Derivation of the HL7 RIM Derivation of the HL7 RIM OntologyOntology
A Top-Down MethodologyA Top-Down Methodology
Concept - “a thing in the Concept - “a thing in the minds eye”minds eye”
Hmmm Hmmm - - “Frank “Frank needs needs an ace an ace of of hearts”hearts”
The Concept The Concept ChallengeChallenge
Thing
Concept
• marine animal• eats smaller things• nice to eat
Symbols (Many)
Thing (1)Can’t put the “thing”
on this slide since the instance
exists only in physical space
Concept (1)
Adapted from Charlie Mead & the Semantic Triangle
“Frank the Shark” (in English)
Predicate Logic in Predicate Logic in RDF, RIM, and SNOMEDRDF, RIM, and SNOMED
Subject Predicate Object
Observ-ation
hasParticipation
Subject
Patient
Fracture of Femur
hasFinding Site
Structure of Neck of
Femur
RDF:
SNOMED:
RIM:
SNOMED in the HL7 RIMSNOMED in the HL7 RIM
Subject Predicate Object
Observ-ation
hasParticipation
Subject
Patient
Fracture of Femur
hasFinding Site
Structure of Neck of Femur
hasAssociated Morphology
Compression Fracture
hasResult
HL7 RIM
SNOMED
Propositions & Propositions & AssertionsAssertions
Propositions in RDF triplesPropositions in RDF triples Subject | Predicate | ObjectSubject | Predicate | Object Propositions may be true or falsePropositions may be true or false
Assertions are believed by the Assertions are believed by the author to be trueauthor to be trueSubject Predicate Object
Observ-ation hasParticipation
Subject
Patient
Fracture of Femur
hasFinding Site
Structure of Neck of Femur
hasAssociated Morphology
Compression Fracture
hasResult HL7 RIM
SNOMED
Ontologies: Mass & Ontologies: Mass & Energy Energy
Proposition:Proposition:e=mce=mc22
Mass and Energy Mass and Energy (e=mc(e=mc22) )
EnergyEnergy
Mass
Analogy: Mass to Entity/Energy to Analogy: Mass to Entity/Energy to ActAct
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
0…*
0…*
Ontologies: Materials & Ontologies: Materials & LaborLabor
Proposition:Proposition:Cost = Materials + LaborCost = Materials + Labor
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
0…*
0…*
Association ClassAssociation ClassEntity
id : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
0…*
0…*Associations Class
RIM - BackboneRIM - Backbone
EntityEntity People, Places, Physical ThingsPeople, Places, Physical Things
AssociationsAssociations Roles & RelationshipsRoles & Relationships
ActAct Collections of EventsCollections of Events
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
1
playedRoleplayer
scopedRolescoper
0..1
0..*
Participation
typeCode : CStmr : IVL<TS>note_text : EDsignatureCode : CVfunctionCode : CDawarenessCode : CVsignatureText : EDencounter_accommodationCode : CVstatusCode : CSmodeCode : CV
0..*0..*
RoleclassCode : CSeffectiveTime : IVL<TS>id : SET<II>statusCode : CSpositionNumber : LIST<INT>qty : PQcertificateText : EDaddr : SET<AD>telecom : SET<TEL>code : CE
0..*
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
1
AssociativeAssociativeClassesClasses
Review of UML TermsReview of UML TermsEntity
id : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
0…*
0…*
“Classes”
Simple or ‘hasA’associationsymbol
“Attribute: value pair”
“Datatype”
hierarchy or ‘IsA’ association symbol
‘cardinality’ or ‘multiplicity’ symbol
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
1
playedRoleplayer
scopedRolescoper
0..1
0..*
Participation
typeCode : CStmr : IVL<TS>note_text : EDsignatureCode : CVfunctionCode : CDawarenessCode : CVsignatureText : EDencounter_accommodationCode : CVstatusCode : CSmodeCode : CV
0..*0..*
RoleclassCode : CSeffectiveTime : IVL<TS>id : SET<II>statusCode : CSpositionNumber : LIST<INT>qty : PQcertificateText : EDaddr : SET<AD>telecom : SET<TEL>code : CE
