Personal Health Device Implementation Guide, published by HL7 International / Health Care Devices. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/phd/ and changes regularly. See the Directory of published versions

Generic and Extensible Model

To address the list of all issues and conditions relevant to remote patient monitoring, this IG requires PHDs and PHGs to be based upon the IEEE 11073-10206 ACOM data model where observations and device information are represented in a set of abstract objects. These objects contain attributes that describe the objects. In some sense, the IEEE 11073-10206 objects are analogous to FHIR resources, and the attributes are analogous to FHIR resource elements. The attributes, like resource elements, have specified data types. All IEEE 11073-10206 PHD specializations from thermometers to home ventilators use the same set of objects and associated attributes. The simplest PHDs, like a thermometer, generate only one type of observation whereas more complex PHDs like a home ventilator generate several different types. The sleep apnea breathing therapy equipment PHD defines more than 80 observation types.

In addition, the only PHD and PHG device information that is required to be mapped is the information that is provided by protocol; the patient is not expected to provide this data. For example, the software revision will be mapped if provided in the system information transmitted by the PHD.

This Implementation Guide specifies how one maps the IEEE 11073-10206 objects and their associated attributes to FHIR resources and resource elements. Using this approach, all PHDs based upon the IEEE 11073-10206 model, regardless of what it measures, can be handled by the PHG without requiring the PHG to view the values of the attributes; only the type of the attribute is used. Thus, a numeric attribute is always mapped the same way regardless of whether it is a temperature value or pulse rate value. In addition, if the IEEE 11073-10206 model PHDs are based upon does not change, PHD device types made in the future can also be mapped by current PHG implementations.

In the IEEE 11073-10206 Abstract information Content Model (ACOM), IEEE 11073-10101 nomenclature codes are used to indicate what the items are. Thus, a reader of FHIR resources mapped from these ACOM objects can decode any of these resources if it knows what the codes are. If a future device is deployed the reader will only need an update of its code dictionary to interpret the resource. A PHG uploader will not even need to update its dictionary to perform the mapping to FHIR as the codes are provided by the PHD through protocol. These features eliminate the need for remote updating and/or servicing of PHGs when new IEEE 11073-10206 PHDs are used.

Note – IEEE 11073-10206 does not define a protocol, but requires protocols that support it to support a representation of the objects defined in the model. The Bluetooth SIG Generic Health Sensor Profile (GHSP) defines an ACOM compliant protocol.

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