By: Dr.

Abbas Shojaee February, 2010
Faculty of paramedical sciences, Beheshti University of Medical Sciences

This presentation uses works of:
1. 2. 3.

4. 5.

Tim Benson W. Ted Klein Evangelos Milios Gunther Schadow Veli BICER

  

This is an introduction and it does not go into the details of concepts and interactions. Introduces RIM in detail Does not teach how to design models Does not cover details of project issues (e.g., tools, coordination, balloting, etc.) Contains a simple practice on how to design a software architecture for imposed security needs by HL7.

BUMS, Abbas Shojaee, Feb. 2010

© 1999, 2000 Health Level 7

January 24, 2000

2

Standards in Health care informatics
◦ What is it? Why is needed?


HL7 evolution and history HL7 standard version 3.0
◦ Describe the models in Version 3 ◦ Show how they are used to develop the HL7 message specifications that make up the standard?

 

Practicing development of a standard Practicing implementation of HL7 required functionalities for Security

BUMS, Abbas Shojaee, Feb. 2010

© 1999, 2000 Health Level 7

January 24, 2000

3

and how HL7 solves it ◦ What is Version 3? ◦ Why HL7 is making the move to Version 3 • Part II . 2010 © 1999. business problem. 2000 Health Level 7 January 24.Methodology ◦ Modeling process BUMS.• Part I . Abbas Shojaee.Technical Concepts ◦ Background information • Part III .Introduction ◦ HL7. Feb. 2000 4 .

2000 Health Level 7 5 . 2000 © 1999.What is a standard in medical informatics? Why and where is it needed? What urge them? The process of standard development in Medical Informatics? January 24.

Feb. on-demand BUMS.Migration Towards a Wellness Model Managing Visit Managing Care Clinton’s Reform Managing Health Initial Fee-for-service. Abbas Shojaee. 2010 Transitional Capitated. case-based © 1999. 2000 Health Level 7 Anticipated Present time Preventive. episodal January 24. 2000 6 .

Feb. etc) Digital Dell Micron HP Enterprise Computing (Client/Server) BUMS. Internet.Client/Server. 2000 Health Level 7 January 24. 2000 7 . Multimedia Centralized Computing (Batch) Network Computing (RPC. ORBs. Abbas Shojaee. 2010 © 1999.

Abbas Shojaee. Measurement.Business Strategy & Motivation Methodology. Coordination Planning & Enforcement BUMS. 2000 8 . 2010 Modeling & Voting © 1999. 2000 Health Level 7 January 24. Feb.

2010 © 1999. 2000 Health Level 7 January 24. Abbas Shojaee. Feb. 2000 9 .Evolution and history The structure Organization and methodology BUMS.

2000 10 . Health care environment is a complex environment and a language to describe it needs to accommodate this complexity HL7 is such a language The result of an ad hoc effort to make HIS information exchangeable The HL7 organization was founded in 1987     In June 1994 HL7 was designated as an ANSI accredited standards development organization (SDO) BUMS. 2000 Health Level 7 January 24. Feb. 2010 © 1999. Abbas Shojaee.

Feb. 2000 11 .Implementation Technology Specification "Send as ASCII string in XML format" Hierarchical Message Definition "Discontinue pharmacy order" ITS for XML Data HL7 Message Creation HL7-Conformant Application Message Instance HL7 Message Parsing HL7-Conformant Application Data BUMS. 2000 Health Level 7 January 24. 2010 © 1999. Abbas Shojaee.

. delivery and evaluation of healthcare services.. utilization and adherence. Abbas Shojaee. adoption. market recognition. management and integration of data that supports clinical patient care and the management. Feb.  To provide standards for the exchange. BUMS. 2000 Health Level 7 January 24. the complete „life cycle‟ of a standards specification -. 2000 12 .development. . 2010 © 1999.

Feb. 2000 13 ISO-OSI Communication Architecture Model BUMS.A domain-specific. Function Communication 7 6 5 4 3 2 1 Application Presentation Session Transport Network Data Link Physical © 1999. common protocol for the exchange of health care information. Abbas Shojaee. 2010 . 2000 Health Level 7 January 24.

2010 © 1999. 2000 Health Level 7 January 24. Abbas Shojaee.4 (2000) 3.3.0 Prototype First standard Widely Adopted In operation Current ANSI standard In Ballot BUMS.0 (1988) 2. Feb. 2000 14 .3 (1997) 2.1 (1999) 2.2 (1994) 2.       2.1 (1990) 2.

Abbas Shojaee. 2010 . etc. verbs.). specifically. the basic building blocks of the language (nouns. Feb. their permitted relationships. It is not a model of any message. and Data Types. either.    The HL7 RIM (Reference Information Model) specifies the grammar of V3 messages and. Although it is healthcare-specific and it is used in messages. BUMS. The RIM is not a model of health care.