RoleLinkeffectiveTime : IVL<TS>typeCode : CS
1
outboundLink
0..*
source
1
1
inboundLink
0..*
target
1
0..*
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
1
RecursiveRecursiveAssociativeAssociative
ClassesClassesActRelationship
typeCode : CSinversion_ind : BLsequenceNumber : INTpriorityNumber : INTpauseQty : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegation_ind : BLconjunctionCode : CS
outboundLinkis_source_for
1 0..*
has_target
0..*
target
1
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
1
playedRoleplayer
scopedRolescoper
0..1
0..*
Participation
typeCode : CStmr : IVL<TS>note_text : EDsignatureCode : CVfunctionCode : CDawarenessCode : CVsignatureText : EDencounter_accommodationCode : CVstatusCode : CSmodeCode : CV
0..*0..*
RoleclassCode : CSeffectiveTime : IVL<TS>id : SET<II>statusCode : CSpositionNumber : LIST<INT>qty : PQcertificateText : EDaddr : SET<AD>telecom : SET<TEL>code : CE
RoleLinkeffectiveTime : IVL<TS>typeCode : CS
1
outboundLink
0..*
source
1
1
inboundLink
0..*
target
1
0..*
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
1
ActRelationship
typeCode : CSinversion_ind : BLsequenceNumber : INTpriorityNumber : INTpauseQty : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegation_ind : BLconjunctionCode : CS
outboundLinkis_source_for
1 0..*
has_target
0..*
target
1
Act-Act-RelationshiRelationshi
p p RecursionRecursion
ActRelationship RecursionsActRelationship Recursions*Classes, Instances of Classes, & Instance *Classes, Instances of Classes, & Instance
DiagramsDiagramsActRelationship
typeCode : has component
Act
id : SET<II>moodCode : Eventcode : Chem 4
outboundLinkis_source_forhas_targettarget
Act
id : SET<II>moodCode : Eventcode : Glucose
ActRelationship
typeCode : has component
outboundLinkis_source_forhas_targettarget
Act
id : SET<II>moodCode : Eventcode : Total Cholesterol
ActRelationship
typeCode : has component
outboundLinkis_source_forhas_targettarget
Act
id : SET<II>moodCode : Eventcode : Sodium
ActRelationship
typeCode : has component
outboundLinkis_source_forhas_targettarget
Act
id : SET<II>moodCode : Eventcode : Potassium
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
1
playedRoleplayer
scopedRolescoper
0..1
0..*
Participation
typeCode : CStmr : IVL<TS>note_text : EDsignatureCode : CVfunctionCode : CDawarenessCode : CVsignatureText : EDencounter_accommodationCode : CVstatusCode : CSmodeCode : CV
0..*0..*
RoleclassCode : CSeffectiveTime : IVL<TS>id : SET<II>statusCode : CSpositionNumber : LIST<INT>qty : PQcertificateText : EDaddr : SET<AD>telecom : SET<TEL>code : CE
RoleLinkeffectiveTime : IVL<TS>typeCode : CS
1
outboundLink
0..*
source
1
1
inboundLink
0..*
target
1
0..*
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
1
ActRelationship
typeCode : CSinversion_ind : BLsequenceNumber : INTpriorityNumber : INTpauseQty : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegation_ind : BLconjunctionCode : CS
outboundLinkis_source_for
1 0..*
has_target
0..*
target
1
InfiniteInfiniteNestingNesting
HL7 RIM Act HL7 RIM Act HierarchyHierarchy
SubstanceAdministration
routeCode : CEapproachSiteCode : SET<CD>doseQuantity : IVL<PQ>rateQuantity : IVL<PQ>doseCheckQuantity : SET<RTO>maxDoseQuantity : SET<RTO>potencyQuantity : PQsubstitutionCode : CE
Procedure
methodCode : SET<CE>approachSiteCode : SET<CD>targetSiteCode : SET<CD>
Supply
quantity : PQexpectedUseTime : IVL<TS>
Account
name : STcurrencyCode : CEinterestRateQuantity : RTO<MO,PQ>allowedBalanceQuantity : IVL<MO>
FinancialAct
netAmt : MO
PublicHealthCase
detectionMethodCode : CEtransmissionModeCode : CEdiseaseImportedCode : CE
PatientEncounter
