HL7 v3 and caAdapter Overview

 Session Date:  Session Length: 1 hour  Trainer:

Session Details 
Target Audience: caBIGΠcommunity interested in HL7 v3, caAdapter users, HL7 v3 message builders, NCI Managers, Application Developers, and Domain Analysts.  Prerequisites: None

Session Details:

Presenters and Participants 
Who is Presenting:  Who is in attendance?
± ± ± ±

Name Title Cancer Center or Organization Reason for Attending

.Session Details: Online Training Environment: Centra« Use these buttons (or choose from the Actions menu) to communicate with the trainer and other attendees. Example: Raise your hand to ask a question.

.Session Details: Online Training Environment: Centra You can adjust what you see on screen by choosing from the View menu or by scrolling with the slide bars.

all participants will know who is speaking. . please state your name. please keep your phone on MUTE. ± This way. Avoid the temptation to multi-task. ± Telephone HOLD music will disrupt the call.  When asking a question or making a comment. keep distractions to a minimum.  Please do not put your phone on HOLD. ± This will minimize background noise so that all can hear the person who is speaking.  When not actively asking a question or making a comment.Session Details: Online Training Etiquette  Be an active learner! ± ± Ask lots of questions.

Session Details: Session Objectives  Upon successful completion of this session. you will be able to: ± Provide an introduction to HL7 v3 ± Discuss what HL7 v3 is and how it works ± Explain why HL7 v3 and caAdapter are used within NCI CBIIT and caBIGŒ ± Describe what caAdapter is and how it works .

Session Details: Lesson Plan  Introduction to HL7  HL7 v3 Components and Process  HL7 v3 Interoperability and caBIGΠ High Level Overview of the caAdapter Tool .

we will: ± ± ± Explain what HL7 is and what it does Discuss HL7 v2 and its issues Describe what HL7 v3 is and what it does .Introduction to HL7  In this lesson.

government.´ level of the International Standards Organization (ISO) communications model for Open Systems Interconnection (OSI) networks. vendors.  HL7 is an acronym for Health Level Seven ± Seven represents the highest. customers. etc. . or ³application.Introduction to HL7: What is Health Level Seven (HL7)?  HL7 is an ANSI-accredited Standards Development Organization (SDO) operating in the healthcare arena.  It is a non-profit organization made up of volunteers ± providers.

and to use the information that has been exchanged predictably (IEEE Standard Computer Dictionary)  HL7¶s key goal of interoperability has two aspects: ± ± Syntactic interoperability has to do with structure Semantic interoperability has to do with meaning .Introduction to HL7: What HL7 does«  Provides standards for data exchange to allow interoperability between healthcare information systems  What is interoperability? ± It is the ability of two or more systems or components to exchange information.

 It defines data exchange standards for these domains called messages or messaging specifications (aka HL7 messages).0 (semantic capability added)  HL7 messaging (v2.x (syntactic only) HL7 v3.  HL7 organization defines 2 versions of the messaging standard: ± ± HL7 v2.x and higher) has been recommended as a data exchange standard by the E-Government initiative.Introduction to HL7: What HL7 does  HL7 focuses on the clinical and administrative data domains. . ± Messages are developed by technical committees and special interest groups in the HL7 organization.

x HL7 messages  The HL7 v2 messaging standard is considered: ± ± The workhorse of data exchange in healthcare The most widely implemented standard for healthcare information in the world  HL7 v2.6 is currently under development.Introduction to HL7: The Industry Standard  HL7 v2 is still the most commonly used HL7 standard ± Over 90% of US hospitals have implemented some version of 2. .5 was approved as an ANSI standard in 2003  HL7 v2.

 HL7 v2 does not have conformance rules ± this results in site specific implementation. not an interoperability standard. but does not scale well to inter-enterprise applications. Source: Charlie Mead.Introduction to HL7: Problems with HL7 v2«  HL7 v2 development process has no explicit methodology. MD .  HL7 v2 messages do not specify coded terminologies as value sets.  HL7 v2 does not support semantic grouping of messages to create comprehensive packets of information.  HL7 v2 is an interchange standard.  HL7 v2 works well intra-enterprise.

