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Transcript of January 30, 20001© 2000, HL7 CEN/TC 251 Health Informatics Joint Working Groups Meeting Stockholm,...
January 30, 2000 1© 2000, HL7
http://www.hl7.org
CEN/TC 251 Health InformaticsJoint Working Groups Meeting
Stockholm, Sweden2000-01-31 -- 2000-02-02
January 30, 2000 2© 2000, HL7
http://www.hl7.org
HL7 Version 3 Tutorial - taking the next step with standards
George W. Beeler, Jr., Ph.D.Past-Chair, Health Level Seven BoardChapter editor, HL7 Version 3 methodology
Division Chair
Information Services
Mayo Clinic
Rochester, MN USA
January 30, 2000 3© 2000, HL7
Why standards?• CHANGE
– Change due to medical needs– Change driven by technology– Change driven by growth
• AssertionAs the needs of health care have grown, and as technology has fragmented, it is no longer realistic for a health care provider to expectALL of its clinical systems to be on fully INTEGRATED computers at ALL TIMES.
• In that case, data interfaces are a reality to be dealt with.
• In order to manage interfaces between heterogeneous systems,
THERE MUST BE STANDARDS!
January 30, 2000 4© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 5© 2000, HL7
QUICK history• Founded by healthcare providers early in 1987
• Produced Version 1.0 late in 1987
• Produced Version 2.0 late in 1988
• Versions 2.1, 2.2, 2.3 and 2.3.1 published in 1990, 1994, 1997 and 1999 -- the “production” standards
• Accredited as a Standards Developing Organization by the American National Standards Institute (ANSI) in 1994
• Version 2.2 through 2.3.1 are “American national standards”
• Work on Version 3 (and 2.4) is underway
January 30, 2000 6© 2000, HL7
HL7’s Mission (adopted 7/97)
• To provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services.
• …….
• The mission of HL7 encompasses the complete ‘life cycle’ of a standards specification -- development, adoption, market recognition, utilization and adherence. The HL7 specifications are unified by shared reference models of the healthcare and technical domains
January 30, 2000 7© 2000, HL7
HL7 Activities
Develop & publish ANSI certified specifications
Promote the use of the standards
Provide education
Provide conformance certification services
Provide methodologies for extending standard
Encourage usage of HL7 world wide
Collaborate with developers of healthcare and information technology standards in leveraging our respective skills, knowledge and standards
January 30, 2000 8© 2000, HL7
Who is HL7?
• About 470 organizational members
• About 1000 total members
• Up to 500 attend the Working Group Meetings
• International affiliates in:– Australia -- Canada– Finland -- Germany– India -- Japan – Netherlands -- New Zealand– Southern Africa -- United Kingdom
January 30, 2000 9© 2000, HL7
Being ANSI accredited means:
• Consensus driven– Ballots must pass by 90%– With 60% quorum and “balance”– Open membership & one vote per member
Technical Steering CommitteeTechnical affairs
Appointed officers plus chairsof the committees & SIGs
Technical CommitteesCreate normative specifications
or chapters in the standard
Special Interest GroupsCollaborate in area of interest tocontribute to the work of the TCs
The Working GroupThe "real" HL7
Any member can registerfor any committee or SIG
Board of DirectorsBusiness affairs
Elected
January 30, 2000 10© 2000, HL7
Committees & SIGs of HL7CommitteesArchitectural Review Board
Clinical Decision Support & Arden Syntax
Control/Query
Education & Implementation
Medical Records
Modeling and Methodology
Orders and Observations
Patient Admin./Financial Management
Patient Care
Scheduling & Logistics
XML (PRA)
Visual Integration (CCOW)
Vocabulary
Special Interest Groups (SIG)Acountablity, Quality, Performance
Blood Banking
Claims Attachments
Community-based Health Systems
Component based messaging
Conformance
Data warehousing
Government Projects
Image management
Lab Automation
MPI Mediation
Secure transactionsRed - groups creatingspecifications
Blue - groups specifying infrastructure
Green - Groups defining HL7 process & methodology
January 30, 2000 11© 2000, HL7
Key to HL7 success - The Working Group
• Draws equally from providers, software vendors, and consultants
• Group sets aside their individual interests, rolls up their sleeves and collaborate to get the tough work done
• Most arguments stem either – violent agreement, but failure to see the agreement– passionate beliefs
• Fortunately there are also good facilitators in the working group that help to resolve these
• HARD WORK - five, 12-hour days, three times a year plus active electronic collaboration in between
January 30, 2000 12© 2000, HL7
Versions 2.x
• Widely used:– secondary and tertiary facilities (>90% use HL7)– large practices
• Broad functional coverage:– clinical: laboratory, pharmacy, radiology, dietary,
most other diagnostic services, patient care, public health
– clinical administrative: patient registration, admission; patient accounts; medical document life cycle; master file maintenance, HIPAA attachments
• Designed in 1987– Based on older messaging formats such as X12
January 30, 2000 13© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 14© 2000, HL7
A domain-specific, common protocol for the exchange of health care information.
1 Physical 1 Physical 2 Data Link 2 Data Link 3 Network 3 Network 4 Transport 4 Transport
Communication
5 Session 5 Session 6 Presentation 6 Presentation 7 Application 7 Application
Function
What does “HL7” stand for?
ISO-OSI Communication Architecture Model
January 30, 2000 15© 2000, HL7
(external) admitevent
trigger event
network
AdmissionSystem
Lab system
Receive A01
sendHL7 A01 msg
send ACK
receive ACK msg
Mr. Jones is admitted to the hospital
The HL7 basic transaction model
January 30, 2000 16© 2000, HL7
System A
ORM message
ORR (opt)
Application Ack
Accept ACK (opt)
Accept ACK (opt)
System B
HL7 acknowledgment paradigms
January 30, 2000 17© 2000, HL7
HL7 Admit Patient Example
• Admit patient Sam Jones, whose wife (and next-of-kin) is Barbara, and whose primary care physician is Dr. LeBauer, to the Emergency room because of trauma
• Question: how did we get from this business process to an HL7 message?
January 30, 2000 18© 2000, HL7
Sample Trigger Event definition • When
– “An A01 event is sent as a result of a patient undergoing the admission process which assigns the patient to a bed. It signals the beginning of a patient's stay in a healthcare facility.”
• What– “Normally, this information is entered in the primary Patient
Administration system and broadcast to the nursing units and ancillary systems.”
• Usage examples– “For example, an A01 event can be used to notify: the
pharmacy system that a patient has been admitted and may be legitimately prescribed drugs; …. the clinical repository that an admission has taken place for the EMR (electronic medical record).”
January 30, 2000 19© 2000, HL7
The anatomy of an HL7 V2.3 message
MSH|^~\&|ADT1|MCM|LABADT|MCM|199807201126||ADT^A01| MSG00001|P|2.3|<cr>
EVN|A01|199807201123|<cr>
PID|1||PATID1234^5^M11||Jones^Sam^Houston||19670329|M||C|1200 N ELM STREET^^GREENVILLE^NC^27401-1020|GL|
(919)379-1212|(919)271-3434||S||X454337 ^2^M10| 123456789|987654^NC|<cr>
NK1|1|JONES^BARBARA^K|WIFE||||CP^Contact person|<cr>
PV1|1|I|2000^2012^01|E||||004777^LEBAUER^SARA^J.|| TRMA||||ADM|A0|<cr>
A message is the unit of data transferred between information systems. It is composed of a group of segments in a defined sequence. Each message has a message type that defines its purpose. A three-character code contained within each message identifies its type. The first segment (MSH) in each message identifies the message type and the trigger event type that caused the message to be sent.
January 30, 2000 20© 2000, HL7
PV1|1|I|2000^2012^01|E||||004777^LEBAUER^SARA^J.|| TRMA||||ADM|A0|<cr>
Segment
Message - segments, data fields, components
Data field
Component
MSH|^~\&|ADT1|MCM|LABADT|MCM|199807201126||ADT^A01| MSG00001|P|2.3|<cr>
EVN|A01|199807201123|<cr>
PID|1||PATID1234^5^M11||Jones^Sam^Houston||19670329|M||C|1200 N ELM STREET^^GREENVILLE^NC^27401-1020|GL|
(919)379-1212|(919)271-3434||S||X454337 ^2^M10| 123456789|987654^NC|<cr>
NK1|1|JONES^BARBARA^K|WIFE||||CP^Contact person|<cr>
A segment is a logical grouping of data fields. Segments of a message may be required or optional. They may occur only once in a message or they may be allowed to repeat. A name and a unique three-character code known as the Segment ID identify each segment. Segments are sent within messages as the Segment ID followed by a sequence of data fields. The last field ends with the end-of-segment character, a carriage return.
Data fields are transmitted as character strings separated by characters that are data field separators (the “|” character in the example). Each data field has an assigned datatype.
Many of the datatypes are compound – made up of components. (The “^” character is the usual component separator.)
January 30, 2000 21© 2000, HL7
An HL7 V2.3 Message
MSH|^~\&|ADT1|MCM|LABADT|MCM|199807201126||ADT^A01| MSG00001|P|2.3|<cr>
EVN|A01|199807201123|<cr>
PID|1||PATID1234^5^M11||Jones^Sam^Houston||19670329|M||C|1200 N ELM STREET^^GREENVILLE^NC^27401-1020|GL|
(919)379-1212|(919)271-3434||S||X454337 ^2^M10| 123456789|987654^NC|<cr>
NK1|1|JONES^BARBARA^K|WIFE||||CP^Contact person|<cr>
PV1|1|I|2000^2012^01|E||||004777^LEBAUER^SARA^J.|| TRMA||||ADM|A0|<cr>
January 30, 2000 23© 2000, HL7
MSH Message HeaderEVN Event TypePID Patient Identification [PD1] Additional Demographics [{NK1}] Next of Kin /Associated PartiesPV1 Patient Visit[PV2] Patient Visit - Add’l Info.[{DB1}] Disability Information[{OBX}] Observation/Result . . . . . . . [{GT1}] Guarantor[{IN1 Insurance [IN2] Insurance Additional Info. [IN3] Insurance Add'l Info - Cert. }][ACC] Accident Information[UB1] Universal Bill Information[UB2] Universal Bill Information
V2.3 Abstract Message - ADT
[ ] optional
{ } may repeat
January 30, 2000 24© 2000, HL7
V2.3 Segment - MSH
SEQ - position within segment
LEN - length of field
DT - data type for field
OPT - optionality for field
RP/# - repeatability
TBL# - table number for codes
ITEM# - HL7 field number
ELEMENT NAME - name
January 30, 2000 25© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 26© 2000, HL7
Versions 2.x
Strengths– broad functional coverage– highly adaptable
• IS environments differ
• system capabilities variations
– vocabulary independent– least common denominator
technological base
Challenges– broad functional coverage– highly adaptable
• “Seen one? Seen one.”
• vendor capability mismatch
– vocabulary independent– least common denominator
technological base
January 30, 2000 27© 2000, HL7
Semanticinteroperability
Functionalinteroperability
What is computer interoperability?
• Although an intuitive answer is easy, a specific response is more complex
• Institute of Electrical and Electronics Engineers (IEEE) dictionary:
"The ability of two or more systems or components to exchange information and to use the information that has been exchanged.”
[IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]
January 30, 2000 28© 2000, HL7
HL7 specificationsNouns
Things or entities that are
being communicated.
AdjectivesDescriptors and
relationships of the nouns.
VerbsActions being requested
or communicated.
What must be specified for communication?
The semantics of the communicationThe semantics convey the actual "meaning" of the message. The semantics is conveyed via a set of symbols contained within the communication. An external "dictionary", thesaurus,
or terminology explains the meaning of the symbols as they occur. A syntax for communication
The syntax defines the structure and layout of the communication. Common syntax representations include ASN.1, XML, X.12, HL7, IDL, etc.
Services to accomplish the communicationExamples include the post office, a telephone switchboard, SMTP, FTP, Telnet, RPC, ORB services, etc.
A channel to carry the communicationExamples of channels include written documents, telephones, network connections, satellite links, etc.
January 30, 2000 30© 2000, HL7
Ancestry of message design methodology• IEEE P1157 - MEDIX
– Formed during 1986 MEDINFO Conference by an international group, representing both end users and systems vendors
– Scope: "Specify and establish a robust and flexible communications standard for the interchange of data between heterogeneous healthcare information systems."
– Goals:• Do not assume a particular decomposition of the healthcare system into
subsystems
• Structure the standard in a flexible manner, so that multiple subsets of features are allowed
– International participation
January 30, 2000 31© 2000, HL7
IEEE MEDIX - Base assumptions
• Will specify an Information Model -- an abstraction of the real healthcare environment defining the semantics of the domain of discourse
• Will specify a Computational/Communication Model which defines:– a) Requirements imposed upon the services which must be
offered to Healthcare IT applications to enable medical data interchange in the open environment.
– b) Interchange formats and the mapping rules from the information model to the interchange formats to the interchange formats
– c) Communications profiles based upon the ISO/OSI base standards
January 30, 2000 32© 2000, HL7
IEEE P1157 - MEDIX - Open Issues
By 1990, MEDIX still faced several critical questions:
• How to determine what sub-set of the objects and attributes in the information model should be part of a message
• How to specify when a message should be sent
• How to specify how to assemble the data into a message for communication
January 30, 2000 34© 2000, HL7
V-3 Methodology Use Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model
Supports conformance testing
Supports design reuse
January 30, 2000 35© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 36© 2000, HL7
What is Version 3?
• New kinds of standards– Messaging standards that are logically consistent with
Versions 2.x, and have important semantic improvements – Document standards based on SGML/XML document
architecture– Component standards– Knowledge representation
AND
• A new process or methodology for developing those standards– A wholly new approach to the way HL7 develops its
standards
January 30, 2000 38© 2000, HL7
Version 3 as a methodology
• Is a new approach to developing HL7 standards. The
methodology:
– Is based on models and and a common repository, which
provides better control and consistency of the standards
– Defines trigger events using state diagrams in the information
model
– Includes more detail, clarity and precision of specification
– Decreases options by providing more messages
– Includes standard vocabularies, terminologies and code sets.
January 30, 2000 39© 2000, HL7
Reference Model RepositoryReference Model RepositoryReference Model RepositoryReference Model Repository
RequirementsRequirementsAnalysisAnalysis
Use CaseUse CaseModelModel(UCM)(UCM)
RequirementsRequirementsAnalysisAnalysis
Use CaseUse CaseModelModel(UCM)(UCM)
DomainDomainAnalysisAnalysis
Information Information Model &Model &
VocabularyVocabulary(RIM)(RIM)
DomainDomainAnalysisAnalysis
Information Information Model &Model &
VocabularyVocabulary(RIM)(RIM)
AnalysisAnalysisAnalysisAnalysis DesignDesignDesignDesign
InteractionInteractionDesignDesign
InteractionInteractionModelModel(IM)(IM)
InteractionInteractionDesignDesign
InteractionInteractionModelModel(IM)(IM)
MessageMessageDesignDesign
HierarchicalHierarchicalMessageMessage
DescriptionsDescriptions(HMD)(HMD)
MessageMessageDesignDesign
HierarchicalHierarchicalMessageMessage
DescriptionsDescriptions(HMD)(HMD)
ApplicationApplicationApplicationApplication
2-nd Order2-nd Order 1 choice of1 choice of 0-n Drug0-n Drug
0-1 Nursing0-1 Nursing
2-nd Order2-nd Order 1 choice of1 choice of 0-n Drug0-n Drug
0-1 Nursing0-1 Nursing
Medical logicMedical logic
VariableVariabledefinition for definition for Arden syntaxArden syntax
(AVD)(AVD)
Medical logicMedical logic
VariableVariabledefinition for definition for Arden syntaxArden syntax
(AVD)(AVD)
data:data:location_of_actionlocation_of_action := READ LAST := READ LAST MPSLOC ; MPSLOC ; ‘ ‘ {patient{patient location} location}
data:data:location_of_actionlocation_of_action := READ LAST := READ LAST MPSLOC ; MPSLOC ; ‘ ‘ {patient{patient location} location}
DocumentsDocuments
Document Document Types forTypes forHL7 PRAHL7 PRA
(DTD)(DTD)
DocumentsDocuments
Document Document Types forTypes forHL7 PRAHL7 PRA
(DTD)(DTD)
<!ENTITY %DT_MPSLOC<!ENTITY %DT_MPSLOC“MPSLOC.id,“MPSLOC.id, MPSLOC.name?, MPSLOC.name?, MPSLOC.addr?, MPSLOC.addr?, MPSLOC.phon?, MPSLOC.phon?, MPSLOC.emlAdr?"> MPSLOC.emlAdr?">
<!ENTITY %DT_MPSLOC<!ENTITY %DT_MPSLOC“MPSLOC.id,“MPSLOC.id, MPSLOC.name?, MPSLOC.name?, MPSLOC.addr?, MPSLOC.addr?, MPSLOC.phon?, MPSLOC.phon?, MPSLOC.emlAdr?"> MPSLOC.emlAdr?">
MessagingMessaging
Message TypesMessage Typesfor use with for use with
XML, ER7, etcXML, ER7, etc(MET)(MET)
MessagingMessaging
Message TypesMessage Typesfor use with for use with
XML, ER7, etcXML, ER7, etc(MET)(MET)
TYPE MPSLOC TYPE MPSLOC CONTAINS {CONTAINS {id[id].TYPE IIDid[id].TYPE IIDnm[name].TYPE STnm[name].TYPE STad[addr].TYPE XADad[addr].TYPE XADph[phon].TYPE XTN ph[phon].TYPE XTN email_addressemail_address [emlAdr].TYPE XTN [emlAdr].TYPE XTN}}
TYPE MPSLOC TYPE MPSLOC CONTAINS {CONTAINS {id[id].TYPE IIDid[id].TYPE IIDnm[name].TYPE STnm[name].TYPE STad[addr].TYPE XADad[addr].TYPE XADph[phon].TYPE XTN ph[phon].TYPE XTN email_addressemail_address [emlAdr].TYPE XTN [emlAdr].TYPE XTN}}
Methodology - Phases, Models & Applications
C Code c Codea artb bluec color
January 30, 2000 40© 2000, HL7
HL7 Version 3 Methodology in words1. Define a consensus reference information model (RIM) that defines
the data of interest in the healthcare domain.
2. Assemble the terminologies and data types necessary to express the attributes of the RIM
3. Apply the model, vocabulary and types to: messages, patient record DTDs, medical logic modules, component
specifications, etc.