.1 code : CD 0. 2010 16 ..1 availabilityTime : TS birthTime : TS quantity : RTO source performInd : BL riskCode : CE ControlAct deceasedInd : BL scoper positionNumber : LIST<INT> .n FinancialContract ownershipLevelCode : CE independentInd : BL 0......n noteText : ED seperatableInd : BL text : ED addr : BAG<AD> time : IVL<TS> name : BAG<EN> inboundRelationship 0....n certificateText : ED activityTime : GTS 1 administrativeGenderCode : CE telecom : BAG<TEL> signatureText : ED 0. determinerCode : CS negationInd : BL 0.Organization addr : BAG<AD> standardIndustryClassCode : CE Place mobileInd : BL addr : AD directionsText : ED positionText : ED gpsText : ST Patient confidentialityCode : CE veryImportantPersonCode : CE ManagedParticipation ActRelationship typeCode : CS id : SET<II> inversionInd : BL outboundRelationship statusCode : SET<CS> contextControlCode : CS Access LicensedEntity 0...n title : ST telecom : BAG<TEL> desc : ED modeCode : CE statusCode : SET<CS> statusCode : SET<CS> statusCode : SET<CS> awarenessCode : CE target scopedRole LivingSubject effectiveTime : GTS effectiveTime : IVL<TS> signatureCode : CE existenceTime : IVL<TS>.....2003 BUMS..PQ> unitPriceAmt : RTO<MO...n conjunctionCode : CS 1 negationInd : BL religiousAffiliationCode : CE code : CE code : CE playedRole negationInd : BL localVariableName : ST 1 derivationExpr : ST ethnicGroupCode : SET<CE> negationInd : BL quantity : SET<PQ> 0.PQ> allowedBalanceQuantity : IVL<MO> FinancialTransaction DeviceTask parameterValue : LIST<ANY> amt : MO creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL RIM 2..PQ> netAmt : MO factorNumber : REAL pointsNumber : REAL Device manufacturerModelName : SC softwareName : SC Container localRemoteControlStateCode. deceasedTime : TS 1 target repeatNumber : IVL<INT> multipleBirthInd : BL 1 interruptibleInd : BL multipleBirthOrderNumber : INT WorkingList levelCode : CE organDonorInd : BL Employee outboundLink 0. : CE capacityQuantity : PQ alertLevelCode : CE heightQuantity : PQ lastCalibrationTime : TS diameterQuantity : PQ capTypeCode : CE separatorTypeCode : CE barrierDeltaQuantity : PQ bottomDeltaQuantity : PQ DiagnosticImage subjectOrientationCode : CE PatientEncounter preAdmitTestInd : BL admissionReferralSourceCode : CE lengthOfStayQuantity : PQ dischargeDispositionCode : CE specialCourtesiesCode : SET<CE> specialAccommodationCode : SET<CE> acuityLevelCode : CE PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE Diet energyQuantity : PQ carbohydrateQuantity : PQ Supply quantity : PQ expectedUseTime : IVL<TS> Account name : ST balanceAmt : MO currencyCode : CE interestRateQuantity : RTO<MO.n jobCode : CE RoleLink paymentTermsCode : CE uncertaintyCode : CE jobTitleName : SC Material inboundLink typeCode : CS reasonCode : SET<CE> NonPersonLivingSubject jobClassCode : CE effectiveTime : IVL<TS> .n livingArrangementCode : CE id : SET<II> sequenceNumber : INT id : SET<II> 0.. 0. Feb.n LanguageCommunication languageCode : CE modeCode : CE proficiencyLevelCode : CE preferenceInd : BL salaryQuantity : MO hazardExposureText : ED protectiveEquipmentText : ED InvoiceElement SubstanceAdministration routeCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> maxDoseQuantity : SET<RTO> Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> Procedure methodCode : SET<CE> approachSiteCode : SET<CD> targetSiteCode : SET<CD> modifierCode : SET<CE> unitQuantity : RTO<PQ.. Abbas Shojaee...01 July 17. formCode : CE languageCode : CE strainText : ED salaryTypeCode : CE genderStatusCode : CE ManufacturedMaterial lotNumberText : ST expirationTime : IVL<TS> stabilityTime : IVL<TS> 0..n contextConductionInd : BL approachSiteCode : CD sequenceNumber : INT recertificationTime : TS Person targetSiteCode : CD 1 source priorityNumber : INT gaugeQuantity : PQ addr : BAG<AD> pauseQuantity : PQ Act Participation maritalStatusCode : CE checkpointCode : CS classCode : CS educationLevelCode : CE Entity typeCode : CS splitCode : CS Role moodCode : CS raceCode : SET<CE> classCode : CS functionCode : CD player joinCode : CS id : SET<II> disabilityCode : SET<CE> classCode : CS contextControlCode : CS . 1 substitutionConditionCode . : CE priorityCode : SET<CE> handlingCode : CE confidentialityCode : SET<CE>.

2010 17 . Explicitly representing the connections that exist between the information carried in the fields of HL7 messages BUMS.    Large pictorial representation of the clinical data (domains) Identifies the life cycle of events that a message or groups of related messages will carry. Abbas Shojaee. Shared model between all the domains and as such is the model from which all domains create their messages. Feb.

called Refined Message Information Model (RMIM) to display the structure of a message as a colorcoded diagram. Abbas Shojaee. Feb. 2010 18 .     Each class has a predefined set of attributes HL7 V3 uses a graphical representation. Specifies the grammar of HL7 messages The RIM backbone has just three core classes and a number of permitted relationships between them. ◦ specializations are only shown explicitly in the RIM when they add additional attributes to the general class BUMS. Specialization ◦ the basic building blocks of the language ◦ their permitted relationships.

...1 code : CD 0..n id : SET<II> sequenceNumber : INT 0. 0.....n independentInd : BL 0...n title : ST telecom : BAG<TEL> desc : ED modeCode : CE statusCode : SET<CS> statusCode : SET<CS> statusCode : SET<CS> awarenessCode : CE target scopedRole effectiveTime : GTS effectiveTime : IVL<TS> signatureCode : CE existenceTime : IVL<TS> .ActRelationship typeCode : CS inversionInd : BL outboundRelationship contextControlCode : CS 0.n RoleLink uncertaintyCode : CE inboundLink typeCode : CS reasonCode : SET<CE> effectiveTime : IVL<TS> .. languageCode : CE BUMS.n certificateText : ED activityTime : GTS 1 telecom : BAG<TEL> signatureText : ED 0.. determinerCode : CS negationInd : BL 0. 1 substitutionConditionCode .. 2010 19 . : CE priorityCode : SET<CE> handlingCode : CE confidentialityCode : SET<CE> 1 target repeatNumber : IVL<INT> interruptibleInd : BL levelCode : CE outboundLink 0...n id : SET<II> conjunctionCode : CS 1 negationInd : BL code : CE playedRole code : CE negationInd : BL localVariableName : ST 1 derivationExpr : ST negationInd : BL quantity : SET<PQ> 0.. Feb.. Abbas Shojaee.1 availabilityTime : TS quantity : RTO source performInd : BL riskCode : CE scoper positionNumber : LIST<INT> ...n contextConductionInd : BL sequenceNumber : INT 1 source priorityNumber : INT pauseQuantity : PQ Act Participation checkpointCode : CS classCode : CS Entity typeCode : CS splitCode : CS Role moodCode : CS classCode : CS functionCode : CD player joinCode : CS id : SET<II> classCode : CS contextControlCode : CS ..n noteText : ED seperatableInd : BL text : ED addr : BAG<AD> time : IVL<TS> name : BAG<EN> inboundRelationship 0.

Act. BUMS.g. Feb.     The RIM defines a set pre-defined Attributes for each class These are the only ones allowed in HL7 messages. 2010 20 .id Each attribute has a specified Data Type. Abbas Shojaee. These Attributes and Data Types become tags in HL7 XML messages. Denoting attributes? E.

persons.   One common data type is the Instance Identifier (e. Feb.g. things and information objects. organizations. Abbas Shojaee. The datatype for id is II(instance identifier) II: ◦ Object Identifier (OID) ◦ Universal Unique Identifier (UUID) BUMS. id). 2010 21 . which is used to give unique identity to people.

Abbas Shojaee. 2010 22 . Feb. The second type covers externally defined terms and codes such as SNOMED CT (Clinical Terms). ClassCode to identify the type of Act ◦ ◦  Code to further identify a classcode ◦ to specify precisely what the class means at a leaf level of granularity. ◦ HL7 uses two main types of code. An structural attribute Obligatory BUMS. 2. 1. The first type covers the specialized codes used for structural attributes and are defined by HL7 itself.

Used to specify more precisely what each RIM class means when used in a message. For example, Act has a class code and a mood 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. Mood code indicates whether an Act has happened (an event), or is a request for something to happen, or a goal or even a criterion. ◦ "weight = 100kg" is an observation event; ◦ "measure weight daily" is a request; ◦ "reduce weight to 80Kg" is a goal ◦ "if weight is greater than 80Kg" is a criterion.

For example,

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Every happening is an Act, analogous to a verb in English. Each Act may have any number of Participations, in Roles, played by Entities. These are analogous to nouns. Act
◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Kind of act (what happens) Actor (who performs) Subject whom is affected (e.g. patient) Where (location) When (time) How (manner) Why (Reasons ) What for (motives)

Each Act may also be related to other Acts, via ActRelationships.