INC.4 ORU^R01 for serum glucose: MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01 |CNTRL-3456|P|2.Introduction to HL7: Problems with HL7 v2 Example HL7 v2.4<cr> PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES |196203520|F|||153 FERNWOOD DR.^^STATESVILLE^OH^35292||(206)3345232|(206)752-121|||| AC555444444||67-A4335^OH^20030520<cr> OBR|1|845439^GHH OE|1045813^GHH LAB|1554-5^GLUCOSE|||200202150730|||||| 555-55-5555^PRIMARY^PATRICIA P^^^^MD^^LEVEL SEVEN HEALTHCARE. |||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD<cr> OBX|1|SN|1554-5^GLUCOSE^POST 12H CFST:MCNC:PT:SER/PLAS:QN||^182|mg/dl| 70_105|H|||F<cr> .

Introduction to HL7: The HL7 v3 Solution«  HL7 v3 is not the next release of HL7 v2 .It is a paradigm shift  HL7 v3 addresses the problems of HL7 v2 by: ± ± Reducing HL7 v2 optionality Including testable conformance rules  HL7 v3 is based on a formal development methodology: ± ± Follows an Object Oriented (OO) approach Uses Universal Modeling Language (UML) principles  Most importantly. HL7 v3 supports semantic interoperability .

Introduction to HL7: The HL7 v3 Solution  Additional HL7 v3 features include: ± ± ± ± ± ± A uniform set of models Representation of complex relationships Formalisms for vocabulary support Top-down message development Solving re-use and interoperability issues across multiple domain contexts Scope is expanding to include community medicine. . veterinary medicine. clinical genomics. etc. epidemiology. security.

Introduction to HL7: The Four Pillars of Semantic Interoperability in HL7 v3  A common Reference Information Model (RIM) which spans the entire patient care. administrative and financial healthcare universe  A well-defined and tool-supported process for deriving data exchange specifications ("messages") from the RIM  A formal and robust Data Type Specification upon which to ground the RIM  A formal methodology for binding concept-based terminologies to RIM attributes .

Introduction to HL7: Any Questions?  What HL7 is and what it does  HL7 v2 and its issues  What HL7 v3 is and what it does .

we will: ± Describe the components of HL7 v3 that support semantic interoperability.HL7 v3 Components and Process  In this Lesson. .

abstract model that expresses the information content of all the areas of healthcare ± Forms a shared view of the healthcare domain.HL7 v3 Components and Process: Reference Information Model (RIM)  The RIM is the cornerstone of HL7 v3 messaging. and is used across all HL7 messages independent of message structure .  The RIM: ± Is the fundamental model from which all v3 messages are derived ± Is a generic.  The RIM is an UML Model class diagram.

HL7 v3 Components and Process: RIM Domains Administrative Management Accounting & Billing Claims & Reimbursement Patient Administration Scheduling Health & Clinical Management Clinical Document Arch. Medical Records Public Health Reporting Regulated Studies Common Domains Common Message Element Types (CMETs) Shared Messages .

HL7 v3 Components and Process:

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HL7 v3 Components and Process:

RIM - Domain Related Classes

HL7 v3 Components and Process:

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Entity
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A record of something that is being done, has been done, can be done, or is intended or requested to be done.

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Classes are color coded:
±

Green = Entity, Yellow = Role, Blue = Participation, Red/Pink = Act, Purple = Infrastructure, Lilac = message controller.

Yellow = Role. Lilac = message controller. Smith HealthCare Provider HealthCare Facility Surgeon Prostectomy XYZ Hospital Location Act Relationship Has Pertinent Information (Clinical Trial Act) John Doe Patient Subject Protocol ECOG 1112  Classes are color coded: ± Green = Entity. .HL7 v3 Components and Process: RIM UML Instance Scenario Entity Role Participation Act John Doe Patient Subject (Procedure Act) Dr. Blue = Participation. Red/Pink = Act. Purple = Infrastructure.

HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Entity Classes .

 Entity has the following subclasses: ± ± ± ± ± ± ± ± ± ± Container Device LanguageCommunication LivingSubject ManufacturedMaterial Material NonPersonLivingSubject Organization Person Place . its specializations and related qualifying classes. The classes represent health care stakeholders and other things of interest to health care. organization or thing A collection of classes related to the Entity class. animal.HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Backbone Class: Entity Entity ±  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 a person.

HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Role Classes .

These classes focus on the roles participants may play in health care.g. Person in a role of patient.  Role has the following subclasses: ± ± ± ± Access Employee LicensedEntity Patient . employee. etc.HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Backbone Class: Role  Roles: ± 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> ± A responsibility or part played by an entity (e.) ± different faces of an Entity A collection of classes related to the Role class and its specializations.

HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Participation and Act Classes .

