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Implantable Rhythm Control Device Interrogation Profile ACC, HIMSS and RSNA
Integrating the Healthcare Enterprise



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IHE Cardiology Technical Framework
Supplement 2007-2008


Implantable Device Cardiac Observation
Profile (IDCO)





Public Comment Version 0.09
June 12, 2007


Copyright © 2007: ACC/HIMSS/RSNA
IHE Technical Framework Supplement - Implantable Device Cardiac Observations
______________________________________________________________________________

__________________________________________________________________________


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Table of Contents
Public Comment Version 0.09........................................................................................................ 1
June 12, 2007 .................................................................................................................................. 1
1 Foreword.................................................................................................................................. 4
2 Introduction.............................................................................................................................. 5
2.1 Choice of Standards ............................................................................................................ 6
2.2 Open Issues and Questions ................................................................................................. 6
2.3 Closed Issues....................................................................................................................... 6
Changes to Volume I Integration Profiles ................................................................................... 8
2.2.x Implantable Device Cardiac Observation Profile ............................................................. 8
9 Implantable Device Cardiac Observation Profile (IDCO)..................................................... 11
9.1 Actors/ Transactions ......................................................................................................... 11
9.2 IDCO Integration Profile Options..................................................................................... 13
9.2.1 PIX-based Reconciliation Option ................................................................................... 13
9.3 IDCO Use Cases ............................................................................................................... 13
9.3.1 Use Case I1: Implantable Cardiac Device In-Clinic Followup ...................................... 13
9.3.2 Use Case I2: Implantable Cardiac Device In-Clinic Followup with Networked
Programmer that Translates Information........................................................................ 14
9.3.3 Use Case I3: Implantable Cardiac Device Remote Followup ........................................ 15
9.3.4 Use Case I4: Third Party Value-Added Services ........................................................... 15
9.3.5 Use Case I5: Remote Monitoring of Implanted Cardiac Devices .................................. 15
9.4 IDCO Process Flow .......................................................................................................... 16
9.5 Patient Identification......................................................................................................... 21
H.5 Patient Identifier Cross-referencing Integration Profile (PIX) ............................................ 23
H.5.1 Cardiology Use Case...................................................................................................... 24
H.6 Audit Trail and Node Authentication (ATNA) ................................................................... 24
H.6.1 Cardiology Use Case...................................................................................................... 25
Appendix I: Observation Processors and Repositories - Extended Workflow Actor Groupings 25
I.1 Basic IDCO Report Display using Retrieve Information for Display Profile (RID)........ 26
I.2 IDCO Data Incorporation into a Report using Displayable Reports Profile (DRPT)....... 26
I.3 IDCO Discrete Data Storage using Evidence Documents Profile (ED) ........................... 27
I.4 IDCO Submission to an EHR using Cross Domain Document Sharing Profile (XDS)... 27
I.5 Observation Repository with a Database.......................................................................... 27
Changes to Volume II Transactions........................................................................................... 29
4.12 Send Observation [CARD-12].......................................................................................... 29
4.12.1
Scope ....................................................................................................................... 29
4.12.2
Use Case Roles........................................................................................................ 29
4.12.3
Referenced Standards.............................................................................................. 30
4.12.4
Interaction Diagram................................................................................................. 30
4.12.5
Observation Submission.......................................................................................... 30
4.12.5.1
Trigger Events................................................................................................... 30
4.12.5.2
Message Semantics ........................................................................................... 31
Rev. 09 Public Comment June 12, 2007

Copyright © 2007: ACC/HIMSS/RSNA
IHE Technical Framework Supplement - Implantable Device Cardiac Observations
______________________________________________________________________________

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4.12.5.2.1 MSH Segment Message Header ................................................................ 31
4.12.5.2.2 PID Segment Patient Identification ........................................................... 32
4.12.5.2.3 PV1 Segment Patient Visit (Optional)....................................................... 33
4.12.5.2.4 OBR Segment Observation Request.......................................................... 34
4.12.5.2.5 OBX Segments Pulse Generator and Lead Observation Results............... 35
4.12.5.2.5.1 IEEE 1073.1.1.3 IDC term mapping to OBX segment.............................. 37
4.12.5.2.6 OBX Segment with Encapsulated PDF [Optional]....................................... 37
4.12.5.2.7 NTE Segment Notes and Comments [Optional]........................................ 38
4.12.5.3
Expected Actions .............................................................................................. 39
4.12.5.3.1 HL7 Message Router .................................................................................... 39
4.12.6
Observation Forwarding.......................................................................................... 39
4.12.6.1
Trigger Events................................................................................................... 39
4.12.6.2
Message Semantics ........................................................................................... 39
4.12.6.3
Expected Actions .............................................................................................. 39
4.12.6.3.1 Observation Processor .................................................................................. 39
4.12.6.3.2 Observation Repository ................................................................................ 40
Appendix A MDC_IDC Nomenclature ..................................................................................... 41
A.1 MDC_IDC Term Definitions............................................................................................... 41
A.2 MDC_IDC Term Enumeration Tables ................................................................................ 49
A.3 MDC_IDC Containment Tree ............................................................................................. 56
A.4 MDC_IDC Use of OBX-4 for Containment........................................................................ 59
Appendix Z IDCO Observation Message Example................................................................... 68

Rev. 09 Public Comment June 12, 2007

Copyright © 2007: ACC/HIMSS/RSNA
IHE Technical Framework Supplement - Implantable Device Cardiac Observations
______________________________________________________________________________

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1 Foreword
Integrating the Healthcare Enterprise (IHE) is an initiative designed to stimulate the integration
of the info