4. For any particular application, draw from the RIM to construct an abstract message structure - the Hierarchical Message Description (HMD)
5. For any particular implementation technology, HL7 will define an implementation technology specification (ITS) for mapping the HMD to that technology.
6. When the message (or equivalent) is sent, the HMD is used to marshal the data, and the ITS is used to format the data for communication.
January 30, 2000 41© 2000, HL7
Version 3 Goals
• 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”
January 30, 2000 42© 2000, HL7
HL7 Version 3 Characteristics
• Design based on consensus Reference Information Model - ties message elements to explicit semantic definitions
• Adaptable to current and future technology bases - requires abstract expression of standard data structure
• Vocabulary-level interoperability - requires robust data type(s) for coded data
• Explicit conformance model - means that optional elements in the specification must be eliminated where ever possible
January 30, 2000 43© 2000, HL7
Version 3 is a change to the HL7 Architecture
• The HL7 2.x specifications have:– Segments that suggest information entities– Events that indicate implied behaviors– And descriptive content that suggests use cases but never formally documents these
• Version 3 seeks to formalize this by applying object analytic methods– to improve the internal consistency of HL7– to provide sound semantic definitions– to enable future architectures– to produce an evolution not a revolution Done by applying MODELING to the HL7 process
January 30, 2000 44© 2000, HL7
HL7 Modeling
Abstractions:
ActivitiesActivities(Use Case (Use Case
Model)Model)
Dispense Medications
Manage Care
Perform Lab Tests
Review Utilization
Objects Objects (Information (Information
Model)Model)
AccountAccount PatientPatient ProviderProvider EncounterEncounter OrderOrder
Communication Communication (Interaction (Interaction
Model)Model)ADT Pharmacy
HL7 message HL7 message
Finance
HALHAL
Version 2.x focused its energies at the communication level and covered the other abstractions only loosely in the specifications.
By demanding analysis of the requirements and information content, Version 3 assures consistency in and enhances the value of the resulting messages.
January 30, 2000 45© 2000, HL7
HL7 V3 Deliverables
• Use case model– Hierarchy of tasks and actors
• Interaction model – Trigger events, abstract
messages & application profiles
• Information model– Classes, relationships, states,
and lifecycles
• Vocabulary– Domains for all coded
attributes– Enumerated codes for HL7
structural tables
• Message design model – Abstract message definitions
(HMDs)
• Implementation Specification– Implementation Technology– Specification (ITS)
January 30, 2000 46© 2000, HL7
Models developed in Phases
Use Case ModelUse Case ModelUse Case ModelUse Case Model
Use Case Diagram
Spec
UCM Spec
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM Spec
State DiagramClass Diagram
Message DesignMessage DesignMessage DesignMessage Design
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
h//mt:50”d”………
h//mt:50”d”………
Identify Actors & Events
Develop ScopeCreate Use Cases
Model new concepts
Harmonize withVocabulary Domains & RIM
Draw initial contents from RIM
Develop MessageInformation Model
Develop Refined Message Information ModelSpecify
HMD
Define Trigger Events
Define Application Roles
DefineInteractions
Create Conformance Claims
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
January 30, 2000 47© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 48© 2000, HL7
Domain Analysis
Use Case ModelUse Case ModelUse Case ModelUse Case Model
Use Case Diagram
Spec
UCM Spec
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM Spec
State DiagramClass Diagram
Message DesignMessage DesignMessage DesignMessage Design
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
h//mt:50”d”………
h//mt:50”d”………
Identify Actors & Events
Develop ScopeCreate Use Cases
Model new concepts
Harmonize withVocabulary Domains & RIM
Draw initial contents from RIM
Develop MessageInformation Model
Develop Refined Message Information Model
Specify HMD
Define Trigger Events
Define Application Roles
DefineInteractions
Create Conformance Claims
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
January 30, 2000 49© 2000, HL7
Domain Analysis
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM Spec
State DiagramClass Diagram
Model new concepts
Harmonize withVocabulary Domains & RIM
Draw initial contents from RIM
January 30, 2000 50© 2000, HL7
Observation_intent_or_orderpatient_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_test ing_cd : CEclinically_relevant_begin_dttm : DTMclinically_relevant_end_dttm : DTMobservation_value_txt : NMprobability_number : NMreferences_range_text : STvalue_units_code : CE
Assessment
Healthcare_service_providerspecialty_cd : CNE
Stakeholder_identifierid : STident if ier_type_cd : ID
Organizationorganization_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_practitionerdesc : TXpractitioner_type_cd : CNE
1
0..1
takes_on_role_of1
is_a_role_of0..1
Stakeholderaddr : XADphon : XTN
0..*
1
is_assigned_to0..*
is_assigned1
Healthcare_provider_organization
0..1
1
is_a_role_of0..1
takes_on_role_of
1
Collected_specimen_samplebody_site_cd : CEcollection_end_dttm : DTMcollection_start_dttm : DTMcollection_volume_amt : CQhandling_cd : IDid : IIDmethod_of_collection_desc : TXspecimen_addit ive_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_in0..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_of0..*
0..*
0..1
is_included_in
0..*
includes 0..1
0..1
0..*
is_primary_facility_for0..1
has_as_primary_facility
0..*
Target_participationparticipation_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_orderfiller_order_id : IIDfiller_txt : TXorder_idorder_placed_dttm : DTMorder_quant itytiming_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..*
Table 18: Classes
Abbr Laboratory Term Classes Abbr Clinical Term ClassesABXBACT Antibiotic susceptibility BDYCRC Body circumferenceALLERGY Response to antigens BDYHGT Body heightBC Cell counts (blood, CSF,
pleuritic fluid)BDYSURF Body surface area
BLDBK Blood bank BDYTMP Body temperatureCELLMARK
Cell surface models BDYWGT Body weight
CHAL Challenge tests BP Blood pressureCHALSKIN Skin challenge tests BP.CENT Blood pressure – centralCHEM Chemistry BP.PSTN Blood pressure – positionalCOAG Coagulation study BP.TIMED Blood pressure – timedCYTO Cytology BP.VENOU
SBlood pressure – venous
DRUG Drug levels CLIN Clinical NECDRUGDOSE
Drug dose (for transmittingdoses for pharmacokinetics)
ED Emergency department
FERT Fertility EKG ElectrocardiogramHEM Hematology (excluding
coagulation & differentialcount)
EKG.IMP Electrocardiogramimpression
HLA HLA tissue typing antigens EKG.MEAS Electrocardiogram measuresMICRO Microbiology EYE EyePATH Pathology FUNCTION Functional status (e.g.
Glasgow)SERO Serology (antibodies and most
antigens except blood bank andinfectious agents)
H&P History and physical
SURGPATH
Sugical pathology HEMODYN Hemodynamics
TOX Toxicology HRTRATE Heart rateUA Urinalysis IO Input/OutputVET Veterinary Medicine NEONAT Neonatal measures
OB.US Obstetric ultrasoundOBGYN Obstetrics/gynecologyRESP RespirationSKNFLD Skinfold measurementsUS.URO Urological ultrasoundVOLUME Volume (specimens)
Information models Vocabularies
Observation_intent_or_orderpatient_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_test ing_cd : CEclinically_relevant_begin_dttm : DTMclinically_relevant_end_dttm : DTMobservation_value_txt : NMprobability_number : NMreferences_range_text : STvalue_units_code : CE
Assessment
Healthcare_service_providerspecialty_cd : CNE
Stakeholder_identifierid : STident if ier_type_cd : ID
Organizationorganization_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_practitionerdesc : TXpractitioner_type_cd : CNE
1
0..1
takes_on_role_of1
is_a_role_of0..1
Stakeholderaddr : XADphon : XTN
0..*
1
is_assigned_to0..*
is_assigned1
Healthcare_provider_organization
0..1
1
is_a_role_of0..1
takes_on_role_of
1
Collected_specimen_samplebody_site_cd : CEcollection_end_dttm : DTMcollection_start_dttm : DTMcollection_volume_amt : CQhandling_cd : IDid : IIDmethod_of_collection_desc : TXspecimen_addit ive_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_in0..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_of0..*
0..*
0..1
is_included_in
0..*
includes 0..1
0..1
0..*
is_primary_facility_for0..1
has_as_primary_facility
0..*
Target_participationparticipation_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_orderfiller_order_id : IIDfiller_txt : TXorder_idorder_placed_dttm : DTMorder_quant itytiming_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..*
Table 18: Classes
Abbr Laboratory Term Classes Abbr Clinical Term ClassesABXBACT Antibiotic susceptibility BDYCRC Body circumferenceALLERGY Response to antigens BDYHGT Body heightBC Cell counts (blood, CSF,
pleuritic fluid)BDYSURF Body surface area
BLDBK Blood bank BDYTMP Body temperatureCELLMARK
Cell surface models BDYWGT Body weight
CHAL Challenge tests BP Blood pressureCHALSKIN Skin challenge tests BP.CENT Blood pressure – centralCHEM Chemistry BP.PSTN Blood pressure – positionalCOAG Coagulation study BP.TIMED Blood pressure – timedCYTO Cytology BP.VENOU
SBlood pressure – venous
DRUG Drug levels CLIN Clinical NECDRUGDOSE
Drug dose (for transmittingdoses for pharmacokinetics)
ED Emergency department
FERT Fertility EKG ElectrocardiogramHEM Hematology (excluding
coagulation & differentialcount)
EKG.IMP Electrocardiogramimpression
HLA HLA tissue typing antigens EKG.MEAS Electrocardiogram measuresMICRO Microbiology EYE EyePATH Pathology FUNCTION Functional status (e.g.
Glasgow)SERO Serology (antibodies and most
antigens except blood bank andinfectious agents)
H&P History and physical
SURGPATH
Sugical pathology HEMODYN Hemodynamics
TOX Toxicology HRTRATE Heart rateUA Urinalysis IO Input/OutputVET Veterinary Medicine NEONAT Neonatal measures
OB.US Obstetric ultrasoundOBGYN Obstetrics/gynecologyRESP RespirationSKNFLD Skinfold measurementsUS.URO Urological ultrasoundVOLUME Volume (specimens)
Domain expertise
HL7 committees, affiliates, members & collaborators
Domain expertise
Vocabulary developers, professional societies, government agencies, HL7 committees
Messaging, Document structures, Clinical templates, Arden syntax, Component specification, …..
Applications
HL7 core requirement - Common semantic models
January 30, 2000 51© 2000, HL7
The Information Model
• A detailed and precise definition for the information from which the data content of HL7 messages are drawn.
• Follows object-oriented modeling and diagramming techniques, and is centered on a depiction of the classes that form the basis for the objects in HL7 messages.
• Provides a means for expressing and reconciling differences in data definition independent of message structure.
• Forms a shared view of the information domain used across all HL7 messages.
January 30, 2000 52© 2000, HL7
The Reference Information Model (RIM)
• Used to express the information content for the collective work of the HL7 Working Group.
• A coherent, shared information model that is the source for the data content of all HL7 messages.
• Maintained by a collaborative, consensus building process involving all Technical Committees and Special Interest Groups.
• RIM change proposals are debated, enhanced, and reconciled by technical committee representatives and applied to the RIM during the model harmonization process
January 30, 2000 53© 2000, HL7
Committee Vs. HL7 Model
• What is the RIM?– A HL7-wide common
reference model that integrates all Technical Committees’ domain views
• Why do we need a common model?– To ensure consistency of
concepts– To ensure consistent
vocabulary
• How will we coordinate these efforts?– Iterative reviews– Harmonization meetings
• Who controls RIM?– The M&M committee
• Format, syntax, style
• Revision histories– The Technical Steering
Committee
• Dispute resolution
• Overseer
January 30, 2000 54© 2000, HL7
RIM Class Diagram - v0.94
Champus_coverage
handicapped_program_cdnon_avail_cert_on_file_indretirement_dttmstation_id
Referral
authorized_visits_qtydescreason_txt
Heal thcare_financesHealthcare_finances
Heal thcare_financesPatient_encountersPatient_service_event
Heal thcare_financesPatient_encountersPatient_service_material
Heal thcare_financesPatient_encounters
HEALTH LEVEL 7 REFERENCE INFORMATION MODEL RIM_0094
released January, 2000reflects agreements made through harmonization in November, 1999
Episode
descepisode_type_cdidlist_closed_indoutcome_txtrecurring_service_ind
DATATYPES
Character_string : ST<<Data_type>>
Encapsulated_data : ED<<Data_type>>
ISO_object_identifier : OID<<Data_type>>
Instance_identifier : II<<Data_type>>
Concept_descriptor : CD<<Data_type>>
Code_translation : CDXL<<Data_type>>
Telecommunication_address : TEL<<Data_type>>
Code_value : CV<<Data_type>>
Code_phrase : CDPH<<Data_type>>
Boolean : BL<<Data_type>>
Binary_data : BIN<<Data_type>>
Real : REAL<<Data_type>>
Ratio : RTO<<Data_type>>
Physical_quantity : PQ<<Data_type>>
Monetary_amount : MO<<Data_type>>
No_information : NULL<<Data_type>>
Number : N<<Data_type>>
T
Interval : IVL<<Data_type>>
T
Annotated : ANT<<Data_type>>
T
History_item : HXIT<<Data_type>>
T
History : HIST<<Data_type>>
T
Uncertain_discrete_value_using_probability : UDVP<<Data_type>>
T
Non-parametric_probability_Distribution : NPPD<<Data_type>>
T
Parametric_probability_distribution : PPD<<Data_type>>
T
Uncertain_value-narrative : UVN<<Data_type>>
T, R
List : LIST<<Data_type>>
T, R
Set : SET<<Data_type>>
T, R
Bag : BAG<<Data_type>>
Point_in_time : TS<<Data_type>>
Postal_and_residential_address : AD<<Data_type>>
Address_part : ADXP<<Data_type>>
Person_name_type : PN<<Data_type>>
Person_name_part : PNXP<<Data_type>>
T, S, R
Collection : COLL<<Data_type>>
Quantity : QTY<<Data_type>>
Ordered : ORD<<Data_type>>
Discrete : DSCR<<Data_type>>
Any_data_type : ANY<<Data_type>>
Text
Thing
Generic
Demographic
Quantity/ Time
Generalizations
Integer : INT<<Data_type>>
Set_ON : SET<ON><<Data_type>>
Set_CRR : SET<CRR><<Data_type>>
Universal_resource_identifier : URI<<Data_type>>
Concept_role_relationship : CRR
name : CVinversion_ind : BLvalue : CDPH
<<Data_type>>
Organization_name : ON
type_cd : CVvalue : ST
<<Data_type>>
General_timing_specification : GTS<<Data_type>>
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Procedure
entry_site_cd : CD
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
Condition_node
Episode_of_condition
1
0..1
defines1
is_defined_by 0..1
Consent
Message_ackMessage_header
0..*1 acknowledges0..*is_acknowledged_by1
Query_by_parameter_spec
Query_by_selection_spec
Response_conrol_spec
Query_subscription_spec
Security_authorization
Row_table_data
Query_ack
Bad_debt_billing_account
bad_debt_recovery_amtbad_debt_transfer_amttransfer_to_bad_debt_dttmtransfer_to_bad_debt_reason_cd
Diagnostic_related_group
base_rate_amtcapital_reimbursement_amtcost_weight_amtidmajor_diagnostic_category_cdoperating_reimbursement_amtreimbursement_amtstandard_day_qtystandard_total_charge_amttrim_high_day_qtytrim_low_day_qty
Inpatient_encounter
actual_length_of_stay_qtyestimated_days_qty
Durable_medical_equipment_slot
Durable_medical_equipment_request
requested_qtytype_cd
Durable_medical_equipment_group
id
0..*
0..1
requests 0..*
is_requested_by 0..1
Clinical_document
Authentication
authentication_dttm : TStype_cd : CV
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Material_relationship
type_cd : CVinversion_ind : BLtmr : IVL<TS>position_nmb : LIST<N>qty : PQ
Container
capacty_qty : PQheight_qty : PQdiameter_qty : PQbarrier_delta_qty : PQbottom_delta_qty : PQseperator_type_cd : CDcap_type_cd : CD
Access
gauge_qty : PQentry_site_cd : CDbody_site_cd : CD
Food
preference_cd : CD
Therapeutic_agent
Device
slot_size_increment_qty : PQ
0..*
1
is_scheduleable_unit_for0..*
is_scheduled_by1
0..*
1
requests0..*
is_requested_by1
0..*
1..*
contains0..*
belongs_to1..*
Bad_debt_collection_agency
0..*
1
is_assigned_to 0..*
is_assigned1
Encounter_drg
approval_indassigned_dttmconfidential_indcost_outlier_amtdescgrouper_review_cdgrouper_version_idoutlier_days_nbroutlier_reimbursement_amtoutlier_type_cd
1
0..*
is_assigned_as 1
is_an_assignment_of0..*
0..*
1
is_assigned_to0..*
is_assigned 1
Stakeholder_affiliation
affiliation_type_cddesceffective_dttermination_dt
Healthcare_document_authenticator
1
0..*
created_by 1
is_source_of 0..*
Insurance_certification_contact
participation_type_cd
Stakeholder_affiliate
family_relationship_cd
0..*
1
has_as_secondary_participant 0..*
participates_as_secondary_in 1
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
Document_recipient
Responsibility
