HL7 Version 3 Overview
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This presentation: - Provide an overview of HL7 version 3. - Define terms and concepts used in HL7. - Describe the HL7 modeling methodology.
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HL7 Version 3 Overview
- 1. 1. PRESENTATION DETAILS 2.INTRODUCTION 3.REFERENCE INFORMATION MODEL (RIM) 4.HL7 MODELING CONVENTIONS 5.HL7 PROCESS & ARTIFACTS 6.VOCABULARY & DATA TYPES 7.INFOWAY CANADA 1 HL7 Version 3 Find Out More About Ward Technology Talent and Click Here! As part of Ward Technology Talent’s - TechTalks
- 2. Presentation Details 2 Target Audience: Developers and Analysts Prerequisites: Modeling concepts
- 3. Presentation Details: Presenters and Participants 3 Presenter: Ioan Salau ioan@salau.net Who is in attendance? Ward Technology Talent Reason for Attending
- 4. Presentation Objectives 4 Objectives of this presentation are to: Provide an overview of HL7 version 3 Define terms and concepts used in HL7 Describe the HL7 modeling methodology Infoway Canada EHRS
- 5. Introduction 5 In this section, we will: Introduce the HL7 organization and the version 3 standard Discuss the goal of HL7 HL7 Adoption in Canada
- 6. Introduction: What is HL7? 6 Heath Level Seven (HL7) is an ANSI-accredited Standards Developing Organization (SDO) operating in healthcare arena Provides standards for data exchange to allow interoperability between healthcare information systems HL7 focuses on the clinical and administrative data domains It is a not-for-profit organization made up of volunteers – providers, payers, vendors, government Key goal is syntactic and semantic interoperability
- 7. Introduction: 4 Pillars of Semantic Interoperability 7 The 4 pillars of semantic interoperability are: 1. A common Reference Information Model (RIM) spanning the entire clinical, administrative and financial healthcare universe 2. A well-defined and tool-supported process for deriving data exchange specifications ("messages") from the RIM 3. A formal and robust Data Type Specification upon which to ground the RIM 4. A formal methodology for binding concept-based terminologies to RIM attributes.
- 8. Reference Information Model (RIM) 8 In this section, we will: Discuss the modeling concepts used in HL7 Version 3 Describe the Backbone Classes of the HL7 RIM
- 9. Reference Information Model (RIM): Overview 9 Reference Information Model (RIM): Follows object oriented developmental methodology based on a UML model The fundamental model from which all v3 messages are derived is referred to as the Reference Information Model (RIM) The RIM is a generic, abstract model that expresses the information content of all the areas of healthcare Defines all the information from which the data content of HL7 messages are drawn Forms a shared view of the healthcare domain and is used across all HL7 messages independent of message structure
- 10. Reference Information Model (RIM): Backbone Classes 10 A physical thing, group of physical things or an organization capable of participating in Acts, while in a role. A physical thing, group of physical things or an organization capable of participating in Acts, while in a role. A record of something that is being done, has been done, can be done, or is intended or requested to be done. A record of something that is being done, has been done, can be done, or is intended or requested to be done. A competency of the Entity playing the Role as identified, defined, guaranteed, or acknowledged by the Entity that Scopes the Role. A competency of the Entity playing the Role as identified, defined, guaranteed, or acknowledged by the Entity that Scopes the Role. An association between an Act and a Role with an Entity playing that Role. Each Entity (in a Role) involved in an Act in a certain way is linked to the act by one Participation-instance. An association between an Act and a Role with an Entity playing that Role. Each Entity (in a Role) involved in an Act in a certain way is linked to the act by one Participation-instance. Entity Role Participation Act A connection between two roles expressing a dependency between those roles. A connection between two roles expressing a dependency between those roles. A directed association between a source act and a target act. A directed association between a source act and a target act. Role Link Act Relationship 0..1 0..n 1 0..n 0..n 1 0..1 0..n 0..n 0..n 1 1 0..n 0..n 1 1
- 11. Reference Information Model (RIM) Backbone Class: Entity 11 Entity classCode : CS determinerCode : CS id : SET<II> code : CE quantity : SET<PQ> name : BAG<EN> desc : ED statusCode : SET<CS> existenceTime : IVL<TS> telecom : BAG<TEL> riskCode : CE handlingCode : CE Entity: a person, animal, organization or thing A collection of classes related to the Entity class, its specializations and related qualifying classes. The classes represent health care stakeholders and other things of interest to health care. Entity has the following sub-classes: Container Device LanguageCommunication LivingSubject ManufacturedMaterial Material NonPersonLivingSubject Organization Person Place
- 12. Reference Information Model (RIM): Backbone Class: Role 12 Role classCode : CS id : SET<II> code : CE negationInd : BL addr : BAG<AD> telecom : BAG<TEL> statusCode : SET<CS> effectiveTime : IVL<TS> certificateText : ED quantity : RTO positionNumber : LIST<INT>... Roles: A responsibility or part played by an entity (e.g. Person in a role of patient, employee, etc.) – different faces of an Entity A collection of classes related to the Role class and its specializations. These classes focus on the roles participants may play in health care. Role has the following sub-classes: Access Employee LicensedEntity Patient
- 13. Reference Information Model (RIM): Backbone Class: RoleLink 13 RoleLink typeCode : CS effectiveTime : IVL<TS> Role 0..n outboundLink 0..n source 0..n inboundLink 0..n RoleLink: A connection between two roles expressing a dependency between those roles. RoleLink has no sub-classes.
