George W. Beeler, Jr. [email protected] 1/25/19991© 1999, Health Level Seven, Inc. V3 Education:...

1/25/1999 1© 1999, Health Level Seven, Inc.

George W. Beeler, [email protected]

http://www.mcis.duke.edu/standards/HL7/hl7.htm

V3 Education: Building the HMD

From MIM-to-MOD-to-HMD

Using the tools


How we got here

• Developed use cases

• Developed a RIM

• Defined our interactions

• Defined the Message Information Model (MIM)


MIM for this exercise

Observation_intent_or_order

patient_hazard_codereason_for_study_cdrelevant_clinical_information_txtreporting_priority_cdspecimen_action_cd

Clinical_observation

abnormal_result_ind : IDlast_observed_normal_values_dttm : DTMnature_of_abnormal_testing_cd : CEclinically_relevant_begin_dttm : DTMclinically_relevant_end_dttm : DTMobservation_value_txt : NMprobability_number : NMreferences_range_text : STvalue_units_code : CE

Assessment

Healthcare_service_provider

specialty_cd : CNE

Healthcare_financesHealthcare_stakeholders Healthcare_financesMaster_tables

Healthcare_financesPatient_encounters

HL7 Tutorial MIM - January 1999 RIM_0087T

Stakeholder_identifier

id : STidentifier_type_cd : ID

Organization

organization_name_type_cd : CNEorganization_nm : STstandard_industry_class_cd 0..*

0..1 is_a_subdivision_of

0..*

has_as_a_subdivision

0..1

Person

birth_dttm : DTMgender_cd : CNEmarital_status_cd : CNEprimary_name_representation_cd : CNEprimary_name_type_cd : CNEprimary_prsnm : PNrace_cd : CNE

Individual_healthcare_practitioner

desc : TXpractitioner_type_cd : CNE

1

0..1

takes_on_role_of1

is_a_role_of0..1

Stakeholder

addr : XADphon : XTN

0..*

1

is_assigned_to0..*

is_assigned1

Healthcare_provider_organization

0..1

1

is_a_role_of

0..1

takes_on_role_of

1

Collected_specimen_sample

body_site_cd : CEcollection_end_dttm : DTMcollection_start_dttm : DTMcollection_volume_amt : CQhandling_cd : IDid : IIDmethod_of_collection_desc : TXspecimen_additive_txt : STspecimen_danger_cd : IDspecimen_source_cd : CE

0..*1

is_collected_by

0..*

collects

1

Patient

ambulatory_status_cdbirth_order_numberliving_arrangement_cdliving_dependency_cdmultiple_birth_indnewborn_baby_indorgan_donor_indpreferred_pharmacy_id

0..1

1

is_a_role_of

0..1takes_on_role_of

1

0..*

0..1

has_a_primary_provider

0..*is_the_primary_provider_for

0..1

0..*

0..1

is_sourced_from0..*

is_source_for0..1

Active_participation

participation_type_cd : ID

0..1

0..*

participates_in

0..1

has_as_participant0..*

Master_patient_service_location

addr : XADemail_address : XTNid : IDnm : STphon : XTN

1..*

0..*provides_patient_services_at

1..*

provides_services_on_behalf_of 0..*

0..*

0..1

is_included_in

0..*

includes 0..1

0..1

0..*

is_primary_facility_for0..1

has_as_primary_facility

0..*

Target_participation

participation_type_cd : CE

0..1

0..*

is_target_of

0..1

has_as_target0..*

0..1

0..*

is_target_of

0..1

has_as_target

0..*

0..1

0..*

is_target_for0..1

has_as_target

0..*

Service_intent_or_order

filler_order_id : IIDfiller_txt : TXorder_idorder_placed_dttm : DTMorder_quantitytiming_qt : TQplacer_order_id : IIDplacer_txt : TXreport_results_to_phone : XTNintent_or_order_cd : ID

0..* 0..1

participates_in

0..*

has_as_participant

0..1

1..*

0..1

is_target_of

1..*

has_as_target

0..1

1

0..*

is_entry_location_for

1

is_entered_at

0..*

Master_service

method_cd : CEmethod_desc : TXservice_desc : TXtarget_anatomic_site_cd : CEuniversal_service_id : CE