 Participation has the following sub-class: ± ManagedParticipation .HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Backbone Class: Participation 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.

These relate to the actions and events that constitute health care services. . has been done.  Act has the following sub-classes: ± Observation ± ± ± ± ± ± ± ± Account ControlAct DeviceTask DiagnosticImage Diet FinancialContract FinancialTransaction InvoiceElement ± ± ± ± ± ± ± Participation PatientEncounter Procedure PublicHealthCase SubstanceAdministration Supply WorkingList  Note: Sub-classes also include Core Infrastructure.HL7 v3 Components and Process: Domain Related Classes of the RIM«  RIM Backbone Class: Act 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. can be done. Message Communications Control and Structured Documents classes not shown here. A record of something that is being done. or is intended or requested to be done.

n contextConductionInd : BL Act sequenceNumber : INT priorityNumber : INT pauseQuantity : PQ checkpointCode : CS splitCode : CS joinCode : CS negationInd : BL conjunctionCode : CS localVariableName : ST seperatableInd : BL 0..  ActRelationship has no subclasses.. ..n 1 target inboundRelationship  ActRelationship: ± A directed association between a source Act and a target Act.n outboundRelationship typeCode : CS inversionInd : BL contextControlCode : CS source 0.HL7 v3 Components and Process: Domain Related Classes of the RIM  RIM Backbone Class: ActRelationship ActRelationship 0. A point from a later instance to a earlier instance OR point from collector instance to component instance.

.* DMIM 1..* DMIM ± Domain Message Information Model. RMIM.* 1.Refined Message Information Model...* RMIM MT HMD 1. MT ± Message Type . HMD ± Hierarchical Message Description.HL7 v3 Components and Process: HL7 v3 Process & Artifacts Overview RIM 1.

attributes and relationships that can be used to create messages for a particular domain (a particular area of interest in healthcare).HL7 v3 Components and Process: Domain Message Information Model (DMIM)  A DMIM is a refined subset of the RIM that includes a set of class clones.  This is the DMIM for the Patient Administration Domain Example: PRPA_DM201101UV01 .

 This is the RMIM for the PatientLivingSubject Event Activate Example: PRPA_RM201101UV01 .HL7 v3 Components and Process: Refined Message Information Model (RMIM)  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.

 This is the HMD for the PatientLivingSubject Event Activate Example: PRPA_HD201101UV01 .HL7 v3 Components and Process: Hierarchical Message Definition (HMD)  An HMD is a serialized version of the RMIM in a specific order.

HL7 v3 Components and Process: Message Type (MT)  A Message specification is a set of rules for constructing a message given a specific set of instance data  This is the XML schema for the PatientLivingSubject Event Activate message Example: PRPA_MT201101UV01 .

and each data type is associated with zero or many attributes  Data types in HL7 v3 are complex: ± ± Each data type has attributes Each data type attribute has a data type of its own .HL7 v3 Components and Process: Introduction to Data Types«  Data types are the basic building blocks of attributes  Data types define the meaning (semantics) of data values that can be assigned to a data element  Meaningful exchange of data requires that we know the definition of the values exchanged  Every attribute in the RIM is associated with one and only one data type.

Value is expressed as the data type of integer (int). .HL7 v3 Components and Process: Introduction to Data Types«  HL7 v3 has published a data type specification and supports 42 data types  First example of a complex data type: Physical Quantity (PQ) example <lengthOfStayQuantity value=³10´ unit=³hours"/> The attributes µvalue¶ and µunit¶ are part of the complex data type Physical Quantity (PQ).

HL7 v3 Components and Process: Introduction to Data Types  Second Example of a complex data type: Coded Data type (CE. CS.104´ codeSystemName=³HL7 Race Vocabulary Domain" displayName=³American Indian or Alaska Native" codeSystemVersion=³3.) <raceCode code=³1002-5´ codeSystem= ³2.0´ /> .840.1.5. etc.16. CD.113883.

 Structural attributes/elements use a standard vocabulary defined and controlled by the HL7 organization.HL7 v3 Components and Process: Structural Attributes and Vocabulary classCode and moodCode are both Structural Attributes.  Structural attributes/elements are used to specify the type and state of each RIM class and what it means when used in a message. An Act of the Class Observation (OBS) with a Mood of Event (EVN). .

etc.  This typically involves domain related vocabulary. CTC.HL7 v3 Components and Process: External or User-Defined Vocabulary  User-defined vocabulary is not controlled by the HL7 organization. SNOMED. caDSR/EVS .  Some examples of userdefined vocabulary: ± ± ± For capturing Observations: LOINC. For Adverse Events: MedDRA. etc.