- 14. Reference Information Model (RIM): Backbone Class: Participation 14 Participation typeCode : CS functionCode : CD contextControlCode : CS... sequenceNumber : INT negationInd : BL noteText : ED time : IVL<TS> modeCode : CE awarenessCode : CE signatureCode : CE signatureText : ED performInd : BL substitutionConditionCode : CE Participation: An association between an Act and a Role with an Entity playing that Role. Participation has the following sub-class: ManagedParticipation
- 15. Reference Information Model (RIM): Backbone Class: Act 15 Act classCode : CS moodCode : CS id : SET<II> code : CD negationInd : BL derivationExpr : ST text : ED title : ST statusCode : SET<CS> effectiveTime : GTS activityTime : GTS availabilityTime : TS priorityCode : SET<CE> confidentialityCode : SET<CE> repeatNumber : IVL<INT> interruptibleInd : BL levelCode : CE independentInd : BL uncertaintyCode : CE reasonCode : SET<CE> languageCode : CE Act: A collection of classes including the Act class and its specializations. These relate to the actions and events that constitute health care services. A record of something that is being done, has been done, can be done, or is intended or requested to be done. Act has the following sub-classes: Account ControlAct DeviceTask DiagnosticImage Diet FinancialContract FinancialTransaction InvoiceElement Observation Participation PatientEncounter Procedure PublicHealthCase SubstanceAdministration Supply WorkingList
- 16. Reference Information Model (RIM): Backbone Class: ActRelationship 16 ActRelationship typeCode : CS inversionInd : BL contextControlCode : CS contextConductionInd : BL sequenceNumber : INT priorityNumber : INT pauseQuantity : PQ checkpointCode : CS splitCode : CS joinCode : CS negationInd : BL conjunctionCode : CS localVariableName : ST seperatableInd : BL Act 0..n outboundRelationship 0..n source inboundRelationship 0..n target 1 ActRelationship: A directed association between a source Act and a target Act. A point from a later instance to a earlier instance OR point from collector instance to component instance. ActRelationship has no sub-classes. 16
- 17. Reference Information Model (RIM): The Complete RIM 17 Observation ... SubstanceAdministration routeCode :CE ... Procedure ... Supply ... Diet ... Document ... Container capacityQuantity : PQ heightQuantity :PQ diameterQuantity :PQ capTypeCode :CE ... Access approachSiteCode : CD... ... Device manufacturerModelName :SC softwareName :SC localRemoteControlStateCode :CE... ... Employee jobCode : CE jobTitleName :SC jobClassCode :CE salaryTypeCode :CE ... LivingSubject administrativeGenderCode : CE... birthTime :TS deceasedInd: BL deceasedTime : TS ... Material formCode :CE... LicensedEntity recertificationTime :TS...Place mobileInd :BL addr :AD directionsText: ED... ... ManufacturedMaterial lotNumberText:ST ... NonPersonLivingSubject ... Patient ... Organization ... Account ... Person addr :BAG<AD>... maritalStatusCode: CE... ... Wor kingList ownershipLevelCode :CE... PublicHealthCase ... PatientEncounter pr eAdmitTestInd:BL admissionReferralSourceCode : CE lengthOfStayQuantity :PQ dischargeDispositionCode :CE specialCour tesiesCode :SET<CE> ... Other Acts Infrastructure (Structureddocuments) HEALTH LEVEL 7 REFERENCE INFORMATION MODEL VERSION 1.23 (RIM_0123) Reflects changes to RIM inRIM Harmonization Meeting03/20/2003. Bi