Intermountain Healthcare/GE Clinical Element Models Patient Model and Terminology 1. Introduction The patient CEM1 is used to store demographic data about a patient. 1.1 Purpose The purpose of this document is to describe the patient CEM and it sources for possible information. 1.2 Scope The patient CEM only includes demographic data for a patient. It does not include information associated with a patient visit. Basically, the patient CEM corresponds to the PID segment in an HL7 message. 2. 3. References Revision Document V2.X HL7 Version 2.0+ V3 HL7 Version 3 RIM Document Number Definitions, Acronyms and Abbreviations Term Definition 1 Clinical Element Models and terminology created for the Intermountain Healthcare/GE Healthcare partnership are GE copyright material, licensed to Intermountain to share freely and publicly. 03-06-2016 Page 1 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models 4. Design Convention 5. Design Overview 6. Detailed Design Description 6.1 Model creation PersonName o PersonName followed the GMT design, and also referenced the HL7 v3 RIM. o The name parts of FamilyName, GivenName, MiddleName, PrefixName, SuffixName, TitleName and VoorvoegselName are de-normalized into individual items, because they are used the most often. o Cardinality within Patient 1-M. PersonName Model Item Cardinality CEM Datatype Description HL7 Field FamilyName 1 St The name attributed to a family and is often used to trace genealogy. PID5-1/PID9-1 GivenName 0-1 St The name assigned to a person often near birth by the parents. PID5-2/PID9-2 MiddleName 0-1 St The middle name or initials of the person. PID5-3/PID9-3 PrefixName 0-1 st A description attached to the front of a name often used to indicate special credentials (Dr.) or marital status/gender (Mr., Ms., Mrs.) PID5-5/PID9-5 SuffixName 0-1 St A description attached to the end of a name usually used to indicate special credentials (Dr., Ph.D., RN) PID5-4/PID9-4 TitleName 0-1 st A description indicating job status, profession or academic title (Director, PID5-6 or PID5-14? /PID9-6 or 03-06-2016 Page 2 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models Professor, President.) VoorvoegselName 0-1 st A description indicating nobility in the past (Sir, Lord, Lady.) PersonNameUse 1 cwe Indicates the intended usage of the PERSON NAME. For example: Default name, maiden name, alias. Person Name Use Value Set: 24de9520bd2-45e3aed5e870b750d9b PID9-14? PID57/Inherent in PID-9 Start Concept: Person Name Use (8b1fae4ba3e9-4c7bb1f75f4226a387a0 ) PersonNameStatus 0-1 cne Entity Status Value Set: cbe17d857ff9-4814be9c0fb11d1a3cc7 The status of the PERSON NAME in terms of the relationship to the named person. For example: inactive or active. Start Concept: Entity Status (72e25de04900-4c8b87600d25292a6bc7 ) StartTime 0-1 TS The time this name started to apply. EndTime 0-1 TS The time this name no longer applies. PreferenceInd 0-1 cne Indicates whether this is the preferred name or not. Yes/No Indicator 03-06-2016 Page 3 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models Value Set: b23046996dab-42729df2534cef3ddac9 Start Concept: Yes/No Indicator (f53d9c1b14ee-4538bcaec04725b3242a ) HL7 Suggested Values for PID5-7 (PersonNameUse) Value A B C D I L M N P R S T U 03-06-2016 Description Alias Name Name at Birth Adopted Name Display Name Licensing Name Legal Name Maiden Name Nickname /”Call me” Name/Street Name Name of Partner/Spouse - obsolete Registered Name (animals only) Coded Pseudo-Name to ensure anonymity Indigenous/Tribal/Community Name Unspecified Page 4 of 21 Comment Deprecated in V2.4 106757021 Intermountain Healthcare/GE Clinical Element Models BirthDate o The date/time the patient was born. o This maps to HL7 2.x PID-7. o Data type ts. o Cardinality is 0-1. BirthPlace o The place or location where the patient was born. o This maps to HL7 2.x segment 23. o Data type is string. o Cardinality is 0-1. AdministrativeGender o The gender (sex) of this person. Note: this attribute does not include terms related to clinical gender which is a complex physiological, genetic and sociological concept that requires multiple observations in order to be comprehensively described. o This maps