BUMS, Abbas Shojaee, Feb. 2010

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Acts.classCode specifies the type
of act.
◦ Event ◦ Observation ◦ Notification

Times Lets discuss act specializations
◦ Observation, Procedure, Substance Administration, Supply, and ◦ ActivityTime ◦ EffectivityTime

Acts.modeCode specifies the
tense of act:
◦ ◦ ◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦

Acts.StatusCode
New Active Completed Canceled Aborted

Fact (indicative mood) =EVN Command (imperative mood) = RQO Question (interrogative mood) Wish (optative mood) Conditionality (Subjunctive mood) Promise = PRMS Proposal = PRP

PatientEncounter.

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Abbas Shojaee. Feb. 2010 .BUMS.

determinerCode identifies the type of representation    Either plays a Role or defines the scope for a Role Every Role is played just by a single Entity Some attributes of an Entity. These include id. ◦ Entity. Feb. addr (address). which has or will have existence. name. statusCode. telecom.classCode identifies the represented concept. 2010 . ◦ Living ◦ Non living ◦ Abstract  Structural attributes  Individual instance  Collection  Generic class ◦ Entity. Abbas Shojaee. code. are also found in the Role class. and quantity ◦ What is the rule. Entity is anything. how can I choose using Entity and Role overlapping attributes? BUMS.

Abbas Shojaee. Feb. 2010 . Living subject ◦ Person ◦ NonPersonLivingSubject    Material Places Organization BUMS.

2010 . Feb.BUMS. Abbas Shojaee.

instrument. or employee ◦ Places. such as care provider. such as hospital. such as drug. or place of birth ◦ Organizations. such as parent. 2010 . or manufacturer BUMS. employer. clinic. or computer system ◦ Responsible entities. Feb. home. such as patient. practitioner. employer. ◦ Things. Abbas Shojaee. or supplier  The most important Role specialization is Patient. Role is defined as a competency of an Entity playing the Role Samples: ◦ Whar are Roles for people ◦ What are Roles for inanimate objects  ◦ People.

Feb.BUMS. 2010 . Abbas Shojaee.

  Are used to constrain and verify conformance to profiled HL7 Version 3 Refined Message Information Models (RMIMs). 2010 32 . Feb. Expresses the data content needed in a specific clinical or administrative context BUMS. Abbas Shojaee.

from a Source Act to a Target Act ◦ ActRelationship . Abbas Shojaee. Feb. BUMS. 2010 .  Explicit connection between core classes are needed ActRelationship: ◦ To link Acts together.typeCode to specify the type of association      Composition comprises entries Discharge summary documents a hospital visit Test report fulfills a test request Discharge summary refers to a referral Final report replaces a preliminary report  Role Link: ◦ Role Link is a relationship between two Roles.

practitioners) Subject of act. (e. a surgen) ◦ Participation.typeCode specifies the type of association between an Act and each participating Role     Performer of act (surgeons. informant. 2010 . functions during the scope of an Act ◦ Participants (entities) perform in an act as either actor (active) or target (passive) ◦ A participant in particular role. Feb. Abbas Shojaee. addressee. observers. such as the patient Location of act Author. in a particular Role. can contribute to an act in many ways.g. or information recipient BUMS. Participation: ◦ It shows how an Entity.

  Classification: ordered system of concepts related to a domain Clinical terminology: terminology needed to record all important aspects of health care in standardized form BUMS. Feb. 2010 35 . Abbas Shojaee.

1] conjunctionCode: CS CNE [0.1] negationInd: BL [0.... Feb..* playedRole performInd: BL [0.1] pauseQuantity: PQ [0..*] noteText: ED [0.1] interruptibleInd: BL [0.*] <= Confidentiality repeatNumber: IVL<INT> [0.1] <= EntityCode quantity: SET<PQ> [0.1] <= ParticipationFunction id: SET<II> [0.1] 0......*] name: BAG<EN> [0..*] <= ActReason languageCode: CE CWE [0..1] levelCode: CE CWE [0...*] <= EntityStatus existenceTime: IVL<TS> [0...1] <= RelationshipConjunction localVariableName: ST [0..*participant scopedRole / participation Role type Code *: <= ParticipationType classCode *: <= ROL functionCode: CD CWE [0.1] <= ActContextLevel independentInd: BL [0..1] <= RoleCode sequenceNumber: INT [0.1] <= EntityRisk handlingCode: CE CWE [0. 2010 11/10/2002 36 ..*] desc: ED [0......1] <= ActRelationshipJoin negationInd: BL [0..1] contextControlCode: CS CNE [0...1] <= ActRelationshipCheckpoint splitCode: CS CNE [0.1] statusCode: SET<CS> CNE [0..1] <= ContextControl contextConductionInd: BL [0.1] 0..QTY> [0... Abbas Shojaee.1] text: ED [0....1] <= TargetAwareness certificateText: ED [0..* source 0.*] <= ActStatus effectiveTime: GTS [0.1] <= ContextControl code: CE CWE [0...*] contextControlCode: CS CNE [0.1] negationInd: BL [0.*] <= ActPriority confidentialityCode: SET<CE> CWE [0.1] signatureText: ED [0....* participant 0.1] availabilityTime: TS [0....1] <= ActRelationshipSplit joinCode: CS CNE [0...1] awarenessCode: CE CWE [0.1] <= HumanLanguage Entity classCode *: <= ENT de te r m ine r Code *: <= INSTANCE id: SET<II> [0.1] <= ActUncertainty reasonCode: SET<CE> CWE [0..*] code: CE CWE [0.1] <= ParticipationMode effectiveTime: IVL<TS> [0.* act 0..1] <= ParticipationSignature quantity: RTO<QTY.....1] signatureCode: CE CNE [0..1] checkpointCode: CS CNE [0.1] sequenceNumber: INT [0.1] statusCode: SET<CS> CNE [0....1] addr: BAG<AD> [0....1 playingEntity 0.*] <= RoleStatus modeCode: CE CWE [0.1] seperatableInd: BL [0.1] statusCode: SET<CS> CNE [0.1] positionNumber: LIST<INT> [0.*] time: IVL<TS> [0..1] telecom: BAG<TEL> [0...1] priorityNumber: INT [0.1] telecom: BAG<TEL> [0...Entity Act 0..1] uncertaintyCode: CE CNE [0.1] <= ActCode negationInd: BL [0...* target Act BUMS.1] <= EntityHandling sourceOf / targetOf type Code *: <= ActRelationshipType inversionInd: BL [0.1] activityTime: GTS [0.*] code: CD CWE [0...*] 0..1] priorityCode: SET<CE> CWE [0.1 scopingEntity classCode *: <= ACT m oodCode *: <= EVN id: SET<II> [0.*] riskCode: CE CWE [0..1] derivationExpr: ST [0.