l l boar d produced by: Rochest er O ut door Adverti si ng Roles DiagnosticImage subjectOrientationCode : CE... QueryAck ... QueryContinuation ... Table summary :ST... ... TableStructure ... TableColumn Str ucture spa n : TableCell scope : CS ... LocalAttr ... LocalMarkup ... LinkHtml ... ContextStructure localId:ST Infrastructure (Structured documents) Infrastructure (Communications) Enitites Message Control FinancialTransaction ... InvoiceElement modifierCode :SET<CE>... ... FinancialContract paymentTer msCode : CE... RoleHeir EntityHeir SortControl sequenceNumber :INT... ... QuerySpec modifyCode :CS responseElementGroupId :SET<II>... responseModalityCode :CS responsePriorityCode :CS ... 0..n 1 0..n 1 RelationalExpression ... QueryBySelection SelectionExpression 0..n 1 0..n 1 LogicalExpression relationalConjunctionCode :CS... 0..n 0..1 user AsRight 0..n r ightSide 0..1 0..n 0..1 user AsLeft0..n leftSide0..1 QueryByPa rameter ParameterList Paramet er id:II 0..n 0..10..n 0..1 0..1 0..n 0..1 0..n ParameterItem ... DeviceTask parameterValue :LIST<ANY>... ManagedParticipation ... ActHeir ActRelationship typeCode :CS inversionInd: BL... contextControlCode : CS... contextConductionInd :BL... ... Act classCode : CS moodCode :CS id:SET<II> code :CD negationInd :BL derivationExpr :ST... ... 0. .n 1 inboundRelat ionship 0. .n t arget 1 0. .n1 out boundRelat ionship 0. .n source 1 Participation typeCode : CS functionCode :CD contextControlCode : CS sequenceNumber :INT negationInd :BL noteText: ED time :IVL<TS> modeCode :CE ... 0. . n 1 0. . n 1 RoleLink ... Role classCode :CS id: SET<II> code :CE negationInd:BL addr :BAG<AD> telecom : BAG<TEL> statusCode : SET<CS> ... 0. . n 1 0. . n 1 0. . n1 out boundLink 0. . n sour ce 1 0. . n1 inboundLink 0. . n t ar get 1 LanguageCommunication languageCode : CE modeCode: CE ... AttentionLine ... Batch referenceControlId: II name : SC ... Entity classCode : CS deter minerCode :CS id: SET<II> code :CE quantity :SET<PQ> name : BAG<EN> desc :ED statusCode :SET<CS> ... 0.. n0. . 1 playedRole 0.. n player 0. . 1 0. . n0. . 1 scopedRole 0. . n scoper 0. . 1 10..n 10..n Transmission id: II ... 0..n 1 0..n 1 0..1 0..n 0..1 0..n Communicatio nFunction typeCode :CS telecom :TEL 1..n 0..* 1..n 0..* 1..* 0..* 1..* 0..* InfrastructureRoot ... QueryEvent ... ControlAct ... 0..1 1 0..1 1 Message versionId: ST interactionId:II profileId :SET<II> processingCode : CS processingModeCode :CS acceptAckCode :CS applicationAckCode :CS ... 0.. 1 0. . n 0.. 1 payload 0. . n Acknowledgement ... 0. . n 1 acknowledgedBy 0. . n acknowledges 1 0. . 1 1 conveyedAcknowledgem ent 0. . 1 conveyingM essage 1 AcknowledgementDetail ... 1 0..n 1 0..n 11 11 Domain Related Infrastructure Related Structured Documents
- 18. Reference Information Model (RIM): RIM-UML Instance Scenario 18 John DoeJohn Doe PatientPatient SubjectSubject Entity Role Participation Act Dr. SmithDr. Smith HealthCare Provider HealthCare Provider Surgeon*Surgeon* John DoeJohn Doe PatientPatient SubjectSubject Has Pertinent InformationHas Pertinent Information Act Relationship (Clinical Trial Act) Protocol ECOG 1112 (Clinical Trial Act) Protocol ECOG 1112 XYZ HospitalXYZ Hospital HealthCare Facility* HealthCare Facility* LocationLocation (Procedure Act) Prostectomy (Procedure Act) Prostectomy
