Primary Goal: To demonstrate the ability to provide efficient and accurate transitional care, from the hospital OR suite, to the radiology department and finally the ICU, showing interoperability of patient data across multiple hospital settings. Patient data is collected during surgery and a report is sent to the patients PCP.

Key Points: • All OR patient care devices for the surgery are linked to the hospital EHR, so that data is readily available to hospital staff.• The perioperative information system gathers all the data and creates a report for the PCP.• Patient’s infusion pumps have five rights support and associated alarms are connected to report status and issues.• Following surgery the patient is taken for an MRI where he is continuously monitored by an MRI patient monitor connected by HL7 to

the EHR and the images are viewed on the radiology control room PACS system• Patient data moves seamlessly between departments and the patient is transferred to the ICU.

Meaningful Use Relevance: • Coordination of Care as evidenced by movement of patient data between separate hospital departments and PCP. • Device data is continuous added to the patients chart recording vitals signs.

Care Theme: Transitions of Care, Medical Device IntegrationUse Case Managing Trauma via Intra-facility Care Coordination Leveraging Medical Devices and Imaging

Use Case 1

IHE Profiles & Acto

rs

Domain Profile Vendors Actors

IT Infrastructure (ITI)PIX, PIXv3 ALERT

Manager, Consumer, Identity Source, Repository

XDS.b ALERT Registry, Repository

Patient Care Coordination (PCC)

XDS-MS (Periop Report)

GE Content Creator

XDS-MS Greenway Content Consumer

Patient Care Device (PCD)

DEC, IPEC, PIVBaxter, iSirona, Mindray,

Philips, GE, ALERTDevice Obs. Consumer, Device Obs.

Reporter

ACM Philips, BaxterAlarm Reporter, Alarm Manager, Alarm

Communicator

Radiology (RAD) IOCM InfinittImage Manager, Image Display, Image

Document Consumer

1. A 22 year old male patient is emergently admitted to the OR following multiple gunshot wounds to the abdomen2. The patient is immediately put under anesthesia for trauma surgery and is maintained with the anesthetic machine. Data

from the anesthesia system including measurements, settings and modes are sent to the perioperative system and EHR.3. An exploratory laparotomy is performed to assess and repair injury within the abdominal cavity. During surgery the patient is

constantly monitored through a physiological monitor and data is streamed directly to the EHR in custom time increments.4. The patient is found to have multiple bowel injuries and a liver laceration. The patient is requiring multiple units of blood and

each time the current infusing unit nears empty, the pump alerts the blood bank to send another unit to the OR.5. The interface system receives information from multiple monitoring devices and updates the information in the EHR.

Conforming systems can send data directly to the EHR6. All of the data from the medical devices operating in the OR is being populated in the patients EHR.7. The patient goes for an MRI study to assess secondary injuries while a MRI patient monitor reports data to the EHR.8. Images are viewed during the MRI by the radiologist through the PACS system. 9. The patient is transferred to the ICU to begin recovery from his primary injuries and awaits further surgeries.

Care Theme: Transitions of Care, Medical Device IntegrationUse Case: Managing Trauma via Intra-facility Care Coordination Leveraging Medical Devices and Imaging

Clinical Workflow:

9 – PCP

1 – Trauma OR 2 – Anesthesia 3 – Monitoring Devices 4 – Infusion Pump & Alarms

5 – Interface System 8 – PACS 6 – Hospital EHR 7 – MRI Monitoring

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