NATIVE IMPLEMENTATION OF THE IDCO INTEROPERABILITY STANDARD FOR ALL MAJOR CIED VENDORS (US)

Abstract

BackgroundProcessing the plethora of detailed data acquired from cardiac implantable electronic devices (CIEDs) during both interval remote surveillance and discrete point of care device interrogations has presented a growing challenge among healthcare systems. By automating the conveyance of detailed CIED device and sensor data, our team sought to facilitate effective patient-centric clinical workflows and associated administrative support functions (scheduling, billing, analytics, messaging).MethodsWe installed a native implementation of the Implantable Device Observation workflow interoperability standard (IDCO), developed within IHE's Cardiology domain (with ACC/HRS sponsorship). This interoperability framework was incorporated into our Epic electronic health record (EHR) to accommodate all major CIED brands. Vendor-specific portals were set up that tracked and massaged incoming HL7 messages, which was necessary to account for the variances in vendor-specific IDCO version 1 implementations (providing a means of further assessing the specificity of IDCO profile field definitions).ResultsIDCO-compliant data conveyance works effectively for Abbott, Boston Scientific, Medtronic, and Biotronik CIEDs. Our installed framework first went live in 2014 for 3 of these vendors (with a 4th vendor added in 2019), during which ∼50 thousand CIED transmissions have been processed. Metadata associated with each transmission allows for leveraging of existing EHR tools for administrative support functionality, which is being piloted at an affiliate clinical site.ConclusionUse of the IDCO framework in our EHR for all CIED brands has achieved an automated uniform conveyance of standardized discrete CIED data well-suited to our regional healthcare system, enabling more effective clinic workflows that support CIED patients both locally and remotely. The use of this framework is extensible for additional administrative functionality, further enhancing EHR "meaningful use". BackgroundProcessing the plethora of detailed data acquired from cardiac implantable electronic devices (CIEDs) during both interval remote surveillance and discrete point of care device interrogations has presented a growing challenge among healthcare systems. By automating the conveyance of detailed CIED device and sensor data, our team sought to facilitate effective patient-centric clinical workflows and associated administrative support functions (scheduling, billing, analytics, messaging). Processing the plethora of detailed data acquired from cardiac implantable electronic devices (CIEDs) during both interval remote surveillance and discrete point of care device interrogations has presented a growing challenge among healthcare systems. By automating the conveyance of detailed CIED device and sensor data, our team sought to facilitate effective patient-centric clinical workflows and associated administrative support functions (scheduling, billing, analytics, messaging). MethodsWe installed a native implementation of the Implantable Device Observation workflow interoperability standard (IDCO), developed within IHE's Cardiology domain (with ACC/HRS sponsorship). This interoperability framework was incorporated into our Epic electronic health record (EHR) to accommodate all major CIED brands. Vendor-specific portals were set up that tracked and massaged incoming HL7 messages, which was necessary to account for the variances in vendor-specific IDCO version 1 implementations (providing a means of further assessing the specificity of IDCO profile field definitions). We installed a native implementation of the Implantable Device Observation workflow interoperability standard (IDCO), developed within IHE's Cardiology domain (with ACC/HRS sponsorship). This interoperability framework was incorporated into our Epic electronic health record (EHR) to accommodate all major CIED brands. Vendor-specific portals were set up that tracked and massaged incoming HL7 messages, which was necessary to account for the variances in vendor-specific IDCO version 1 implementations (providing a means of further assessing the specificity of IDCO profile field definitions). ResultsIDCO-compliant data conveyance works effectively for Abbott, Boston Scientific, Medtronic, and Biotronik CIEDs. Our installed framework first went live in 2014 for 3 of these vendors (with a 4th vendor added in 2019), during which ∼50 thousand CIED transmissions have been processed. Metadata associated with each transmission allows for leveraging of existing EHR tools for administrative support functionality, which is being piloted at an affiliate clinical site. IDCO-compliant data conveyance works effectively for Abbott, Boston Scientific, Medtronic, and Biotronik CIEDs. Our installed framework first went live in 2014 for 3 of these vendors (with a 4th vendor added in 2019), during which ∼50 thousand CIED transmissions have been processed. Metadata associated with each transmission allows for leveraging of existing EHR tools for administrative support functionality, which is being piloted at an affiliate clinical site. ConclusionUse of the IDCO framework in our EHR for all CIED brands has achieved an automated uniform conveyance of standardized discrete CIED data well-suited to our regional healthcare system, enabling more effective clinic workflows that support CIED patients both locally and remotely. The use of this framework is extensible for additional administrative functionality, further enhancing EHR "meaningful use". Use of the IDCO framework in our EHR for all CIED brands has achieved an automated uniform conveyance of standardized discrete CIED data well-suited to our regional healthcare system, enabling more effective clinic workflows that support CIED patients both locally and remotely. The use of this framework is extensible for additional administrative functionality, further enhancing EHR "meaningful use".