- 19. HL7 Version 3 Process & Artifacts 19 In this section, we will discuss: Domain Message Information Model (DMIM) Refined Message Information Model (RMIM) Hierarchal Message Definitions (HMDs) Message Type (MT)
- 20. HL7 Version 3 Process & Artifacts: Overall Process 20 RIM D-MIM R-MIM 1..* 1..* 1..*HMD MT 1..*
- 21. 21 Entry points HL7 Version 3 Process & Artifacts: Examples Arrows Color-coding Labeling Directional
- 22. Reference Information Model (RIM): HL7 Modeling Conventions 22 Color-coding – colors of classes in the model denote the type of backbone class to which it belongs Arrows – Participations, ActRelationships and RoleLinks are directional arrows that have rather than being lines that connect classes like in UML Entry points – where to start reading the model; DMIMs have one or more entry points, RMIMs have one RMIMs are directional – all associations flow out from the entry point to the remaining parts of the model Labeling – associations in RMIMs are labeled on the distal end only
- 23. HL7 Process & Artifacts: Domain Message Information Model (DMIM) 23 A DMIM is a refined subset of the RIM that includes a set of class clones, attributes and relationships that can be used to create messages for a particular domain (a particular area of interest in healthcare).
- 24. HL7 Process & Artifacts: Refined Message Information Model (RMIM) 24 The RMIM is a subset of a DMIM that is used to express the information content for a message or set of messages with annotations and refinements that are message specific.
- 25. HL7 Process & Artifacts: Hierarchal Message Definitions (HMDs) 25 A Hierarchal Message Definition (HMD) is a serialized version of the RMIM in a specific order.
- 26. HL7 Process & Artifacts: Message Type (MT) 26 The Message Type elements and attributes in an XML message instance correspond to the sequence of data in the HMD
- 27. Vocabulary & Data Types 27 In this section, we will discuss: HL7 Standard Vocabulary Structural Attributes – prescribed HL7 vocabulary Non-Structural Attributes – vocabulary chosen by organization Robust Data Types
- 28. Vocabulary & Data Types: Structural Attributes 28 Structural attributes are used to specify type and state of each RIM class and what it means when used in a message. They use a standard vocabulary defined and controlled by HL7. An Act of the Class Observation (OBS) with a Mood of Event (EVN). classCode and moodCode are both Structural Attributes
- 29. Vocabulary & Data Types : Non-Structural Attributes 29 Other attributes don’t have an assigned vocabulary Organizations can choose any industry standard vocabulary For example, commonly used ones for Observation Acts are LOINC, SNOMED, MedDRA, etc. Must specify more than just the code value, other data is needed for semantic interoperability…this is where data types come in
- 30. Vocabulary & Data Types : Data Types 30 What is a data type? lengthOfStayQuantity is attribute of the EncounterProcess class. lengthOfStayQuantity has a data type of Physical Quantity (PQ).
- 31. Vocabulary & Data Types : Data Types 31 Data types in HL7 version 3 are complex Each data type has attributes Each attribute has a data type of its own <lengthOfStayQuantity value=“10” unit=“hours"/> Physical Quantity (PQ) example The attributes ‘value’ and ‘unit’ are part of the complex data type Physical Quantity (PQ). Value is expressed as the data type of integer (int).