type_cd : CVtmr : IVL<TS>material_id : SET<II>
Language_ability
mode_cdproficiency_level_cd
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
Living_subject
birth_dttmbirthplace_addrorigin_country_cdtaxonomic_classification_cdbreed_txtstrain_txteye_color_cdcoat_or_feather_coloring_txtconfidentiality_constraint_cddeceased_dttmdeceased_indeuthanasia_indgender_cdgender_status_cdprimary_name_type_cdprimary_nmimportance_status_txtqtyproduction_class_cd
Patient_information_recipient
Accident_information_source
Health_chart_deficiency
assessment_dttmdesclevel_cdtype_cd
Clinical_document_header
availability_status_cdchange_reason_cdcompletion_status_cdconfidentiality_status_cdcontent_presentation_cddocument_creation_dttm : TSfile_nm : STid : IIlast_edit_dttmreporting_priority_cdresults_report_dttmstorage_status_cdtranscription_dttmtype_cd : CDdocument_change_cd : CVversion_nbr : INTversion_dttm : TS
0..1
0..*
is_parent_document_for
0..1
has_as_a_parent_document0..*
11
is_part_of 1
has_parts
1
0..*1is_authenticated_by
0..* authenticates 1
0..1 0..*of0..1 has_been_received_by 0..*
Patient_service_location_group
id
Patient_service_location_request
type_cd
0..1
0..*
is_requested_by 0..1
requests0..*
Healthcare_provider_organization
0..*
0..1
has_originating_organization 0..*
originates 0..1
Material
id : SET<II>type_cd : CDform_cd : CVdanger_cd : CDqty : PQ
0..*
1
has_source0..*
is_target_for1
0..*
1
has_target
0..*
is_target_for 1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
is_the 1
for0..1
Patient_service_location_slot
Healthcare_service_provider
board_certification_type_cdboard_certified_indcertification_dttmeffective_tmrlicense_idrecertification_dttmspecialty_cd
Billing_information_item
condition_cdoccurrence_cdoccurrence_dttmoccurrence_span_cdoccurrence_span_from_dttmoccurrence_span_thru_dttmquantity_nbrquantity_type_cdvalue_amtvalue_cd
Individual_healthcare_practitioner_slot
Individual_healthcare_practitioner_pool
id
Certification_additional_opinion
effective_dttmstatus_cd
Individual_healthcare_practitioner_request
practitioner_type_cd
0..1
0..*
is_requested_by 0..1
requests 0..*
Risk_management_incident
incident_cdincident_dttmincident_severity_cdincident_type_cd
Episode_of_care
Location_encounter_role
accommodation_cdeffective_tmrlocation_role_cdstatus_cdtransfer_reason_cdusage_approved_ind
Encounter_practitioner
participation_type_cd
Transportation
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*
1
has_source
0..*
is_source_for 1
0..1
1
has_target 0..1
is_target_for1
1
0..*
represented_as 1
represents0..*
0..*
1
for0..*
has 1
0..*
0..*
is_documented_by 0..*
documents
0..*
Heal thcare_stakeholdersHealthcare_stakeholders
CONTROL_QUERY
Insurance_certification
appeal_reason_cdcertification_duration_qtyeffective_tmridinsurance_verification_dttmmodification_dttmnon_concur_cdnon_concur_effective_dttmpenalty_amtreport_of_eligibility_dttmreport_of_eligibility_ind
1
1..*
has_contact1
is_contact_for 1..*
0..*
1
provides_opinion_on0..*
includes 1
Organization
nm : SET<ON>standard_industry_class_cd
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..*
1
is_assigned_by 0..*
assigns1
0..*
0..1
is_a_subdivision_of0..*
has_as_a_subdivision0..1
0..1
1
is_role_of 0..1
takes_on_role_of1
Preauthorization
authorized_encounters_qtyauthorized_period_begin_dtauthorized_period_end_dtidissued_dttmrequested_dttmrestriction_descstatus_cdstatus_change_dttm
Guarantor_contract
billing_hold_indbilling_media_cdcharge_adjustment_cdcontract_duration_cdcontract_type_cdeffective_tmrinterest_rate_nbrperiodic_payment_amtpriority_ranking_cd
10..* has_coverage_affi rmed_by 1affirms_insurance_coverage_for0..*
Resource_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Service_scheduling_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Person_employment
addreffective_dthazard_exposure_txtjob_class_cdjob_title_nmphonprotective_equipment_txtsalary_qtysalary_type_cdstatus_cdtermination_dtoccupation_cdjob_status_cd
Stakeholder
addr : SET<AD>credit_rating_cdemail_address_txtphon : SET<TEL>type_cdreal_id : SET<II>id : SET<II>
0..* 1has_as_primary_participant0..* participates_as_primary_in 1
0..1
1
is_a0..1
takes_on_role_of1
1
0..1
takes_on_role_of 1
is_role_of
0..1
0..1
1
is_role_of0..1
takes_on_role_of 11
0..*
participates_as1
participation_of
0..*
1
0..1
acts_as1
is_role_of0..1
1
0..*
has 1
of 0..*
1
0..1
takes_on_role_of1
is_a_role_of0..1
1
0..1
takes_role_of1
is_role_of0..1
Notary_public
effective_interval_tmrnotary_county_cdnotary_state_cd
Transcriptionist0..1
0..*
transcribes0..1
is_transcribed_by 0..*
Employee
1
0..*
is_employee_in 1
has_as_employee0..*
Financial_transaction
alternate_descdescextended_amtfee_schedule_cdinsurance_amtposting_dtqtytransaction_batch_idtransaction_cdtransaction_dttmtransaction_idtransaction_type_cdunit_amtunit_cost_amt
0..1
0..*
categorizes0..1
is_categorized_by
0..*
0..*
1
pertains_to0..*
is_associated_wi th 1
Person_name
effective_dtcdnmpurpose_cdtermination_dttype_cd
0..* 0..*refers_to_person_by0..* is_used_by 0..*
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
0..*
1
in 0..*
has 1
0..*
0..1
participation_of 0..*
participates_as0..1
0..1
0..*
participates_as 0..1
participation_of0..*
Language
0..*
1
specifies_abi lity_in 0..*
is_speci fied_by1
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
1
0..*
has_parts 1
is_part_of 0..*
0..*
1
owned_by 0..*
owns1
0..*
0..1
is_about0..*
is_subject_of0..1
Administrative_birth_event
baby_detained_indbirth_certificate_idbirth_method_cdbirth_recorded_county_cdbirth_recorded_dttmnewborn_days_nbrstillborn_ind
Originator1..*1..* has_been_originated_by 1..*of1..*
Specimen
body_site_cd : CD
0..*
1
is_sourced_from 0..*
is_source_for1
1
0..1
takes_on_role 1
is_a_role_of
0..1
Administrative_patient_death
death_certificate_iddeath_certificate_recorded_dttmdeath_classification_cddeath_dttmdeath_location_txtdeath_notification_source_nmdeath_verification_cddeath_verification_dttmdeath_verification_nm
Patient_information_disclosure
disclosure_dttminfo_disclosed_descinfo_requested_descreason_cdrequested_dttmurgency_cd
1
0..*
is_the_recipient_of 1
is_provided_to 0..*
Disability
effective_dttmreturn_to_work_auth_dttmtermination_dttmunable_to_work_effective_dttm
Patient_appointment_request
Patient_slot
Preferred_provider_participation
role_cdeffective_dttermination_dt
0..*
1
has_as_care_provider0..*
participates_in 1
Administrative_patient_accident
accident_death_indaccident_descaccident_dttmaccident_location_descaccident_state_cdaccident_type_cdjob_related_accident_indassessment_dttm
1
0..*
identifies1
is_identified by
0..*
0..1
1..*
is_the_source_of 0..1
is_obtained_from
1..*
Health_chart
health_chart_idhealth_chart_type_cdstatus_cd
1
0..*
has_an_assessment_of 1
is_assessed_against0..*
0..1
0..*
contains 0..1
contained_in 0..*
Master_patient_service_location
addr : ADopen_tmrdescemail_addressid : IIlicensed_bed_nbrnmphonservice_specialty_cdslot_size_increment_qtystatus_cdtype_cdequipment_type_cd
1..* 0..*belongs_to1..* contains 0..*
1
0..*
is_requested_by1
requests0..*
0..*
0..1
is_included_in
0..*
includes 0..1
1..*
0..*
provides_patient_services_at1..*
provides_services_on_behal f_of 0..*
0..*
1
is_housed_at0..*
houses 1
1 0..*has1 pertains_to 0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
1
is_scheduleable_unit_for 0..*
is_scheduled_by1
Patient_provider_association1 0..*knows_of1 is_known_to 0..*
Patient_billing_account
account_idadjustment_cdauthorization_information_txtbilling_status_cdcertification_required_indcurrent_unpaid_balance_qtydelete_dttmdeleted_account_reason_cdexpected_insurance_plan_qtyexpected_payment_source_cdnotice_of_admission_dttmnotice_of_admission_indpatient_financial_class_cdprice_schedule_idpurge_status_cdpurge_status_dttmreport_of_eligibility_dttmretention_indsignature_on_file_dttmspecial_program_cdstoploss_limit_indsuspend_charges_indtotal_adjustment_qtytotal_charge_qtytotal_payment_qtyseparate_bill_ind
0..*
1
pertains_to0..*
has 1
0..1
0..1
is_the_prior_account_for
0..1
has_as_a_prior_account
0..1
0..*
0..*
has_payment_guaranteed_by 0..*
provides_payment_guarantee_for
0..*
0..*
0..1
is_charged_to 0..*
has_charges_for
0..1
0..*
1
is_associated_wi th0..*
has 1
Healthcare_benefit_coverage_item
service_category_cdservice_cdservice_modifier_cdauthorization_indnetwork_indassertion_cdcovered_parties_cdqtyquantity_qualifier_cdtime_period_qualifier_cdrange_low_qtyrange_high_qtyrange_units_cdassertion_effective_tmreligibility_cdpolicy_source_cdeligibility_source_cdcopay_limit_ind
0..*
0..1 is_governed_by
0..*
governs0..1
0..1
0..*
has_as_components
0..1
is_a_component_of
0..*
0..*
1
provides_validation_for0..*
is_validated_by1
1..*
0..*
is_covered_by 1..*
provides_coverage_for0..*
Individual_healthcare_practitioner
fellowship_field_cdgraduate_school_nmgraduation_dttmposition_cdpractitioner_type_cdprimary_care_indresidency_field_cdslot_size_increment_qtyid
1
0..*
is_scheduled_by 1
is_scheduleable_unit_for0..*
1..*
0..*
belongs_to1..*
contains0..*
0..*
1
is_provided_by0..*
provides 1
0..*
1
is_participant_for0..*
participates_as1
1
0..*
is_requested_by1
requests 0..*
Master_healthcare_benefit_product
assignment_of_benefits_indbenefit_product_descidbenefit_product_nmbenefit_product_type_cdbenefits_coordination_indcob_priority_nbrcombine_baby_bill_indeffective_tmrgroup_benefit_indmail_claim_party_cdrelease_information_cdstatus_cdcoverage_type_cdagreement_type_cdpolicy_category_cdaccess_protocol_desc 0..*
0..1
is_child_of
0..*
is_parent_of
0..1
0..*
1
is_a_instance_of 0..*
is_instantiated_as1
0..*
0..1
covers 0..*
is_covered_by 0..1
Resource_slot
offset_qtyallocated_qtyresource_type_cdstatus_cdstart_dttm
Schedule
id
1
0..*
manages 1
is_managed_by0..*
Entering_person
Patient_encounter
administrative_outcome_txtcancellation_reason_cddescencounter_classification_cdexpected_insurance_plan_qtyfirst_similar_illness_dttmfollow_up_type_cdid : IIclassification_cdpurpose_cdspecial_courtesies_cdactive_tmrstatus_cdurgency_cdtriage_classification_cdmedical_service_cdpublicity_constraint_cdreason_cdreferral_cdsource_cdpatient_valuables_descpre_admit_test_indreadmission_indvaluables_location_descacuity_level_cdactual_discharge_disposition_cddischarge_location_idexpected_discharge_disp_cdbirth_encounter_ind
0..*
1
pertains_to
0..*
has1
1..*
1
is_part_of
1..*
has_parts 1
1..*
1
pertains_to 1..*
has1
0..*
0..1
precedes0..*
fol lows0..1
1..*
1
is_associated_wi th 1..*
has_as_participant
1
0..*
1
is_util ized_during 0..*
uti l izes1
0..1 0..*as_assigned to it0..1 is_assigned_to 0..*
1
0..*
has_parts1
is_part_of0..*
1..*
0..*
has 1..*
is_present_in 0..*
1..*
0..1
is_authorized_by
1..*
authorizes 0..1
Insurer
effective_tmr1
0..*
issues1
is_issued_by 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
1
0..*
offers1
is_offered_by 0..*
1
0..*
issues1
is_issued_by 0..*
Guarantor
financial_class_cdhousehold_annual_income_amthousehold_size_nbr
1
1..*
guarantees_payment_under
1
has_payment_guaranteed_by
1..*
0..1
1
is_role_of0..1
takes_on_role_of 1
Healthcare_benefit_product_purchaser
0..1
1
is_role_of 0..1
takes_on_role_of 1
1..1
0..*
is_the_purchaser_of1..1
has_as_purchaser
0..*
Appointment_request
reason_cdadministrative_type_cdequip_selection_criteria_expridlocation_selection_criteria_exprpriority_cdrepeating_interval_duration_qtyrepeat_pattern_exprchange_reason_cdduration_qtystart_tmrtime_selection_criteria_exprexplicit_time_interval_exprappointment_rqst_category_cdstatus_cddttm
0..*1 is_requested_by 0..*requests1
1
0..*
requests1
is_requested_by 0..*
0..1
0..*
enters0..1
is_entered_by0..*
Employer
<>> effective_tmr 1
0..*
is_employer_of1
has_as_employer
0..*
0..1
1
is_role_of0..1
takes_on_role_of 1
0..*
1..*
represents 0..*
is_represented_by1..*
Person
birth_dttm : TSbirthplace_addrcitizenship_country_cdconfidentiality_constraint_cddeceased_dttmdeceased_inddisability_cdeducation_level_cdethnic_group_cdadministrative_gender_cdmarital_status_cdmilitary_branch_of_service_cdmilitary_rank_nmmilitary_status_cdnationality_cdrace_cdreligious_affiliation_cdstudent_cdvery_important_person_cdstatus_cdambulatory_status_cdbirth_order_nbrliving_arrangement_cdliving_dependency_cdmultiple_birth_indorgan_donor_indpreferred_pharmacy_id
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..1
1
is_role_of 0..1
acts_in_role_of 1
1
0..1
takes_on_role_of 1
is_role_of0..1
0..*
1
is_entered_by
0..*
enters 1
1
0..*
has 1
is_for 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
0..*
0..1
participation_of 0..*
participates_as0..1
1
0..*communicates_in
1 is_communicated_by
0..*
0..*
0..1
is_about 0..*
is_subject_of0..1
0..1
1
pertains_to0..1
has1
1
0..1
takes_on_role_of1
is_a_role_of 0..1
0..1
1
is_role_of
0..1
takes_on_role_of 1
0..*
1
is_sourced_from 0..*
is_source_for 1
Patient
0..1
1
pertains_to0..1
has 1
0..*
1
pertains_to
0..*
has 1
0..*
1
pertains_to
0..*
has1
1
0..*
is_requested_by1
requests 0..*
1
0..*
is_scheduled_by 1
is_a_scheduleable_uni t_for 0..*
1
0..*
participates_in 1
has_as_care_recipient
0..*
1
0..*
has1
pertains_to 0..*
0..*
1
belongs_to0..*
has 1
0..1
0..*
is_primary_facil i ty_for 0..1
has_as_primary_facil i ty 0..*
1..*
1
identifies 1..*
is_known_by 1
0..*
1
belongs_to0..*
has 1
1
0..*
has 1
is_for0..*
0..*1 involves 0..*is_involved_in10..*
0..1
has_a_primary_provider 0..*
is_the_primary_provider_for0..1
0..1
1
is_a_role_of 0..1
takes_on_role_of10..*
0..*
is_insured_by 0..*
insures0..*
Appointment
appointment_duration_qtyappointment_timing_qtevent_reason_cdexpected_service_descexpected_start_dttmidstatus_cdurgency_cd
0..*
0..*
is_reserved_by0..*
reserves 0..*
1..*
0..*
books 1..*
is_booked_in 0..*
0..1
0..*
is_parent_of
0..1
is_child_of 0..*
0..*
1
is_entered_by 0..*
enters1
0..1
0..1
is_scheduled_by
0..1
schedules 0..1
Contact_person
contact_reason_cd
0..*
0..1
is_contact_for
0..*
provides_contact0..1
0..*
0..1
is_contact_for0..*
provides_contact
0..1
0..1
0..*
provides_contact 0..1
is_contact_for 0..*
0..*
0..1
has_as_contact0..*
is_contact_for0..1
0..1
0..*
provides_contact
0..1
is_contact_for0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
0..1
is_a_contact_for0..*
has_as_a_contact 0..1
0..*
0..1
has_as_a_contact 0..*
is_a_contact_for0..1
January 30, 2000 55© 2000, HL7
Current 0.94 RIM Statistics
• 114 Classes
• 542 Attributes
• 160 Association Relationships
• 27 Inheritance Relationships
• 2 Aggregation Relationships
• 37 Subject Areas– 19 Domain, 8 Work-in-Progress, 10 Administrative
• 34 Data types
• Maintained in an Access database, expressed in UML, and annotated with a literary expression.
January 30, 2000 56© 2000, HL7
RIM Domain Subject Areas
• Stakeholders– Patient– Person– Stakeholder– Healthcare_service_
provider– Organization
• Healthcare finances– Patient_billing_account– Healthcare_benefit_plan– Guarantor_contract
• Patient_encounters– Clinical Documents– Scheduling– Patient_service_material– Patient_encounter– Patient_service_event
• Master_tables
• Message_control
January 30, 2000 58© 2000, HL7
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM SpecClass Diagram State Diagram
Use Case ModelUse Case ModelUse Case ModelUse Case Model
Use Case Diagram
Spec
UCM Spec
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
HL7HL7Technical Technical
CommitteesCommittees
HL7HL7Member Member OrganizationsOrganizations
Other Standard Development Other Standard Development OrganizationsOrganizations
OthersOthers
Sources of Models for Harmonization
January 30, 2000 59© 2000, HL7
RIM Harmonization Process
Change Proposal Preparation
Prepare RIMChange Proposal
Prepare RIMChange Proposal
Review RIMChange Proposal
w/ Stewards
Review RIMChange Proposal
w/ Stewards
Document Rationalefor not supporting
RIM change proposal
Document Rationalefor not supporting
RIM change proposal
Revise or WithdrawRIM Proposal
Revise or WithdrawRIM Proposal
Post RIM Change Proposals
SubmitRIM Change
Proposal
SubmitRIM Change
Proposal
Post RIMChange Proposal
Post RIMChange Proposal
Notify HL7 Membersof RIM ChangeProposal Posting
Notify HL7 Membersof RIM ChangeProposal Posting
Provide Commenton RIM Change
Proposals
Provide Commenton RIM Change
Proposals
Harmonization Meeting
Discuss the RIMChange ProposalDiscuss the RIMChange Proposal
Revise, withdraw,or Table RIM
Change Proposal
Revise, withdraw,or Table RIM
Change Proposal
Vote on RIMChange Proposal
Vote on RIMChange Proposal
Apply ApprovedChanges to RIMApply ApprovedChanges to RIM
Apply TechnicalCoorections
Apply TechnicalCoorections
Post Harmonization Meeting Review
Present RIMHarmonization Report
to TSC
Present RIMHarmonization Report
to TSC
Hold TSC and/orBoard AppealsHold TSC and/orBoard Appeals
FinalizeRevised RIM
FinalizeRevised RIM
January 30, 2000 60© 2000, HL7
Information Model Facilitators
• A team of model facilitators was recruited from within the HL7 working group.