0..*

1

is_an_instance_of

0..*

is_instantiated_as

1

Service_event

service_desc : STservice_event_descspecimen_received_dttm : DTMname : CE

0..*

0..1

participates_in0..*

has_as_active_participant

0..1

0..*

0..1

is_performed_at

0..*

is_location_for

0..1

0..*

0..1

is_target_of

0..*

has_as_target

0..1

0..1

0..*

is_fulfilled_by0..1

fulfills0..*

1

0..*

is_delivered_during1

delivers

0..*


HMD - message structureR

ow

Num

ber

Nest

ing

Str

uct

ure

Segment Slot Type

/ Tag Value S

hare

d T

ype?

Slot Name Slo

t

Data Field

Domain Spec. N

ote

Condit

ional

Pre

sence

Requir

ed V

alu

e

Incl

usi

on

Repeti

tions

Note

1 1 ENC ENC 1 M 1

2 encounter_classification_cd 1 12 M 1

3 end_dttm 2 M 1

4 expected_insurance_plan_qty 3 M 1

5 first_similar_illness_dt 4 M 1

6 patient_classification_cd 5 13 M 1

7 start_dttm 6 M 1

8 status_cd 7 22 M 1

9 1 Choice IPChoice M 1

10 Tag N 2

11

12 Tag I 2

13 2 IPE IPE 1 M 1

14 actual_days_qty 1 R 1

15 estimated_days_qty 2 R 1

16 2 PADM PADM 2 M 1

17 admission_dttm 1 M 1

18 admission_reason_cd 2 555 R 1

Segment Segment or Data Field

Message Elements Message Structure A01

Union U1


Next steps from MDF 3.1 (Jan 1998)

• Build a Message Object Diagram (MOD)– Starting from that root class, the committee will step from

one class in the MIM to another by following the relationships appropriate to the use case. As each class is visited the icon for an object view is created on the message object diagram. This process is complete when an icon for each object view that will contribute some attributes has been placed on the diagram.

• Build a Hierarchical Message Description (HMD)– Establish rows for each object view in the Message Object

Diagram• This is done by transcribing the material from the Message Object

Diagram into the Information Model Mapping portion of the HMD


Next steps from MDF 3.1 (Jan 1998)

• Build a Message Object Diagram (MOD)– Starting from that root class, the committee will

• step from one class in the MIM to another by

• following the relationships appropriate to the use case.

• As each class is visited – the icon for an object view is created on the message object diagram.

– This process is complete when an icon for each object view that will contribute some attributes has been placed on the diagram.

• Build a Hierarchical Message Description (HMD)– Establish rows for each object view in the Message Object

Diagram• This is done by transcribing the material from the Message Object

Diagram into the Information Model Mapping portion of the HMDThis step is redundant


Message Object DiagramPatient_encounter

none

Inpatient_encounter

Patient_admission

Patient

Patient_billing_account

Individual_HC_practioner[Prim care phys]

C

is_preceded_by 1..1

involves 1..1

is_a_role_of 1..1

has 0..*

has_a_primary_provider 0..1

is_a_role_of 1..1

is_participant_for 1..1

Individual_healthcare_practitioner[Participant HCP]

is_a_role_of 1..1

Encounter_practitionerincludes 1..*

Stakeholder_identifier[Pt]

is_assigned 1..1

Stakeholder[Pt]

Person[Pt]

Stakeholder_identifier[Prim care phys]

is_assigned 1..1

Stakeholder[Prim care phys]

Person[Prim care phys]

Stakeholder_identifier[Participant HCP]

is_assigned 1..1

Stakeholder[Participant HCP]

Person[Participant HCP]


Information Model Mapping

Nes

tin

g

Relationship Name Car

din

alit

y/

Rep

Allo

wed

?

Op

tio

nal

?

Dat

a T

yp

e

Ro

w N

um

ber

Nes

tin

g

Str

uct

ure Segment

Slot Type/ Tag Value Sh

ared

Ty

pe?