- 32. 32 Infoway Canada - Interoperability challenges 700 hospitals 40,000 general practitioners 315,000 nurses 29,000 specialists 26,000 pharmacists 1,600 long term care facilities Homecare Emergency Services Pharmacy Laboratory Diagnostic Hospital Emergency Specialist Clinic Community Care Centre Clinic
- 33. Access to detailed data 33 Results and images Patient information Medical alerts Medication history Interactions ImmunizationProblem list
- 34. EHR Architecture 34 JURISDICTIONAL INFOSTRUCTURE POINT OF SERVICE Terminology Repository Ancillary Data & Services Registries Data & Services EHR Data & Services Data Warehouse Immunization Management PHS Reporting Shared Health Record Drug Information Diagnostic Imaging Laboratory Health Information Hospital, LTC, CCC, EPR Physician Office EMR EHR Viewer Physician/ Provider Business Rules EHR Index Message Structures Normalization Rules Security Mgmt Data Privacy Data Configuration Physician/ Provider Physician/ Provider Lab System (LIS) Lab Clinician Radiology Center PACS/RIS Radiologist Pharmacy System Pharmacist Public Health Services Public Health Provider Longitudinal Record Services HIAL Communication Bus Common Services Client Registry Provider Registry Location Registry
- 35. EHRSEHRS EHRSEHRS EHRS EHRSEHRS EHRS In Canada Federated Databases, Peer-to-Peer, Message Based EHR SOLUTION (EHRS) EHR INFOSTRUCTURE (EHRi) EHR Viewer Point of Service Application Point of Service Application Ancillary Data & Services Health Information Data Warehouse EHR Data & Services Registries Data & Services Longitudinal Record Services HIAL EHR SOLUTION (EHRS) EHR INFOSTRUCTURE (EHRi) EHR Viewer Point of Service Application Point of Service Application Ancillary Data & Services Health Information Data Warehouse EHR Data & Services Registries Data & Services Longitudinal Record Services HIAL 35
- 36. Thank You 36
Notes de l'éditeur
- Instructor: Introduce yourself The notes provide you with additional information on slide topic.
- At the end of this training you should: Understand what HL7 is Define terms and concepts used in HL7 Read HL7 RIM based models HL7 at the NCI
- In this section, we will: Goal of HL7 4 Pillars of semantic interoperability
- The goal of HL7 is HL7 V3 is a standard for exchanging messages among information systems that implement healthcare applications. To accomplish this, HL7 uses an object-oriented development methodology and is based on a Reference Information Model (RIM) to create messages. The goal of HL7 is semantic interoperability. What Does the Name HL7 Mean "Level Seven" refers to the highest level of the International Standards Organization's (ISO) communications model for Open Systems Interconnection (OSI) - the application level. The application level addresses definition of the data to be exchanged, the timing of the interchange, and the communication of certain errors to the application. The seventh level supports such functions as security checks, participant identification, availability checks, exchange mechanism negotiations and, most importantly, data exchange structuring. How is HL7 Organized HL7 is managed by a Board of Directors, which is comprised of eight elected positions and three appointed positions. The organization is comprised of Technical Committees and Special Interest Groups that are responsible for defining the HL7 standard protocol. Each Technical Committee and Special Interest group is chaired by two or more co-chairs. Collectively, the co-chairs comprise the Technical Steering Committee, which votes on issues related to the standard. Votes of the Technical Steering Committee as passed as recommendations to the Board of Directors, who make the final decision. HL7 members are encouraged to participate in all of these committees.
- The 4 Pillars: The following slides will discuss these pillars. The Reference Information Model (RIM) The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry. It is a shared model between all the domains and as such is the model from which all domains create their messages. Explicitly representing the connections that exist between the information carried in the fields of HL7 messages, the RIM is essential to our ongoing mission of increasing precision and reducing implementation costs. Data Types Data types are the basic building blocks of attributes. They define the structural format of the data carried in the attribute and influence the set of allowable values an attribute may assume. Some data types have very little intrinsic semantic content and the semantic context for that data type is carried by its corresponding attribute. However HL7 also defines quite extensive data types such as PNMP, person Name Part, which provides all the structure and semantics to support a person name. Every attribute in the RIM is associated with one and only one data type, and each data type is associated with zero or many attributes. Data Exchange Specifications HL7 defines its messages at an abstract level. The "7" in HL7 stands for the Application level of the ISO communication model -- ISO level 7. The V3 abstract message model is based on the RIM. HL7 Version 3 messages can be thought of as the communication of graphs of RIM objects from sender to receiver. Vocabulary Within HL7, a vocabulary domain is the set of all concepts that can be taken as valid values in an instance of a coded field or attribute. For example, the Living_subject class has a coded attribute called administrative_gender_code. The administrative_gender_code attribute becomes part of an HMD, and a message instance is subsequently created as part of an implemented interface, one would expect the administrative_gender_code attribute to convey male or female. In this example, male and female are concepts and there may be several coding schemes that contain concepts for male and female.