...1] <= RoleCode type Code *: <= SBJ addr: BAG<AD> [0.1] <= Ob servationType statusCode: CS CNE [1.*] <= Race ethnicGroupCode: SET<CE> CWE [0..*] <= Ethnicity ObservationEvent classCode *: <= OBS m oodCode *: <= EVN id*: II [1..*] telecom: BAG<TEL> [0.*] statusCode: SET<CS> CNE [0..1 researchSponsor ObservationEvent ResearchSubject 0.....1] code*: CD CWE [1.*] code: CE CWE [0.1] <= completed effectiveTime*: IVL<TS> [0..* subjectOf classCode *: <= OBS m oodCode *: <= EVN id*: II [1....1] <= EducationLevel disabilityCode: SET<CE> CWE [0.*] <= Confidentiality component type Code *: <= C OMP 0.1] 0.*] subject code: CE CWE [0. Feb. 2010 37 . Abbas Shojaee..1] maritalStatusCode: CE CWE [0.* observationEvent 0.1] <= EntityCode name: BAG<EN> [0..1] <= ReligiousAffiliation raceCode: SET<CE> CWE [0...1] statusCode*: CS CNE [1..1] <= EntityHandling administrativeGenderCode: CE CWE [0.1] confidentialityCode: SET<CE> CWE [0....1] <= Ob servationType text: ED [0....1] <= MaritalStatus educationLevelCode: CE CWE [0..1 subjectPerson Person classCode *: <= PSN de te r m ine r Code *: <= INSTANCE id: SET<II> [0....1] <= OrganizationIndustryClass 0.* sponsoredSubject classCode *: <= RESBJ 0...1] code*: CD CWE [1..1] confidentialityCode: SET<CE> CWE [0.Organization classCode *: <= OR G de te r m ine r Code *: <= INSTANCE name: BAG<EN> [0.1] <= EntityRisk handlingCode: CE CWE [0...1] <= completed effectiveTime*: IVL<TS> [1.*] <= Confidentiality BUMS..*] <= RoleStatus effectiveTime: IVL<TS> [0.*] <= PersonDisab ilityType livingArrangementCode: CE CWE [0.*] riskCode: CE CWE [0.1] deceasedTime: TS [0..1] <= LivingArrangement religiousAffiliationCode: CE CWE [0..* researchSubject id: SET<II> [0...*] standardIndustryClassCode: CE CWE [0..1] <= AdministrativeGender birthTime: TS [0.

Feb. Abbas Shojaee.BUMS. 2010 .

attributes. scenarios. use cases.  A model is a collection of subject areas. and a message design model. classes. that depict the information needed to specify HL7 Version3 messages. interactions. Feb. 2010 . BUMS. an interaction model. an information model. Abbas Shojaee. etc. actors. trigger events.a use case model. HL7 models are further divided into four specific models .

Feb. Abbas Shojaee. Decomposition ◦ Divide-and-conquer  Abstraction ◦ Chunking the information  Hierarchy ◦ Increasing semantic content of individual chunks of information through reuse BUMS. 2010 40 .

2010 . Abbas Shojaee. Feb.• Captures healthcare requirements Use Case Model • Defines scope for TSC approval • Specifies data and its semantics Information Model • Specifies major state transitions • Specifies vocabulary for domains • Defines information flows Interaction Model • Defines communication roles • Forms basis for conformance claims 2-nd Order 1 choice of 0-n Drug 0-1 Nursing • Defines message contents Message Specification • Apply constraints to the information model and vocabulary 41 BUMS.

2010 HL7 Models . Feb.BUMS. Abbas Shojaee.

2010 Use Case Model . Feb.BUMS. Abbas Shojaee.

BUMS. Describes specific situations in which communication between healthcare entities is needed. Feb. 2010 . Abbas Shojaee.

2010 Information Model . Feb. Abbas Shojaee.BUMS.

Feb. ◦ Documented in the Reference Information Model. Classes. and the Message Information Model BUMS. Attributes. Abbas Shojaee. Data Types and Constraints. and Relationships   State Transition Models for certain selected classes. 2010 . the Domain Information Model.  A detailed and precise definition for the information from which all data content of HL7 messages are drawn.

2010 . Provides a static view of the information. HL7 development methodology calls for creation of small subset of the RIM .    Root of all information models. Abbas Shojaee. Feb. A HL7-wide common reference model that is result of the combined consensus view of information and integrates all Technical Committees‟ domain views.called Domain specific Information Model or DIM and incremental refining to achieve Problem-area-specific design models BUMS.

Abbas Shojaee. Foundation Classes ◦ Acts ◦ Entities ◦ Roles  Communication Infrastructure ◦ Core Infrastructure ◦ Message Communications Control ◦ Structured Documents BUMS. 2010 . Feb.

Feb. 2010 Interaction Model .BUMS. Abbas Shojaee.

  Specifies all Trigger Events and Message Flows. Abbas Shojaee. BUMS. 2010 . Feb. Specifies the Application Roles.

message is sent  Receiver responsibility BUMS. ◦ Message ID  Each interaction sends one particular message ◦ Sender role ◦ Receiver role  When trigger event detected. Feb. Each Interaction consists of: ◦ Trigger event  Initiators of Interactions. Abbas Shojaee. 2010 .

Feb. 4: admit_patient Interactio n BUMS.Encounter_manager : AR_Encounter_ Encounter_tracker : AR_Encounter_ Encounter_archivist : AR_Encounter_ 1: schedule_encounter Application Role 2: delete_scheduled_encounter identifies an information management responsibility for one of the subject classes. 3: admit_patient Responsibilities typically are: Creator. Manager. 2010 5: admit_patient Healthcare applications are assumed to take on one or more application roles. . Tracker and Archivist. Abbas Shojaee.

Feb.Interaction ID Interaction Name Trigger Event Name Event Dependency PA231 Send Registration to Trackers Patient Registers for Encounter Account must be in the unregistered or pregistered state A01 Encounter Manager Encounter Tracker PA232 Send Registration to Archivists Patient Registers for Encounter Account must be in the unregistered or pregistered state A02 Encounter Manager Encounter Archivist Message ID Sender Receiver Receiver Responsibility BUMS. 2010 . Abbas Shojaee.

BUMS. Abbas Shojaee. 2010 Message Model . Feb.

* has Patient_admission estimated_days_qty is_for admission_dttm Person_name_for_Patient Patient_billing_account admission_reason_cd 1 nm : PN admission_referral_cd id : TII is_preceded_by effective_dt : TS admission_source_cd 1 s tatus_cd : CV 0..* has_a_primary_provider expected_insurance_plan_qty : NM 1 deceased_dttm : TS 1 first_similar_illness_dttm Patient education_level_cd : CV 1.... 2010 ...1 is_the_primary_provider_for start_dttm birth_dttm : TS involves end_dttm birthplace_addr : ST 0.Domain Information Model Reference Information Model Person_name_for_IHCP 1 Person_as_IHCP cd : CV has purpose_cd : CV phon : TIL 1 type_cd : CV nm : PN is_for takes_on_role_of 1 is_participant_for 0.1 cd : CV admission_type_cd billing_s tatus_cd : CV preceded purpose_cd : CV pre_admit_test_ind patient_financial_class_cd : CV belongs_to termination_dt : TS readmission_ind price_schedule_id : TII type_cd : CV Use Case Model Hierarchical Message Interaction Model Description Message Information Model BUMS.1 id : TII gender_cd : CV takes_on_role_of has 1 s tatus_cd : CV marital_s tatus_cd : CV 1..* Exactly one occurrence 1 participates_as has_as_participant 1 1 Individual_healthcare_practitioner Patient_encounter is_a_role_of id : TII id : TII s tatus_cd : CV encounter_classification_cd : CV Person_as_Patient 0. Feb.. Abbas Shojaee.1 newborn_baby_ind race_cd : CV is_involved_in is_a_role_of multiple_birth_ind religious_affiliation_cd : CV Inpatient_encounter organ_donor_ind phon : TIL 1 actual_days_qty 1.* Encounter_practitioner is_associated_with participation_type_cd 1.