acuityLevelCode : CEadmissionSourceCode : CEbirthEncounterInd : BLdischargeDispositionCode : CElengthOfStayQuantity : PQpreAdmitTestInd : BLreferralSourceCode : CEspecialAccommodationCode : SET<CE>specialCourtesiesCode : SET<CE>urgencyCode : CE
DiagnosticImage
subjectOrientationCode : CE
FinancialTransaction
creditExchangeRateQuantity : REALdebitExchangeRateQuantity : REALinterestRateQuantity : RTO
InvoiceElement
modifierCode : SET<CE>unitQuantity : RTO<PQ,PQ>unitPriceAmt : RTO<MO,PQ>factorNumber : REALpointsNumber : REALcoverageSourceCode : CEnotifySubjectInd : BL
FinancialContract
paymentTermsCode : CE
DeviceTask
parameterValue : LIST<ANY>
WorkingList
ownershipLevelCode : CE
structureTypeId : IIresponseCode : CS
1
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
Observation
value : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>derivationExpr : ST
Diet
energyQuantity : PQcarbohydrateQuantity : PQ
ControlAct
Bottom-Up Modeling Bottom-Up Modeling ArtifactsArtifacts
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
0…*
0…*
“Classes”
Simple or ‘hasA’associationsymbol
“Attribute: value pair”
“Datatype”
hierarchy or ‘IsA’ association symbol
‘cardinality’ or ‘multiplicity’ symbol
The Meaning of The Meaning of HierarchyHierarchy
SubstanceAdministration
routeCode : CEapproachSiteCode : SET<CD>doseQuantity : IVL<PQ>rateQuantity : IVL<PQ>doseCheckQuantity : SET<RTO>maxDoseQuantity : SET<RTO>potencyQuantity : PQsubstitutionCode : CE
Procedure
methodCode : SET<CE>approachSiteCode : SET<CD>targetSiteCode : SET<CD>
Supply
quantity : PQexpectedUseTime : IVL<TS>
Account
name : STcurrencyCode : CEinterestRateQuantity : RTO<MO,PQ>allowedBalanceQuantity : IVL<MO>
FinancialAct
netAmt : MO
PublicHealthCase
detectionMethodCode : CEtransmissionModeCode : CEdiseaseImportedCode : CE
PatientEncounter
acuityLevelCode : CEadmissionSourceCode : CEbirthEncounterInd : BLdischargeDispositionCode : CElengthOfStayQuantity : PQpreAdmitTestInd : BLreferralSourceCode : CEspecialAccommodationCode : SET<CE>specialCourtesiesCode : SET<CE>urgencyCode : CE
DiagnosticImage
subjectOrientationCode : CE
FinancialTransaction
creditExchangeRateQuantity : REALdebitExchangeRateQuantity : REALinterestRateQuantity : RTO
InvoiceElement
modifierCode : SET<CE>unitQuantity : RTO<PQ,PQ>unitPriceAmt : RTO<MO,PQ>factorNumber : REALpointsNumber : REALcoverageSourceCode : CEnotifySubjectInd : BL
FinancialContract
paymentTermsCode : CE
DeviceTask
parameterValue : LIST<ANY>
WorkingList
ownershipLevelCode : CE
structureTypeId : IIresponseCode : CS
1
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
Observation
value : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>derivationExpr : ST
Diet
energyQuantity : PQcarbohydrateQuantity : PQ
ControlAct
Act-Supply-Diet Act-Supply-Diet HierarchyHierarchy
Supply
quantity : PQexpectedUseTime : IVL<TS>
1
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
Diet
energyQuantity : PQcarbohydrateQuantity : PQ
Diet Act Combines Attributes in Diet Act Combines Attributes in HierarchyHierarchy1
0..*
1
Diet Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
energyQuantity : PQcarbohydrateQuantity : PQ
quantity : PQexpectedUseTime : IVL<TS>
From SupplyFrom Diet
The Meaning of The Meaning of HierarchyHierarchy
SubstanceAdministration
routeCode : CEapproachSiteCode : SET<CD>doseQuantity : IVL<PQ>rateQuantity : IVL<PQ>doseCheckQuantity : SET<RTO>maxDoseQuantity : SET<RTO>potencyQuantity : PQsubstitutionCode : CE
Procedure
methodCode : SET<CE>approachSiteCode : SET<CD>targetSiteCode : SET<CD>
Supply
quantity : PQexpectedUseTime : IVL<TS>
Account
name : STcurrencyCode : CEinterestRateQuantity : RTO<MO,PQ>allowedBalanceQuantity : IVL<MO>
FinancialAct
netAmt : MO
PublicHealthCase
detectionMethodCode : CEtransmissionModeCode : CEdiseaseImportedCode : CE