Slot Name Slo

t

Data Field Domain Spec. N

ote

Co

nd

itio

nal

P

rese

nce

Req

uir

ed V

alu

e

Incl

usi

on

Rep

etit

ion

s

No

te

1 root Patient_encounter 1 1 1 ENC ENC 1 M 1

encounter_classification_cd n y CE 2 encounter_classification_cd 1 12 M 1

end_dttm n y VTS 3 end_dttm 2 M 1

expected_insurance_plan_qty n yNM

4 expected_insurance_plan_qty 3 M 1

first_similar_illness_dt n y VTS 5 first_similar_illness_dt 4 M 1

patient_classification_cd n y CE 6 patient_classification_cd 5 13 M 1

start_dttm n y VTS 7 start_dttm 6 M 1

status_cd n y CE 8 status_cd 7 22 M 1

9 1 Choice IPChoice M 1

10 Tag N 2

2 specialization none 11

12 Tag I 2

2 specialization Inpatient_encounter 1 13 2 IPE IPE 1 M 1

3 is_preceded_by Patient_admission 1 16 2 PADM PADM 2 M 1

24End

Choice

2 involves Patient 1 25 1 PTP PTP 3 M 1

3 is_a_role_of Person [Pt] 1 32

generalize Stakeholder 42

is_assigned Stakeholder_identifier 44

3has_a_primary_ provider

Individual_HC_provider [Prim care phys]

0,1 46 1 PCP PCP 4 M 0,1

4 is_a_role_of Person [Prim care phys] 1 47

53 1 List ListPTBA AccountList 5 R 0,M

3 has Patient_billing_account 0,M 54 2 PTBA PTBA 1 M 1

59 End List

60 1 List ListEP EncPracList 6 M

61 Group EncPrac EncPrac

Object View Object Views and Attributes SegmentAttrib Segment or Data Field

Message Elements Message Structure A01

Union U1

Hierarchical Message Description

Information Model MappingMessageStructure

Message Elements


HMD - MOD correspondenceInformation Model Mapping

Nest

ing

Relationship Name Card

inality

/R

ep A

llow

ed?

Opti

onal?

Data

Typ

e

Row

Num

ber

Nest

ing

Str

uct

ure

Segment Slot Type

/ Tag Value S

hare

d T

ype?

Slot Nam S

lot

Data FieN

ote

1 root Patient_encounter 1 1 1 ENC ENC1

9 1 Choice IPChoice

10 Tag N 2

2 specialization none 11

12 Tag I 2

2 specialization Inpatient_encounter 1 13 2 IPEIP1

3 is_preceded_by Patient_admission 1 16 2 PADMPA2

24End

Choice2 involves Patient 1 25 1 PTP PTP3

3 is_a_role_of Person [Pt] 1 32

generalize Stakeholder 42

is_assigned Stakeholder_ identifier 44

3has_a_primary_ provider

Individual_HC_provider [Prim care phys]

0,1 46 1 PCP PCP4

4 is_a_role_of Person [Prim care phys] 1 47

53 1 List ListPTBA AccountList5

3 has Patient_billing_account 0,M 54 2 PTBAPT1

Object View Object Views and Attributes SegmentAttrib Segment

Message Elements


Next steps from MDF 3.1 (continued)

– Add attributes• Underneath each row that represents an object view, the committee

adds rows to contain the attributes that represent data appropriate for the messages. It adds attributes for all of the interactions that are described by the HMD.

– Determine the message elements• The Technical Committee now fills in the center portion of the HMD.

Generally, an object view in the Message Object Diagram will be represented by a segment in the message. However, the committee has the ability to combine object views into a single segment as will be described. Attributes in the information model are related to data fields in the message.

– Establish the various message structures that will be used• NOT COVERED IN THIS TUTORIAL

typetype

types


HOW ???? Tools, techniqueshttp://www.mcis.duke.edu/standards/HL7/committees/

methodology-modeling/Rose_tooling/ – AccessTools.EXE

• Self extracting archive of Access97 databases, including the latest hl7Tools.mdb, which manages repositories and provides reference files

– RoseTre_1011.EXE • An application that is the primary MOD/HMD tool. This will INSTALL

RoseTree.exe on your system.