2010 . Feb. Abbas Shojaee. The RIM must first be refined by subsetting and constraining it ◦ Create a MIM with RIM classes needed ◦ Develop an R-MIM from these classes   Collection of classes with some constraints Collection of attributes and associations to support the R-MIM BUMS.

.* is_for 1 has Stakeholder addr credit_rating_cd email_address_txt phon type_cd real_id : SET<RWII> id : SET<II> participates_as_primary_in 0..1 has_as_secondary_participant marital_status_cd military_branch_of_service_cd 0....1 proposes 1.1 Person Organization 0..* participates_as_secondary_in 1 has_as_secondary_participant Stakeholder_affiliation affiliation_type_cd desc effective_dt termination_dt has_as_a_subdivision 0.1 status_cd Person Organization 0.* is_for military_rank_nm military_status_cd nationality_cd race_cd religious_affiliation_cd has_as_a_subdivision 1..1 1..* affiliation_type_cd : CD type_cd : CD language_cd id : SET<II> 1.1 has_as_primary_participant Stakeholder_affiliation addr : ST nm : ST administrative_gender_cd participates_as_secondary_in email_address_txt : TEL 0.* is_a_subdivision_of organization_name_type_cd organization_nm standard_industry_class_cd Fewer attributes BUMS...1 living_arrangement_cd has_as_role sponsors living_dependency_cd multiple_birth_ind Shojaee.1 student_cd has very_important_person_cd 0...* is_role_of organ_donor_ind RIM content MIM content (a proper subset of the RIM) .* ambulatory_status_cd organization_nm : ST id education_level_cd : CD is_a_subdivision_of hispanic_ind birth_order_nbr 1..* has_as_primary_participant 1 0... Feb...Person_name effective_dt cd nm purpose_cd termination_dt type_cd 0.* participates_as_primary_in education_level_cd Stakeholder Person_name ethnic_group_cd 1. 20100. Abbas birth_dttm birthplace_addr citizenship_country_cd confidentiality_constraint_cd deceased_dttm deceased_ind disability_cd 0.

  Constrain cardinality on Associations Constraints on Attributes   Classes are duplicated for different uses May modify the Inheritance structure ◦ Some specializations may subsume the generalization ◦ Always inherit downwards to specializations ◦ Some may be left out ◦ Sub-components may be individually constrained BUMS. 2010 . Abbas Shojaee. Feb.

.1 Organization 0..* sponsored_by Individual_representative dues_current_ind : BL Organizational_representative cast_by BUMS.* comments_txt : ST dttm : TS vote_cd : CV votes_on 0.1 1...* participates_as_primary_in Stakeholder 1..* is_role_of Voting_member draft_level_voting_ind : BL 1.1 has_as_secondary_participant 1.* MIM ... Feb.* organization_nm : ST is_a_subdivision_of 1....1 has Person education_level_cd : CD 1... 2010 Ballot 0..* is_for 0.1 has_as_role 0.1 receives_votes 0.Person_name nm : ST type_cd : CD 0.* affiliation_type_cd : CD id : SET<II> 1.* 1... Abbas Shojaee.1 standard_level_voting_ind : BL casts sponsors has_as_a_subdivision 0....1 has_as_primary_participant Stakeholder_affiliation addr : ST email_address_txt : TEL participates_as_secondary_in 0.1 proposes Proposed_item ballot_period_tmr : IVL<TS> proposed_by content_txt : ED standard_level_ind : BL 0.

1 Person_as_Voter education_level_cd : CD email_address_txt : TEL 1.* participates_as_secondary_in has_as_primary_participant Stakeholder_affiliation affiliation_type_cd : CD 1..1 0.* 0.1 has 1... Feb...Person_name is_for nm : ST type_cd : CD 0. 2010 votes_on Ballot 0.1 1..1 Organization_as_Committee organization_nm : ST 1.* comments_txt : ST dttm : TS vote_cd : CV RMIM ..1 standard_level_voting_ind : BL casts proposes proposed_by Organization_as_HL7_member organization_nm : ST email_address_txt : TEL sponsors 0....1 Person_as_Committee_contact email_address_txt : TEL participates_as_primary_in has_as_a_subdivision 0..1 0..* sponsored_by Organizational_representative cast_by BUMS..* has_as_secondary_participant 0. Abbas Shojaee.* Proposed_item ballot_period_tmr : IVL<TS> content_txt : ED standard_level_ind : BL 1...1 receives_votes Individual_representative dues_current_ind : BL 0.* 0.1 is_for 0.* Voting_member draft_level_voting_ind : BL 1....* is_a_subdivision_of has 1..1 has_as_role is_role_of 0..

..* 0.....1 1. Feb..* comments_txt : ST dttm : TS vote_cd : CV 0 .. 2010 votes_on Ballot 0.* 2a 2 is_a_subdivision_of proposes proposed_by Organization_as_HL7_member organization_nm : ST email_address_txt : TEL sponsors 0. Abbas Shojaee..1 5 has_as_secondary_participant 0..* Voting_member draft_level_voting_ind : BL 1.* 1.* 0.1 receives_votes Individual_representative dues_current_ind : BL 0..1 standard_level_voting_ind : BL casts participates_as_primary_in has_as_a_subdivision 0.....1 Person_as_Committee_contact email_address_txt : TEL 4 has 1.1 has 1...1 0.Person_name is_for nm : ST type_cd : CD 0.1 Person_as_Voter education_level_cd : CD email_address_txt : TEL 1.* participates_as_secondary_in has_as_primary_participant Stakeholder_affiliation affiliation_type_cd : CD 3 is_for 0.1 has_as_role is_role_of 0.* Proposed_item ballot_period_tmr : IVL<TS> content_txt : ED standard_level_ind : BL 1 1..* sponsored_by Organizational_representative cast_by BUMS...1 0.1 Organization_as_Committee organization_nm : ST 1.

Feb. Abbas Shojaee.BUMS. 2010 .

Feb. 2010 .BUMS. Abbas Shojaee.

Abbas Shojaee.  A method of encoding and sending HL7 messages. Feb. XML represents one of several ITS to be developed BUMS. 2010 .