PatientEncounter
acuityLevelCode : CEadmissionSourceCode : CEbirthEncounterInd : BLdischargeDispositionCode : CElengthOfStayQuantity : PQpreAdmitTestInd : BLreferralSourceCode : CEspecialAccommodationCode : SET<CE>specialCourtesiesCode : SET<CE>urgencyCode : CE
DiagnosticImage
subjectOrientationCode : CE
FinancialTransaction
creditExchangeRateQuantity : REALdebitExchangeRateQuantity : REALinterestRateQuantity : RTO
InvoiceElement
modifierCode : SET<CE>unitQuantity : RTO<PQ,PQ>unitPriceAmt : RTO<MO,PQ>factorNumber : REALpointsNumber : REALcoverageSourceCode : CEnotifySubjectInd : BL
FinancialContract
paymentTermsCode : CE
DeviceTask
parameterValue : LIST<ANY>
WorkingList
ownershipLevelCode : CE
structureTypeId : IIresponseCode : CS
1
0..*
1
Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
Observation
value : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>derivationExpr : ST
Diet
energyQuantity : PQcarbohydrateQuantity : PQ
ControlAct
Observation Act = Act Attributes + Observation Act = Act Attributes + Observation AttributesObservation Attributes
1
0..*
1
Observation Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
From Observationvalue : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>derivationExpr : ST
Observation.code / Observation.code / Observation.valueObservation.value
What is the Question? / What is the Answer?What is the Question? / What is the Answer?1
0..*
1
Observation Act
id : SET<II>moodCode : CSclassCode : CScode : CDtext : EDstatusCode : CSconfidentialityCode : SET<CE>effectiveTime : GTSactivityTime : GTSinterruptibleInd : BLavailabilityTime : TScontextLockInd : BLindependentInd : BLinterruptibleInd : BLnegationInd : BLpriorityCode : SET<CE>repeatNumber : IVL<INT>reasonCode : SET<CE>substitutionConditionCode : CElevelCode : CEuncertaintyCode : CE
11
From Observationvalue : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>derivationExpr : ST
‘White Blood Count’
CTP code‘xyz’
10,000
‘EstablishedDiagnosis’SNOMED
code‘14657009’
‘Malig Tumor of Breast’SNOMED
code‘254837009’
Sample GlossarySample GlossarySource Term Term Source Storyboard Sentence Nominalized
VerbGeneral Dictionary Definition
Domain Dictionary Definition
Inferred Question
SNOMED CT
Lexical Match
Meaning Match
Christine Storyboard: Single-word Term
Christine, age 46, was recently diagnosed with stage II breast cancer.
not applicable Not Applicable What was the name?
diagnosed Storyboard: Single-word Term
Christine, age 46, was recently diagnosed with stage II breast cancer.
diagnosis The act or process of determining the nature and cause of a disease or injury through examination of the patient
The act or process of identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data
What was the diagnosis?
Establish-ed diagnosis 14657009
breast cancer Storyboard: Multi-word Term
Christine, age 46, was recently diagnosed with stage II breast cancer.
none none What was the diagnosis?
254837009 Malignant tumour of breast
RN Activity Diagram: Role A graduate trained nurse who has passed a state registration examination and has been licensed to practice nursing
A nurse who has graduated from an accredited school of nursing and licensed to practice by a state authority
224535009 Registered nurse
reviews chart Activity Diagram: Action State
chart review Review: An inspection or examination for purposes of evaluation
Chart: A recording, in tabular form, of clinical data relating to a case
Review of 55210009 medical
records review, 312853008
requests education appointment
Activity Diagram: Action State
education appointment request
Patient education 311401005
request Activity Diagram: Flow Class
What is an Information What is an Information Model?Model?
