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IEEE 11073 20401 Common Network Services

Vivek Kamath, vpkamath@westhealth.org

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IEEE 11073-20401 Project (PAR) Scope:

Within the framework of IEEE 11073 standards, this standard will define a common, transport neutral set of networking services that will enable plug-and-play interoperability of medical devices.

This project shall not address quality of service over RF wireless network connections.

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Scope Summary:

Define common set of networking services

Transport Neutral

Enable plug-and-play

For medical devices

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Aspects of CNS

Describes topological framework to standardize network semantics for medical devices

Enables profiling of clinical scenarios from a communication perspective.

Defines a Transport Independent System Layer (TISL) as a standard interface for upper layers

Recommends technologies that can be used for networking medical devices

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CNS Discussion Outline

Topological View Clinical Scenarios Profiles and Services Transport Stack Preferred Technologies TISL Services

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Clinical Scenarios - ENV 13735 Annex E 2.1Scenario Communication Requirements

Emergency Situation – One of the main scenarios is alarm (2.1.1)

Plug and Play - the device communication must start immediately after device connection without any further user intervention. That implies e.g. automatic device recognition, identification, and initialization of communication.

Safety and reliability of communication and network - connection of a new device must not influence the communication of other devices connected earlier

Unique device identification

Normal patient nursing condition in ICU, non emergency situations (2.2)

Same as above

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Scenario Communication Requirements

Data Logger ( 3.1) Graphic parameter data volumes can require high bandwidth‘Loose’ device time stamp synchronization, in the order of 0.01 second, is required.

Real Time Data Display (3.2)

Latency of data between amplifier output and display on screen must be less than 0.2 seconds to be invisible for user.

Patient Alarm Monitoring (3.3)

The communication of alarm related information must be expedited, in order to be processed prior to other data, and must be reliable.Display Device must be able to detect when a Data Agent is removed. Ideally it should be able to distinguish between an intentional disconnection and unintentional disconnection.The latency of occurrence of alarm and signaling to user must be less than 0.25 seconds.

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Scenario Communication Requirements

Remote Control (3.4) In a remote control system, the communication must fulfill a higher level of reliability, because of a higher risk for the patient. This includes the needs for comprehensive message validation, data verification, message retries, and notification of communication system failures. This implies the need for system management functionality.A mechanism to send control data to the data agent and acknowledge receipt is required. In some cases manual control of the device should be precluded.

Patient Viewing Interoperability (3.5)

There must be some level of control such that a remote user (i.e. outside the care unit) cannot change the settings established by a nurse at the bedside. Harmonization of communication methods for RF telemetry systems would be required in order to support interoperable telemetry systems.Bandwidth management may become a big issue.The issue of managing multiple associations between a Data Agent and multiple Data Loggers or Data Dis -play needs attention.

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Scenario Communication Requirements

Patient Monitoring Interoperability (3.6)

Communication over different hospital LANs and maybe even on the Internet.Ordering of physiological data is important.Latency from Data Agent to Remote Monitoring Device must be controlled and specified. Generally, this should be less than one second to be acceptable.

Maintenance and Configuration Support (3.8)

Physical connect/disconnect sensing for devices.System management protocol

Intrabed Symmetric Data Exchange between DCC and BCC (4.1) Interbed Symmetric Data Exchange over an "Interbed Network“ (4.2)

Symmetry in communication between device (DCC) and BCCSymmetry in data propagation in through the BCC - from device (DCC) through BCC to Application System and vice versaPropagation of a containment tree of a remote device to the receiver (DCC)

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CNS- Profiles

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Transport Stack View

ethe

rnet

11073“upper layers”

Wi-F

i

Cel

lula

r D

ata

Wi-M

ax

802.3

10/100/1000BT

802.11

RF

GPRSEDGE1xRTT 4G /LTE

RF

802.16

RF

IP

RTP/SCTPTCP UDP SCTP

IrLAP

IR

IrLMP

TinyTP

RS-232

IP Support Services

11073 config service

11073 assoc service

DHCP

DNS

Net. capacity service

LDAP

NTP

Radius

Location services

Presence servicesSNMP

802.1xNAT

US

B

Blu

eToo

thPHDC MDP

current short term

point to point links

short term possible future

IP centric linksU

SB

etherclass drv

Blu

eToo

th

IPprofile

MICSWMTS

Zig

Bee

possible future

Interface to ‘upper layers” - TISL

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Technologies that can be used for CNS(Initial Scope)