RMIM.HL7 v3 Components and Process: Any Questions?  Reference Information Model (RIM)  Structured Process Components (DMIM. HMD and MT)  Data Types  HL7 and User-defined Vocabulary .

HL7 v3 Interoperability and caBIGŒ  In this lesson. we will: ± ± ± Explain why HL7 and HL7 v3 are used at NCI CBIIT Discuss how caAdapter supports NCI CBIIT and caBIGTM goals of interoperability Explain NCI CBIIT¶s Clinical Architecture .

 Support for translational research requires integration of research data with clinical data at a semantic level. ± Only then can it yield semantically computable data. Health and Human Service (HHS) has recommended HL7 as the messaging standard for the electronic exchange of clinical data.  HL7 v3 offers the syntactic and semantic interoperability to make this integration possible.  A goal of NCI CBIIT is to accelerate discovery through the synthesis of different types of cancer research data.x HL7 messages. ± Therefore. thus facilitating translational research (combination of different disciplines of research).HL7 v3 Interoperability and caBIGŒ: The Role of HL7 and HL7 v3 at NCI CBIIT  Nine out of ten US hospitals have implemented some version of 2. .

HL7 v3 Interoperability and caBIGŒ: caAdapter and the caBIGŒ Principles«  caAdapter supports NCI CBIIT and caBIGŒ principles of: ± ± ± ± ± ± Open source Open access Standards based Open development Collaboration with other intiatives Provides a toolset to support a federation of data sources .

.  caAdapter has leveraged HL7 Java Special Interest Group (SIG) work and built new enhancements.  caAdapter provides the capability to perform vocabulary validation of core structural attributes through integration with NCI CBIIT caCORE components. parsing and validation based on specific message definitions. such as the Enterprise Vocabulary System (EVS).HL7 v3 Interoperability and caBIGŒ: caAdapter and the caBIGŒ Principles«  caAdapter (formerly called the HL7 SDK) is an open source tool that facilitates HL7 v3 message building.

CSM .HL7 v3 Interoperability and caBIGŒ: The Clinical Architecture Vision  HL7 v3 is a potential data exchange solution within the NCI CBIIT Clinical Architecture Vision.

 Message Exchange ± Service supporting message transmission and routing  HL7 Transactional Database ± HL7 RIM based transactional database and data access service  De-identification Service ± De-identifies patient information from HL7 v3 messages  Research Application ± CMAP (Cancer Molecular Analysis Program) use case for demonstration purposes  Cancer Data Standards Repository (caDSR) ± Shared metadata repository  Enterprise Vocabulary Services (EVS) ± Vocabulary service for hosting controlled vocabulary. parsing and validation.HL7 v3 Interoperability and caBIGŒ: The Clinical Architecture Vision«  caAdapter ± Toolset which facilitates v3 message building. caAdapter provides Comma Separated Values (CSV) and Excel files to HL7 v3 conversion capability. including HL7 v3 structural terminology .

HL7 v3 Interoperability and caBIGŒ: Any Questions?  Why HL7 and HL7 v3 are used at NCI CBIIT  How caAdapter supports NCI CBIIT and caBIGTM goals of interoperability  The NCI CBIIT Clinical Trials Architecture .

we will: ± ± ± Discuss the usage of caAdapter Describe the components of caAdapter Illustrate how caAdapter works .Introduction to caAdapter  In this lesson.

 It provides a mechanism to convert clinical data from legacy data sources to HL7 v3 messages.  It has a component based architecture that supports HL7 v3 message generation. parsing.  caAdapter provides a user interface that can help cancer centers transform their clinical data into HL7 v3 messages and help them achieve the goal of interoperability. .Introduction to caAdapter: Usage of caAdapter  caAdapter is a tool set that facilitates HL7 v3 message building. as well as some validation.

Introduction to caAdapter: Using caAdapter«  Assuming your data is in a non-HL7 v3 file format. how can you take advantage of HL7 v3¶s capabilities right now? ± By converting your comma separated value (.csv) files to the proper HL7 v3 format using caAdapter .

Introduction to caAdapter: The Organization of caAdapter  caAdapter has a component based architecture that offers a tool set to support HL7 v3 message generation.  It accomplishes this via two major components: ± ± The Core Engine The Mapping Tool .

