Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter December 22, 2017

Connecting the clinical IT infrastructure to a service-oriented architecture of medical devices

Björn Andersen ORCID logo, Martin Kasparick ORCID logo, Hannes Ulrich, Stefan Franke, Jan Schlamelcher, Max Rockstroh and Josef Ingenerf

Abstract

The new medical device communication protocol known as IEEE 11073 SDC is well-suited for the integration of (surgical) point-of-care devices, so are the established Health Level Seven (HL7) V2 and Digital Imaging and Communications in Medicine (DICOM) standards for the communication of systems in the clinical IT infrastructure (CITI). An integrated operating room (OR) and other integrated clinical environments, however, need interoperability between both domains to fully unfold their potential for improving the quality of care as well as clinical workflows. This work thus presents concepts for the propagation of clinical and administrative data to medical devices, physiologic measurements and device parameters to clinical IT systems, as well as image and multimedia content in both directions. Prototypical implementations of the derived components have proven to integrate well with systems of networked medical devices and with the CITI, effectively connecting these heterogeneous domains. Our qualitative evaluation indicates that the interoperability concepts are suitable to be integrated into clinical workflows and are expected to benefit patients and clinicians alike. The upcoming HL7 Fast Healthcare Interoperability Resources (FHIR) communication standard will likely change the domain of clinical IT significantly. A straightforward mapping to its resource model thus ensures the tenability of these concepts despite a foreseeable change in demand and requirements.

  1. Research funding: This work was supported by the German Federal Ministry of Education and Research (BMBF) as part of the OR.NET project (grant numbers 16KT1236, 16KT1237, 16KT1238, and 16KT1239).

References

[1] An Application Protocol for Electronic Data Exchange in Healthcare Environments, Health Level Seven Messaging Standard Version 2.6, Health Level Seven International Std., Rev. Version 2.6, 2007.Search in Google Scholar

[2] Andersen B, Dehm J, Gessner C, et al. Weissbuch – Interoperabilität von Geräten und Systemen in OP und Klinik (2. Version). 2015.Search in Google Scholar

[3] Andersen B, Kasparick M, Golatowski F, Ingenerf J. Extending the IEEE 11073-1010X nomenclature for the modelling of surgical devices. In: 2016 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI). 2016: 244–247.10.1109/BHI.2016.7455880Search in Google Scholar

[4] Andersen B, Kasparick M, Ulrich H, et al. Point-of-care medical devices and systems interoperability: a mapping of ICE and FHIR. In: 2016 IEEE Conference on Standards for Communications and Networking (CSCN). 2016: 1–5.10.1109/CSCN.2016.7785165Search in Google Scholar

[5] Andersen B, Kock A-K, Wrage J-H, Ingenerf J. Propagation of patient data from IT systems to medical devices. In: Engineering in Medicine and Biology Society (EMBC), 2014 36th Annual International Conference of the IEEE, 2014.Search in Google Scholar

[6] Andersen B, Ulrich H, Kock A-K, Wrage J-H, Ingenerf J. Semantic Interoperability in the OR. NET Project on Networking of Medical Devices and Information Systems – A Requirements Analysis,” In: 2014 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI). IEEE, 2014: 428–431.10.1109/BHI.2014.6864394Search in Google Scholar

[7] Andersen B, Ulrich H, Rehmann D, Kock AK, Wrage JH, Ingenerf J. Reporting device observations for semantic interoperability of surgical devices and clinical information systems. In: 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 2015: 1725–1728.10.1109/EMBC.2015.7318710Search in Google Scholar PubMed

[8] CEN ISO/IEEE 11073 Health informatics – Medical/health device communication standards, ISO Std. ISO/IEEE 11 073, 2004–2014.Search in Google Scholar

[9] DICOM Working Group 6. Supplement 67: Configuration Management. 2004. [Online]. Available: ftp://medical.nema.org/medical/dicom/final/sup67_ft.pdf.Search in Google Scholar

[10] “DOOP-Projekt (Dienst-orientierte OP-Integration),” 16.01.2017. [Online]. Available: http://www.doop-projekt.de/.Search in Google Scholar

[11] Eichelberg M, Riesmeier J, Wilkens T, Jensch P. One decade of medical imaging standardisation and implementation: a short review of DICOM and the OFFIS DICOM Toolkit. In: Proceedings of the 22th EuroPACS Annual Meeting, 01 2004.10.1117/12.534853Search in Google Scholar

[12] Gregorczyk D, Bußhaus T, Fischer S. Robust and semi-automatic electronic health record dissemination using the devices profile for web services. In: ICIW 2013, The Eighth International Conference on Internet and Web Applications and Services. 2013: 38–44.Search in Google Scholar

[13] Health Level Seven International (HL7), HL7 Fast Healthcare Interoperability Resources Specification (FHIR), Health Level Seven International Std., Rev. Version 3.0.1, 2017. [Online]. Available: www.hl7.org/fhir/.Search in Google Scholar

[14] Healthcare Information and Management Systems Society (HIMSS). HIMSS dictionary of healthcare information technology terms, acronyms and organizations. 3rd ed. 2013: 75.Search in Google Scholar

