(Blood Pressure Measurement) VMD (Patient Monitor)
11073 to CDA R-MIM VMD (Patient Monitor)
11073 to CDA R-MIM Channel (Non-Invasive Blood Pressure) VMD (Patient Monitor)
11073 to CDA R-MIM Channel (Non-Invasive Blood Pressure) Metric (Blood Pressure Measurement) VMD (Patient Monitor)
11073 to CDA Example (Recording) • <observation> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <id extension="67" root="2.16.840.1.113883.6.1" assigningAuthorityName="HL7 GAS WG" displayable="true"/> • <code code="19229" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_PRESS_CUFF_SYS"/> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <effectiveTime value="20080527074500"/> • <targetSiteCode code="1781" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_UPEXT_ARM_UPPER_L"/> • <statusCode codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="validated-data"/> • <value code="3872" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_DIM_MMHG" value="119"/> • </observation> • </entryRelationship> • </observation>
11073 to CDA Example (Recording) Channel (Non-Invasive Blood Pressure) • <observation> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <id extension="67" root="2.16.840.1.113883.6.1" assigningAuthorityName="HL7 GAS WG" displayable="true"/> • <code code="19229" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_PRESS_CUFF_SYS"/> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <effectiveTime value="20080527074500"/> • <targetSiteCode code="1781" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_UPEXT_ARM_UPPER_L"/> • <statusCode codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="validated-data"/> • <value code="3872" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_DIM_MMHG" value="119"/> • </observation> • </entryRelationship> • </observation>
11073 to CDA Example (Recording) Channel (Non-Invasive Blood Pressure) • <observation> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <id extension="67" root="2.16.840.1.113883.6.1" assigningAuthorityName="HL7 GAS WG" displayable="true"/> • <code code="19229" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_PRESS_CUFF_SYS"/> • <entryRelationship typeCode="COMP"> • <observation classCode="OBS" moodCode="EVN"> • <effectiveTime value="20080527074500"/> • <targetSiteCode code="1781" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_UPEXT_ARM_UPPER_L"/> • <statusCode codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="validated-data"/> • <value code="3872" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_DIM_MMHG" value="119"/> • </observation> • </entryRelationship> • </observation> Metric (Blood Pressure Measurement)
11073 to CDA Example (Setup) • <organizer classCode="CLUSTER" moodCode="EVN"> • <participant contextControlCode="OP" typeCode="DEV"> • <participantRole classCode="ROL"> • <id extension="23" root="2.16.840.1.113883.6.1" assigningAuthorityName="HL7 GAS WG" displayable="true"/> • <id extension="1.3.2" root="2.16.840.1.113883.7.1" assigningAuthorityName="GE Healthcare" displayable="true"/> • <playingDevice classCode="DEV" determinerCode="INSTANCE"> • <code code="4429" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_DEV_MON_PHYSIO_MULTI_PARAM_MDS"/> • <manufacturerModelName displayName="GE8001i"/> • <softwareName displayName="1.2.3"/> • </playingDevice> • </participantRole> • </participant>
11073 to CDA Example (Setup) • <organizer classCode="CLUSTER" moodCode="EVN"> • <participant contextControlCode="OP" typeCode="DEV"> • <participantRole classCode="ROL"> • <id extension="23" root="2.16.840.1.113883.6.1" assigningAuthorityName="HL7 GAS WG" displayable="true"/> • <id extension="1.3.2" root="2.16.840.1.113883.7.1" assigningAuthorityName="GE Healthcare" displayable="true"/> • <playingDevice classCode="DEV" determinerCode="INSTANCE"> • <code code="4429" codeSystem="1.3.6.1.4.1.19376.1.6" codeSystemName="ISO/IEEE 11073" codeSystemVersion="10201" displayName="MDC_DEV_MON_PHYSIO_MULTI_PARAM_MDS"/> • <manufacturerModelName displayName="GE8001i"/> • <softwareName displayName="1.2.3"/> • </playingDevice> • </participantRole> • </participant> VMD (Patient Monitor)