• The model facilitators are provided focused training in the HL7 modeling methods and tools.
• The model facilitators provide modeling assistance to the technical committees and special interest groups.
• The facilitators meet as a team at each working group meeting to update each other on progress and to identify modeling or process issues.
• The facilitators prepare change proposals for the RIM and attend RIM harmonization meetings.
January 30, 2000 61© 2000, HL7
Domain Specialists and Data Stewards• The members of the message producing technical committees
and message content special interest groups are the domain specialists for the HL7 RIM.
• The technical committees are assigned stewardship responsibility for components of the information model, based upon their domain expertise.
• The technical committee designates a domain specialist from among its members to represent their stewardship interest at RIM harmonization meetings.
• Data steward representatives and model facilitators collaborate with each other to prepare RIM change proposals.
• Data steward representatives attend RIM harmonization meetings.
January 30, 2000 62© 2000, HL7
November 1999 Harmonization Meeeting
• What:– Physicians– Data administrators– System developers– Informaticists
• From:– Very large software companies– Five-person firms– Consultancies– Large provider organizations– Solo practices
January 30, 2000 63© 2000, HL7
State Transition Diagrams
null
Scheduled
Active
Deleted
Discharged
start_encounter ^C00XMT005
delete_scheduled_encounter ^C00XMT006
delete_discharged_encounter
cancel_discharge ^C00XMT009
delete_active_encounter ^C00XMT007
discharge_patient ̂ C00XMT008
schedule_encounter ^C00XMT003
start_encounter ^C00XMT004
State diagram: Patient_encounter
Transitions include reference to the trigger event.
January 30, 2000 64© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 65© 2000, HL7
RIM - 0.94 -- In depth
Champus_coverage
handicapped_program_cdnon_avail_cert_on_file_indretirement_dttmstation_id
Referral
authorized_visits_qtydescreason_txt
Heal thcare_financesHealthcare_finances
Heal thcare_financesPatient_encountersPatient_service_event
Heal thcare_financesPatient_encountersPatient_service_material
Heal thcare_financesPatient_encounters
HEALTH LEVEL 7 REFERENCE INFORMATION MODEL RIM_0094
released January, 2000reflects agreements made through harmonization in November, 1999
Episode
descepisode_type_cdidlist_closed_indoutcome_txtrecurring_service_ind
DATATYPES
Character_string : ST<<Data_type>>
Encapsulated_data : ED<<Data_type>>
ISO_object_identifier : OID<<Data_type>>
Instance_identifier : II<<Data_type>>
Concept_descriptor : CD<<Data_type>>
Code_translation : CDXL<<Data_type>>
Telecommunication_address : TEL<<Data_type>>
Code_value : CV<<Data_type>>
Code_phrase : CDPH<<Data_type>>
Boolean : BL<<Data_type>>
Binary_data : BIN<<Data_type>>
Real : REAL<<Data_type>>
Ratio : RTO<<Data_type>>
Physical_quantity : PQ<<Data_type>>
Monetary_amount : MO<<Data_type>>
No_information : NULL<<Data_type>>
Number : N<<Data_type>>
T
Interval : IVL<<Data_type>>
T
Annotated : ANT<<Data_type>>
T
History_item : HXIT<<Data_type>>
T
History : HIST<<Data_type>>
T
Uncertain_discrete_value_using_probability : UDVP<<Data_type>>
T
Non-parametric_probability_Distribution : NPPD<<Data_type>>
T
Parametric_probability_distribution : PPD<<Data_type>>
T
Uncertain_value-narrative : UVN<<Data_type>>
T, R
List : LIST<<Data_type>>
T, R
Set : SET<<Data_type>>
T, R
Bag : BAG<<Data_type>>
Point_in_time : TS<<Data_type>>
Postal_and_residential_address : AD<<Data_type>>
Address_part : ADXP<<Data_type>>
Person_name_type : PN<<Data_type>>
Person_name_part : PNXP<<Data_type>>
T, S, R
Collection : COLL<<Data_type>>
Quantity : QTY<<Data_type>>
Ordered : ORD<<Data_type>>
Discrete : DSCR<<Data_type>>
Any_data_type : ANY<<Data_type>>
Text
Thing
Generic
Demographic
Quantity/ Time
Generalizations
Integer : INT<<Data_type>>
Set_ON : SET<ON><<Data_type>>
Set_CRR : SET<CRR><<Data_type>>
Universal_resource_identifier : URI<<Data_type>>
Concept_role_relationship : CRR
name : CVinversion_ind : BLvalue : CDPH
<<Data_type>>
Organization_name : ON
type_cd : CVvalue : ST
<<Data_type>>
General_timing_specification : GTS<<Data_type>>
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Procedure
entry_site_cd : CD
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
Condition_node
Episode_of_condition
1
0..1
defines1
is_defined_by 0..1
Consent
Message_ackMessage_header
0..*1 acknowledges0..*is_acknowledged_by1
Query_by_parameter_spec
Query_by_selection_spec
Response_conrol_spec
Query_subscription_spec
Security_authorization
Row_table_data
Query_ack
Bad_debt_billing_account
bad_debt_recovery_amtbad_debt_transfer_amttransfer_to_bad_debt_dttmtransfer_to_bad_debt_reason_cd
Diagnostic_related_group
base_rate_amtcapital_reimbursement_amtcost_weight_amtidmajor_diagnostic_category_cdoperating_reimbursement_amtreimbursement_amtstandard_day_qtystandard_total_charge_amttrim_high_day_qtytrim_low_day_qty
Inpatient_encounter
actual_length_of_stay_qtyestimated_days_qty
Durable_medical_equipment_slot
Durable_medical_equipment_request
requested_qtytype_cd
Durable_medical_equipment_group
id
0..*
0..1
requests 0..*
is_requested_by 0..1
Clinical_document
Authentication
authentication_dttm : TStype_cd : CV
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Material_relationship
type_cd : CVinversion_ind : BLtmr : IVL<TS>position_nmb : LIST<N>qty : PQ
Container
capacty_qty : PQheight_qty : PQdiameter_qty : PQbarrier_delta_qty : PQbottom_delta_qty : PQseperator_type_cd : CDcap_type_cd : CD
Access
gauge_qty : PQentry_site_cd : CDbody_site_cd : CD
Food
preference_cd : CD
Therapeutic_agent
Device
slot_size_increment_qty : PQ
0..*
1
is_scheduleable_unit_for0..*
is_scheduled_by1
0..*
1
requests0..*
is_requested_by1
0..*
1..*
contains0..*
belongs_to1..*
Bad_debt_collection_agency
0..*
1
is_assigned_to 0..*
is_assigned1
Encounter_drg
approval_indassigned_dttmconfidential_indcost_outlier_amtdescgrouper_review_cdgrouper_version_idoutlier_days_nbroutlier_reimbursement_amtoutlier_type_cd
1
0..*
is_assigned_as 1
is_an_assignment_of0..*
0..*
1
is_assigned_to0..*
is_assigned 1
Stakeholder_affiliation
affiliation_type_cddesceffective_dttermination_dt
Healthcare_document_authenticator
1
0..*
created_by 1
is_source_of 0..*
Insurance_certification_contact
participation_type_cd
Stakeholder_affiliate
family_relationship_cd
0..*
1
has_as_secondary_participant 0..*
participates_as_secondary_in 1
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
Document_recipient
Responsibility
type_cd : CVtmr : IVL<TS>material_id : SET<II>
Language_ability
mode_cdproficiency_level_cd
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
Living_subject
birth_dttmbirthplace_addrorigin_country_cdtaxonomic_classification_cdbreed_txtstrain_txteye_color_cdcoat_or_feather_coloring_txtconfidentiality_constraint_cddeceased_dttmdeceased_indeuthanasia_indgender_cdgender_status_cdprimary_name_type_cdprimary_nmimportance_status_txtqtyproduction_class_cd
Patient_information_recipient
Accident_information_source
Health_chart_deficiency
assessment_dttmdesclevel_cdtype_cd
Clinical_document_header
availability_status_cdchange_reason_cdcompletion_status_cdconfidentiality_status_cdcontent_presentation_cddocument_creation_dttm : TSfile_nm : STid : IIlast_edit_dttmreporting_priority_cdresults_report_dttmstorage_status_cdtranscription_dttmtype_cd : CDdocument_change_cd : CVversion_nbr : INTversion_dttm : TS
0..1
0..*
is_parent_document_for
0..1
has_as_a_parent_document0..*
11
is_part_of 1
has_parts
1
0..*1is_authenticated_by
0..* authenticates 1
0..1 0..*of0..1 has_been_received_by 0..*
Patient_service_location_group
id
Patient_service_location_request
type_cd
0..1
0..*
is_requested_by 0..1
requests0..*
Healthcare_provider_organization
0..*
0..1
has_originating_organization 0..*
originates 0..1
Material
id : SET<II>type_cd : CDform_cd : CVdanger_cd : CDqty : PQ
0..*
1
has_source0..*
is_target_for1
0..*
1
has_target
0..*
is_target_for 1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
is_the 1
for0..1
Patient_service_location_slot
Healthcare_service_provider
board_certification_type_cdboard_certified_indcertification_dttmeffective_tmrlicense_idrecertification_dttmspecialty_cd
Billing_information_item
condition_cdoccurrence_cdoccurrence_dttmoccurrence_span_cdoccurrence_span_from_dttmoccurrence_span_thru_dttmquantity_nbrquantity_type_cdvalue_amtvalue_cd
Individual_healthcare_practitioner_slot
Individual_healthcare_practitioner_pool
id
Certification_additional_opinion
effective_dttmstatus_cd
Individual_healthcare_practitioner_request
practitioner_type_cd
0..1
0..*
is_requested_by 0..1
requests 0..*
Risk_management_incident
incident_cdincident_dttmincident_severity_cdincident_type_cd
Episode_of_care
Location_encounter_role
accommodation_cdeffective_tmrlocation_role_cdstatus_cdtransfer_reason_cdusage_approved_ind
Encounter_practitioner
participation_type_cd
Transportation
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*
1
has_source
0..*
is_source_for 1
0..1
1
has_target 0..1
is_target_for1
1
0..*
represented_as 1
represents0..*
0..*
1
for0..*
has 1
0..*
0..*
is_documented_by 0..*
documents
0..*
Heal thcare_stakeholdersHealthcare_stakeholders
CONTROL_QUERY
Insurance_certification
appeal_reason_cdcertification_duration_qtyeffective_tmridinsurance_verification_dttmmodification_dttmnon_concur_cdnon_concur_effective_dttmpenalty_amtreport_of_eligibility_dttmreport_of_eligibility_ind
1
1..*
has_contact1
is_contact_for 1..*
0..*
1
provides_opinion_on0..*
includes 1
Organization
nm : SET<ON>standard_industry_class_cd
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..*
1
is_assigned_by 0..*
assigns1
0..*
0..1
is_a_subdivision_of0..*
has_as_a_subdivision0..1
0..1
1
is_role_of 0..1
takes_on_role_of1
Preauthorization
authorized_encounters_qtyauthorized_period_begin_dtauthorized_period_end_dtidissued_dttmrequested_dttmrestriction_descstatus_cdstatus_change_dttm
Guarantor_contract
billing_hold_indbilling_media_cdcharge_adjustment_cdcontract_duration_cdcontract_type_cdeffective_tmrinterest_rate_nbrperiodic_payment_amtpriority_ranking_cd
10..* has_coverage_affi rmed_by 1affirms_insurance_coverage_for0..*
Resource_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Service_scheduling_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Person_employment
addreffective_dthazard_exposure_txtjob_class_cdjob_title_nmphonprotective_equipment_txtsalary_qtysalary_type_cdstatus_cdtermination_dtoccupation_cdjob_status_cd
Stakeholder
addr : SET<AD>credit_rating_cdemail_address_txtphon : SET<TEL>type_cdreal_id : SET<II>id : SET<II>
0..* 1has_as_primary_participant0..* participates_as_primary_in 1
0..1
1
is_a0..1
takes_on_role_of1
1
0..1
takes_on_role_of 1
is_role_of
0..1
0..1
1
is_role_of0..1
takes_on_role_of 11
0..*
participates_as1
participation_of
0..*
1
0..1
acts_as1
is_role_of0..1
1
0..*
has 1
of 0..*
1
0..1
takes_on_role_of1
is_a_role_of0..1
1
0..1
takes_role_of1
is_role_of0..1
Notary_public
effective_interval_tmrnotary_county_cdnotary_state_cd
Transcriptionist0..1
0..*
transcribes0..1
is_transcribed_by 0..*
Employee
1
0..*
is_employee_in 1
has_as_employee0..*
Financial_transaction
alternate_descdescextended_amtfee_schedule_cdinsurance_amtposting_dtqtytransaction_batch_idtransaction_cdtransaction_dttmtransaction_idtransaction_type_cdunit_amtunit_cost_amt
0..1
0..*
categorizes0..1
is_categorized_by
0..*
0..*
1
pertains_to0..*
is_associated_wi th 1
Person_name
effective_dtcdnmpurpose_cdtermination_dttype_cd
0..* 0..*refers_to_person_by0..* is_used_by 0..*
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
0..*
1
in 0..*
has 1
0..*
0..1
participation_of 0..*
participates_as0..1
0..1
0..*
participates_as 0..1
participation_of0..*
Language
0..*
1
specifies_abi lity_in 0..*
is_speci fied_by1
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
1
0..*
has_parts 1
is_part_of 0..*
0..*
1
owned_by 0..*
owns1
0..*
0..1
is_about0..*
is_subject_of0..1
Administrative_birth_event
baby_detained_indbirth_certificate_idbirth_method_cdbirth_recorded_county_cdbirth_recorded_dttmnewborn_days_nbrstillborn_ind
Originator1..*1..* has_been_originated_by 1..*of1..*
Specimen
body_site_cd : CD
0..*
1
is_sourced_from 0..*
is_source_for1
1
0..1
takes_on_role 1
is_a_role_of
0..1
Administrative_patient_death
death_certificate_iddeath_certificate_recorded_dttmdeath_classification_cddeath_dttmdeath_location_txtdeath_notification_source_nmdeath_verification_cddeath_verification_dttmdeath_verification_nm
Patient_information_disclosure
disclosure_dttminfo_disclosed_descinfo_requested_descreason_cdrequested_dttmurgency_cd
1
0..*
is_the_recipient_of 1
is_provided_to 0..*
Disability
effective_dttmreturn_to_work_auth_dttmtermination_dttmunable_to_work_effective_dttm
Patient_appointment_request
Patient_slot
Preferred_provider_participation
role_cdeffective_dttermination_dt
0..*
1
has_as_care_provider0..*
participates_in 1
Administrative_patient_accident
accident_death_indaccident_descaccident_dttmaccident_location_descaccident_state_cdaccident_type_cdjob_related_accident_indassessment_dttm
1
0..*
identifies1
is_identified by
0..*
0..1
1..*
is_the_source_of 0..1
is_obtained_from
1..*
Health_chart
health_chart_idhealth_chart_type_cdstatus_cd
1
0..*
has_an_assessment_of 1
is_assessed_against0..*
0..1
0..*
contains 0..1
contained_in 0..*
Master_patient_service_location
addr : ADopen_tmrdescemail_addressid : IIlicensed_bed_nbrnmphonservice_specialty_cdslot_size_increment_qtystatus_cdtype_cdequipment_type_cd
1..* 0..*belongs_to1..* contains 0..*
1
0..*
is_requested_by1
requests0..*
0..*
0..1
is_included_in
0..*
includes 0..1
1..*
0..*
provides_patient_services_at1..*
provides_services_on_behal f_of 0..*
0..*
1
is_housed_at0..*
houses 1
1 0..*has1 pertains_to 0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
1
is_scheduleable_unit_for 0..*
is_scheduled_by1
Patient_provider_association1 0..*knows_of1 is_known_to 0..*
Patient_billing_account
account_idadjustment_cdauthorization_information_txtbilling_status_cdcertification_required_indcurrent_unpaid_balance_qtydelete_dttmdeleted_account_reason_cdexpected_insurance_plan_qtyexpected_payment_source_cdnotice_of_admission_dttmnotice_of_admission_indpatient_financial_class_cdprice_schedule_idpurge_status_cdpurge_status_dttmreport_of_eligibility_dttmretention_indsignature_on_file_dttmspecial_program_cdstoploss_limit_indsuspend_charges_indtotal_adjustment_qtytotal_charge_qtytotal_payment_qtyseparate_bill_ind
0..*
1
pertains_to0..*
has 1
0..1
0..1
is_the_prior_account_for
0..1
has_as_a_prior_account
0..1
0..*
0..*
has_payment_guaranteed_by 0..*
provides_payment_guarantee_for
0..*
0..*
0..1
is_charged_to 0..*
has_charges_for
0..1
0..*
1
is_associated_wi th0..*
has 1
Healthcare_benefit_coverage_item
service_category_cdservice_cdservice_modifier_cdauthorization_indnetwork_indassertion_cdcovered_parties_cdqtyquantity_qualifier_cdtime_period_qualifier_cdrange_low_qtyrange_high_qtyrange_units_cdassertion_effective_tmreligibility_cdpolicy_source_cdeligibility_source_cdcopay_limit_ind
0..*
0..1 is_governed_by
0..*
governs0..1
0..1
0..*
has_as_components
0..1
is_a_component_of
0..*
0..*
1
provides_validation_for0..*
is_validated_by1
1..*
0..*
is_covered_by 1..*
provides_coverage_for0..*
Individual_healthcare_practitioner
fellowship_field_cdgraduate_school_nmgraduation_dttmposition_cdpractitioner_type_cdprimary_care_indresidency_field_cdslot_size_increment_qtyid
1
0..*
is_scheduled_by 1
is_scheduleable_unit_for0..*
1..*
0..*
belongs_to1..*
contains0..*
0..*
1
is_provided_by0..*
provides 1
0..*
1
is_participant_for0..*
participates_as1
1
0..*
is_requested_by1
requests 0..*
Master_healthcare_benefit_product
