DCM4MD:Project Use Cases
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Contents
- 1 :: May 2011 Use Cases ::
- 1.1 Associate the Medical Device with a Patient by Location
- 1.2 Associate the Medical Device with a Patient by Identifier and Point-of-Care
- 1.3 Associate the Medical Device with a Patient by Selecting Patient on Device
- 1.4 Associate the Medical Device with a Patient by Patient Identifier Only
- 1.5 Synchronize Device Time Across the LAN
- 1.6 Synchronize information from patient transport
- 1.7 Associate the measurement with a clinician
:: May 2011 Use Cases ::
The following use cases have been identified to be in scope for the May 2011 ballot of the DCM for Medical Devices Project. The focus of this ballot will constitute DCMs that are required to support
- patient-to-device association in order to assign the data produced by the device to appropriate patient for charting and,
- time consistency across information systems and devices.
- operator-to-device association in order to assign the data produced by the device to the attending caregiver for charting [SBP - waiting for peer review of this item before modifying the use cases further accordingly]
Associate the Medical Device with a Patient by Location
This use case is currently implemented by most legacy devices in critical and acute care environments. These legacy devices do not have the ability to record the patient's medical record number or receive patient demographics from hospital information systems.
Actors
Pre-Conditions
- The patient is associated with a specific bed/location and the location is tracked by a hospital system. This use case applies only to specific inpatient and ambulatory settings.
- The device is associated with a specific bed/location and it is not moved from that location until its location is recorded in an information system.
- The device is not capable of acquiring an accurate date/time from a reference server. TheDevice Manager provides the time/stamp and, optionally, the location if it's not reported by device itself.
Main Scenario
The patient is placed at a specific location/bed and the medical devices are used to monitor specific physiological parameters or deliver specific therapies. The information produced by the device reports the location where the device was placed.
Alternate Scenario
Instead of the device, the Device Manager or concentrator is associated with the patient location. The information system or EHR-System- uses the information reported by the device or the configure configuration reported by the device manager along with the known location of the patient to infer whose data/results/therapy needs to be recorded.
Post-Conditions
The information/data produced by the device is added to the patient's medical record based on the device to location to patient assignments perfore the Device Manager and EHR-system respectively. In some cases, the data may need to be validated by a clinician (e.g. nurse) before it is permanently committed to the patient's record.
Dependency
Synchronize Time is used to synchronize the device clock to ensure that the results are reported accurately.
Associate the Medical Device with a Patient by Identifier and Point-of-Care
Both location and patient's identifier are used to determine whether the device should be associated with a specific location.
This use case may represent a transitional state of interoperability.
Actors
Pre-Conditions
- The device is able to record the patient's identity
Main Scenario
- The operator scans or enters the patient's identity into the device using its user interface, bar code reader, etc.
- The device is used to treat or monitor the patient's condition.
- Once the device is not longer needed, the operator discontinues the association. This removes the patient's identity from the data produced by the device.
Post-Conditions
When the device is no longer acquiring data for the patient, the association with the medical device is broken. In some cases, the data may need to be validated by a clinician (e.g. nurse) before it is permanently committed to the patient's record.
Dependency
Synchronize Time is used to synchronize the device clock to ensure that the results are reported accurately.
Associate the Medical Device with a Patient by Selecting Patient on Device
This use case is applicable in highly integrated environments. It requires an encounter management system (ADT) integrated either with the Medical Device directly or through its Device Manager .
Actors
Pre-Conditions
- The device or its device manager is tracking encounter events (e.g admission) or queries its Device Manager for patients as needed.
Main Scenario
- The operator enter a set of patient identifier traits into the medical device to loop up the patient's identity.
- The operator selects the appropriate patient record and associates the device with the patient.
- When the device is disconnected from the patient, the association is automatically broken.
Post-Conditions
The information reported by the device while the device was associated with the patient is charted to the patient's record. In some cases, the data may need to be validated by a clinician (e.g. nurse, respiratory therapist) before it is permanently committed to the patient's record.
Dependency
Synchronize Time is used to synchronize the device clock to ensure that the results are reported accurately.
Associate the Medical Device with a Patient by Patient Identifier Only
This use cases provides the most efficient patient-to-device association provided that the patient's identifier is entered correctly into the device.
Actors
Pre-Conditions
- The device is able to record the patient's identity.
Main Scenario
The Operator enter the patient's identity using the device input device (e.g. keyboard, bar code scanner). The precision with which the patient's identifier is entered into the device determines how accurate the association between the patient and device is, and consequently, how accurate the patient identity component of the output data is.
Post-Conditions
The information is received by the destination information system or EHR-System and associated with the patient identified by the their patient identifier. In some cases, the data may need to be validated by a clinician (e.g. nurse) before it is permanently committed to the patient's record.
Security Risk Assessment
- The date in transit may not require encryption since no identifiable patient information needs to be sent by the device
Dependency
Synchronize Time is used to synchronize the device clock to ensure that the results are reported accurately.
Synchronize Device Time Across the LAN
Actors
Pre-Conditions
- The device has network connectivity and access to a reference Network Time Server.
Main Scenario
The medical device connects to the Network Time Server to set up its clock to accurate date/time. The device clock is used to timestamp the results or parameters reported by the device to the EHR-System.
Post-Conditions
The device is synchronized with the Network Time Server and implicitly with any other information systems or devices.
Synchronize information from patient transport
This use case applies to those scenarios when medical devices are used during patient transport to capture vital signs and the information is uploaded into the hospital information systems
Actors
Pre-Conditions
- The device has network connectivity and access to a reference Network Time Server.
Main Scenario
The medical device connects to the Network Time Server to set up its clock to acurate date/time. The device clock is used to timestamp the results or parameters reported by the device to the EHR-System.
Post-Conditions
The device is synchronized with the Network Time Server and implicitly with any other information systems or devices.
Associate the measurement with a clinician
In addition to the device-patient association, the providers organizations would like to record in the EHRS the clinician's id. Ideally this identifier would be scanned into the device.
- The identifier may be entered at the point-of-care
- The identifier is authenticated with the device or device manager