- The Health Level Seven (HL7) Reference Information Model (RIM) is a static model of health and health care information as viewed within the scope of HL7 standards development activities. It is the combined consensus view of information from the perspective of the HL7 working group and the HL7 international affiliates. The RIM is the ultimate source from which all HL7 version 3.0 protocol specification standards draw their information-related content. What is a information model? An information model is a structured specification of the information within a specific domain of interest. It expresses the classes of information required and the properties of those classes, including attributes, relationships, constraints, and states. In HL7, the scope of a domain of interest ranges from the domain of the entire system of health services to the specific context of a set of information exchanges to meet a particular identified business purpose. HL7 defines different types of information models to represent the different contexts of interest Information Model Components The information model consists of the following components: classes, their attributes, and relationships between the classes; data types for all attributes and vocabulary domains for coded attributes; state transition models for some classes. HL7 information models are based upon the Unified Modeling Language (UML), and may be represented graphically using the UML style. UML is a modeling language that unifies the object-oriented modeling methods of Grady Booch, Jim Rumbaugh, Ivar Jacobson, and others. The UML is a rich, mainly graphical, means of expressing object-oriented concepts. To obtain more information about UML see http://www.rational.com/uml/ or the book UML Distilled by Martin Fowler (ISBN 0-201-32563-2).
- Note: RIM model is color coded based on the backbone class. The HL7 RIM The HL7 RIM is a critical component of the V3 development process. It is the root of all information models and structures. The HL7 V3 development process is a model-driven methodology. Inter-related models are developed that depict underlying semantics and business rules that govern them. The RIM provides a static view of the information needs of HL7 V3 standards. It includes class and state-machine diagrams and is accompanied by use case models, interaction models, data type models, terminology models, and other types of models. The classes, attributes, state-machines, and relationships in the RIM are used to derive domain-specific information models. The HL7 V3 standard development process defines the rules governing the derivation of domain information models from the RIM and the refinement of those. The rules require that all information structures in derived models be traceable back to the RIM and that their semantic and related business. The RIM therefore is the ultimate source for all information content in HL7 V3 standards. Examples of Subclasses of Foundation Classes: Entity - Organization - Place - Person - Living Subject - Material Role - Patient - Member - Healthcare facility - Practitioner - Practitioner assignment - Specimen - Location Participation - Author - Reviewer - Verifier - Subject - Target - Tracker - Performer Act - Referral - Transportation - Supply - Procedure - Consent - Observation - Medication - Administrative act - Financial act
- Note: classes are not the only.. The only ones show are the ones that have unique attributes Definition of Entity: A physical thing, group of physical things or an organization capable of participating in Acts, while in a role.
- Note: classes are not the only.. The only ones show are the ones that have unique attributes Definition of Role: A competency of the Entity playing the Role as identified, defined, guaranteed, or acknowledged by the Entity that scopes the Role.
- Definition of RoleLink: A connection between two roles expressing a dependency between those roles. Examples: A role of assignment or agency depends on another role of employment, such that when the employment role is terminated, the assignments would be terminated as well. This is the dependency of the assignment role with the employment role, or in other words, the assignment is "part of" the employment.
- Note: classes are not the only.. The only ones show are the ones that have unique attributes Definition of Participation: An association between an Act and a Role with an Entity playing that Role. Each Entity (in a Role) involved in an Act in a certain way is linked to the act by one Participation-instance. The kind of involvement in the Act is specified by the Participation.typeCode.
- Note: classes are not the only.. The only ones show are the ones that have unique attributes Definition of Act: A record of something that is being done, has been done, can be done, or is intended or requested to be done. Examples: The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.
- Definition of ActRelationship: A directed association between a source Act and a target Act. ActRelationship on the same source Act are called the "outbound" act relationships of that Act. ActRelationships on the same target Act are called the "inbound" relationships of that Act. The meaning and purpose of an ActRelationship is specified in the ActRelationship.typeCode attribute.