to HL7 2.x segment 8. o Datatype is cwe. o Cardinality is 0-1. o Administrative Gender Value Set: 7fc263ed-89d9-4ade-9c48-3ab45e294936 o Start Concept: Administrative Gender (7897e68d-38eb-4367-b888-7ea88453533a) HL7 Suggested Values for PID8 (Administrative Gender) Value 03-06-2016 Description Comment F M O U Female Male Other Unknown Also in V3 Also in V3 A N Ambiguous Not applicable Page 5 of 21 Also in V3, but value is UN 106757021 Intermountain Healthcare/GE Clinical Element Models DeceasedIndicator o A flag which indicates whether the patient is dead or alive. A value of yes means the patient is deceased. A value of no means the patient is not deceased. A full value has no real meaning and the patient is assumed alive if the value is null. o This maps to HL7 2.x segment 30. o Datetype is CNE. o Cardinality is 0-1. o Yes/No Indicator Value Set: b2304699-6dab-4272-9df2-534cef3ddac9 o Start Concept: Yes/No Indicator (f53d9c1b-14ee-4538-bcae-c04725b3242a) DeceasedDate o The date/time the person died. o This maps to the 2.x segment 29. o Data type is ts. o Cardinality is 0-1. RoleStatus o The status of the person as a patient. For example, the person is a current/active patient or the person is no longer a patient. o This maps to HL7 v3 StatusCode in PatientClass. o Data type is CWE. o Cardinality is 0-1. o HL7 V3 suggests the domain RoleStatus and ECIS uses the Role Status Value Set: 36f18350-2d6f-4c74-b61d-08c5d5fa30b5 o Start Concept: Role Status df50d7c7-3388-4d92-a8c3-00dba9614760 MultipleBirthInd o An indication that this person was the product of a multiple birth. Yes means there was more than one fetus/child. A no means there was not. A null value indicates no information and no assumption should be made. o This maps to HL7 2.x segment 24. o Data type is CWE. o Cardinality is 0-1. o Yes/No Indicator Value Set: b2304699-6dab-4272-9df2-534cef3ddac9 o Start Concept: Yes/No Indicator (f53d9c1b-14ee-4538-bcae-c04725b3242a) MultipleBirthOrderNumber o 03-06-2016 The order within a multiple birth in which this living subject was born. Page 6 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models o This maps to HL7 2.x segment 25 o Data type is integer. o Cardinality = 0-1. o There has been some discussion around deviating this to a birth order number of the number of babies in the multiple birth (2 of 3.) The other option is change MultipleBirthInd to be an integer which would hold the number of babies born and this would indicate the birth order. Address o Addresses where the patient can be found or where correspondence can be sent. o Cardinality within Patient 0-M. Address Model Item Cardinality CEM Datatype Description HL7 Field AddressLine1 0-1 st The first line of an address. PID11-1 AddressLine2 0-1 st The second line of an address. PID11-2 AddressLine3 0-1 st The third line of an address. AddressLine4 0-1 st The fourth line of an address. City 0-1 st A defined territory within a county. PID11-3 County 0-1 st A defined territory within a state. PID12 PostalCode 0-1 st The postal code of a physical address in the country. PID11-5 State 0-1 cwe A defined territory within the borders of a country. Corresponds to a province in Canada. PID11-4 State Value Set: babf4737a0d9-47e580810f4a337d4160 Start Concept: State ( 03-06-2016 Page 7 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models Country 0-1 cwe Country Value Set: 66a0d35e6998-448c8e7204aeb7957e8a A defined territory in the world. PID11-6 Start Concept: Country (3566141376da-4fb8beb3f9a147488df7) PostalBoxNumber 0-1 st A location in the public postal system for a postal address which it not a physical address. CareOf 0-1 st The name of the party who will take receipt of the specified address. AddressUse 0-1 cwe The manner in which this address is used. For example, business, permanent home, vacation home and etc. Address Use Value Set: 2e779f28feb1-4a3c8c412e66cac5f5dd In 2.x messages is indicated by location in message (business or home) or PID11-7. Start Concept: Address Use (ba02a80c3a92-41a0aadc023e702d5b5e ) PreferenceInd 0-1 cne Yes/No Indicator Value Set: b23046996dab-42729df2- 03-06-2016 Page 8 of 21 An indication of whether is the preferred address for contact