Personal Health Device PHD Implementation Guide Home FHIR

Personal Health Device (PHD) Implementation Guide Home FHIR Server Personal Health Gateways 1 Personal Health Devices 2 Remote Patient Monitoring

IEEE 20601 Heart Rate Blood Pressure PHG Personal Health Gateway (PHG) Thermometer Glucometer Pulse Oximeter Weight Scale Proprietary # 1 Proprietary # 2 Proprietary # 3 Special code for each device Proprietary # 4 Each arrow represents suffering for the PHG implementer. Proprietary # 5 Proprietary # 6 Proprietary # 7 Proprietary # 8 Proprietary # 9 PHDs Proprietary # 10 Proprietary # 11 Proprietary # 12 X

IEEE 20601 PHG Personal Health Gateway (PHG) Blood Pressure Thermometer Glucometer Pulse Oximeter Weight Scale Proprietary # 1 Proprietary # 2 Proprietary # 3 Special code for each device Proprietary # 4 Proprietary # 5 Proprietary # 6 Proprietary # 7 Proprietary # 8 PHD Implementation Guide Part 1 Heart Rate Again, each arrow represents suffering for the PHG implementer. • The 20601 arrow represents the mapping to FHIR as in IG part 1 • The BTLE arrows are done by mapping to the IEEE 20601 standard. • The dashed arrows are done by mapping to the IEEE 20601 but may not be possible Proprietary # 9 PHDs Proprietary # 10 Proprietary # 11 Proprietary # 12 X

PHG IEEE 20601 Personal Health Gateway (PHG) Oauth Token Server Heart Rate Glucometer Pulse Oximeter Weight Scale Proprietary # 1 Proprietary # 2 Proprietary # 3 Special code for each device Proprietary # 4 Proprietary # 5 Proprietary # 6 Proprietary # 7 Proprietary # 8 Patient FHIR Resources Thermometer FHIR Server PHD Implementation Guide Part 1 Blood Pressure PHG Device PHD Device Observation n PHD Implementation Guide Part 2 Proprietary # 9 PHDs Proprietary # 10 Proprietary # 11 Proprietary # 12 FHIR reader X

Let’s Skip the PHD to FHIR that’s for PHG implementers and requires significant 11073 20601 domain knowledge We examine the FHIR data generated by the PHG We consider only PHD data delivered by protocol

What data does a PHD provide? Device Information (MDS) MDS = Medical Device System Metric Information (observation, measurement, …)

Device Information • • • Specialization (blood pressure, pulse ox, etc. )* Manufacturer name* Model number* Serial number** Firmware**, hardware, software, protocol, and Continua** versions Part number * = required System Identifier* ** = conditionally required Time properties • Clock type** • Synchronization** • Resolution • Accuracy Regulatory information • Regulation status** • Certification status** Current Time**

Device Information • • • • Specialization • Manufacturer name • Model number • Serial number Firmware, hardware, software, • protocol, and Continua versions • Part number • System Identifier • Time properties • Clock type • Synchronization • Resolution • Accuracy • Regulatory information • Regulation status • Certification status Current Time Device Resource profile: http: //hl 7. org/fhir/uv/phd/Structure. Definition/Phd. Device type: PHD specialization – code, version manufacturer model. Number serial. Number version – code, value part. Number identifier – code, system, value property – code, value (code, quantity) property Coincident Time Stamp

Metric Information: • Type: what it is. Given by an MDC code. • Time stamp: when the sensor recording was made. • Recorded by the sensor • Recorded by the Gateway (time of reception) • Value: the quantitative representation; one of six possible representations • Optional descriptions: • Supplemental information • Duration of recording (such as a cardio session) • Status (questionable, invalid, in progress, etc. ) • Related metrics (src-handle-references) • Thresholds, etc.

The 6 Value Representations: • Single Number (scalars): weight, temperature, pulse rate, glucose concentration, etc. - units • Multiple numbers (vectors): blood pressure {systolic, diastolic, mean), acceleration (x, y, z components), etc. - units • Coded: meal context, test method, health context, etc. • State and Event: sensor status, patient’s room status, etc. State example: door opened or closed Event example: finger poorly placed • Waveforms (periodic scalars): ecg trace, pleth wave, spirometry flow rates, etc. - units • String: human readable message

Metric Observation • meta. profile (depends on value) • code • Type • effective[x] • Time stamp • effective. Date. Time • without duration • effective. Period • with duration • value[x] • Value • value. Quantity* • Single number • component. code, value. Quantity* • Multiple numbers • value. Codeable. Concept • Coded • component. code, • State/Event value. Codeable. Concept • value. Sampled. Data • Waveform • value. String • String * data. Absent. Reason on Na. N, Pinf, Ninf

Metric Special • Optional descriptions • status • Supplemental types • Related metrics • Thresholds, etc Observation • data. Absent. Reason • interpretation • component. code, value. Codeable. Concept • derived. From • component. code, value[x]

Patient • PHD gives no patient data • meta. profile http: //hl 7. org/fhir/uv/phd/Structure. D efinition/Phd. Patient • identifier

Coincident Time Stamp It’s a measure of the current time of the PHD at the current time of the PHG code - Type of PHD time stamp effective. Date. Time - Current Time of PHG value. Datetime value. Quantity Current Time of PHD data. Absent. Reason - PHG corrects measurement time stamps and provides local time plus offset to UTC

Devices Track WE PROVIDE: Personal Health Gateways FHIR Server IT DOES 1 Personal Health Devices 2 Remote Patient Monitoring YOU DO

How We Help WE PROVIDE: Java Intellij ‘RPM’ Source project: • MDC dictionary • Asn 1 To. HL 7 dictionary • Websockets subscription support Examples of Observation and Device decoding FHIR Server Gateways allow manual data entry so one can simulate various medical conditions like hypertension. Gateways are on Android Play. Store - BYOA Remote Patient Monitoring, Alert system, Diagnostics, Whatever else you can dream up, PC, Linux, Android 2