AG Telemedizinische Implantatnachsorge

1 AG Telemedizinische Implantatnachsorge / Telemedicine for implant follow Up

Ziel dieser Initiative ist die strukturierte Dateneinbindung von Implantatsparametern von aktiven kardiologischen Implantaten (zB Herzschrittmacher und Defibrillatoren) in die IT – Landschaften der GDAs für geplante und ungeplante Nachsorgen. GESPAG in Oberösterreich ist bemüht, den Datenaustausch in diesem Bereich in den nächsten drei Jahren strukturiert bis hin zum KIS aufzubauen. Diese Initiative soll in Österreich und international breit abgestimmt werden, im Sinne der nachhaltigen Entwicklung und um Insellösungen zu vermeiden.

Aufbauen wird das auf der "Rahmenrichtlinie für die IT Infrastruktur bei der Anwendung von Telemonitoring: Messdatenerfassung" siehe hier https://www.bmgf.gv.at/home/Rahmenrichtlinie_IT-Infrastruktur-Telemonitoring_Messdatenerfassung

Dieses Thema wird seit 2018 im Österreichischen Interoperabilitätsforum diskutiert: https://hl7.at/home/iopf/

Diese Initiative steht in Abstimmung mit zahlreichen Partner-Institutionen weltweit. Daher werden wir hier die Englische Sprache verwenden.

2 Telemedicine for implant follow up

Planned, long term follow up of cardiac implantable electronic devices, like pacemakers and defibrillators, today typically requires the patient to physically visit a resident cardiologist or even a hospital. There the implant data is read from the implant via a reader device. The data is reviewed by the cardiologist who then provides guidance to the patient and acts if necessary.Modern implants provide telemonitoring. The implant transmits data to the handheld patient device, which then hands it on over mobile communication to the server sided IT infrastructure of the implant vendor. From there the cardiologists who implanted the device can access the data, for example via IT interfaces or web portals.OEGTelemed intends to promote the use of standardized exchange formats and IT protocols in order to enable implant vendors to provide the implant data to cardiologists in a harmonized electronic format that enables further automated processing of the data and to provide one interface to the clinical users for all implants, no matter which vendor. Large parts of these specifications are already available and will be considered. The market for implants is global, so this initiative connects to all stakeholders worldwide to assure that the chosen solutions indeed support this global market.

See this slideset about preliminary thoughts on use cases and ways to address them:

• https://cloud.technikum-wien.at/index.php/s/2R5zpw8w3gBLe4B
• This is the result of many discussion among standards developers, medical experts, device vendors, and IT experts from Austria and internationally.
• Comments are welcome to stefan.sauermann@technikum-wien.at

3 Connected work that we want to consider

3.1 Standards

• IEEE / ISO / CEN 11073 Health informatics -- Point-of-care medical device communication
  • Part 10101 (2004): Nomenclature, including Amendment 1 (2015): Additional Definitions
  • Part 10102 (2012): Nomenclature —Annotated ECG
  • Part 10103 (2012): Nomenclature—Implantable device, cardiac.
  • recent work in 2019 targets to provide a concise list of the most important parameters in a revised version of the IEEE 11073 nomenclature.
    • download here, comments welcome to stefan.sauermann@technikum-wien.at

• IHE Patient Care Coordination, Technical Framework Supplement: Remote Patient Monitoring (RPM)
  • Trial Implementation, August 5, 2015, https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_RPM.pdf
• HL7 CDA® R2 Implementation Guide: Personal Healthcare Monitoring Report
• Release 1. January 2017. Online 20.2.2019: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=33
• PCHAlliance Continua Design Guidelines (2017)
  • Online 20.2.2019: http://www.pchalliance.org/continua-design-guidelines
• EU Commission Recommendation on a European Electronic Health Record exchange format.
  • (C(2019)800) of 6 February 2019. Online 20.2.2019: https://ec.europa.eu/digital-single-market/en/news/recommendation-european-electronic-health-record-exchange-format
• Commission Decision (EU) 2015/1302 of 28 July 2015 on the identification of ‘Integrating the Healthcare Enterprise’ profiles for referencing in public procurement
  • (OJ L 199, 29.7.2015) Online 20.2.2019: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32015D1302&from=EN
• Austrian Framework guideline for the IT Infrastructure for Telemonitoring Applications
  • January 2018. Austrian Federal Ministry of Labour, Social Affairs, Health and Consumer Protection. Online 20.2.2019: https://www.sozialministerium.at/site/Gesundheit/Gesundheitssystem/E_Health_ELGA/Telemedizin/Rahmenrichtlinie_f_uuml_r_die_IT_Infrastruktur_bei_der_Anwendung_von_Telemonitoring_Messdatenerfassung

3.2 Information from Medical societies

• 22. April 2019: White paper of the Heart Rhythm Society (USA)
  • HRS White Paper on Interoperability of Data from Cardiovascular Implantable Electronic Devices (CIEDs)
  • https://www.heartrhythmjournal.com/article/S1547-5271(19)30433-3/fulltext
• 22. April 2019: Call to Action of the Heart Rhythm Society (USA)
  • Transparent Sharing of Digital Health Data: A Call to Action
  • https://www.heartrhythmjournal.com/article/S1547-5271(19)30371-6/fulltext

4 Get in contact and stay connected

• https://www.oegtelemed.at/implant_followup_2019/
  • Implant follow up area of the Austrian Society for Telemedicine and eHealth (ÖGTelemed)
• Register for the HL7 Austria mailing list "CIED - cardiac implantable electronic devices".
  • The list distributes regular news. Communication will be in English language.
• Input is highly welcome! Please contact stefan.sauermann@technikum-wien.at.