Middleware Grete Gartz BM6068 Oct-2015 Table of content Introduction HL7 vs. Cerner Connectivity Engine SI Manager User Interface 1
Table of content Introduction HL7 vs. Cerner Connectivity Engine BUS (Cerner Middleware) User Interface Table of content Introduction HL7 vs. Cerner Connectivity Engine SI Manager User Interface 2
Table of content Introduction HL7 vs. Cerner Connectivity Engine SI Manager User Interface Table of content Introduction HL7 vs. Cerner Connectivity Engine SI Manager User Interface 3
Table of content Introduction HL7 vs. Cerner Connectivity Engine SI Manager User Interface Introduction Integration Basic Components: Medical devices must have the ability to export data in a digital form. Have a serial port. A network connection right in the medical device or through a Database. A centralized computer or server that aggregates data from your medical devices. Server will store the data in a temporary database, or provide users the means to review and validate acquired data before it is sent into the chart. An HL7 interface that takes your device data, in your proprietary protocol, converts it to serial data and sends it on to the EMR. 4
Introduction Middleware Middleware is a general term for software that serves to "glue together" separate, often complex and already existing, programs. Introduction Middleware Middleware is the software that connects software components or enterprise applications. Middleware is the software layer that lies between the operating system and the applications on each side of a distributed computer network 5
Example: Patient Bedside Monitor HL7 vs. Cerner Connectivity Engine Middlesex: Cerner House CareAware IBus: Cerner solution for collecting Data (from Medical Devices) Two ways to collect the Data: Cerner Connectivity Engine HL7 6
HL7 vs. Cerner Connectivity Engine IBus Cerner Connectivity Engine CCE: utilizes a USB Port or CareAware adapter that converts data collected to serial data. IBus HL7: sends data directly to IBus Cerner Connectivity Engine Is mostly used when you do not have a Gateway Used for Capturing alarms from the Philips Bedside Monitor : Alertlink (loaded to the CCE) Departments: CCU, Labor and Delivery (Fetalink), Endoscopy. Gateway Data/Vital Signs Alarms 7
AlertLink in IBus structure Components How is it connected? How is it configured? How do you create the containers? Making sure Data is flowing Name conventions/ Create conventions What do to do with that Data? 8
How is it connected? IBus Back end of Cerner to associate patient to a device IBus is not tied to a Patient, it only carries raw data. Middlesex: 2 IBuses for production 1IBus for testing Configuration: It must be configured to receive this Data regardless of which method it obtains it. CareAware ICommand: used to configure the IBus. Allows the user to add the necessary drivers to the IBus and to configure it to recognize the device. Containers : each device requires a configuration Programmers Guide: For each piece of equipment that has been Cerner Certified. Cerner has built a driver for that device (software version) and certifies the data can be acquired from it. Contains the directions for how to configure IBus. 9
Guide for integrating the Patient Monitor has some prerequisites: Specific software version Reporting interval IP Address Port Service Packages to be installed on the IBus A local IP needs to be set, the destination IP set to the IP of the IBus, the destination port set to an available port as long as that port is used on the IBus to receive the device data Note: The machine does not need to be on the same network as the IBus, but the networks need to be able to communicate with each other. Creating the containers ICommand is used to create the container in the IBus. This container differentiates between device models. Drivers are installed by downloading them from Cerner and placing them with other required drivers on the Ibus and then they are added to the container. Container IBus 10
List of Containers Device Dashboard 11
Philips Gateway Device List Making sure Data is flowing: Once data is being acquired by the ibus: IT is able to pull from this data up to a determine time (set during the configuration phase) Data must be mapped to its specific fields on the chart and associated - device and patient (Further Step) This data only contains the parameters that Cerner drivers allow to obtain. 12
Name conventions/ Create conventions Specific name is assigned for the Device (Device ID) and is shared with IT for further configuration steps. Philips Device ID supports up to 6 characters Example: 201 (Room 201 @ CCU) or MHED01 GUID (Generated Unique Identifier) needs to be locate and shared with IT. Alias Parameters: for the parameter sent from the device. They change from Manufacturer to Manufacturer. Example: SPO2, RR (Respiratory Rate) What do you do with that Data? Data is sent to SI Manager Raw Data. 13
SI Manager (System Integrations Manager) Need to know: Conventions OR Alias Mapping Fields on Chart Codes: from device and from SI Manager Codes mapping to a specific field. SI Manager (System Integrations Manager) IT uses an application: SI Manager to build a new type of Patient Bedside Monitor or Medical Device. SI Manager: Cerner tool to Link Data from the IBus to the EMR SI manager is a Build tool that allows to configure Alias SI Manager: Matches Device ID, Device Alias, GUID and Parameter Alias New build: the parameters are matched using their aliases to an event. Each event is then matched up with its corresponding field in the patient record. 14
SI Manager (System Integrations Manager) The name assigned is used by Nursing Informatics to enter into SI manager The Patient Monitor Information Management System knows what data is coming in from that machine and what it should do with it. Each device has to be built this way so that each separate device can be associated with a specific patient. User interface iview: Validation software EMR 15
User interface iview: Validation: Where Staff validates data Type of Document on chart. Associated to patient s record. Check to see if the data is coming from the machine correctly or if the data going to the SI Management Systems between correct fields: Responsibility of Biomedical Engineering and Nursing Informatics. (In validation testing phase) User interface Test: Connecting the Patient Bedside Monitor to a patient simulator - Biomedical Engineering must verify that the IBus is receiving the data from the machine. Done in test environment. Check the device inside the container and verify that values are being populated. Device must be associated with a test patient to begin populating the record. Data is being sent to an specific field (Example:201), now patient has to be assigned to the device (Example: John Doe to 201 from 11:00 am ) Now Cerner knows where to put the data (Field) 16
User interface Verify all of the fields are being populated with data in the record. Once it is confirmed: verify that it is the correct data values. Verify data is being populated at all of the necessary time intervals. After the data has been confirmed to populate a patient s record correctly and the machine has been deemed safe for patient use the device will be used in actual cases. Thank you! Any questions? 17