Special Interest Group for the Generation of Anesthesia Standards: SIGGAS

1. Special Interest Group for the Generation of Anesthesia Standards: SIGGAS HL7 Meeting San Diego 13 September 2005 Co-chairs: Terri Monk M.D. & Martin Hurrell, Ph.D.

2. SIGGAS (Special Interest Group for the Generation of Anesthesia Standards) • SIGGAS supports the HL7 mission to create and promote IT standards by defining peri-operative data standards pertinent to anesthesiology that enhance anesthesia and national peri-operative performance measurement. This will be accomplished by: • Promoting and developing anesthetic specificity in data standards • Augmenting the HL7 model for continuous quality improvement in anesthetic patient care • Serving as model for representing specialty interests in HL7

3. Work Products and Contributions to HL7 Processes e.g. X.73 • Identify critical data standards specific to anesthesiology necessary for standardized quality and outcomes reporting and measuring • Identify and promote required terminology to support reporting and measurement • Identify and promote requirements for a standardized anesthesia record to facilitate exchange and aggregation of peri-operative data • Coordinate and cooperate with other groups interested in using anesthesia data standards • Enable and promote use of these standards nationally and internationally • Identify appropriate anesthesia constraints against existing HL7 artifacts. IOTA SNOMED CDA?

4. Agenda for this meeting • Identify and promote requirements for a standardized anesthesia record to facilitate exchange and aggregation of peri-operative data • Review of Co-star XML schema • Use cases • Review terminology development for anesthesia • Activities of IOTA (International Organization for Terminologies in Anesthesia) • Collaboration with IEEE 1073 and ISO/TC215/WG 7 • IOTA OWL ontology • Identify other groups interested in using anesthesia data standards with whom SIGGAS should form links • Forward work plan

5. “And that’s why we need SIGGAS”

6. Data Dictionary Task Force • Created in 2001 by Anesthesia Patient Safety Foundation (APSF) in the USA • Chairperson: Terri G. Monk, M.D. • Given the mission to create a “Data Dictionary” for the specialty of anesthesia

7. APSF Commitment to AIMS Systems “ The APSF endorses and advocates the use of automated record keeping in the perioperative period and the subsequent retrieval and analysis of that data to improve patient safety ” APSF Board of Directors October 2001

8. APSF Executive Board • Financial control • Guidance and direction • Task Force Chair • Dr. Terri Monk • Organizational control • Project reporting • Technical Director • Dr. Martin Hurrell • Technical direction • Tools construction • Content Director • Dr. Andrew Norton • Content direction • Term submission • Ontology and Schema Development • Clinical review • Modelling • Terming Group • Clinical review • Minimum data set DDTF Organization U.S. Content Adviser Dr. David Reich

9. DDTF’s transition to IOTA I O T AThe International Organization for Terminology in AnesthesiaModeling and maintaining anesthesia terms for the English-speaking anaesthesia community

10. DDTF Reference set Anesthesia Subset SNOMED CT The terms are mapped/linked to an existing wider body of work … which is adopted by the medical community DDTF Reference set Used by APSF Corporate partners Relevance of a Data Dictionary

11. Present Status of Terming Effort • 2200 clinical terms • A read only version of DATAMS allowing interested parties to review the terms • Term viewer is available on the APSF website at www.apsf.org/datams

12. General anaesthesia Local anaesthesia Vascular access procedures Attributes and modifiers for procedures Anaesthetic drugs Fluids and blood products Monitoring terms Anaesthesia equipment Airway management Some administrative terminology Scales and assessments relevant to anaesthesia Positioning and patient protection The October 2004 termset

13. Terminology:Text elements Schema: record structure Ontology: domain model Foundations for future AIMS

14. Reasons for a SIG now • Anesthesia Information Management Systems (AIMS) are only installed in 3-5% of US hospitals and there is a similar picture in the UK but this is set to change in the near future • We need to identify requirements for communication between AIM systems and the wider healthcare IT environment • HL7 is a natural meeting place for these efforts

15. Proposed Work of SIGGAS • Identify critical data standards specific to anesthesiology that are necessary for standardized quality and outcomes reporting and measurement • Identify and promote required terminology to support reporting and measurement • Identify and promote requirements for a standardized anesthesia record to facilitate exchange and aggregation of peri-operative data • Coordinate and cooperate with other groups interested in using anesthesia data standards • Enable and promote use of these standards nationally and internationally • Identify appropriate anesthesia constraints against existing HL7 work

16. Martin’s talk • AIMS system (Martin’s) interesting workbench • Co-Star – Common Structure for Anesthetic Records • Difference between US and UK – no nurse anaesthetists in UK • Decision support is vital future issue