– ExImWizard_1011.EXE• An application to manage movement of models from Rose to the

repository, validation of Rose models, and extraction of WMFs from Rose.

– hl7Rosie_102.EXE • A utility that assists in setting properties for attributes in a model and for

working with Rose diagrams. Helps in preparing MIMs. This will INSTALL hl7_Rosie.exe on your system


RoseTree basics

• Creates an in-memory, object representation of a model– Extracts from a Rose model– Assembles from a repository

• Methods in the object representation simplify modifying the software and extending its capability

• Complete representation of meta-model in-memory allows direct navigation through the model - software and human

• Provides an interface to support multiple “open” models and representations

• Has subsumed RosToAcc98 functions.


RoseTree menu correspondence

• File menu – Refers to whole things

• Models

• MODs

• CMEDs

• Edit menu– Refers to parts of things

• Nodes

• Object views

• Rows

• etc


Introducing RoseTreeFile menu:

“Files” are external models or MODs (Rose models, models or MODs in Access databases)

Open, close save are “typical”

Reload restores the state of a previously loaded “file”

Up to eight previous files are remembered.File open action:

*.mdb - Access repository - If repository holds single model, that model is loaded. If it holds several, a dialog box is presented to allow selection of one model to load.

*.mdl - Rose model - Will (a) load Rose, if it is not already open, (b) load the file into Rose (if Rose does not already have that file loaded) and then (c) use Rose to extract the information into RoseTree.


Model is loaded

Tree window:

Used for browsing a model or MOD

Text window:

Describes element selected in tree

Subject areas

Model identifier

Check to include subject areas in the tree


Browsing a model“Standard” tree controls -

Expand/collapse

Selecting a node may “reveal” that it has children

Can navigate as well with the keyboard (next slide).“Resetting” the tree:

1) Menu select File.Reload

2) Select any Class in the tree and menu select Edit.Reset to node. This reloads the tree without Subject Areas, selects the class chosen and scrolls to assure the class is visible.

Text window provides RIM description and detail for the selected node.


Keyboard navigation of a treeUsers can navigate through a tree using the keyboard as well.

UP ARROW and DOWN ARROW keys cycle downward through all expanded Node objects. Node objects are selected from left to right, and top to bottom. At the bottom of a tree, the selection jumps back to the top of the tree, scrolling the window if necessary.

RIGHT ARROW and LEFT ARROW keys also tab through expanded Node objects, but if the RIGHT ARROW key is pressed while an unexpanded Node is selected, the Node expands; a second press will move the selection to the next Node.

Conversely, pressing the LEFT ARROW key while an expanded Node has the focus collapses the Node.

Pressing the ENTER key while a Node is selected, alternately expands or collapses a Node.

If a user presses an ANSI key, the focus will jump to the nearest Node that begins with that letter. Subsequent pressings of the key will cause the selection to cycle downward through all expanded nodes that begin with that letter.


MOD - Step one - select the MIMa) Reload tree with Use

subject areas checked

b) Select the subject area that contains the MIM

c) Menu select Edit.Use as MIM

(or right-click on the subject area)


MOD Step two A,B - Choose the ROOT object

MOD window identified by labels, like

Tree starts as Browser for the MIM

(Later will provide the tree view of the MOD)Information window supports MIM browsing

(Later will be replaced with two windows - the MOD construction options, and the LIFO list of classes visited.)

A) Select the root class

B) Select menu:Edit.Set MOD Root


MOD Step two C,D - Describe the ROOT object

C) Enter Version (optional in next release)D) Select Root (message) cardinality, usually 1..1


MOD Step three - Build MODTree window displays

the MOD as you build it

Options window - make your choices by selecting a row in this window

When needed, will get a cardinality popup menu.

Prompts at each step of the way, providing the options that are permitted according to 5.3.2.4 of MDF 3.1 (98)

Keeps track of your choices for each instance to provide only the possible choices

LIFO list of objects that have been started, but not finished.


