Medical Device Communication - RTMMS

Nearly all medical device manufacturers currently use proprietary or individualized terminology when exchanging device information between devices, and devices and electronic health record systems. Substantial benefits may be realized from vendor-vetted, standardized terminology across both point-of-care acute (e.g., patient monitors, respirators, ventilators, implantable cardiac, and infusion pumps) and personal health (e.g., pulse oximeters, blood pressure monitors, thermometers, weighing scales, and glucose meters) device domains. Key benefits include the reduction (ultimately to one) of the current need of developing and supporting many interfaces for each communicating entity and enabling semantic interoperability between devices and the healthcare enterprise including electronic medical record and electronic healthcare record systems.

Collaborating closely with medical device manufacturers and standards developers, ITL’s Software and Systems Division (SSD) has developed and made publicly available a medical device nomenclature database in support of on-going conformance and interoperability test efforts. The freely available web application, named “RTMMS” for Rosetta Terminology Mapping Management System, allows agreement and harmonization by users (including medical device manufacturers and vendors) and facilitates access, review, and reporting of medical device terminology and associated co-constraints (including standardized units of measurement, body site, and enumerations). The terminology system includes an easy to use workflow process which walks a standards development organization lead through the process of adding new vetted terminology. This process has substantially reduced the ‘typical’ time of adding new terms to the paper-based standard from approximately 3 years to about 4 months for the electronic counterpart – thus introducing needed information critical for semantic interoperability of medical device data and making terminology available for immediate use by device and healthcare system implementers.

The RTMMS fulfills several critical vocabulary service needs including:

• Harmonization of vendor-specific terms to reduced sets (common to all vendors) of standardized terms and available to wider community,
• Enabling rigorous conformance validation of messages (both syntactically and semantically) by (other) NIST-developed tooling leading to an increased likelihood of device interoperability,
• Providing the capability to seamlessly update and provide electronic representation of the traditional paper-based standard,
• Making device terminology (and key corresponding terminology information) freely and publicly available [via a NIST-IEEE memorandum of understanding agreement],
• An approval process tool available to standard representatives for addition to the nomenclature standard that are vetted in-between and balloted at each standard working group meeting - thus reducing the time to formal approval,
• A workspace for medical device “contributing organizations” to view existing standardized terms, store vendor-specific terminology, map to standardized terms, and propose terminology to be included in the International Standard,
• Provision for identifying equivalency mappings from device nomenclature terminology to other prominent healthcare vocabularies (including LOINC and SNOMED CT),
• A working forum to addressing particular nomenclature attributes by physiological body site groupings, units of measurement and related enumerations, and
• Facility to download electronic-formatted harmonized term and associated co-constraints.

The RTMMS web application is located at: https://rtmms.nist.gov#home ; simply click on the “Register” link (top right of home page) to obtain one of several available user types. For more information regarding the RTMMS or NIST’s Semantic Interoperability of Medical Devices (SIMD) project please contact John J. Garguilo (john.garguilo [at] nist.gov (john[dot]garguilo[at]nist[dot]gov)). 

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