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.
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.
Andersen B, Dehm J, Gessner C, et al. Weissbuch – Interoperabilität von Geräten und Systemen in OP und Klinik (2. Version). 2015.
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.
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.
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.
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.
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.
CEN ISO/IEEE 11073 Health informatics – Medical/health device communication standards, ISO Std. ISO/IEEE 11 073, 2004–2014.
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.
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.
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/.
Healthcare Information and Management Systems Society (HIMSS). HIMSS dictionary of healthcare information technology terms, acronyms and organizations. 3rd ed. 2013: 75.
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.
IEEE 11073-20702-2016 – IEEE Approved Draft Standard for Medical Devices Communication Profile for Web Services, IEEE Std., 2016.
IEEE P11073-10207 – IEEE Draft Standard for Domain Information & Service Model for Service-Oriented Point-of-Care Medical Device Communication, IEEE Std., 2017.
IEEE P11073-20701 – Standard for Service-Oriented Medical Device Exchange Architecture & Protocol Binding, IEEE Std., 2017.
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.
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.
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.
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.
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.
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.
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/.
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: 81–93
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.
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.
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.
Salazar C. A security architecture for medical application platforms. Ph.D. dissertation, Kansas State University, 2014.
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.
The Health Level Seven Version 3 (V3) Normative Edition, Health Level Seven International Std., 2014.
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.
Will A, Pahontu R, Bergh B. Vernetzte Medizintechnik im Krankenhaus: Vernetzung von Medizingeräten und weiteren IT-Komponenten. KU Gesundheitsmanagement, 2015: 54–56.
Biomedical Engineering / Biomedizinische Technik (BMT) is a high-quality forum for the exchange of knowledge in the fields of biomedical engineering, medical information technology and biotechnology/bioengineering. BMT addresses engineers, natural scientists, and clinicians working in research, industry, or clinical practice. All articles are peer-reviewed.