Components Layer Technology

Interface Physical/Link 802.3

Connectivity Transport/Network UDP/IP v4 and TCP/IP v4

Security Network IPSec over UDP, IPSec over TCP, None

Quality Of Service Application RTP over UDP, RSVP

Discovery Application mDNS, DNS

Provisioning Application DHCP, Statically provisioned

CNS requirements fall between Transport Type3-Transport Type4

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TISL

Provides uniform interface to upper layers

Provides support for following services Discovery of services Connectivity Provisioning Security Quality Of Service (QoS)

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Interface – Physical/Link Layer 802.3

Will be used as specified in IEEE 11073-30400

MAC/PHY specified in 11073-30400

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Provisioning Services DHCP

Apart from IP address Following options will be implemented

Domain Name Server Option. Code = 6 Subnet Mask Option. Code=1 Time Server Option. Code=4 Others?

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Provisioning Services DHCPMedical Device (DHCP Client)DHCP Server (not selected) DHCP Server (selected)

Begins InitializationDHCPDISCOVERDHCPDISCOVER

Determines ConfigurationDetermines ConfigurationDHCPOFFER

DHCPOFFER Collects replies

Selects configuration

DHCPREQUESTDHCPREQUEST

Commits ConfigurationDHCPACK

Initialization complete

Graceful shutdownDHCPRELEASE

Discards Lease

DHCP Server can be used to provision IP Address and other artifacts

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Provisioning Services DHCP – Autonet address selection

Medical Device (DHCP Client)

Begins Initialization

Pick random address in 169.* scope

Is address available?

No Response

Self assign selected address

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Provisioning Services (TISL primitives)Name Description

TISL_provisioning_init Initialize provisioning services

TISL_provisioning_enum_providers Enumerate available provisioning providers

TISL_provisioning_set_provider Set current provider

TISL_provisioning_add_item Add provisioning item given the code

TISL_provisioning_remove_item Remove provisioning item given the code

TISL_provisioning_get_item Get item value given code

TISL_provisioning_auto_start Start automatic provisioning using current provider.

TISL_provisioning_uninit Uninitialize provisioning services

Providers DHCP, none (for static provisioning)

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Provisioning Services (TISL State Chart)

Events/States Uninitialized Initialized AutoStarted

TISL_provisioning_init

Initialize provider, Change state to Initialized

TISL_provisioning_enum_providers Return all providersTISL_provisioning_set_provider Set current provider

TISL_provisioning_add_item Add Item and set valueTISL_provisioning_remove_item Remove itemTISL_provisioning_get_item Get item value Get item value

TISL_provisioning_auto_startChange state to Autostarted

TISL_provisioning_uninit

Uninitialize service and change state to uninitialized

Uninitialize service and change state to uninitialized

Empty fields in the table mean that the event does not cause any actions or state changes.

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Discovery Services – DNS mDNS

Plug and Play scenarios need provisioning in order to successfully associate with the peer

Can be used to discover services on a medical network

Examples: An Agent starts up and tries to find Manager on local sub-

network with some additional information to connect Manager needs to find one of the IHE applications on the

enterprise network to send PCD01 message

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Discovery Services – DNS mDNS

Can be done using multicast DNS for local subnet and unicast DNS for enterprise scope

Has two parts to it: Resource Description Resource Discovery

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Discovery Services –DNS discovery in domain

Medical Device (DNS Client) DNS Server

DNS Standard Query(SRV)

DNS Standard Query Response (SRV)

DNS Standard Query(A/AAAA)

DNS Standard Query Response (A/AAAA)

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Discovery Services – mDNS Name Selection and Publication

Medical Device (mDNS Client)

Use configured name bed2floor1unit4._11073PocAgent._udp.local.

Is address available?

No Response

Start Service with configured Name on udp port XXXX

Register SRV record with bed2floor1unit4._11073PocAgent._udp.local.

Now available bed2floor1unit4._11073PocAgent._udp.local.

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Discovery Services – mDNS Service Discovery

Medical Device (mDNS Client)

Configured to find _11073PocAgent._udp.local.