assignment_of_benefits_indbenefit_product_descidbenefit_product_nmbenefit_product_type_cdbenefits_coordination_indcob_priority_nbrcombine_baby_bill_indeffective_tmrgroup_benefit_indmail_claim_party_cdrelease_information_cdstatus_cdcoverage_type_cdagreement_type_cdpolicy_category_cdaccess_protocol_desc 0..*
0..1
is_child_of
0..*
is_parent_of
0..1
0..*
1
is_a_instance_of 0..*
is_instantiated_as1
0..*
0..1
covers 0..*
is_covered_by 0..1
Resource_slot
offset_qtyallocated_qtyresource_type_cdstatus_cdstart_dttm
Schedule
id
1
0..*
manages 1
is_managed_by0..*
Entering_person
Patient_encounter
administrative_outcome_txtcancellation_reason_cddescencounter_classification_cdexpected_insurance_plan_qtyfirst_similar_illness_dttmfollow_up_type_cdid : IIclassification_cdpurpose_cdspecial_courtesies_cdactive_tmrstatus_cdurgency_cdtriage_classification_cdmedical_service_cdpublicity_constraint_cdreason_cdreferral_cdsource_cdpatient_valuables_descpre_admit_test_indreadmission_indvaluables_location_descacuity_level_cdactual_discharge_disposition_cddischarge_location_idexpected_discharge_disp_cdbirth_encounter_ind
0..*
1
pertains_to
0..*
has1
1..*
1
is_part_of
1..*
has_parts 1
1..*
1
pertains_to 1..*
has1
0..*
0..1
precedes0..*
fol lows0..1
1..*
1
is_associated_wi th 1..*
has_as_participant
1
0..*
1
is_util ized_during 0..*
uti l izes1
0..1 0..*as_assigned to it0..1 is_assigned_to 0..*
1
0..*
has_parts1
is_part_of0..*
1..*
0..*
has 1..*
is_present_in 0..*
1..*
0..1
is_authorized_by
1..*
authorizes 0..1
Insurer
effective_tmr1
0..*
issues1
is_issued_by 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
1
0..*
offers1
is_offered_by 0..*
1
0..*
issues1
is_issued_by 0..*
Guarantor
financial_class_cdhousehold_annual_income_amthousehold_size_nbr
1
1..*
guarantees_payment_under
1
has_payment_guaranteed_by
1..*
0..1
1
is_role_of0..1
takes_on_role_of 1
Healthcare_benefit_product_purchaser
0..1
1
is_role_of 0..1
takes_on_role_of 1
1..1
0..*
is_the_purchaser_of1..1
has_as_purchaser
0..*
Appointment_request
reason_cdadministrative_type_cdequip_selection_criteria_expridlocation_selection_criteria_exprpriority_cdrepeating_interval_duration_qtyrepeat_pattern_exprchange_reason_cdduration_qtystart_tmrtime_selection_criteria_exprexplicit_time_interval_exprappointment_rqst_category_cdstatus_cddttm
0..*1 is_requested_by 0..*requests1
1
0..*
requests1
is_requested_by 0..*
0..1
0..*
enters0..1
is_entered_by0..*
Employer
<>> effective_tmr 1
0..*
is_employer_of1
has_as_employer
0..*
0..1
1
is_role_of0..1
takes_on_role_of 1
0..*
1..*
represents 0..*
is_represented_by1..*
Person
birth_dttm : TSbirthplace_addrcitizenship_country_cdconfidentiality_constraint_cddeceased_dttmdeceased_inddisability_cdeducation_level_cdethnic_group_cdadministrative_gender_cdmarital_status_cdmilitary_branch_of_service_cdmilitary_rank_nmmilitary_status_cdnationality_cdrace_cdreligious_affiliation_cdstudent_cdvery_important_person_cdstatus_cdambulatory_status_cdbirth_order_nbrliving_arrangement_cdliving_dependency_cdmultiple_birth_indorgan_donor_indpreferred_pharmacy_id
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..1
1
is_role_of 0..1
acts_in_role_of 1
1
0..1
takes_on_role_of 1
is_role_of0..1
0..*
1
is_entered_by
0..*
enters 1
1
0..*
has 1
is_for 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
0..*
0..1
participation_of 0..*
participates_as0..1
1
0..*communicates_in
1 is_communicated_by
0..*
0..*
0..1
is_about 0..*
is_subject_of0..1
0..1
1
pertains_to0..1
has1
1
0..1
takes_on_role_of1
is_a_role_of 0..1
0..1
1
is_role_of
0..1
takes_on_role_of 1
0..*
1
is_sourced_from 0..*
is_source_for 1
Patient
0..1
1
pertains_to0..1
has 1
0..*
1
pertains_to
0..*
has 1
0..*
1
pertains_to
0..*
has1
1
0..*
is_requested_by1
requests 0..*
1
0..*
is_scheduled_by 1
is_a_scheduleable_uni t_for 0..*
1
0..*
participates_in 1
has_as_care_recipient
0..*
1
0..*
has1
pertains_to 0..*
0..*
1
belongs_to0..*
has 1
0..1
0..*
is_primary_facili ty_for 0..1
has_as_primary_facili ty 0..*
1..*
1
identifies 1..*
is_known_by 1
0..*
1
belongs_to0..*
has 1
1
0..*
has 1
is_for0..*
0..*1 involves 0..*is_involved_in10..*
0..1
has_a_primary_provider 0..*
is_the_primary_provider_for0..1
0..1
1
is_a_role_of 0..1
takes_on_role_of10..*
0..*
is_insured_by 0..*
insures0..*
Appointment
appointment_duration_qtyappointment_timing_qtevent_reason_cdexpected_service_descexpected_start_dttmidstatus_cdurgency_cd
0..*
0..*
is_reserved_by0..*
reserves 0..*
1..*
0..*
books 1..*
is_booked_in 0..*
0..1
0..*
is_parent_of
0..1
is_child_of 0..*
0..*
1
is_entered_by 0..*
enters1
0..1
0..1
is_scheduled_by
0..1
schedules 0..1
Contact_person
contact_reason_cd
0..*
0..1
is_contact_for
0..*
provides_contact0..1
0..*
0..1
is_contact_for0..*
provides_contact
0..1
0..1
0..*
provides_contact 0..1
is_contact_for 0..*
0..*
0..1
has_as_contact0..*
is_contact_for0..1
0..1
0..*
provides_contact
0..1
is_contact_for0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
0..1
is_a_contact_for0..*
has_as_a_contact 0..1
0..*
0..1
has_as_a_contact 0..*
is_a_contact_for0..1
Champus_coverage
handicapped_program_cdnon_avail_cert_on_file_indretirement_dttmstation_id
Referral
authorized_visits_qtydescreason_txt
Healthcare_financesHealthcare_finances
Healthcare_financesPatient_encountersPatient_service_event
Healthcare_financesPatient_encountersPatient_service_material
Healthcare_financesPatient_encounters
HEALTH LEVEL 7 REFERENCE INFORMATION MODEL RIM_0094
released January, 2000reflects agreements made through harmonization in November, 1999
Episode
descepisode_type_cdidlist_closed_indoutcome_txtrecurring_service_ind
DATATYPES
Character_string : ST<<Data_type>>
Encapsulated_data : ED<<Data_type>>
ISO_object_identifier : OID<<Data_type>>
Instance_identifier : II<<Data_type>>
Concept_descriptor : CD<<Data_type>>
Code_translation : CDXL<<Data_type>>
Telecommunication_address : TEL<<Data_type>>
Code_value : CV<<Data_type>>
Code_phrase : CDPH<<Data_type>>
Boolean : BL<<Data_type>>
Binary_data : BIN<<Data_type>>
Real : REAL<<Data_type>>
Ratio : RTO<<Data_type>>
Physical_quantity : PQ<<Data_type>>
Monetary_amount : MO<<Data_type>>
No_information : NULL<<Data_type>>
Number : N<<Data_type>>
T
Interval : IVL<<Data_type>>
T
Annotated : ANT<<Data_type>>
T
History_item : HXIT<<Data_type>>
T
History : HIST<<Data_type>>
T
Uncertain_discrete_value_using_probability : UDVP<<Data_type>>
T
Non-parametric_probability_Distribution : NPPD<<Data_type>>
T
Parametric_probability_distribution : PPD<<Data_type>>
T
Uncertain_value-narrative : UVN<<Data_type>>
T, R
List : LIST<<Data_type>>
T, R
Set : SET<<Data_type>>
T, R
Bag : BAG<<Data_type>>
Point_in_time : TS<<Data_type>>
Postal_and_residential_address : AD<<Data_type>>
Address_part : ADXP<<Data_type>>
Person_name_type : PN<<Data_type>>
Person_name_part : PNXP<<Data_type>>
T, S, R
Collection : COLL<<Data_type>>
Quantity : QTY<<Data_type>>
Ordered : ORD<<Data_type>>
Discrete : DSCR<<Data_type>>
Any_data_type : ANY<<Data_type>>
Text
Thing
Generic
Demographic
Quantity/ Time
Generalizations
Integer : INT<<Data_type>>
Set_ON : SET<ON><<Data_type>>
Set_CRR : SET<CRR><<Data_type>>
Universal_resource_identifier : URI<<Data_type>>
Concept_role_relationship : CRR
name : CVinversion_ind : BLvalue : CDPH
<<Data_type>>
Organization_name : ON
type_cd : CVvalue : ST
<<Data_type>>
General_timing_specification : GTS<<Data_type>>
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Procedure
entry_site_cd : CD
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
Condition_node
Episode_of_condition
1
0..1
defines1
is_defined_by 0..1
Consent
Message_ackMessage_header
0..*1 acknowledges0..*is_acknowledged_by1
Query_by_parameter_spec
Query_by_selection_spec
Response_conrol_spec
Query_subscription_spec
Security_authorization
Row_table_data
Query_ack
Bad_debt_billing_account
bad_debt_recovery_amtbad_debt_transfer_amttransfer_to_bad_debt_dttmtransfer_to_bad_debt_reason_cd
Diagnostic_related_group
base_rate_amtcapital_reimbursement_amtcost_weight_amtidmajor_diagnostic_category_cdoperating_reimbursement_amtreimbursement_amtstandard_day_qtystandard_total_charge_amttrim_high_day_qtytrim_low_day_qty
Inpatient_encounter
actual_length_of_stay_qtyestimated_days_qty
Durable_medical_equipment_slot
Durable_medical_equipment_request
requested_qtytype_cd
Durable_medical_equipment_group
id
0..*
0..1
requests 0..*
is_requested_by 0..1
Clinical_document
Authentication
authentication_dttm : TStype_cd : CV
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Material_relationship
type_cd : CVinversion_ind : BLtmr : IVL<TS>position_nmb : LIST<N>qty : PQ
Container
capacty_qty : PQheight_qty : PQdiameter_qty : PQbarrier_delta_qty : PQbottom_delta_qty : PQseperator_type_cd : CDcap_type_cd : CD
Access
gauge_qty : PQentry_site_cd : CDbody_site_cd : CD
Food
preference_cd : CD
Therapeutic_agent
Device
slot_size_increment_qty : PQ
0..*
1
is_scheduleable_unit_for0..*
is_scheduled_by1
0..*
1
requests0..*
is_requested_by1
0..*
1..*
contains0..*
belongs_to1..*
Bad_debt_collection_agency
0..*
1
is_assigned_to 0..*
is_assigned1
Encounter_drg
approval_indassigned_dttmconfidential_indcost_outlier_amtdescgrouper_review_cdgrouper_version_idoutlier_days_nbroutlier_reimbursement_amtoutlier_type_cd
1
0..*
is_assigned_as 1
is_an_assignment_of0..*
0..*
1
is_assigned_to0..*
is_assigned 1
Stakeholder_affiliation
affiliation_type_cddesceffective_dttermination_dt
Healthcare_document_authenticator
1
0..*
created_by 1
is_source_of 0..*
Insurance_certification_contact
participation_type_cd
Stakeholder_affiliate
family_relationship_cd
0..*
1
has_as_secondary_participant 0..*
participates_as_secondary_in 1
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
Document_recipient
Responsibility
type_cd : CVtmr : IVL<TS>material_id : SET<II>
Language_ability
mode_cdproficiency_level_cd
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
Living_subject
birth_dttmbirthplace_addrorigin_country_cdtaxonomic_classification_cdbreed_txtstrain_txteye_color_cdcoat_or_feather_coloring_txtconfidentiality_constraint_cddeceased_dttmdeceased_indeuthanasia_indgender_cdgender_status_cdprimary_name_type_cdprimary_nmimportance_status_txtqtyproduction_class_cd
Patient_information_recipient
Accident_information_source
Health_chart_deficiency
assessment_dttmdesclevel_cdtype_cd
Clinical_document_header
availability_status_cdchange_reason_cdcompletion_status_cdconfidentiality_status_cdcontent_presentation_cddocument_creation_dttm : TSfile_nm : STid : IIlast_edit_dttmreporting_priority_cdresults_report_dttmstorage_status_cdtranscription_dttmtype_cd : CDdocument_change_cd : CVversion_nbr : INTversion_dttm : TS
0..1
0..*
is_parent_document_for
0..1
has_as_a_parent_document0..*
11
is_part_of 1
has_parts
1
0..*1is_authenticated_by
0..* authenticates 1
0..1 0..*of0..1 has_been_received_by 0..*
Patient_service_location_group
id
Patient_service_location_request
type_cd
0..1
0..*
is_requested_by 0..1
requests0..*
Healthcare_provider_organization
0..*
0..1
has_originating_organization 0..*
originates 0..1
Material
id : SET<II>type_cd : CDform_cd : CVdanger_cd : CDqty : PQ
0..*
1
has_source0..*
is_target_for1
0..*
1
has_target
0..*
is_target_for 1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
takes_on_role 1
is_a_role_of
0..1
1
0..1
is_the 1
for0..1
Patient_service_location_slot
Healthcare_service_provider
board_certification_type_cdboard_certified_indcertification_dttmeffective_tmrlicense_idrecertification_dttmspecialty_cd
Billing_information_item
condition_cdoccurrence_cdoccurrence_dttmoccurrence_span_cdoccurrence_span_from_dttmoccurrence_span_thru_dttmquantity_nbrquantity_type_cdvalue_amtvalue_cd
Individual_healthcare_practitioner_slot
Individual_healthcare_practitioner_pool
id
Certification_additional_opinion
effective_dttmstatus_cd
Individual_healthcare_practitioner_request
practitioner_type_cd
0..1
0..*
is_requested_by 0..1
requests 0..*
Risk_management_incident
incident_cdincident_dttmincident_severity_cdincident_type_cd
Episode_of_care
Location_encounter_role
accommodation_cdeffective_tmrlocation_role_cdstatus_cdtransfer_reason_cdusage_approved_ind
Encounter_practitioner
participation_type_cd
Transportation
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*
1
has_source
0..*
is_source_for 1
0..1
1
has_target 0..1
is_target_for1
1
0..*
represented_as 1
represents0..*
0..*
1
for0..*
has 1
0..*
0..*
is_documented_by 0..*
documents
0..*
Heal thcare_stakeholdersHealthcare_stakeholders
CONTROL_QUERY
Insurance_certification
appeal_reason_cdcertification_duration_qtyeffective_tmridinsurance_verification_dttmmodification_dttmnon_concur_cdnon_concur_effective_dttmpenalty_amtreport_of_eligibility_dttmreport_of_eligibility_ind
1
1..*
has_contact1
is_contact_for 1..*
0..*
1
provides_opinion_on0..*
includes 1
Organization
nm : SET<ON>standard_industry_class_cd
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..*
1
is_assigned_by 0..*
assigns1
0..*
0..1
is_a_subdivision_of0..*
has_as_a_subdivision0..1
0..1
1
is_role_of 0..1
takes_on_role_of1
Preauthorization
authorized_encounters_qtyauthorized_period_begin_dtauthorized_period_end_dtidissued_dttmrequested_dttmrestriction_descstatus_cdstatus_change_dttm
Guarantor_contract
billing_hold_indbilling_media_cdcharge_adjustment_cdcontract_duration_cdcontract_type_cdeffective_tmrinterest_rate_nbrperiodic_payment_amtpriority_ranking_cd
10..* has_coverage_affi rmed_by 1affirms_insurance_coverage_for0..*
Resource_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Service_scheduling_request
allowable_substitutions_cdduration_qtystart_dttmstart_offset_qtystatus_cd
Person_employment
addreffective_dthazard_exposure_txtjob_class_cdjob_title_nmphonprotective_equipment_txtsalary_qtysalary_type_cdstatus_cdtermination_dtoccupation_cdjob_status_cd
Stakeholder
addr : SET<AD>credit_rating_cdemail_address_txtphon : SET<TEL>type_cdreal_id : SET<II>id : SET<II>
0..* 1has_as_primary_participant0..* participates_as_primary_in 1
0..1
1
is_a0..1
takes_on_role_of1
1
0..1
takes_on_role_of 1
is_role_of
0..1
0..1
1
is_role_of0..1
takes_on_role_of 11
0..*
participates_as1
participation_of
0..*
1
0..1
acts_as1
is_role_of0..1
1
0..*
has 1
of 0..*
1
0..1
takes_on_role_of1
is_a_role_of0..1
1
0..1
takes_role_of1
is_role_of0..1
Notary_public
effective_interval_tmrnotary_county_cdnotary_state_cd
Transcriptionist0..1
0..*
transcribes0..1
is_transcribed_by 0..*
Employee
1
0..*
is_employee_in 1
has_as_employee0..*
Financial_transaction
alternate_descdescextended_amtfee_schedule_cdinsurance_amtposting_dtqtytransaction_batch_idtransaction_cdtransaction_dttmtransaction_idtransaction_type_cdunit_amtunit_cost_amt
0..1
0..*
categorizes0..1
is_categorized_by
0..*
0..*
1
pertains_to0..*
is_associated_with 1
Person_name
effective_dtcdnmpurpose_cdtermination_dttype_cd
0..* 0..*refers_to_person_by0..* is_used_by 0..*
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
0..*
1
in 0..*
has 1
0..*
0..1
participation_of 0..*
participates_as0..1
0..1
0..*
participates_as 0..1
participation_of0..*
Language
0..*
1
specifies_abi lity_in 0..*
is_speci fied_by1
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
1
0..*
has_parts 1
is_part_of 0..*
0..*
1
owned_by 0..*
owns1
0..*
0..1
is_about0..*
is_subject_of0..1
Administrative_birth_event
baby_detained_indbirth_certificate_idbirth_method_cdbirth_recorded_county_cdbirth_recorded_dttmnewborn_days_nbrstillborn_ind
Originator1..*1..* has_been_originated_by 1..*of1..*
Specimen
body_site_cd : CD
0..*
1
is_sourced_from 0..*
is_source_for1
1
0..1
takes_on_role 1
is_a_role_of
0..1
Administrative_patient_death
death_certificate_iddeath_certificate_recorded_dttmdeath_classification_cddeath_dttmdeath_location_txtdeath_notification_source_nmdeath_verification_cddeath_verification_dttmdeath_verification_nm
Patient_information_disclosure
disclosure_dttminfo_disclosed_descinfo_requested_descreason_cdrequested_dttmurgency_cd
1
0..*
is_the_recipient_of 1
is_provided_to 0..*
Disability
effective_dttmreturn_to_work_auth_dttmtermination_dttmunable_to_work_effective_dttm
Patient_appointment_request
Patient_slot
Preferred_provider_participation
