Stream: implementers
Topic: Infusion pumps data
Christophe Reynier (Jan 27 2018 at 11:09):
Hello everyone,
I am starting to delve into the FHIR world and as i already know the IHE PCD technical framework i try to find the best resource to transmit infusion events from a pump.
What would be the best resource? Observation? Communication? other?
Looking to the structure description i am today a bit lost and especially how to fill it.
Is there a repository with sample messages?
Thank you for your help
Lloyd McKenzie (Jan 27 2018 at 12:48):
@Todd Cooper , @Melva Peters? I suspect you'd use MedicationAdministration for some of them, but others would likely be device-related.
Jose Costa Teixeira (Jan 27 2018 at 12:49):
@Christophe Reynier the reporting of infusions is also included in the recent IHE Pharmacy MMA profile - the medication part only.
Jose Costa Teixeira (Jan 27 2018 at 12:50):
That profile includes the medication events.
Other device-specific events i am not sure how to handle
Jose Costa Teixeira (Jan 27 2018 at 12:52):
http://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharm_Suppl_MMA_Rev1.0_PC_2017-10-19.pdf
John Silva (Jan 27 2018 at 13:09):
This MMA profile seems to be more for home or nursing care use cases, not necessarily for inpatient (hospital) care situations. @Christophe Reynier - are you targeting an inpatient infusion pump use case? @Jose Costa Teixeira - I quickly read through the MMA document you provided and I don't see some of the events I would expect to have to deal with in the infusion pump scenario, e.g. 'delivery start ', 'delivery stop', 'delivery complete', 'change rate', etc., those events that are defined in the IHE Infusion Pump profile.
https://www.ihe.net/uploadedFiles/Documents/PCD/IHE_PCD_Suppl_IPEC.pdf
Jose Costa Teixeira (Jan 27 2018 at 13:11):
MMA is about reporting the medication bits and is for home, nursing and institutional (inpatients) settings (i am sure it says something about that somewhere but I don't know where).
Jose Costa Teixeira (Jan 27 2018 at 13:11):
Delivery start is start of medicationAdministration. DeliveryComplete is the end of medicationAdministration for the interval, etc.
Jose Costa Teixeira (Jan 27 2018 at 13:12):
Change of rate is also there
John Silva (Jan 27 2018 at 13:13):
How about infusion pump "unique" events like "KVO" and "change rate or dose" (though I suppose these last two can be modeled as a new start with a different does and/or rate)
Jose Costa Teixeira (Jan 27 2018 at 13:13):
yep, dose is as you say. it is important if we want to keep track of what is administered (think calculating total volumes, traceability...)
Jose Costa Teixeira (Jan 27 2018 at 13:15):
if KVO is a rate for adminitration, it is there as the others.
John Silva (Jan 27 2018 at 13:15):
Is an infusion really "complete" if the nurse is simply (?) changing the rate of the same administered drug? I don't know enough about the infusion pump clinical process but it is a complex med admin delivery mechanism. (KVO I believe implies that the pump is still delivering something, e.g. normal saline, but NOT the medication.)
Jose Costa Teixeira (Jan 27 2018 at 13:15):
if you want to define "the flow rate for keeping veins open is xx ml/h" then it is another event (programming the pump?) i am not sure
Jose Costa Teixeira (Jan 27 2018 at 13:16):
i see the point. check the specs, they cover the scenarios you mention.
Jose Costa Teixeira (Jan 27 2018 at 13:16):
you can use that spec to track delivery of any amount and substance, in a very fine or coarse manner. This is necessary because (as it is mentioned in MMA) sometimes you don't know upfront how fine-grained you need to capture information.
So the same approach holds whether you want to administer a bolus, or if you want more complete stuff like "scan a barcode when changing saline bags to track stock depletion and lot number of the saline"
Jose Costa Teixeira (Jan 27 2018 at 13:20):
Is an infusion really "complete" if the nurse is simply (?) changing the rate of the same administered drug?
No, it is not complete. you finish one step and start another but the administration is in progress. This i know is captured in MMA.
Jose Costa Teixeira (Jan 27 2018 at 13:23):
But we may be diverging here. The question is about Infusion pumps. I pointed out to a specification on the medication bit. Not sure if those are the events that @Christophe Reynier wants to capture
Lloyd McKenzie (Jan 27 2018 at 15:10):
From a resource perspective, if you change the rate, that is typically the end of one event and the start of a new event. That's because MedicationAdministration only has a single start and end time and a single rate.
Last updated: Apr 12 2022 at 19:14 UTC