30-5. Abbas Shojaee. Feb.MSH|^~###BOT_TEXT###amp;|LABGL1||DMCRES||199812300100||ORU^R01|LABGL1199510221838581|P|2.3 |||NE|NE PID|||6910828^Y^C8||Newman^Alfred^E||19720812|M||W|25 Centscheap Ave^^ Whatmeworry^UT^85201^^P||(555)777-6666|(444)677-7777||M||773789090 OBR||110801^LABGL|387209373^DMCRES|18768-2^CELL COUNTS+DIFFERENTIAL TESTS (COMPOSITE)^LN|||199812292128||35^ML|||||||IN2973^Schadow^Gunther^^^^MD^UPIN ||||||||||^Once||||||CA20837^Spinosa^John^^^^MD^UPIN OBX||NM|4544-3^HEMATOCRIT (AUTOMATED)^LN||45||39-49 ||||F|||199812292128||CA20837 OBX||NM|789-8^ERYTHROCYTES COUNT (AUTOMATED)^LN||4. 2010 .90||||F|||199812292128||CA20837 BUMS.94|10*12/mm3 |4.

Feb.16.1.1" codeSystemName="LOINC" … /> <statusCode code="completed" /> <effectiveTime value="20030506230256" /> <confidentialityCode code="N" /> <component> <documentBody> <component> <documentSectionEvent> <code code="10164-2" codeSystem="2.16.1.113883.113883. BUMS.113883.368.<ClinicalDocument xmlns:xsi="http://www.w3.6.1" codeSystemName="LOINC" … /> <text /> </documentSectionEvent> </component> <component> <documentSectionEvent> <code code="11384-5" codeSystem="2..840.16.org/2001/XMLSchema-instance" …> <id root="" /> <code code="11488-4" codeSystem="2.16.1.840. 2010 .840.9876.6. Abbas Shojaee.840.1.113883.1" codeSystemName="LOINC" … /> <text /> <component> <observation> <id root="2.2" … /> ….6.

3” extension=“A1234”/> <code code=“..4.6.113883.1.6.1.<act classCode=“ACT” moodCode=“…”> <id root=“1.1.1..12009.</name> </scopingEntity> </participant> </participant> <sourceOf typeCode=“REL”> <target classCode=“ACT”> <id root=“1.840.6.4.4” extension=“1234567-8”/> <code code=“…” codeSystem=“2...1”/> <participant typeCode=“…”> <participant classCode=“ROL”> <id root=“1.21”/> <playingEntity classCode=“ENT”> <name>. Abbas Shojaee.1.1.6.. Feb.6.3.4.1.12009.3.</name> </playingEntity> <scopingEntity classCode=“ENT”> <name>.113883.” codeSystem=“2. 2010 67 .12009..3.16.1.840.16.3” extension=“A1235”/> </target> </sourceOf> </act> BUMS.

*] standardIndustryClassCode: CE CWE [0...1] <= AdministrativeGender birthTime: TS [0.1] <= ReligiousAffiliation raceCode: SET<CE> CWE [0.*] <= Ethnicity ObservationEvent classCode *: <= OBS m oodCode *: <= EVN id*: II [1. Feb.*] <= Confidentiality classCode *: <= PAT 0...1] <= OrganizationIndustryClass 0.. Abbas Shojaee. 2010 68 .* observationEvent Person classCode *: <= PSN de te r m ine r Code *: <= INSTANCE id: SET<II> [0...*] <= PersonDisab ilityType livingArrangementCode: CE CWE [0.*] riskCode: CE CWE [0....Organization classCode *: <= OR G de te r m ine r Code *: <= INSTANCE name: BAG<EN> [0..* patient ObservationEvent classCode *: <= OBS m oodCode *: <= EVN id*: II [1..1] code*: CD CWE [1..1] <= completed effectiveTime*: IVL<TS> [1.1] <= Confidentiality veryImportantPersonCode: CE CWE [0.....* healthCareProvider 0.1] <= TargetAwareness statusCode: SET<CS> CNE [0.*] <= Race ethnicGroupCode: SET<CE> CWE [0.*] subject code: CE CWE [0.....1] confidentialityCode: SET<CE> CWE [0.*] awarenessCode: CE CWE [0.1] code*: CD CWE [1.1] <= PatientImportance 0.1] <= MaritalStatus educationLevelCode: CE CWE [0.1] confidentialityCode: SET<CE> CWE [0...* patient id: SET<II> [0.1] <= Ob servationType statusCode: CS CNE [1.1] <= LivingArrangement religiousAffiliationCode: CE CWE [0..1] <= Ob servationType text: ED [0.1] confidentialityCode: CE CWE [0..1 providerOrganization Patient 0...1] maritalStatusCode: CE CWE [0.1] <= EntityHandling administrativeGenderCode: CE CWE [0..*] <= RoleStatus effectiveTime: IVL<TS> [0........1] <= EntityCode name: BAG<EN> [0.*] <= Confidentiality BUMS.1] deceasedTime: TS [0.*] code: CE CWE [0.1] <= RoleCode addr: BAG<AD> [0.1 patientPerson component type Code *: <= C OMP 0....1] statusCode*: CS CNE [1..*] type Code *: <= SBJ telecom: BAG<TEL> [0.1] <= EntityRisk handlingCode: CE CWE [0.1] <= completed effectiveTime*: IVL<TS> [0.1] <= EducationLevel disabilityCode: SET<CE> CWE [0.....

3.1.1”/> <subject typeCode=“…”> <patient classCode=“ROL”> <id root=“1.12009.16..<observationEvent classCode=“OBS” moodCode=“EVN”> <id root=“1.6.3” extension=“A1235”/> </observationEvent> </component> </observationEvent> BUMS.21”/> <patientPerson classCode=“PSN”> <name><given>John</given><family>Doe</family></name> </patientPerson> <providerOrganization classCode=“ORG”> <name>St.1.6.3.. Josephs Hospital</name> </providerOrganization> </patient> </subject> <component typeCode=“REL”> <observationEvent classCode=“ACT”> <id root=“1.6.12009.113883.12009. Feb.113883.4” extension=“1234567-8”/> <code code=“…” codeSystem=“2.840.1. Abbas Shojaee.1..1.1.4.840.4. 2010 69 .3.6.16.1.6.3” extension=“A1234”/> <code code=“.” codeSystem=“2.1.4.

Abbas Shojaee.BUMS. Feb. 2010 .

2010 . Feb. Abbas Shojaee.BUMS.

BUMS. Feb. 2010 . Abbas Shojaee.

Clinical Document Architecture BUMS. 2010 . Abbas Shojaee. Feb.

and human readability. stewardship. wholeness. 2010 74 . Feb.   CDA: document model using XML tags RIM: defines the tags Why CDA is needed: ◦ Difference between documents and databases  Documents carry meta data  persistence. authentication.  CDA evolution history BUMS. Abbas Shojaee.

Feb. Pathology Report  Based on XML. 2010 75 . RIM and coded vocabularies. CDA makes documents both ◦ Machine readable ◦ Human readable BUMS. HL7. Abbas Shojaee. Admission & Physical. exchange model for clinical documents ◦ ◦ ◦ ◦ Discharge Summary. Imaging Report.

SNOMED. Abbas Shojaee. Feb. doc or scanned image file  ◦ RIM ◦ Controlled vocabulary (LOINC. … BUMS. 2010 76 . ICD.  Users set their own level of compliance Minimal CDA: High end CDA: ◦ small number of XML-encoded metadata fields ◦ Body in pdf.