Any services of type _11073PocManager._udp.local

.

bed2floor1unit4._11073PocManager._udp.local.

configured as bed2floor1unit4._11073PocManager._

udp.local.

Request domain name and port for service bed2floor1unit4._11073PocManager._udp.local.

machine1.local.:2030 IP:10.10.10.23

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Discovery Services – DNS Service URL format

General Service URL format <Instance> . <Service> . <Domain>

_tcp – used when tcp is the underlying protocol _udp – used for everything else Example, _11073PoCAgent._udp.example.com –

11073 agent services that don’t use tcp in the domain example.com

Instance name is a user friendly name consisting of upto 63 Net-Unicode [RFC5198] characters.

Example, bed2Floor1Unit4._11073PoCAgent._tcp.example.com

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Discovery Services – Resource Types

Device Resource Types _11073PoCAgent _11073PoCManager More?

Additional information in TXT record Data-proto-id=“20101”,”20202” More?

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Discovery Services - TISL PrimitivesName Description

TISL_discovery_init Initializes discovery services

TISL_discovery_enum_providers Enumerates available discovery service providers

TISL_discovery_init_provider Initializes provider for use

TISL_discovery_register_service_notification Sets callback for service discovery

TISL_discovery_start Start discovery

TISL_discovery_cancel Cancel discovery in progress

TISL_discovery_setDiscoverable Set current device as discoverable for zero-touch mode

TISL_discovery_resetDiscoverable Cancel current device as discoverable for zero-touch mode

TISL_discovery_uninit Uninitialize discovery services

Providers mDNS for local. scope, DNS for managed network

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Discovery Services – State ChartEvents/States Uninitialized Initialized Discovery Started

TISL_discovery_init

Initialize discovery service, Change state to Initialized

TISL_discovery_enum_providers Return all providers

TISL_discovery_init_providerInitialize provider, return provider handle

TISL_discovery_register_service_notificationRegister Notification Handler

TISL_discovery_start

Start Discovery, change state to discovery started

TISL_discovery_cancel

Cancel discovery in progress, change state to initialized

TISL_discovery_setDiscoverableAdvertise service discoverability

Advertise service discoverability

TISL_discovery_resetDiscoverable

Don’t respond to service discovery requests

Don’t respond to service discovery requests

TISL_discovery_uninit

Uninitialize service and change state to uninitialized

Uninitialize service and change state to uninitialized

Empty fields in the table mean that the event does not cause any actions or state changes.

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Connectivity Services – TCP/IP and UDP/IP v4

TCP or UDP can be used to establish communication between agent and manager

IP address and port needed for manager or agent service can be obtained using DNS or mDNS mechanism

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Connectivity Services – TISL primitivesName Description

TISL_connectivity_init Initialize connectivity services

TISL_connectivity_enum_providers Enumerate connectivity service providers

TISL_connectivity_init_provider Initialize provider

TISL_connectivity_set_notification Set connectivity notification

TISL_connectivity_set_mode Set synchronous or asynchronous mode of operation

TISL_connectivity_connect Connect to peer

TISL_connectivity_disconnect Disconnect from peer

TISL_connectivity_accept Accept connection from peer

TISL_connectivity_listen Listen for connections

TISL_connectivity_send Send data

TISL_connectivity_receive Receive data

TISL_connectivity_sendto Send datagram

TISL_connectivity_uninit Uninitialize connectivity services

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CNS Topics for further discussion

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Quality Of Service (QoS)

Reliability Latency Priority Bandwidth

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QoS Services – Requirements (11073-00101-2008)

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QoS Services – Preferred Technologies

RTP over UDP RTP provides a reliability layer over UDP

TCP/IP Guaranteed delivery

RSVP for bandwidth reservation All hops in the network have to participate

to reserve bandwidth

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Security Services IPSec

CNS will provide mechanisms to allow for secure connection

Technologies such as IPSec can be used for end to end security.

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Security Services - TISL

Name Description

TISL_security_init Initialize security services

TISL_security_enum_providers Enumerate security providers

TISL_security_set_provider Set current security provider

TISL_security_uninit Uninitialize security services

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What’s next …

Next steps:o Align with IHE DPI Discussions @ Thursdays

11:00 “AFC” Pacifico Get content to completion by 2014 January

WGMo Draft by 2014 January WGM

Questions?