HRS White Paper on Interoperability of Data from Cardiac Implantable Electronic Devices

May 8, 2019—This document provides a brief overview of U.S. federal initiatives to promote interoperability of data, the requirements needed to communicate data between information technology systems in a way that permits the sending and receiving systems to understand and process the data, a summary of the work of HRS to date, and finally strategies for clinicians seeking an environment in which they can manage their cardiac implantable electronic device (CIED) patient data in a single IT system.

Background

Cardiac implantable electronic device (CIED) technologies have improved significantly over the past decade, and indications for these devices have expanded. This has led to an increasing number of patients being managed with CIEDs, resulting in an exponential quantity of data that needs to be sorted, interpreted, acted upon, and stored. The basic settings anddiagnosticandtherapeuticcapabilitiesofCIEDsaresimilar regardless of manufacturer. Each has developed proprietary nomenclature, technical standards, and communication protocols to describe similar if not identical features and functionalities.

Clinicians, primarily concerned with evaluating battery status, programmed parameters, arrhythmias, and therapies delivered, must pull together data from multiple settings (hospital, office, remote monitoring) and multiple vendors in order to manage large numbers of CIED patients. Traditional electronic health records (EHR) used for both inpatient and outpatient care are not well suited to managing CIED data, and standalone products designed for this purpose struggle with mixed success to unlock the data from proprietary formats.