[15] Hooper MH, Weavind L, Wheeler AP, et al. Randomized trial of automated, electronic monitoring to facilitate early detection of sepsis in the intensive care unit. Crit Care Med 2012; 40: 2096.10.1097/CCM.0b013e318250a887Search in Google Scholar PubMed PubMed Central

[16] IEEE 11073-20702-2016 – IEEE Approved Draft Standard for Medical Devices Communication Profile for Web Services, IEEE Std., 2016.Search in Google Scholar

[17] IEEE P11073-10207 – IEEE Draft Standard for Domain Information & Service Model for Service-Oriented Point-of-Care Medical Device Communication, IEEE Std., 2017.Search in Google Scholar

[18] IEEE P11073-20701 – Standard for Service-Oriented Medical Device Exchange Architecture & Protocol Binding, IEEE Std., 2017.Search in Google Scholar

[19] ISO/IEEE 11073-10101:2004 Health Informatics – Point-of-care Medical Device Communication – Part 10101: Nomenclature, ISO Std. ISO/IEEE 11 073-10 101, 2004.Search in Google Scholar

[20] Janß A, Thorn J, Schmitz M, et al. Certification and testing procedures for the approval process of integrated medical devices using the IEEE 11073 communication standard. Biomed Eng-Biomed Tech 2018; 63: 95–103.10.1515/bmt-2017-0055Search in Google Scholar PubMed

[21] Kasparick M, Schlichting S, Golatowski F, Timmermann D. Medical DPWS: New IEEE 11073 standard for safe and interoperable medical device communication. In: 2015 IEEE Conference on Standards for Communications and Networking (CSCN). Tokyo, Japan, 2015: 212–217.Search in Google Scholar

[22] Kasparick M, Schlichting S, Golatowski F, Timmermann D. New IEEE 11073 standards for interoperable, networked point-of-care Medical Devices. In: 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Milan, Italy, 2015: 1721–1724.10.1109/EMBC.2015.7318709Search in Google Scholar PubMed

[23] Kasparick M, Schmitz M, Andersen B, et al. OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability. Biomed Eng-Biomed Tech 2018; 63: 11–30.10.1515/bmt-2017-0020Search in Google Scholar PubMed

[24] Koeny M, Benzko J, Czaplik M, et al. Distributed Networks – Intelligence, Security, and Applications. Boca Raton, FL, USA: CRC Press, 2013, ch. Chapter 12. The Smart Operating Room: smartOR, pp. 291–315.10.1201/b15282-12Search in Google Scholar

[25] NEMA. Digital Imaging and Communications in Medicine (DICOM). Rosslyn, VA, USA: NEMA Standards Publication PS 3.x/ISO 12052, National Electrical Manufacturers Association, 2017. [Online]. Available: ftp://medical.nema.org/MEDICAL/Dicom/2017b/.Search in Google Scholar

[26] Oasis. Devices Profile for Web Services (DPWS). 2009. [Online]. Available: http://docs.oasis-open.org/ws-dd/ns/dpws/2009/01.Search in Google Scholar

[27] Pfeiffer JH, Kasparick M, Strathen B, et al. OR.NET RT: how service-oriented medical device architecture meets real-time communication. Biomed Eng-Biomed Tech 2018; 63: 81–9310.1515/bmt-2017-0016Search in Google Scholar PubMed

[28] Riesmeier J. An approach to DICOM image display handling the full flexibility of the standard’s specification. In: Medical Imaging 1999: Image Display. SPIE 01, 1999: 363–369.10.1117/12.349448Search in Google Scholar

[29] Rockstroh M, Franke S, Dees R, et al. From SOMDA to application – integration strategies in the OR.NET demonstration sites. Biomed Eng-Biomed Tech 2018; 63: 69–80.10.1515/bmt-2017-0023Search in Google Scholar PubMed

[30] Rockstroh M, Franke S, Hofer M, et al. OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC. Int J Comput Assist Radiol Surg 2017: 1–9. [Online]. Available: http://dx.doi.org/10.1007/s11548-017-1589-2.10.1007/s11548-017-1589-2Search in Google Scholar PubMed

[31] Salazar C. A security architecture for medical application platforms. Ph.D. dissertation, Kansas State University, 2014.Search in Google Scholar

[32] Schlamelcher J, Onken M, Eichelberg M, Hein A. Dynamic DICOM configuration in a service–oriented medical device architecture. In: Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE. 2015: 1717–1720.10.1109/EMBC.2015.7318708Search in Google Scholar PubMed

[33] The Health Level Seven Version 3 (V3) Normative Edition, Health Level Seven International Std., 2014.Search in Google Scholar

[34] Ulrich H, Kock-Schoppenhauer A-K, Andersen B, Duhm-Harbeck P, Ingenerf J. Mapping clinical care and research data to HL7 FHIR to improve sharing and reuse. In: MIE 2017. Manchester, United Kingdom, 2017, in press.Search in Google Scholar

[35] Will A, Pahontu R, Bergh B. Vernetzte Medizintechnik im Krankenhaus: Vernetzung von Medizingeräten und weiteren IT-Komponenten. KU Gesundheitsmanagement, 2015: 54–56.Search in Google Scholar

Received: 2017-2-22
Accepted: 2017-10-13
Published Online: 2017-12-22
Published in Print: 2018-2-23

©2017 Walter de Gruyter GmbH, Berlin/Boston