role_cdeffective_dttermination_dt
0..*
1
has_as_care_provider0..*
participates_in 1
Administrative_patient_accident
accident_death_indaccident_descaccident_dttmaccident_location_descaccident_state_cdaccident_type_cdjob_related_accident_indassessment_dttm
1
0..*
identifies1
is_identified by
0..*
0..1
1..*
is_the_source_of 0..1
is_obtained_from
1..*
Health_chart
health_chart_idhealth_chart_type_cdstatus_cd
1
0..*
has_an_assessment_of 1
is_assessed_against0..*
0..1
0..*
contains 0..1
contained_in 0..*
Master_patient_service_location
addr : ADopen_tmrdescemail_addressid : IIlicensed_bed_nbrnmphonservice_specialty_cdslot_size_increment_qtystatus_cdtype_cdequipment_type_cd
1..* 0..*belongs_to1..* contains 0..*
1
0..*
is_requested_by1
requests0..*
0..*
0..1
is_included_in
0..*
includes 0..1
1..*
0..*
provides_patient_services_at1..*
provides_services_on_behal f_of 0..*
0..*
1
is_housed_at0..*
houses 1
1 0..*has1 pertains_to 0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
1
is_scheduleable_unit_for0..*
is_scheduled_by1
Patient_provider_association1 0..*knows_of1 is_known_to 0..*
Patient_billing_account
account_idadjustment_cdauthorization_information_txtbilling_status_cdcertification_required_indcurrent_unpaid_balance_qtydelete_dttmdeleted_account_reason_cdexpected_insurance_plan_qtyexpected_payment_source_cdnotice_of_admission_dttmnotice_of_admission_indpatient_financial_class_cdprice_schedule_idpurge_status_cdpurge_status_dttmreport_of_eligibility_dttmretention_indsignature_on_file_dttmspecial_program_cdstoploss_limit_indsuspend_charges_indtotal_adjustment_qtytotal_charge_qtytotal_payment_qtyseparate_bill_ind
0..*
1
pertains_to0..*
has 1
0..1
0..1
is_the_prior_account_for
0..1
has_as_a_prior_account
0..1
0..*
0..*
has_payment_guaranteed_by 0..*
provides_payment_guarantee_for
0..*
0..*
0..1
is_charged_to 0..*
has_charges_for
0..1
0..*
1
is_associated_with0..*
has 1
Healthcare_benefit_coverage_item
service_category_cdservice_cdservice_modifier_cdauthorization_indnetwork_indassertion_cdcovered_parties_cdqtyquantity_qualifier_cdtime_period_qualifier_cdrange_low_qtyrange_high_qtyrange_units_cdassertion_effective_tmreligibility_cdpolicy_source_cdeligibility_source_cdcopay_limit_ind
0..*
0..1 is_governed_by
0..*
governs0..1
0..1
0..*
has_as_components
0..1
is_a_component_of
0..*
0..*
1
provides_validation_for0..*
is_validated_by1
1..*
0..*
is_covered_by 1..*
provides_coverage_for0..*
Individual_healthcare_practitioner
fellowship_field_cdgraduate_school_nmgraduation_dttmposition_cdpractitioner_type_cdprimary_care_indresidency_field_cdslot_size_increment_qtyid
1
0..*
is_scheduled_by 1
is_scheduleable_unit_for0..*
1..*
0..*
belongs_to1..*
contains0..*
0..*
1
is_provided_by0..*
provides 1
0..*
1
is_participant_for0..*
participates_as1
1
0..*
is_requested_by1
requests 0..*
Master_healthcare_benefit_product
assignment_of_benefits_indbenefit_product_descidbenefit_product_nmbenefit_product_type_cdbenefits_coordination_indcob_priority_nbrcombine_baby_bill_indeffective_tmrgroup_benefit_indmail_claim_party_cdrelease_information_cdstatus_cdcoverage_type_cdagreement_type_cdpolicy_category_cdaccess_protocol_desc 0..*
0..1
is_child_of
0..*
is_parent_of
0..1
0..*
1
is_a_instance_of 0..*
is_instantiated_as1
0..*
0..1
covers 0..*
is_covered_by 0..1
Resource_slot
offset_qtyallocated_qtyresource_type_cdstatus_cdstart_dttm
Schedule
id
1
0..*
manages 1
is_managed_by0..*
Entering_person
Patient_encounter
administrative_outcome_txtcancellation_reason_cddescencounter_classification_cdexpected_insurance_plan_qtyfirst_similar_illness_dttmfollow_up_type_cdid : IIclassification_cdpurpose_cdspecial_courtesies_cdactive_tmrstatus_cdurgency_cdtriage_classification_cdmedical_service_cdpublicity_constraint_cdreason_cdreferral_cdsource_cdpatient_valuables_descpre_admit_test_indreadmission_indvaluables_location_descacuity_level_cdactual_discharge_disposition_cddischarge_location_idexpected_discharge_disp_cdbirth_encounter_ind
0..*
1
pertains_to
0..*
has1
1..*
1
is_part_of
1..*
has_parts 1
1..*
1
pertains_to 1..*
has1
0..*
0..1
precedes0..*
fol lows0..1
1..*
1
is_associated_with 1..*
has_as_participant
1
0..*
1
is_util ized_during 0..*
uti lizes1
0..1 0..*as_assigned to it0..1 is_assigned_to 0..*
1
0..*
has_parts1
is_part_of0..*
1..*
0..*
has 1..*
is_present_in 0..*
1..*
0..1
is_authorized_by
1..*
authorizes 0..1
Insurer
effective_tmr1
0..*
issues1
is_issued_by 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
1
0..*
offers1
is_offered_by 0..*
1
0..*
issues1
is_issued_by 0..*
Guarantor
financial_class_cdhousehold_annual_income_amthousehold_size_nbr
1
1..*
guarantees_payment_under
1
has_payment_guaranteed_by
1..*
0..1
1
is_role_of0..1
takes_on_role_of 1
Healthcare_benefit_product_purchaser
0..1
1
is_role_of 0..1
takes_on_role_of 1
1..1
0..*
is_the_purchaser_of1..1
has_as_purchaser
0..*
Appointment_request
reason_cdadministrative_type_cdequip_selection_criteria_expridlocation_selection_criteria_exprpriority_cdrepeating_interval_duration_qtyrepeat_pattern_exprchange_reason_cdduration_qtystart_tmrtime_selection_criteria_exprexplicit_time_interval_exprappointment_rqst_category_cdstatus_cddttm
0..*1 is_requested_by 0..*requests1
1
0..*
requests1
is_requested_by 0..*
0..1
0..*
enters0..1
is_entered_by0..*
Employer
<>> effective_tmr 1
0..*
is_employer_of1
has_as_employer
0..*
0..1
1
is_role_of0..1
takes_on_role_of 1
0..*
1..*
represents 0..*
is_represented_by1..*
Person
birth_dttm : TSbirthplace_addrcitizenship_country_cdconfidentiality_constraint_cddeceased_dttmdeceased_inddisability_cdeducation_level_cdethnic_group_cdadministrative_gender_cdmarital_status_cdmilitary_branch_of_service_cdmilitary_rank_nmmilitary_status_cdnationality_cdrace_cdreligious_affiliation_cdstudent_cdvery_important_person_cdstatus_cdambulatory_status_cdbirth_order_nbrliving_arrangement_cdliving_dependency_cdmultiple_birth_indorgan_donor_indpreferred_pharmacy_id
0..1
1
is_a_role_of 0..1
takes_on_role_of1
0..1
1
is_role_of 0..1
acts_in_role_of 1
1
0..1
takes_on_role_of 1
is_role_of0..1
0..*
1
is_entered_by
0..*
enters 1
1
0..*
has 1
is_for 0..*
1
0..1
takes_on_role_of1
is_role_of0..1
0..*
0..1
participation_of 0..*
participates_as0..1
1
0..*communicates_in
1 is_communicated_by
0..*
0..*
0..1
is_about 0..*
is_subject_of0..1
0..1
1
pertains_to0..1
has1
1
0..1
takes_on_role_of1
is_a_role_of 0..1
0..1
1
is_role_of
0..1
takes_on_role_of 1
0..*
1
is_sourced_from 0..*
is_source_for 1
Patient
0..1
1
pertains_to0..1
has 1
0..*
1
pertains_to
0..*
has 1
0..*
1
pertains_to
0..*
has1
1
0..*
is_requested_by1
requests 0..*
1
0..*
is_scheduled_by 1
is_a_scheduleable_uni t_for 0..*
1
0..*
participates_in 1
has_as_care_recipient
0..*
1
0..*
has1
pertains_to 0..*
0..*
1
belongs_to0..*
has 1
0..1
0..*
is_primary_facili ty_for 0..1
has_as_primary_facili ty 0..*
1..*
1
identifies 1..*
is_known_by 1
0..*
1
belongs_to0..*
has 1
1
0..*
has 1
is_for0..*
0..*1 involves 0..*is_involved_in10..*
0..1
has_a_primary_provider 0..*
is_the_primary_provider_for0..1
0..1
1
is_a_role_of 0..1
takes_on_role_of10..*
0..*
is_insured_by 0..*
insures0..*
Appointment
appointment_duration_qtyappointment_timing_qtevent_reason_cdexpected_service_descexpected_start_dttmidstatus_cdurgency_cd
0..*
0..*
is_reserved_by0..*
reserves 0..*
1..*
0..*
books 1..*
is_booked_in 0..*
0..1
0..*
is_parent_of
0..1
is_child_of 0..*
0..*
1
is_entered_by 0..*
enters1
0..1
0..1
is_scheduled_by
0..1
schedules 0..1
Contact_person
contact_reason_cd
0..*
0..1
is_contact_for
0..*
provides_contact0..1
0..*
0..1
is_contact_for0..*
provides_contact
0..1
0..1
0..*
provides_contact 0..1
is_contact_for 0..*
0..*
0..1
has_as_contact0..*
is_contact_for0..1
0..1
0..*
provides_contact
0..1
is_contact_for0..*
1
0..1
takes_on_role_of 1
is_a_role_of0..1
0..*
0..1
is_a_contact_for0..*
has_as_a_contact 0..1
0..*
0..1
has_as_a_contact 0..*
is_a_contact_for0..1
USAM
Unified Service
Action Model
Data typemodel
January 30, 2000 66© 2000, HL7
Patient
name : PNDOB : Dateaddress : AD
Doctor
name : PNspecialty : CDphone : TEL
seeks care at
provides care for0..*
1..*
Information Modeling Language
• Class defines things
• Attributes are the data we record about classes
• Associations describe the way things relate
“Every Patient … seeks care at … 1 to many … Doctors”
“Reading” associations in plain English:
“Every Doctor … provides care for ... zero to many … Patients”
January 30, 2000 67© 2000, HL7
RIM - in-depth -- Unified Service Action Model
• USAM – is the Unified Service Action Model– has been introduced to the RIM in stages over the last 24
months– seeks to bind the core concepts underlying clinical care and
patient management into a unified set of classes– still a ‘work in progress’, although definitely nearing the
finish line
January 30, 2000 68© 2000, HL7
The Service Action Oriented Perspective
Condition_node
Procedure
entry_site_cd : CD
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
1
0..*
has_parts1
is_part_of0..*
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*1
for
0..*
has
1
1
0..*represented_as
1represents
0..*
0..*
1has_source
0..*
is_source_for
1
0..1
1
has_target
0..1
is_target_for1
0..*
1
in
0..*
has1
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Transportation
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
• Covers all health care related services.
• Unifies all services in a common “super-class.”
• Models the detail in specializations of the service.– observation: value– medication: dose, form, route
• Relates to actors, targets, and other services through the super-class.– tracking of responsibilities– tracking of resources– tracking of reason, etc.
January 30, 2000 69© 2000, HL7
Condition_node
Procedure
entry_site_cd : CD
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
1
0..*
has_parts1
is_part_of0..*
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*1
for
0..*
has
1
1
0..*represented_as
1represents
0..*
0..*
1has_source
0..*
is_source_for
1
0..1
1
has_target
0..1
is_target_for1
0..*
1
in
0..*
has1
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Transportation
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
Service and Context• who is the actor?
• provider, individual or organization• patient, relative, neighbors in home health
• what is the service?• observation, judgement, medication, surgery, physiotherapy• consents, advanced directives, education, consultation
• on whom or what (recipient)?• people: patient, relative, neighbor (caring person), community • things: specimen, food, environmental samples
– indirect recipient, beneficiary (“for whom”)• patient, community (population)
• when?
• where? (facility, location)
• with what? (material resources)
January 30, 2000 70© 2000, HL7
?? b-b-but where is
Condition_node
Procedure
entry_site_cd : CD
Service_list
id : SET<II>type_cd : CVname : STdesc : ED
Actor
type_cd : SET<CV>tmr : IVL<TS>note : EDsignature_cd : CV
List_item
sequence_nmb : REALpriority_nmb : REALnote_txt : ED
1
0..*
has_parts1
is_part_of0..*
Service_relationship
type_cd : CVinversion_ind : BLsequence_nmb : INTpriority_nmb : INTpause_qty : PQcheckpoint_cd : CVsplit_cd : CVjoin_cd : CVnegation_ind : BLconjunction_cd : BL
Target
type_cd : SET<CV>tmr : SET<CV>awareness_cd : CV
Service
id : SET<II>mood_cd : SET<CV>universal_service_cd : CDdescr : EDstatus_cd : CVtotal_time : GTScritical_time : GTSmethod_cd : CDbody_site_cd : CDinterpretation_cd : SET<CV>confidentiality_cd : CVmax_repeat_nmb : INTinterruptible_ind : BLsubstitution_cd : CVpriority_cd : SET<CV>orderable_ind : BL
0..*1
for
0..*
has
1
1
0..*represented_as
1represents
0..*
0..*
1has_source
0..*
is_source_for
1
0..1
1
has_target
0..1
is_target_for1
0..*
1
in
0..*
has1
Observation
value : ANYderivation_expr : STproperty_cd : CV
Medication
form_cd : CDroute_cd : CDdose_qty : PQstrength_qty : PQrate_qty : PQcheck_qty : PQ
Transportation
Supply
qty : PQ
Diet
energy_qty : PQcarbohydrate_qty : PQ
Service catalog entry?
Service order or plan?
Service event?
Result of service?
Clinical goal?
???
January 30, 2000 71© 2000, HL7
Service class & Mood code • A service is an intentional action ... A Service instance
is a record of such an intentional action.
• The mood of an action tells whether the action represents a fact (event) an order, a plan (intent), a goal, a risk, a potential (definition) or the like.
• A service instance represents an action in one and only one such mood. Thus, service definitions (master), orders, plans, and performance records (events) are all represented by an instance of class Service.
• Any instance of a Service assumes one and only one mood and will not change its mood along its life cycle. ... the mood of a service instance is static and not part of the state.
January 30, 2000 72© 2000, HL7
Examples of constructs enabled by USAM
• Condition Node and Condition Thread– Managing patient problems collaboratively and continuously.
• Representing Knowledge– Defining service concepts and semantic relationships– Take a stab at the vocabulary problem
• Workflow Management– Defining and managing collaborative processes.– Timed and conditioned care plans and clinical guidelines.
• Accountability, security, privacy– Application layer-based approaches– Integrated in the information model
January 30, 2000 73© 2000, HL7
Data types vis-à-vis Classes - the basics
• A data type is represented as a UML class
• Both have descriptions
• A primitive data type has no components and is defined solely by its description
• Data types may have components, as classes have attributes
• Components and attributes are each assigned a data type
• “Abstract” data types may not be assigned to attributes. They are reserved for use in defining other data types
January 30, 2000 74© 2000, HL7
Quantity data types
Null is not a type to be assigned an attribute, but rather one that is communicated (sent) when the information is missing
The flavor of the null value. Can be interpreted as the reason why the information is missing.
Integer : INT
Boolean : BL
Binary_data : BIN
Real : REAL
value : Nprecision : N
Ratio : RTO
numerator : QTYdenominator : QTY
Physical_quantity : PQ
value : REALunit : CV
Monetary_amount : MO
value : REALcurrency_unit : CV
No_information : NULL
flavor : CD
Number : N
January 30, 2000 75© 2000, HL7
Time-related data types• Point in time - very similar to the
Version 2.x time stamp -- a scalar defining a point on the axis of natural time.
• General timing specification is a primitive data type that is conceptually an arbitrary set of points in time. It is any combination of (1) a point in time, and/or (2) an interval of time. This includes uncertain points and intervals of time. Values are defined in terms of a literal expression syntax. Regardless of how complex the literal definition is, it will always decompose into an ordered sequence of points or intervals of time.
• Primarily used for scheduling of events to allow concepts like “the last Tuesday of each month” (Poker night)
Point_in_time : TS
General_timing_specification : GTS
January 30, 2000 76© 2000, HL7
Text-related data types
• Encapsulated data– media descriptor - MIME types– data - the pay-load– compression - code for compression algorithm– charset - character encoding if other than default– reference - the telecommunication address to the pay-load in
cases where the pay-load is too large to include– thumbnail - a logical precis of the pay-load– integrity_check - a cryptographically strong sum-check for
use in signing, authenticating, etc.– ic_algorithm - the algorithm used to create the integrity check
Character_string : ST
Encapsulated_data : ED
media_descriptor : CVdata : BINcompression : CVcharset : CVreference : TELthumbnail : BINintegrity_check : BINic_algorithm : CV
January 30, 2000 77© 2000, HL7
Demographic data types
• Postal address is a list ofaddress parts whose rolesare things like ZIP code, city, country, post box, etc.