2010 . Feb. Abbas Shojaee. CDA structure BUMS.

Limitations of Version 2.3 Benefits of Version 3 Version 3 Statement of Principles Goals Mission

BUMS, Abbas Shojaee, Feb. 2010

Complex integration: at least 2-4 months to install HL7 interfaces

Problem Honest misunderstanding of specifications

Cause Different implicit information models
• No vocabulary to describe conformance concepts

• Misleading conformance claims

BUMS, Abbas Shojaee, Feb. 2010

79


Unmeasurable progress Unpredictable results Metastasizing optionality

Outcome...

Past V2 Process
Patient Care ADT/ Financ e

MnM
Orders Control / Home Health
80

BUMS, Abbas Shojaee, Feb. 2010

Abbas Shojaee. 2010 81 .       Implicit information model. Feb. not explicit Events not tightly coupled to profiles Need for controlled vocabularies Limited to a single encoding syntax No explicit support for object technologies No explicit support for security functions Optionality is ubiquitous and troublesome BUMS.

0 Certified BUMS. conformance claims HL7 V3. fine-grained. Abbas Shojaee. Reduces optionality: results in more specific messages Uncovers hidden assumptions about application boundaries   Facilitates defining clear. 2010 82 . Feb.

2000 83 . 2010 24. Feb.Deals with complexity of the HC environment: Facilitates integration of heterogeneous systems best-of-breed  Increases choices of innovative solutions   Provides support for legacy systems Allows reliable verification of vendors’ conformance claims BUMS. Abbas Shojaee.

2010 . Abbas Shojaee. Provides improved protocol for interconnecting heterogeneous systems installation effort  Reduces – – reduces site-specific negotiations simplifies interface programming  Promotes vendor specialization by allowing segmentation of product lines into niche market spaces 84 BUMS. Feb.

    Provide a framework for coupling events. data elements and messages Improve clarity and precision of specification Improve adaptability of standards to change Begin to approach “plug and play” BUMS. Abbas Shojaee. Feb. 2010 85 .

Feb.X (limited) Management . 2010 86 .        Explicit Scope. Target Users Support for Legacy Systems Loosely Coupled Systems Internationalization Compatibility with Versions 2.ANSI and by-laws Uniform Trigger Event Model Information System Role BUMS. Abbas Shojaee.

Abbas Shojaee. and Integrity BUMS.         Conformance Claims The Version 3 Development Process Project Scope Version 3 Methodology . Privacy.MDF Quality Assurance Processes Process Support Confidentiality of Patient Information Authenticated Authorization for Services Security. Feb. 2010 87 .

understandability. Feb. 2010 88 . and flexibility to a messaging standard   Incorporate concept abstractions and behavior modeling using roles in a rigorous set of work products Express the standard in widely accepted UML notation  BUMS. to the standards development process To bring the highest level of quality. To bring modern software engineering practices. such as Object Oriented Analysis and Design and formal modeling. Abbas Shojaee.

Segment s and Fields Trigger Event and Message s BUMS. Abbas Shojaee. Feb. 2010 89 .. 4.Chapters 2 and 8 Common Specs ChapterChapterChapterSpecific Specific Specific Specs Specs Specs Chapters 3. . 6..

2010 90 . Abbas Shojaee. Trigger events ◦ Actions or occurrences  Messages ◦ Information content  Segments ◦ Repeating structures  Data elements ◦ Data representation BUMS. Feb.

2010 . Feb. Abbas Shojaee.HL7 Referenc e Model Commo n Specs Chapter Specific Specs *Future Considerati on Use Case Model Information Model Interaction Model Message Model Implementable Message Implementable Specification Implementable Message 2-nd Order Message Specification 1 choice of XML/ER7/… Specification 0-n Drug OLE/CORBA 0-1 Nursing EDIFACT* 91 BUMS.

Abbas Shojaee. 2010 .x specifications have: ◦ Segments that imply information entities ◦ Events that indicate implied behaviors ◦ Descriptive content that suggests use cases but never formally documents these  Version 3 seeks to formalize this by applying object analytic methods and style ◦ ◦ ◦ ◦ to to to to improve the internal consistency of HL7 provide sound semantic definitions enable future architectures produce an evolution not a revolution Done by applying MODELING to the HL7 process 92 BUMS. Feb. The HL7 2.

By demanding Dispense Manage Perform Lab Review Abstractions: analysis of the Medications Tests Utilization Version Care 2.x focused its requirements and Activities energies at the information (Use Case communication level and content. Version 3 Model) covered the other assures Account Encounter Provider Patient abstractions only loosely in Order Objects consistency in and the specifications. 2010 Finance ADT Pharmacy 93 . Abbas Shojaee. Feb. HL7 message HL7 message Communicatio n (Interaction and Message Models) BUMS. (Information enhances the value Model) of the resulting messages.

abstract messages & application profiles  Vocabulary  Information model ◦ Classes. Abbas Shojaee. Use case model ◦ Hierarchy of tasks and actors  Message design model ◦ Refined Message Information Model (R-MIM) ◦ Abstract message definitions (HMDs)  Interaction model ◦ Trigger events. relationships. Feb. states. and lifecycles  ◦ Domain definitions ◦ Representations and mappings Implementation ◦ Implementation Technology Specification (ITS) 94 BUMS. 2010 .

Concepts Modeling January 24. 2000 © 1999. 2000 Health Level 7 95 .

Abbas Shojaee.Process: Method: Model: subject Operation Activities leading to the orderly construction of the models An approach to problem solving Abstract representation of a Attributes (Data) Operation Object: Domain specific concept © 1999. 2000 96 . 2000 Health Level 7 BUMS. 2010 January 24. Feb.

0 Message Design BUMS. Feb.Domain Analysis Requirements Analysis Release 3. Abbas Shojaee. 2000 Health Level 7 Message Specification January 24. 2010 © 1999. 2000 97 .

2000 98 . Abbas Shojaee. Feb. 2010 © 1999. Decomposition ◦ Divide-and-conquer  Abstraction ◦ Chunking the information  Hierarchy ◦ Increasing semantic content of individual chunks of information through reuse BUMS. 2000 Health Level 7 January 24.

Abbas Shojaee. 2000 Health Level 7 January 24. Applying analysis techniques leads to solutions to integrate components Modeling provides the framework for the analysis steps and products Object Oriented Analysis and Modeling form the basis of the standard techniques adopted for Version 3   BUMS. 2000 99 . 2010 © 1999. Feb.

     The deliverables are expressed as models Each model leads to greater understanding of areas that influence content. Feb. Abbas Shojaee. 2000 10 0 . structure. 2010 © 1999. 2000 Health Level 7 January 24. and behavior of messages Messages are defined when the models are merged The HL7 standard message specification will be derived from the models Models are expressed in UML BUMS.

Abbas Shojaee. Feb. Process Overview Model Deliverables and Phases Generation of Messages  Process in Detail Methodology Activities Coordination of Parallel Committee Projects (Harmonization) BUMS. 2000 Health Level 7 January 24. 2000 10 1 . 2010 © 1999.