Describes Relationships Between Concepts (in UML)Describes Relationships Between Concepts (in UML) Class conceptsClass concepts Attribute conceptsAttribute concepts Association conceptsAssociation concepts Data-type conceptsData-type concepts
Provides Data-type Links to Vocabulary ConceptsProvides Data-type Links to Vocabulary Concepts SNOMEDSNOMED LOINCLOINC ICNPICNP ……....
Not a Data Model!Not a Data Model! Not concerned with application performance in a relational Not concerned with application performance in a relational
databasedatabase Not concerned with ease of application programmingNot concerned with ease of application programming Is concerned with communicating knowledge of domainIs concerned with communicating knowledge of domain
What is an Information What is an Information Model?Model?
Describes Relationships Between Concepts Describes Relationships Between Concepts (in UML)(in UML) Class conceptsClass concepts Attribute conceptsAttribute concepts Association conceptsAssociation concepts Data-typeData-type concepts concepts
Provides Provides Data-typeData-type Links to Vocabulary Links to Vocabulary ConceptsConcepts SNOMEDSNOMED LOINCLOINC ICNPICNP ……....
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Indirect Object
-onBehalfOf
Building an Information Building an Information ModelModel
--an iterative process--an iterative process Identify Basic ConceptsIdentify Basic Concepts Define Basic Concepts in GlossaryDefine Basic Concepts in Glossary Identify Relationships Between ConceptsIdentify Relationships Between Concepts
AttributesAttributes MultiplicitiesMultiplicities AssociationsAssociations
Abstract Basic Concepts into Hierarchies Abstract Basic Concepts into Hierarchies Identify attributes that can be sharedIdentify attributes that can be shared Define Abstract Concepts in GlossaryDefine Abstract Concepts in Glossary
Identify Basic ConceptsIdentify Basic Concepts Subjects Subjects
(actors)(actors) PatientPatient NurseNurse PhysicianPhysician Patient care Patient care
aideaide ……
VerbsVerbs AskedAsked ReviewedReviewed DecidedDecided PrintedPrinted MovedMoved DocumentedDocumented SpokeSpoke VerbalizedVerbalized AssessAssess ……
ObjectsObjects PatientPatient StrategiesStrategies Breast Breast
cancercancer NauseaNausea VomitingVomiting InterventionIntervention VideoVideo ……
Identify Abstract Identify Abstract ConceptsConcepts
Subjects Subjects (actors)(actors) PatientPatient NurseNurse PhysicianPhysician Patient care Patient care
aideaide ……
VerbsVerbs AskedAsked ReviewedReviewed DecidedDecided PrintedPrinted MovedMoved DocumentedDocumented SpokeSpoke VerbalizedVerbalized AssessAssess ……
ObjectsObjects PatientPatient StrategiesStrategies Breast Breast
cancercancer NauseaNausea VomitingVomiting InterventionIntervention VideoVideo ……
Verbs = “Actions”Subjects = “Persons”Subjects = “Do’ers”
Objects = “?”
Define Abstract Concepts in Define Abstract Concepts in GlossaryGlossary
Do’er is someone who performs an actionDo’er is someone who performs an action Action is a word that describes what a Action is a word that describes what a
do’er is doing to the objectdo’er is doing to the object Object is a direct object or an indirect Object is a direct object or an indirect
object of a sentenceobject of a sentence A direct object of a sentence is the thing A direct object of a sentence is the thing
being done tobeing done to An indirect object of a sentence is the ….An indirect object of a sentence is the ….