• Person_name is a similarconstruct, where the classifiers are may express multiple dimensions such as given name vs. family name and name in public records vs. nickname.
Postal_and_residential_address : AD
purpose : CVbad_ind : BLvalue : LIST<ADXP>
Address_part : ADXP
value : STrole : CV
Person_name_type : PN
value : LIST<PNXP>
Person_name_part : PNXP
value : STclassifiers : SET<CV>
Organization_name : ON
type_cd : CVvalue : ST
January 30, 2000 78© 2000, HL7
“Thing” data types (1)• OIDs - HL7 can issue OIDs and can
enable a member or user organization tocreate OIDs ‘underneath’ the HL7 root.
• In the Instance Identifier, thecombination of assigning_authority andvalue_text must be unique.
• The universal resource identifier isdefined and maintained by the IETF andW3C. Refers to addresses ofcommunicating entities used to transmit information. Might be: (a) Web servers (HTTP), (b) File Transfer Protocol servers (FTP), (c) Telephone numbers, (d) Telefax numbers, (e) Dialup Modem connections.
ISO_object_identifier : OID
Instance_identifier : II
assigning_authority : OIDassigning_authority_print_nm : STvalue_txt : STtype_cd : CVvalid_tmr : IVL<TS>
Telecommunication_address : TEL
address : URIuse_cd : SET<CV>valid_time : GTS
Code_value : CV
value : STcode_system : OIDcode_system_version : STprint_name : STreplacement : ST
Concept_descriptor : CD
translations : SET<CDXL>original_text : ED
Code_translation : CDXL
term : CDPHorigin : CDXLproducer : IIquality : REAL
Code_phrase : CDPH
primary_cd : CVmodifier_cd : SET<CRR>
Universal_resource_identifier : URI
Concept_role_relationship : CRR
name : CVinversion_ind : BLvalue : CDPH
January 30, 2000 79© 2000, HL7
“Thing” data types (2)• A code value is exactly one symbol in a code system. The
meaning of the symbol is defined exclusively and completely by the code system that the symbol is from.
• A concept descriptor communicates a real world concept (such as a finding or a diagnosis). A given concept may be expressed in multiple terms where each term is a translation of some other term, or is a (re-)encoding of the original human readable text.
• Code_translation is one translation in a set of translations describing a concept. Components point to the source code used in the translation process and describe who or what performed the translation and what the quality of this translation is.
• A code phrase is a list of code values which all together make up a meaning. This can be used for example in SNOMED, where you can combine multiple codes into a new composite meaning. HL7 V2.x combines codes and modifiers for the OBR specimen source.
ISO_object_identifier : OID
Instance_identifier : II
assigning_authority : OIDassigning_authority_print_nm : STvalue_txt : STtype_cd : CVvalid_tmr : IVL<TS>
Telecommunication_address : TEL
address : URIuse_cd : SET<CV>valid_time : GTS
Code_value : CV
value : STcode_system : OIDcode_system_version : STprint_name : STreplacement : ST
Concept_descriptor : CD
translations : SET<CDXL>original_text : ED
Code_translation : CDXL
term : CDPHorigin : CDXLproducer : IIquality : REAL
Code_phrase : CDPH
primary_cd : CVmodifier_cd : SET<CRR>
Universal_resource_identifier : URI
Concept_role_relationship : CRR
name : CVinversion_ind : BLvalue : CDPH
January 30, 2000 80© 2000, HL7
Generic data types• Provide a means for applying an operation (such as an
interval or a probability distribution) to values expressed in another data type.
• Examples - – interval - of time, of values, etc.– list - of addresses, of person name parts– set - of codes
• Interval applies to any ordered type
• List - an ordered collection of items
• Set - an unordered collection of unique items
• Bag - an unordered collection of items
T
Interval : IVL
low : Tlow_closed : BLhigh : Thigh_closed : BL
T
Annotated : ANT
value : Tnote : CD
T
History_item : HXIT
value : Tvalidity_period : IVL<TS>
T
History : HIST
alias : LIST<HXIT>
T
Uncertain_discrete_value_using_probability : UDVP
value : Tprobability : REAL
T
Non-parametric_probability_Distribution : NPPD
distribution : SET<UDVP<T>>
T
Parametric_probability_distribution : PPD
mean : Tstandard_deviation : Ttype : CVparameters : ANY
T
Uncertain_value-narrative : UVN
value : Tconfidence : CD
T, R
List : LIST
T, R
Set : SET
T, R
Bag : BAG
Set_CV : SET<CV>
Interval_of_integer : IVL<INT>
Set_CDXL : SET<CDXL>
Interval_of_time : IVL<TS>
Set_UDVP : SET<UDVP<T>>
List_ADXP : LIST<ADXP>
List_PNXP : LIST<PNXP>
Set_of_II : SET<II> Set_CRR : SET<CRR>
Set_ON : SET<ON>
List_N: LIST<N>
Set_TEL : SET<TEL>
Set_Address : SET<AD>
January 30, 2000 81© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 82© 2000, HL7
Information Modeling Language
Patient
gender : CDdonor : BLV.I.P. : BL
Doctor
specialty : CDphone : TELprivileges: CV
Person
name : PNDOB : Dateaddress : AD
1
1..*
Encounter
type : CVtime : IVLTSreason : CD
1
0..*
0..10..1
follow-up
• Class defines things
• Objects are instances
• Associations relate things
• Associative classes
• Generalization classes
• Reflexive associations
• Reflexive associations structure instances of one class– chain (predecessor-successor,) hierarchy (parent-child,) or network
Coded attributes
Over 40% of RIM attributes are coded!
January 30, 2000 83© 2000, HL7
Goals of Vocabulary Technical Committee
• Decrease time and cost of implementations
• Approach “plug-and-play”
• Enable data sharing– Mergers due to managed care– Regional or national clinical studies– Disease prevention and control
• Enable sharing of decision support modules– Alerts– Protocols– Clinical pathways
January 30, 2000 84© 2000, HL7
HL7 Vocabulary Development Strategy
• Reference existing vocabularies
• Collaborate with other SDO’s– DICOM– ASTM– X12
• Add value by creating linkage between HL7 messages and existing vocabularies
• Only add items that do not already exist
• Collaborate with vocabulary developers
January 30, 2000 85© 2000, HL7
Vocabulary domain
• “The set of all concepts that can be taken as valid values in an instance of a coded field or attribute.”
• Concept - “A unit of thought constituted through abstraction on the basis of characteristics common to a set of objects.” ISO 1087
• Each concept in the domain can be represented using a specific vocabulary/terminology
January 30, 2000 86© 2000, HL7
Each coded attribute has a domain specification
Class: Patient
Description: A person who may receive, is receiving, or has received healthcare services.
Associationsis_a_role_of (1,1) :: Personis_source_for (0,n) :: Specimen_sample
Attributesbirth_order_numberbirth_dttm (from Person)gender_cd <Gender, Ext:CWE>
January 30, 2000 87© 2000, HL7
Vocabulary Domain Specification
• One and only one domain for each coded RIM attribute
• General form:– <domain name, list of domain qualifiers>– <Gender, Ext:CWE>
• Currently two types of domain qualifiers– Extensibility (Extensibility)
• CNE - Coded No Exceptions
• CWE - Coded With Exceptions
– Realm (RealmOfUse)• Universal
• USA?
• Europe?
• Others
January 30, 2000 88© 2000, HL7
Specialization of Domains• Used in specifying message
– MIM, MET, CMET, HMD, Clinical Templates(?)
• Example:– MyGender = (“Gender:USA:HL7” - “Other:USA:HL7-001”)
• General Form– “value set name” <set operator> “value set name”
• Value set name– “Domain name:Realm:Terminology”
• Allowed set operators– “+” Union ()– “-” Difference (sometimes represented as “\”) – “*” Intersection ()
January 30, 2000 89© 2000, HL7
General process of maintaining domains
• Follow pattern of RIM harmonization
• Vocabulary TC appoints facilitators
• Message development TCs have stewardship– Ultimate authority for domain contents– Follow RIM harmonization rules
• Vocabulary Facilitators– Insure that good vocabulary practices are followed– Actual maintenance of domain specification database– Submit new concepts to vocabulary providers
• All vocabulary/terminology providers can provide mappings to HL7 domains
January 30, 2000 90© 2000, HL7
Interaction Design
Use Case ModelUse Case ModelUse Case ModelUse Case Model
Use Case Diagram
Spec
UCM Spec
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM Spec
State DiagramClass Diagram
Message DesignMessage DesignMessage DesignMessage Design
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
h//mt:50”d”………
h//mt:50”d”………
Identify Actors & Events
Develop ScopeCreate Use Cases
Model new concepts
Harmonize withVocabulary Domains & RIM
Draw initial contents from RIM
Develop MessageInformation Model
Develop Refined Message Information ModelSpecify HMD
Define Trigger Events
Define Application Roles
DefineInteractions
Create Conformance Claims
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
January 30, 2000 91© 2000, HL7
Interaction Design
Define Trigger Events
Define Application Roles
DefineInteractions
Create Conformance Claims
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
January 30, 2000 93© 2000, HL7
Interaction Model Contents
• Each Interaction consists of:– Trigger event
• Event dependency usually expressed as the state of one or more classes
– Message ID • Each interaction sends one particular message
– Sender role– Receiver role– Receiver responsibility
• A specific functional responsibility for the receiver to initiate another (consequential) interaction
January 30, 2000 94© 2000, HL7
Interaction Model Example
Encounter_manager : AR_Encounter_
Encounter_tracker : AR_Encounter_
Encounter_archivist : AR_Encounter_
1: schedule_encounter
4: admit_patient
5: admit_patient
7: activate_scheduled_encounter
8: activate_scheduled_encounter (tid)
2: delete_scheduled_encounter
13: discharge_patient (tid)
3: admit_patient
6: activate_scheduled_encounter
9: delete_active_encounter (tid)
10: delete_active_encounter (tid)
11: delete_active_encounter (tid)
12: discharge_patient (tid)
14: discharge_patient (tid)
15: cancel_discharge (tid)
16: cancel_discharge (tid)
17: cancel_discharge (tid)
Application Role -identifies an information management responsibility for one of the subject classes. Responsibilities typically are: Creator, Manager, Tracker and Archivist.
Healthcare applications are assumed to take on one or more application roles.
Interaction -Trigger Event causes a Message to be sent by a Sending role to a Receiving role for which there may be a Receiver responsibility
January 30, 2000 97© 2000, HL7
Application Roles and Conformance Claims
• A conformance claim is a commitment to fulfill one or more Application Roles
• For each Role, the application must send and receive all of the interactions (messages) specified for that Role:– At specified trigger events– Obeying specifications about conditionality, required presence, etc.
• Provides a consistent, unambiguous vocabulary for pre-contract understanding of vendor capabilities
• The collection of these roles is an Application Profile
January 30, 2000 99© 2000, HL7
Message Design
Use Case ModelUse Case ModelUse Case ModelUse Case Model
Use Case Diagram
Spec
UCM Spec
Information ModelInformation ModelInformation ModelInformation Model
Spec
DIM Spec
State DiagramClass Diagram
Message DesignMessage DesignMessage DesignMessage Design
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
h//mt:50”d”………
h//mt:50”d”………
Identify Actors & Events
Develop ScopeCreate Use Cases
Model new concepts
Harmonize withVocabulary Domains & RIM
Draw initial contents from RIM
Develop MessageInformation Model
Develop Refined Message Information Model
Specify HMD
Define Trigger Events
Define Application Roles
DefineInteractions
Create Conformance Claims
Interaction ModelInteraction ModelInteraction ModelInteraction Model
Interaction Diagram
Spec
Inter Spec
January 30, 2000 100© 2000, HL7
Message Design
Message DesignMessage DesignMessage DesignMessage Design
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
2-nd Order 1 choice of 0-n Drug 0-1 Nursing
h//mt:50”d”………
h//mt:50”d”………
Develop MessageInformation Model
Develop Refined Message Information ModelSpecify HMD
January 30, 2000 101© 2000, HL7
Our agenda
What is HL7?
Brief review of HL7 Version 2.x
Why undertake Version 3?
Version 3 - an overall standards strategy
Version 3 - Analysis StepsRIM - in Depth
Version 3 for Messages
January 30, 2000 102© 2000, HL7
Problem statement• Domain facts:
– HL7 Voting Members are either: (a) individual members, or (b) sponsored by an organizational member, usually their employer.
– Items for balloting are proposed by HL7 Committees or Subcommittees, and the proposing committee designates an individual to serve as their contact for a particular proposal.
– Voting members submit ballots on items proposed as HL7 standards. – Each ballot may vote aye, nay or abstain, and all negative ballots must be
accompanied by a supporting comment.
• Messaging requirements:– HL7 has a ballot acceptance system, and a ballot notification system. – HL7 seeks a message to go from the ballot acceptance system to the ballot
notification system. – This message will be sent upon receipt of a completed ballot.– The message will allow the notification system to send a confirming e-mail to
each of: the voter, the voter’s sponsor organization (if any) and the contact person for the item being voted upon.
January 30, 2000 105© 2000, HL7
Message basics (1)• Every part of the message, from the entire message
down to the smallest subcomponent of a subcomponent of a data type, is a message element.
• Every message element has a type.
• Every message element that is an attribute of a RIM has a type that is an HL7 data type.
• Every message element that represents a component of an HL7 data type also has a type that is an HL7 data type.
• Every message that represents a class has a type that is based on that class or a Common Message Element Type.
January 30, 2000 106© 2000, HL7
Message basics (2)
• Every message element that represents an association has a type that is based on the distal class of the association or a Common Message Element Type.
• Every message element type is one of these four metatypes: primitive, composite, collection, or choice.
• Primitives have no subordinate components.
• Composites do have heterogeneous subordinate components, each with its own name.
• Collections have repetitions of a homogeneous message element. The name of the repeating message element is derived from its type.
January 30, 2000 107© 2000, HL7
V-3 Methodology - working the processUse Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model
Subset &constrain
Specialize &constrain
Order, select& constrain
January 30, 2000 108© 2000, HL7
Message Information Model (MIM)
• Expressed as a UML model
• All parameters are same as an information model
• Constrained subset of the RIM
• Possible constraints:– Selected set of classes– Selected set of attributes for classes– Selected set of associations– Optionality reduces in attributes & associations
January 30, 2000 109© 2000, HL7
Refined-MIM - compared to the MIM
• Additional constraints on cardinality of attributes and associations
• Specialization - when a class will be used with different semantics, it may be shown as two separate classes (clones), with different constraints - – eg. Person_as_patient vs. Person_as_practitioner
• Attributes and associations of general classes may be subsumed into specializations, with different attributes or associations chosen
January 30, 2000 110© 2000, HL7
New parameters contained in R-MIM
• This has all the information of the HMD except the path resulting from the tree-walk
• Classes are in an arbitrary order; no semantic significance
• For each class and attribute, records:– domains - specification of the domain specification for
message elements that contain codes– default values - a value that the receiver should use when it
receives a message instance that does not contain the message element
– inclusion (following)– update (following)
January 30, 2000 111© 2000, HL7
RMIM -- Inclusion parameter
• Parameter determines when and how an element must be valued.
• Mandatory - element may never be null
• Required - element may be null
• Not required - a vendor may choose not to support, this element, must must so decalre as part of vendor’s conformance claim
• Not permitted - Element must always be null (occurs because multiple messages are defined from a single R-MIM and HMD)
January 30, 2000 112© 2000, HL7
Update semantics
• Defines the receiver's processing of the element as:– R replace– D Delete– I Ignore– K (Key) element is a key to a collection of elements– V (Verify) that this element matches a value already in
the receiving systems database– ESA Edit set add, add the element to the collection of items– ESD Edit set delete, delete item that corresponds to this
message element– ESC Edit set change, change the item that corresponds to this
message element– ESAC Edit set add or change, change the item or if a
matching element does not exist, add it
January 30, 2000 113© 2000, HL7
Hierarchical Message Description
• Reflects the– path through the R-MIM– choices – interpolated items for collections
• Special treatment for generalizations that are not subsumed in the R-MIM
• Other than the path, there is no additional semantic content in the HMD, when compared to the R-MIM (the other differences are algorithmically developed)
January 30, 2000 114© 2000, HL7
Message element Type definitions
• Determined by the order of selecting classes in R-MIM
• HMD expresses the type definitions for all message elements
• Sources for message types are:– N - new type defined in the HMD– D - an HL7 data type.– C - refers to an HL7 Common Message Element Type.– U - use same type as previously defined in this HMD– R - recursive reuse of the type that contains this row.– I - refers to a previous instance of the same type
January 30, 2000 115© 2000, HL7
HMD components (1)• The Information Model Mapping.
• The Message Element Type definitions.
• General constraints and defaults provides the ‘default’ for message-specific columns
• Message-specific constraints and defaults section repeats, once for each message type defined in the HMD. These describe one or more message types. Each message type is identified with one or more interactions in the interaction model. If a value in a column is left empty, it will be the same as in the general constraints section. Any particular row may be
excluded from the specific message type being defined.
Repeat this set of ninecolumns for each message type defined
January 30, 2000 116© 2000, HL7
V-3 Methodology - working the processUse Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model
January 30, 2000 117© 2000, HL7
Problem statement• Domain facts:
– HL7 Voting Members are either: (a) individual members, or (b) sponsored by an organizational member, usually their employer.
– Items for balloting are proposed by HL7 Committees or Subcommittees, and the proposing committee designates an individual to serve as their contact for a particular proposal.
– Voting members submit ballots on items proposed as HL7 standards. – Each ballot may vote aye, nay or abstain, and all negative ballots must be
accompanied by a supporting comment.
• Messaging requirements:– HL7 has a ballot acceptance system, and a ballot notification system. – HL7 seeks a message to go from the ballot acceptance system to the ballot
notification system. – This message will be sent upon receipt of a completed ballot.– The message will allow the notification system to send a confirming e-mail to
each of: the voter, the voter’s sponsor organization (if any) and the contact person for the item being voted upon.