- Understanding the RIM The RIM uses a abstract modeling style. The back-bone classes of the RIM and their structural attributes are its core. An understanding of these classes and attributes are essential to understanding the RIM. Defines all the information from which the data content of HL7 messages are drawn Follows object-oriented modeling techniques, where the information is organized into classes that have attributes and that maintain associations with other classes Forms a shared view of the information domain used across all HL7 messages independent of message structure Provides a means for discovering and reconciling differences in data definition
- Notes about HL7 processes … message are derived from the RIM. Focus on the model methodology of DMIM and RMIM. People will be looking at the RMIM.
- color-coded colors denotes type of backbone class Red = Act Blue = Participation Yellow = Role Green = Entity Light red or pink = Act Relationship Light Yellow = Role Link Arrows Participations, Role_Links and Act_Relationships are arrows that are directional have attributes rather than being lines that connect classes like in UML Entry Point Each D-MIM diagram will have at least one Entry Point. Entry Points designate the class(es) from which the messages begin for the particular domain. Since the D-MIM encompasses an entire domain, there may be several Entry Points, one for each R-MIM contained in the domain. Entry Point Each D-MIM diagram will have at least one Entry Point. Entry Points designate the class(es) from which the messages begin for the particular domain. Since the D-MIM encompasses an entire domain, there may be several Entry Points, one for each R-MIM contained in the domain. RMIMs are directional All associations flow out from the entry point toward the remaining parts of the message labeling HL7 diagrams are a little different in how they label associations (only on distal end, not bi-directional) Normally in UML diagrams you have a label on both ends of an association and the association can be read both ways, but in an HL7 RMIM the association can only be read one way and thus there is only one label and it's on the distal (far) end of the association
- HL7 Modeling Conventions color-coded - colors mean type of backbone class arrows - participations and actRelationships are arrows that are directional have attributes rather than being lines that connect classes like in UML entry points - HL7 DMIMs and RMIMs have entry points (boxes with arrow pointing to a class); DMIMs can have more than one, RMIMs can only have one RMIMs are directional - all associations flow out from the entry point toward the remaining parts of the message labeling - HL7 diagrams are a little different in how they label associations (only on distal end, not bi-directional)
- Hierarchal Message Definitions (HMDs) is a serialize version of the RIM in a specific order
- The XML elements and attributes in a message instance correspond one-to-one with individual rows in the HMD. The names of the XML elements and attributes are taken from the "element name" column of the HMD.
- Structural attributes Structural attributes are used to specify more precisely what each RIM class means when used in a message. For example , Act has a class code. The class code states what sort of Act this is, such as an observation, an encounter, or the administration of a drug. Mood is analogous to the tense of a verb.
- Coded Values HL7 uses two main types of code. The first type covers the specialized codes used for structural attributes and are defined by HL7 itself. The second type covers externally defined terms and codes such as SNOMED CT (Clinical Terms). Vocabulary Vocabulary is the set of allowed values for a coded field. All attributes with a code data type will have a vocabulary assigned to them. The ‘code system’ must be identified for any coded value in a message. NameTypeDescription Code= The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache. codeSystem= Specifies the code system that defines the code. codeSystemName= A common name of the coding system. codeSystemVersion= A version descriptor defined specifically for the given code system. displayName= A name or title for the code, under which the sending system shows the code value to its users. .
- Coded Values HL7 uses two main types of code. The first type covers the specialized codes used for structural attributes and are defined by HL7 itself. The second type covers externally defined terms and codes such as SNOMED CT (Clinical Terms). Vocabulary Vocabulary is the set of allowed values for a coded field. All attributes with a code data type will have a vocabulary assigned to them. The ‘code system’ must be identified for any coded value in a message. NameTypeDescription Code= The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache. codeSystem= Specifies the code system that defines the code. codeSystemName= A common name of the coding system. codeSystemVersion= A version descriptor defined specifically for the given code system. displayName= A name or title for the code, under which the sending system shows the code value to its users. .
- Speed Real-time on read requests: response time under 2 seconds Near real-time on updates Legal Assumption - Exchanges of clinical patient information between systems will be achievable at reasonable speeds while applying consent policies as part of privacy and confidentiality rules and regulations Scalable From growth in number of source systems From growth in point-of-care usage From growth in territory coverage From growth in surveillance usage From growth in administrative usage Reliable (High Availability) Redundancy: Power, Network, Servers (Application & Database), Disks Healthy economic balance in HIS vendor industry It is possible to maintain healthy business dynamics in the HIS vendor industry while insuring the uptake of a central source of EHR data in all provinces;