2000 Health Level 7 102 . 2000 © 1999.Tasks Deliverables Phases January 24.

Abbas Shojaee. 2010 Implementation Technology © 1999. Feb. 2000 10 3 . Analysis ◦ Requirements Analysis ◦ Domain Analysis Use Case Model (UCM) Information Model (RIM & DIM) Vocabulary Domain Specification  Design ◦ Component and Object Interaction Model (IM) Message Information Model Interaction Design (MIM) ◦ Message Design  Voting and Publishing Implementation Guide ◦ Technology Hierarchical Message Description (HMD)  BUMS. 2000 Health Level 7 January 24.

Feb. Abbas Shojaee. 2000 10 4 .Use Case Model • Captures healthcare requiremen • Defines scope for TSC approval • Specifies data and its Information Model • • • • 2-nd Order 1 choice of 0-n Drug 0-1 Nursing semantics • Specifies major state Interaction Model transitions Defines information flows Specifies vocabulary for Defines communication roles domains Forms basis for conformance c • Defines message contents Message Specification • Apply constraints to the information model and © 1999. 2010 vocabulary January 24. 2000 Health Level 7 BUMS.

2010 © 1999. 2000 Health Level 7 January 24.      Is a Methodology for building HL7 models Is a description for defining HL7 standard messages Full instruction book for HL7 participants Basis for member training Five years in development Continues to evolve as we gain experience BUMS. 2000 10 5 . Feb. Abbas Shojaee.

2000 10 6 . Abbas Shojaee.Analysis Requirements Analysis Domain Analysis Design Interaction Design Message Design Voting Approval 2-nd Order 1 choice of  0-n Drug  0-1 Nursing Domain Information Model (DIM) Hierarchical Message Descriptions (HMD)  Use Case Model (UCM) RIM Interaction Model (IM) Ballots BUMS. Feb. 2010 Reference Model Repository © 1999. 2000 Health Level 7 January 24.

2010 © 1999. 2000 10 7 . 2000 Health Level 7 January 24.Develop Scope Create Use Cases Information Model Use Case Model Spec DIM Spec Class Diagram State Diagram UCM Spec Use Case Diagram Spec Draw initial contents from RIM Model new concepts Identify Actors & Events Define Trigger Events Define Application Roles Define Interactions Create Conformanc e Claims Harmonize with RIM Interaction Model Spec Message Design Develop Message Information Mode Develop Message Object Diagram Specify HMD Inter Spec Interaction Diagram 2-nd Order h//mt:50”d” 1 choice of… 0-n Drug … 0-1 Nursing … BUMS. Abbas Shojaee. Feb.

2000 10 8 BUMS.Reference Information Model Domain Information Model Use Case Model Interaction Model Message Information Model Person_name_for_IHCP 1 Person_as_IHCP cd : CV has purpose_cd : CV phon : TIL 1 type_cd : CV nm : PN is_for takes_on_role_of 1 is_participant_for 0. 2010 ... Feb...* Exactly one occurrence 1 participates_as 1 Individual_healthcare_practitioner is_a_role_of id : TII has_as_participant 1 Patient_encounter id : TII s tatus_cd : CV encounter_classification_cd : CV Person_as_Patient 0..1 id : TII gender_cd : CV takes_on_role_of has 1 s tatus_cd : CV marital_s tatus_cd : CV 1.* Encounter_practitioner is_associated_with participation_type_cd 1.* has Patient_admission estimated_days_qty is_for admission_dttm Person_name_for_Patient Patient_billing_account admission_reason_cd 1 nm : PN admission_referral_cd id : TII is_preceded_by effective_dt : TS admission_source_cd 1 s tatus_cd : CV 0.1 cd : CV admission_type_cd billing_s tatus_cd : CV preceded purpose_cd : CV pre_admit_test_ind patient_financial_class_cd : CV belongs_to termination_dt : TS readmission_ind price_schedule_id : TII type_cd : CV Domain Specification Database Hierarchical Message Description Common Message Element Types © 1999.1 is_the_primary_provider_for start_dttm birth_dttm : TS involves end_dttm birthplace_addr : ST 0...1 newborn_baby_ind race_cd : CV is_involved_in is_a_role_of multiple_birth_ind religious_affiliation_cd : CV Inpatient_encounter organ_donor_ind phon : TIL 1 actual_days_qty 1. Abbas Shojaee.* has_a_primary_provider expected_insurance_plan_qty : NM 1 deceased_dttm : TS 1 first_similar_illness_dttm Patient education_level_cd : CV 1.. 2000 Health Level 7 January 24.

2000 .Implementation Technology Specifications "Send as ASCII string in XML format" Hierarchical Message Definition "Discontinue pharmacy order" ITS Data HL7 Message Creation Message Instance HL7 Message Parsing Data HL7-Conformant Application HL7-Conformant Application 10 9 BUMS. 2000 Health Level 7 January 24. 2010 © 1999. Feb. Abbas Shojaee.

2000 11 0 . Abbas Shojaee.   Internal consistency . 2010 © 1999.captured in a repository Enables variety of implementation technologies ◦ ranging from ASCII to ORBs and EDIFACT to XML  Eliminates rampant optionality in the messages ◦ reduces implementation effort   Application roles are a basis for component functional specifications Provides verifiable conformance claims BUMS.enforced in models Sound definitions . Feb. 2000 Health Level 7 January 24.

. The Benjamin/Cummings Publishing Company.   Jacobson. Feb. Object-Oriented Analysis and Design with Applications.. Addison-Wesley. Rumbaugh. BUMS. CA. Redwood City. 1994.. Inc. NJ. 2010 © 1999. Object-Oriented Modeling and Design. J. G. Et Al. Object-Oriented Software Engineering: A Use Case Driven Approach. 1991. Englewood Cliffs. Abbas Shojaee. Et Al. 2000 11 1 . Prentice Hall International. 1994. Reading. MA. 2000 Health Level 7 January 24. I. Booch. 2nd ed.

Addison-Wesley. BUMS. Abbas Shojaee. Reading. Client/Server Strategies..A.A. Inc. John Wiley & Sons. Inc.. D.. D. The Benjamin/Cummings Publishing Company. Taylor. Addison-Wesley. UML Distilled. CA. 2010 © 1999.. Reading. Applying the Standard Object Modeling Language. D. MA. Feb. CA. I. San Mateo. 1995. MA. Using the Booch Method.. IDG Books. Business Engineering with Object Technology. 1990. Object-Oriented Technology: A Manager‟s Guide. 1994. New York. A Rational Approach.     White. 2000 11 2 . NY. Redwood City. 2000 Health Level 7 January 24. Taylor. Fowler. 1997. M. Vaskevitch. 1993.

2010 © 1999. 2000 Health Level 7 January 24. SIGS Publication Distributed Object Computing (DOC) Journal of Object-Oriented Programming (JOOP) BUMS. Abbas Shojaee. 2000 11 3 . Feb.   Object Magazine.

Abbas Shojaee. 2010 . Feb.BUMS.