Editing the MOD

Select a node

Use Edit menu to edit the label. Offers chance to change BOTH the qualifier and the cardinality.

Re-open the MOD

Use Edit…Change Node ...Re-open MOD presents all choices that were by-passed the first time through,

Includes option to “Replace with CMED”

Move siblings up or down to change order.


“Super”-MOD - includes attributes

MDF Fig. 5.9


Let’s try it





Assessment


specialty_cd : CNE






Organization



0..*


0..1

Person




1

0..1

takes_on_role_of1

is_a_role_of0..1

Stakeholder


0..*

1

is_assigned_to0..*

is_assigned1


0..1

1

is_a_role_of

0..1

takes_on_role_of

1



0..*1

is_collected_by

0..*

collects

1

Patient


0..1

1

is_a_role_of


1

0..*

0..1



0..1

0..*

0..1

is_sourced_from0..*

is_source_for0..1



0..1

0..*

participates_in

0..1




1..*


1..*


0..*

0..1

is_included_in

0..*

includes 0..1

0..1

0..*



0..*



0..1

0..*

is_target_of

0..1

has_as_target0..*

0..1

0..*

is_target_of

0..1

has_as_target

0..*

0..1

0..*

is_target_for0..1

has_as_target

0..*



0..* 0..1

participates_in

0..*

has_as_participant

0..1

1..*

0..1

is_target_of

1..*

has_as_target

0..1

1

0..*


1

is_entered_at

0..*

Master_service


0..*

1

is_an_instance_of

0..*

is_instantiated_as

1

Service_event


0..*

0..1

participates_in0..*


0..1

0..*

0..1

is_performed_at

0..*

is_location_for

0..1

0..*

0..1

is_target_of

0..*

has_as_target

0..1

0..1

0..*

is_fulfilled_by0..1

fulfills0..*

1

0..*


delivers

0..*


What do we get?


Extract the Person stuff as a CMED


And use it in the previous MOD


Build a more complex one





Assessment


specialty_cd : CNE






Organization



0..*


0..1

Person




1

0..1

takes_on_role_of1

is_a_role_of0..1

Stakeholder


0..*

1

is_assigned_to0..*

is_assigned1


0..1

1

is_a_role_of

0..1

takes_on_role_of

1



0..*1

is_collected_by

0..*

collects

1

Patient


0..1

1

is_a_role_of


1

0..*

0..1



0..1

0..*

0..1

is_sourced_from0..*

is_source_for0..1



0..1

0..*

participates_in

0..1




1..*


1..*


0..*

0..1

is_included_in

0..*

includes 0..1

0..1

0..*



0..*



0..1

0..*

is_target_of

0..1

has_as_target0..*

0..1

0..*

is_target_of

0..1

has_as_target

0..*

0..1

0..*

is_target_for0..1

has_as_target

0..*



0..* 0..1

participates_in

0..*

has_as_participant

0..1

1..*

0..1

is_target_of

1..*

has_as_target

0..1

1

0..*


1

is_entered_at

0..*

Master_service


0..*

1

is_an_instance_of

0..*

is_instantiated_as

1

Service_event


0..*

0..1

participates_in0..*


0..1

0..*

0..1

is_performed_at

0..*

is_location_for

0..1

0..*

0..1

is_target_of

0..*

has_as_target

0..1

0..1

0..*

is_fulfilled_by0..1

fulfills0..*

1

0..*


delivers

0..*

A

B

C

E

F

G

H

I

J

K

L

MD


And get MOD


Populate the attributes


… and ...


… and… and


… and… and… and


… and… and… and… and


… and… and… and… and… and finally


Make an ACTP CMED


Slot types & names to be filled

from MOD

automatic

and now the HMD - raw form


filling it in ...


and finish!


Save your work!!!


HMD with attributes suppressed

George W. Beeler, Jr. [email protected] 1/25/19991© 1999, Health Level Seven, Inc. V3 Education:...

Documents

Transcript of George W. Beeler, Jr. [email protected] 1/25/19991© 1999, Health Level Seven, Inc. V3 Education:...