Data-Types Data-Types
What “kinds of” values can an attribute What “kinds of” values can an attribute have?have? Timing (date-timestamps; frequency text; etc)Timing (date-timestamps; frequency text; etc) Code (alphanumeric text strings from code Code (alphanumeric text strings from code
field of published vocabulary)field of published vocabulary) Vocabulary (string with official identifier for Vocabulary (string with official identifier for
published vocabulary)published vocabulary) Vtext (string with English text corresponding Vtext (string with English text corresponding
to code in published vocabulary)to code in published vocabulary) Stext (string with exact text from storyboard)Stext (string with exact text from storyboard)
+timing-code-vocabulary-vtext-stext
Action
Identify Relationships Identify Relationships Between ConceptsBetween Concepts
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Object of Action
-name-role-code-vocabulary-vtext
Do’er-actsOn
Do’ersDo’ers PatientPatient NurseNurse PhysicianPhysician Patient care aidePatient care aide ……
ActionsActions AskedAsked ReviewedReviewed DecidedDecided PrintedPrinted MovedMoved DocumentedDocumented SpokeSpoke VerbalizedVerbalized AssessAssess ……
Objects (direct & Objects (direct & indirect)indirect)
PatientPatient StrategiesStrategies Breast cancerBreast cancer NauseaNausea VomitingVomiting InterventionIntervention VideoVideo ……
-code-vocabulary-vtext-stext
Indirect Object
-code-vocabulary-vtext-stext
Direct Object
Identify Relationships Identify Relationships Between ConceptsBetween Concepts
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Object of Action
-name-role-code-vocabulary-vtext
Do’er-actsOn
Do’ersDo’ers PatientPatient NurseNurse PhysicianPhysician Patient care aidePatient care aide ……
ActionsActions AskedAsked ReviewedReviewed DecidedDecided PrintedPrinted MovedMoved DocumentedDocumented SpokeSpoke VerbalizedVerbalized AssessAssess ……
Objects (direct & Objects (direct & indirect)indirect)
PatientPatient StrategiesStrategies Breast cancerBreast cancer NauseaNausea VomitingVomiting InterventionIntervention VideoVideo ……
-code-vocabulary-vtext-stext
Indirect Object
-onBehalfOf
Storyboard Information Storyboard Information Model Model
Instance DiagramsInstance Diagrams Test the combination of Information Test the combination of Information
Model and vocabularies against the Model and vocabularies against the storyboardstoryboard
Use the Storyboard Glossary to Use the Storyboard Glossary to provide the vocabulary for the provide the vocabulary for the instance diagramsinstance diagrams
Nursing Domain Nursing Domain Information ModelInformation Model
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Site
-hasSite
-code-vocabulary-vtext-stext
Route
-hasRoute
-code-vocabulary-vtext-stext
Means
-code-vocabulary-vtext-stext
Object of Action
-hasMeans
-actsOn
-name-role-code-vocabulary-vtext
Recipient of Care-hasRecipientOfCare
OtherObjects
-degree-potentiality-acuity-timing
Judgement
-timing-focusType
Focus
-code-vocabulary-vtext-stext
Subject of information
-hasSubjectOfInformation
-hasSite
-name-role-code-vocabulary-vtext
Provider Role
-Result
Finding
Diagnosis
Supply
-hasSupply*
focusType Value Set =
• Patient Functioning• Environment• ICF and other similar concepts in other vocabularies
Finding includes theconcepts of Goal andOutcome dependingon relationship timingand other actions
Subject is coded forindividual, family,or other physical entity
-code-vocabulary-vtext-stext
-hasFocus
-hasJudgement
Example Instance DiagramExample Instance Diagram“Susan , an RN , reviews Christine's “Susan , an RN , reviews Christine's
chart”chart”
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Site
-hasSite
-code-vocabulary-vtext-stext
Route
-hasRoute
-code-vocabulary-vtext-stext
Means
-code-vocabulary-vtext-stext
Object of Action
-hasMeans
-actsOn
-name-role-code-vocabulary-vtext