Introduction to caAdapter: Introduction to the Core Engine  The Core Engine ± ± ± ± ± A Java based API to HL7 v3 RIM components (such as RIM classes) HL7 Data Type classes Other supporting classes A Utility Package to support HL7 v3 message building and parsing Additional services of vocabulary validation .

Introduction to caAdapter: Introduction to the Mapping Tool  The Mapping Tool component: ± ± ± Has a GUI based front-end application for mapping clinical data to HL7 v3 specifications Has a user-friendly drag-and-drop interface Provides some data transformation functions .

caAdapter Introduction: How the Mapping Tool Works« Mapping Tool Clinical Data Source Data (CSV) Transformation (APIs) HL7 v3 XML .

caAdapter Introduction: How the Mapping Tool Works CDMS Source Data (CSV) 1 .

caAdapter Introduction: How the Mapping Tool Works CDMS Mapping Tool 2 Source Specification 2a 2b Source Data (CSV) 1 .

caAdapter Introduction: How the Mapping Tool Works .

Introduction to caAdapter: Any Questions?  Discussed the usage of caAdapter  Explained the components of caAdapter  Described how caAdapter works .

we will: ± ± ± Describe the architecture and features of the Core Engine component Describe the architecture and features of the Mapping Tool component List the four main functions and sub-functions of caAdapter .caAdapter Architecture and Capabilities  In this Lesson.

caAdapter Architecture and Capabilities: caAdapter Core Engine Features  HL7 v3 Message Parser ± Parses HL7 v3 messages to RIM object graph  HL7 v3 Message Builder ± Builds HL7 v3 messages from the RIM object graph  HL7 v3 Artifacts ± Implements RIM objects. data types and metadata objects  Metadata Loader ± Represents HL7 v3 metadata in-memory  Validation Services ± Using HL7 v3 specifications  caApapter API ± Uses mappings to generate HL7 v3 messages .

caAdapter Architecture and Capabilities: caAdapter Mapping Tool Features  The Mapping Tool ± Graphical application for mapping clinical data to an HL7 v3 message  Source and Target Specification ± Graphical interface for defining input and output data formats  Drag and Drop Interface ± Simple interface for mapping source fields to target elements  Mapping Functions ± Capability to do simple source data manipulation  XML Transformer ± Generation of XML message instances from source data based on the mapping .

caAdapter Architecture and Capabilities: Main functions and Sub-functions  The four main functions of caAdapter are: ± ± ± ± Defining source specification Defining target specification Defining mapping specification Converting source data to target data format  Each of these four functions has four sub-functions for handling data: ± ± ± ± Creating Saving Editing Validating .

caAdapter Architecture and Capabilities: Any Questions?  The features of the Core Engine component  The features of the Mapping Tool component  The four main functions and sub-functions of caAdapter .

and HL7 v3 ± Discuss what HL7 v3 is and how it works ± Explain why HL7 v3 is used at NCI CBIIT and in caBIGŒ ± Describe what caAdapter is and how it works . HL7 v2. you should be able to: ± Provide an introduction to HL7.Session Review  Now that you have successfully completed this session.

hl7.htm .htm  HL7 Vocabulary Domains ± http://www.Additional Sources of Information«  Follow on Training ± caAdapter Fundamentals  Health Level Seven ± www.hl7.org/library/data-model/RIM/C30202/rim.hl7.org/library/data-model/RIM/C30123/vocabulary.org  HL7 Reference Information Model ± https://www.htm  HL7 v3 Standard ± http://www.hl7.org/v3ballot/html/welcome/environment/index.

MD.healthcare-informatics.gov/NCICB/infrastructure/cacore_overview/caa dapter  HL7 v3: ± ³Driving Interoperability & Transforming Healthcare Information Management´ by Charles Mead.com/webinars/05_20_04.nci.nih. ± http://www.nih. MSc.htm  caAdapter Contacts ± http://trials.gov/projects/infrastructureProject/caAdapter/HL T_Tutorial .Additional Sources of Information  NCI CBIIT caAdapter Site ± http://ncicb.nci.

8 am ± 8 pm Eastern Time.nci. You may leave a message.NCICB Application Support  Live Support: Monday ± Friday 8 am ± 8 pm Eastern Time ± ± Telephone support is available Monday to Friday. send an email or submit a support request via the Web at any time.nih.nci. excluding government holidays.gov/NCICB/support .nih.gov  Phone: 301-451-4384  Toll-free: 888-478-4423  Web: http://ncicb.  Email: ncicb@pop.