January 30, 2000 118© 2000, HL7
Portion of Reference Information Model (RIM)
Organization
organization_name_type_cdorganization_nmstandard_industry_class_cd
0..*
0..1
is_a_subdivision_of0..*
has_as_a_subdivision0..1
Person
birth_dttmbirthplace_addrcitizenship_country_cdconfidentiality_constraint_cddeceased_dttmdeceased_inddisability_cdeducation_level_cdethnic_group_cdadministrative_gender_cdlanguage_cdmarital_status_cdmilitary_branch_of_service_cdmilitary_rank_nmmilitary_status_cdnationality_cdrace_cdreligious_affiliation_cdstudent_cdvery_important_person_cdstatus_cdambulatory_status_cdidhispanic_indbirth_order_nbrliving_arrangement_cdliving_dependency_cdmultiple_birth_indorgan_donor_indpreferred_pharmacy_id
Person_name
effective_dtcdnmpurpose_cdtermination_dttype_cd
1
0..*
has1
is_for0..*
Stakeholder_affiliation
affiliation_type_cddesceffective_dttermination_dt
Stakeholder
addrcredit_rating_cdemail_address_txtphontype_cdreal_id : SET<RWII>id : SET<II>
0..*
1 has_as_primary_participant
0..*participates_as_primary_in
10..*
1 has_as_secondary_participant
0..*participates_as_secondary_in1
January 30, 2000 119© 2000, HL7
Initial message information model (MIM)
Organization
organization_nm : ST0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Person
education_level_cd : CD
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
January 30, 2000 120© 2000, HL7
Message information model (MIM)
Organization
organization_name_type_cdorganization_nmstandard_industry_class_cd
0..*
0..1
is_a_subdivision_of0..*
has_as_a_subdivision0..1
Person
birth_dttmbirthplace_addrcitizenship_country_cdconfidentiality_constraint_cddeceased_dttmdeceased_inddisability_cdeducation_level_cdethnic_group_cdadministrative_gender_cdlanguage_cdmarital_status_cdmilitary_branch_of_service_cdmilitary_rank_nmmilitary_status_cdnationality_cdrace_cdreligious_affiliation_cdstudent_cdvery_important_person_cdstatus_cdambulatory_status_cdidhispanic_indbirth_order_nbrliving_arrangement_cdliving_dependency_cdmultiple_birth_indorgan_donor_indpreferred_pharmacy_id
Person_name
effective_dtcdnmpurpose_cdtermination_dttype_cd
1
0..*
has1
is_for0..*
Stakeholder_affiliation
affiliation_type_cddesceffective_dttermination_dt
Stakeholder
addrcredit_rating_cdemail_address_txtphontype_cdreal_id : SET<RWII>id : SET<II>
0..*
1 has_as_primary_participant
0..*participates_as_primary_in
10..*
1 has_as_secondary_participant
0..*participates_as_secondary_in1
RIMcontent
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
proposed_by
0..*
proposes1..1
Ballot
comments_txt : STdttm : TSvote_cd : CV
0..*
1..1
votes_on
0..*
receives_votes
1..1
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
MIMcontent
(a proper subsetof the RIM)
Fewerattributes
January 30, 2000 121© 2000, HL7
Add voters to MIM
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
HL7 Voting Members are either: (a) individual members, or (b) sponsored by an organizational member, usually their employer.
Organization
organization_nm : ST0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Person
education_level_cd : CD
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
January 30, 2000 122© 2000, HL7
Message information model (MIM)
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
proposed_by
0..*
proposes1..1
Ballot
comments_txt : STdttm : TSvote_cd : CV
0..*
1..1
votes_on
0..*
receives_votes
1..1
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
Items for balloting are proposed by HL7 Committees or Subcommittees, Voting members submit ballots on items. Each ballot may vote aye, nay or abstain, and all negative ballots must be accompanied by a supporting comment.
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
January 30, 2000 123© 2000, HL7
V-3 Methodology - working the processUse Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model
January 30, 2000 124© 2000, HL7
Message information model (MIM)
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
proposed_by
0..*
proposes1..1
Ballot
comments_txt : STdttm : TSvote_cd : CV
0..*
1..1
votes_on
0..*
receives_votes
1..1
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
January 30, 2000 125© 2000, HL7
Partially morphed MIM
Individual_representative
dues_current_ind : BL
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_name
nm : STtype_cd : CD
Person
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of0..*
has_as_role1..1
1..1
0..*
has1..1
is_for0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Organizational_representative
Organization
organization_nm : STemail_address_txt : TEL
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_secondary_in1..1
has_as_secondary_participant
0..*
1..1
0..*
participates_as_primary_in1..1
has_as_primary_participant
0..*
January 30, 2000 126© 2000, HL7
Remove inconsequential inheritance
Individual_representative
dues_current_ind : BL
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_name
nm : STtype_cd : CD
Person
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of0..*
has_as_role1..1
1..1
0..*
has1..1
is_for0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Organizational_representative
Organization
organization_nm : STemail_address_txt : TEL
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_secondary_in1..1
has_as_secondary_participant
0..*
1..1
0..*
participates_as_primary_in1..1
has_as_primary_participant
0..*
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
proposed_by
0..*
proposes1..1
Ballot
comments_txt : STdttm : TSvote_cd : CV
0..*
1..1
votes_on
0..*
receives_votes
1..1
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
Subsume inherited attributes Transfer inherited associations
January 30, 2000 127© 2000, HL7
Partially morphed MIM
Individual_representative
dues_current_ind : BL
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_name
nm : STtype_cd : CD
Person
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of0..*
has_as_role1..1
1..1
0..*
has1..1
is_for0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Organizational_representative
Organization
organization_nm : STemail_address_txt : TEL
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_secondary_in1..1
has_as_secondary_participant
0..*
1..1
0..*
participates_as_primary_in1..1
has_as_primary_participant
0..*
January 30, 2000 128© 2000, HL7
Refined Message Information Model (R-MIM)
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
January 30, 2000 129© 2000, HL7
Refined Message Information Model (R-MIM)
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
Individual_representative
dues_current_ind : BL
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_name
nm : STtype_cd : CD
Person
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of0..*
has_as_role1..1
1..1
0..*
has1..1
is_for0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Organizational_representative
Organization
organization_nm : STemail_address_txt : TEL
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_secondary_in1..1
has_as_secondary_participant
0..*
1..1
0..*
participates_as_primary_in1..1
has_as_primary_participant
0..*
Specialize cloned views of Person to meet specific requirements
Constrain navigability of associations
January 30, 2000 130© 2000, HL7
Refined Message Information Model (R-MIM)
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
January 30, 2000 131© 2000, HL7
V-3 Methodology - working the processUse Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model
January 30, 2000 132© 2000, HL7
Refined Message Information Model (R-MIM)
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
0
1
2
2a4
5 3
January 30, 2000 133© 2000, HL7
Refined Message Information Model (R-MIM)
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
0
6
7
89
10
January 30, 2000 135© 2000, HL7
HMD adds constraints, defaults, cardinality, etc.
Link to RIMVocab domain
constraints,cardinality,
etc.
January 30, 2000 136© 2000, HL7
Conversion from HMD to a DTD is algorithmic<!-- HL7-generated DTD for HMD C00_RIM_0092Da_1 19991205 -->
<!ENTITY % V3DT SYSTEM "V3DT991006a.dtd">
%V3DT;
<!-- Entity Definitions -->
<!ENTITY % Ballt-cont.model "(commntsTxt?, dttm?, vote, votesOn_PropsdItm, castBy_VotngMembr)?"><!ENTITY % Ballt-attrib.list "
T CDATA #FIXED 'Ballt'NULL %null.code.set; #IMPLIEDNOTE CDATA #IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
<!ENTITY % PropsdItm-cont.model "(balltPeriodTmr?, contntTxt?, standrdLevlInd?, propsdBy_OrgnztnAsCommtte)?"><!ENTITY % PropsdItm-attrib.list "
T CDATA #FIXED 'PropsdItm'NULL %null.code.set; #IMPLIEDNOTE CDATA #IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
<!ENTITY % OrgnztnAsHL7Membr-cont.model "(nm, emailAddrssTxt?)?"><!ENTITY % OrgnztnAsHL7Membr-attrib.list "
T CDATA #FIXED 'OrgnztnAsHL7Membr'NULL %null.code.set; #IMPLIEDNOTE CDATA#IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
<!-- Element Definitions -->
<!ELEMENT Ballt %Ballt-cont.model;><!ATTLIST Ballt %Ballt-attrib.list; HL7_NAME CDATA #FIXED 'Ballot'>
<!ELEMENT IndvdlReprsntv %IndvdlReprsntv-cont.model;><!ATTLIST IndvdlReprsntv %IndvdlReprsntv-attrib.list; HL7_NAME CDATA #FIXED 'Individual_representative'>….<!ELEMENT balltPeriodTmr %IVL_TS-cont.model;><!ATTLIST balltPeriodTmr %IVL_TS-attrib.list; HL7_NAME CDATA #FIXED 'balltPeriodTmr'>
<!ELEMENT castBy_VotngMembr %VotngMembr-cont.model;><!ATTLIST castBy_VotngMembr %VotngMembr-attrib.list; HL7_NAME CDATA #FIXED 'castBy_VotngMembr'>
<!ELEMENT emailAddrssTxt %TEL-cont.model;><!ATTLIST emailAddrssTxt %TEL-attrib.list; HL7_NAME CDATA #FIXED 'emailAddrssTxt'>
<!ELEMENT vote %CV-cont.model;><!ATTLIST vote %CV-attrib.list; HL7_NAME CDATA #FIXED 'vote'>
January 30, 2000 137© 2000, HL7
HL7-Conformant
Application
HL7-Conformant
Application
Hierarchical
Message
Description
Implementation
Technology
Specifications
Data
HL7
Message
Creation
HL7
Message
ParsingData
ITS
Message
Instance
V-3 Methodology - sending a message instance
1. Use HMD to collect & structure data
2. Use ITS to format message instance
3. Communicate the instance
4. Use ITS to parse message instance
5. Use HMD to disassemble and store data
January 30, 2000 138© 2000, HL7
Message instance<?xml version="1.0"?><!DOCTYPE Ballt SYSTEM "Ballot_C00_RIM_0092Da_1.dtd" [ ]>
<Ballt> <dttm V="199912052357+0100"/> <vote V="A" S="HL7001" R="3.0" PN="Abstain"/> <votesOn_PropsdItm> <standrdLevlInd V='T'/> <propsdBy_OrgnztnAsCommtte> <nm V="Humble Task Group"/> <isAsubdvsnOf_OrgnztnAsCommtte> <nm V="Grand Committee"/> </isAsubdvsnOf_OrgnztnAsCommtte> <partcpesAsPrimryIn_StkhldrAffltn> <_StkhldrAffltn> <type V="X" S="HL7004" R="3.0" PN="XXX"/> <hasSecndryPartcpnt_PrsnAsCommtteContct> <has_PrsnName> <pnm> <G V="George" CLAS="R"/> <G V="Woody" CLAS="C"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> </hasSecndryPartcpnt_PrsnAsCommtteContct> </_StkhldrAffltn> </partcpesAsPrimryIn_StkhldrAffltn> </propsdBy_OrgnztnAsCommtte> </votesOn_PropsdItm>
<castBy_VotngMembr T="OrgnztnlReprsntv"> <OrgnztnlReprsntv> <isRoleOf_PrsnAsVotr> <has_PrsnName> <pnm> <G V="George" CLAS="R"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> <has_PrsnName> <pnm> <G V="Woody" CLAS="C"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> </isRoleOf_PrsnAsVotr> <sponsrdBy_OrgnztnAsHL7Membr> <nm V="Mayo Clinic"/> <emailAddrssTxt v=“[email protected]”/> </sponsrdBy_OrgnztnAsHL7Membr> </OrgnztnlReprsntv> </castBy_VotngMembr></Ballt>
January 30, 2000 139© 2000, HL7
Auditability - Message instance<?xml version="1.0"?><!DOCTYPE Ballt SYSTEM "Ballot_C00_RIM_0092Da_1.dtd" [ ]>
<Ballt> <dttm V="199912052357+0100"/> <vote V="A" S="HL7001" R="3.0" PN="Abstain"/> <votesOn_PropsdItm> <standrdLevlInd V='T'/> <propsdBy_OrgnztnAsCommtte> <nm V="Humble Task Group"/> <isAsubdvsnOf_OrgnztnAsCommtte> <nm V="Grand Committee"/> </isAsubdvsnOf_OrgnztnAsCommtte> <partcpesAsPrimryIn_StkhldrAffltn> <_StkhldrAffltn> <type V="X" S="HL7004" R="3.0" PN="XXX"/> <hasSecndryPartcpnt_PrsnAsCommtteContct> <has_PrsnName> <pnm> <G V="George" CLAS="R"/> <G V="Woody" CLAS="C"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> </hasSecndryPartcpnt_PrsnAsCommtteContct> </_StkhldrAffltn> </partcpesAsPrimryIn_StkhldrAffltn> </propsdBy_OrgnztnAsCommtte> </votesOn_PropsdItm>
<castBy_VotngMembr T="OrgnztnlReprsntv"> <OrgnztnlReprsntv> <isRoleOf_PrsnAsVotr> <has_PrsnName> <pnm> <G V="George" CLAS="R"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> <has_PrsnName> <pnm> <G V="Woody" CLAS="C"/> <G V="W." CLAS="R I"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> </isRoleOf_PrsnAsVotr> <sponsrdBy_OrgnztnAsHL7Membr> <nm V="Mayo Clinic"/> <emailAddrssTxt v=“[email protected]”/> </sponsrdBy_OrgnztnAsHL7Membr> </OrgnztnlReprsntv> </castBy_VotngMembr></Ballt>
<!-- Element Definitions -->
<!ELEMENT Ballt %Ballt-cont.model;><!ATTLIST Ballt %Ballt-attrib.list; HL7_NAME CDATA #FIXED 'Ballot'>
<!ELEMENT IndvdlReprsntv %IndvdlReprsntv-cont.model;><!ATTLIST IndvdlReprsntv %IndvdlReprsntv-attrib.list; HL7_NAME CDATA #FIXED 'Individual_representative'>….<!ELEMENT balltPeriodTmr %IVL_TS-cont.model;><!ATTLIST balltPeriodTmr %IVL_TS-attrib.list; HL7_NAME CDATA #FIXED 'balltPeriodTmr'>
<!ELEMENT castBy_VotngMembr %VotngMembr-cont.model;><!ATTLIST castBy_VotngMembr %VotngMembr-attrib.list; HL7_NAME CDATA #FIXED 'castBy_VotngMembr'>
<!ELEMENT emailAddrssTxt %TEL-cont.model;><!ATTLIST emailAddrssTxt %TEL-attrib.list; HL7_NAME CDATA #FIXED 'emailAddrssTxt'>
<!ELEMENT vote %CV-cont.model;><!ATTLIST vote %CV-attrib.list; HL7_NAME CDATA #FIXED 'vote'>
Auditability - DTD Element definition<!-- HL7-generated DTD for HMD C00_RIM_0092Da_1 19991205 -->
<!ENTITY % V3DT SYSTEM "V3DT991006a.dtd">
%V3DT;
<!-- Entity Definitions -->
<!ENTITY % Ballt-cont.model "(commntsTxt?, dttm?, vote, votesOn_PropsdItm, castBy_VotngMembr)?"><!ENTITY % Ballt-attrib.list "
T CDATA #FIXED 'Ballt'NULL %null.code.set; #IMPLIEDNOTE CDATA #IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
<!ENTITY % PropsdItm-cont.model "(balltPeriodTmr?, contntTxt?, standrdLevlInd?, propsdBy_OrgnztnAsCommtte)?"><!ENTITY % PropsdItm-attrib.list "
T CDATA #FIXED 'PropsdItm'NULL %null.code.set; #IMPLIEDNOTE CDATA #IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
<!ENTITY % OrgnztnAsHL7Membr-cont.model "(nm, emailAddrssTxt?)?"><!ENTITY % OrgnztnAsHL7Membr-attrib.list "
T CDATA #FIXED 'OrgnztnAsHL7Membr'NULL %null.code.set; #IMPLIEDNOTE CDATA#IMPLIEDUPDATE_MODE %update.mode.code.set; 'R'
">
Auditability - DTD Entity definitionsAuditability - Hierarchical Message Description
Individual_representative
dues_current_ind : BL
Organization_as_HL7_member
organization_nm : STemail_address_txt : TEL
Organizational_representative
0..1
0..*
sponsors 0..1
sponsored_by0..*
Ballot
comments_txt : STdttm : TSvote_cd : CV
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person_as_Voter
education_level_cd : CDemail_address_txt : TEL
0..*
1..1
is_role_of 0..*
has_as_role1..1
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
votes_on
0..*
receives_votes
1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has 1..1
is_for 0..*
Organization_as_Committee
organization_nm : ST
0..*
1..1
proposed_by
0..*
proposes1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Person_as_Committee_contact
email_address_txt : TEL
1..1
0..1
has 1..1
is_for
0..1
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*
participates_as_primary_in
1..1
has_as_primary_participant
0..*
1..1
0..*
participates_as_secondary_in
1..1
has_as_secondary_participant
0..*
Auditability - Refined Message Info. Model
Individual_representative
dues_current_ind : BL
Organizational_representative
Organization
organization_nm : ST
0..*
1..1
sponsored_by0..*
sponsors1..1
0..*
0..1
is_a_subdivision_of
0..*
has_as_a_subdivision0..1
Stakeholder
addr : STemail_address_txt : TELid : SET<II>
Stakeholder_affiliation
affiliation_type_cd : CD
1..1
0..*participates_as_primary_in
1..1 has_as_primary_participant
0..*
1..10..*participates_as_secondary_in
1..1 has_as_secondary_participant0..*
Proposed_item
ballot_period_tmr : IVL<TS>content_txt : EDstandard_level_ind : BL
0..*
1..1
proposed_by
0..*
proposes1..1
Ballot
comments_txt : STdttm : TSvote_cd : CV
0..*
1..1
votes_on
0..*
receives_votes
1..1
Voting_member
draft_level_voting_ind : BLstandard_level_voting_ind : BL
0..*
1..1
cast_by
0..*
casts
1..1
Person
education_level_cd : CD
0..*
1..1
is_role_of0..*
has_as_role1..1
Person_name
nm : STtype_cd : CD
1..1
0..*
has1..1
is_for0..*
Auditability - Message Information Model
January 30, 2000 140© 2000, HL7
V-3 Methodology - defining abstract messageUse Case
Model
Interaction
Model
Hierarchical
Message
Description
Domain
Information
Model
Message
Information
Model
Refined
Message
Information
Model
Common
Message
Element
Definition
Reference
Information
Model