Recipient of Care-hasRecipientOfCare
OtherObjects
-degree-potentiality-acuity-timing
Judgement
-timing-focusType
Focus
-code-vocabulary-vtext-stext
Subject of information
-hasSubjectOfInformation
-hasSite
-name-role-code-vocabulary-vtext
Provider Role
-Result
Finding
Diagnosis
Supply
-hasSupply*
focusType Value Set =
• Patient Functioning• Environment• ICF and other similar concepts in other vocabularies
Finding includes theconcepts of Goal andOutcome dependingon relationship timingand other actions
Subject is coded forindividual, family,or other physical entity
-code-vocabulary-vtext-stext
-hasFocus
-hasJudgement
SusanRN
224535009S
RegisteredNurse 55210009
Review ofReviews
S2B.2.1.1.1.1.1.1.22
ChristinePatient
ICNP
ICNPRecord chart
chart
Mapping from Nursing to Mapping from Nursing to HL7HL7
From Nursing From Nursing DomainDomain To HL7 RIMTo HL7 RIM
Provider RoleProvider Role Entity (Person) + Entity (Person) + RoleRole
Care RecipientCare Recipient Entity (Person) + Entity (Person) + RoleRole
Action + Object of Action + Object of ActionAction
ActAct
SupplySupply MaterialMaterial
Diagnosis.resultDiagnosis.result Observation.valueObservation.value
Finding.resultFinding.result Observation.valueObservation.value
RouteRoute SubstAdmin.routeCoSubstAdmin.routeCodede
Example Instance DiagramExample Instance Diagram“Susan , an RN , reviews Christine's “Susan , an RN , reviews Christine's
chart”chart”
+timing-code-vocabulary-vtext-stext
Action
-code-vocabulary-vtext-stext
Site
-hasSite
-code-vocabulary-vtext-stext
Route
-hasRoute
-code-vocabulary-vtext-stext
Means
-code-vocabulary-vtext-stext
Object of Action
-hasMeans
-actsOn
-name-role-code-vocabulary-vtext
Recipient of Care-hasRecipientOfCare
OtherObjects
-degree-potentiality-acuity-timing
Judgement
-timing-focusType
Focus
-code-vocabulary-vtext-stext
Subject of information
-hasSubjectOfInformation
-hasSite
-name-role-code-vocabulary-vtext
Provider Role
-Result
Finding
Diagnosis
Supply
-hasSupply*
focusType Value Set =
• Patient Functioning• Environment• ICF and other similar concepts in other vocabularies
Finding includes theconcepts of Goal andOutcome dependingon relationship timingand other actions
Subject is coded forindividual, family,or other physical entity
-code-vocabulary-vtext-stext
-hasFocus
-hasJudgement
SusanRN
224535009S
RegisteredNurse 55210009
Review ofReviews
S2B.2.1.1.1.1.1.1.22
ChristinePatient
ICNP
ICNPRecord chart
chart
Entityid : SET<II>classCode : CSdeterminerCode : CSimportanceStatusText : EDqty : SET<PQ>telecom : SET<TEL>description : EDstatusCode : CScode : CEnm : SET<EN>riskCode : CE
1
playedRoleplayer
scopedRolescoper
0..1
0..*
Participation
typeCode : CStmr : IVL<TS>note_text : EDsignatureCode : CVfunctionCode : CDawarenessCode : CVsignatureText : EDencounter_accommodationCode : CVstatusCode : CSmodeCode : CV
0..*0..*
--adapted from RIM V1.18
RoleLinkeffectiveTime : IVL<TS>typeCode : CS
RoleclassCode : CSeffectiveTime : IVL<TS>id : SET<II>statusCode : CSpositionNumber : LIST<INT>qty : PQcertificateText : EDaddr : SET<AD>telecom : SET<TEL>code : CE
1
outboundLink
0..*
source
1
1
inboundLink
0..*
target
1
0..*
0..*
1
ActRelationship
typeCode : CSinversion_ind : BLsequenceNumber : INTpriorityNumber : INTpauseQty : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegation_ind : BLconjunctionCode : CS
Act
id : SET<II>moodCode : CSclassCode : CStxt : EDstatusCode : CSactivityTime : GTSeffectiveTime : GTSconfidentialityCode : SET<CV>repeatNumber : IVL<INT>interruptible_ind : BLpriorityCode : SET<CV>independent_ind : BLavailability_dttm : GTScode : CDtransfer_reasonCode : CV
1
outboundLinkis_source_for
1 0..*
has_target
0..*
target
1
MappingMappingto theto theRIMRIM
SusanRN 224535009 S
RegisteredNurse
2B.2.1.1.1.1.1.1.22Patient ICNP
312853008 Medical Record Review S
Reviewed Chart
Christine
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