or not. 106757021 Intermountain Healthcare/GE Clinical Element Models 534cef3ddac9 Start Concept: Yes/No Indicator (f53d9c1b14ee-4538bcaec04725b3242a ) AddressStatus 0-1 cne Entity Status Value Set: cbe17d857ff9-4814be9c0fb11d1a3cc7 The status of an address. Is it currently active or inactive? May map to PID11-11 Start Concept: Entity Status (72e25de04900-4c8b87600d25292a6bc7 ) AddressType 0-1 The method in which this address is represented (Alphabetic, Syllabic, Ideographic) StartTime 0-1 The date/time this address became valid. PID11-13 EndTime 0-1 The date/time this address is no longer valid. PID11-14 Telecom o Telecom numbers where the patient can be found or where correspondence can be sent. o Cardinality within Patient 0-M. Telecom Model HL7 v2.X PID 13 & 14 Item 03-06-2016 Cardinality CEM Datatype Page 9 of 21 Description HL7 Field 106757021 Intermountain Healthcare/GE Clinical Element Models TelecomScheme 0-1 cwe TelecomSchem Value Set: d0947eb6-cc294bf7-8b530b8ae901270a The protocol for telecommunication. HL7 values: fax, file, ftp, http, mailto, mllp, modem, nfs, tel, telnet. Start Concept: Telecom Scheme (3d33f086-c6e24eda-a23c085fe479d468) TelecomStatus 0-1 cne Entity Status Value Set: cbe17d85-7ff94814-be9c0fb11d1a3cc7 The status of this number in relation to the patient (active, inactive.) Start Concept: Entity Status (72e25de0-49004c8b-87600d25292a6bc7) TelecomType 0-1 cwe Telecom Type Value Set: 1d1a9d92-89714112-a2f407eecda1cf95) The type of the electronic contact (pager, answering service, cell phone) PID13-3 & PID14-3 The purpose of this number. Location where this number applies (Home, Business.) PID13-2 & PID14-2 Start Concept: Telecom Type (4263f7a8-06524610-90685339f35f4161) TelecomUse 0-1 cwe Telecom Use Value Set: 074538c7-7f7f4519-85440ad5b23e1232 Start Concept: Telecom Use 03-06-2016 Page 10 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models (4263f7a8-06524610-90685339f35f4161) StartTime 0-1 ts The date/time this number became valid. EndTime 0-1 ts The date/time this number is no longer valid. AdministrativeRace o A social-political construct in which an individual's own identification with one more race categories. o This maps to HL7 2.x segment 10. o Data type is CWE o Cardinality is 0-1. o Race Value Set: ec8cd4e6-2f99-4d78-bca1-6f3f442acb57 o Start Concept: Race (437a6379-de94-44cf-be29-38ef66c56851) HL7 Suggested Values for PID10 (Administrative Race) Value 1002-5 2028-9 2054-5 2076-8 2106-3 2131-1 Description American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Other Race Comment Also in V3 Also in V3 Also in V3 Also in V3 Also in V3 Also in V3 AdministrativeEthnicGroup o A social-political construct in which an individual's own identification with a particular ethnicity o This maps to HL7 2.x segment 22. o Data type is CWE. o Cardinality is 0-1. o Ethnic Group Value Set: 08fd0dcb-5db2-4471-ac53-0f96471787bc o Start Concept: Ethnic Group (1b6aa33c-79b2-4e56-9d22-fc85ea6be0d2) HL7 Suggested Values for PID22 (Ethnic Group) Value H N 03-06-2016 Description Comment Hispanic or Latino Not Hispanic or Latino Page 11 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models HL7 Suggested Values for PID22 (Ethnic Group) Value U Description Comment Unknown AdministrativeMaritalStatus o The domestic partnership status of this person. o This maps to HL7 2.x segment 16. o Data type is CWE. o Cardinality is 0-1. o Marital Status Value Set: 8b5b6753-3c83-4b44-8b36-0dc6877934b0 o Start Concept: Marital Status (e5029b3a-96d6-4128-8ba8-00e6e8d68ed2) HL7 Suggested Values for PID16 (Marital Status) Value 03-06-2016 Description A Separated D M S Divorced Married Single W C G P Widowed Common law Living together Domestic partner R E Registered domestic partner Legally Separated N Annulled I B U O T Interlocutory Unmarried Unknown Other Unreported Page 12 of 21 Comment In V3, value of A = Annulled, Separated is not in V3 Also in V3 Also in V3 In V3, value of S = Never Married, Single is not in V3 Also in V3 In V3, domestic partner has a value of T. There is no value of P. In V3, legally separated has a value of L. There is no value of E. In V3, Annulled has a value of A. There is no value of N. Also in V3. In V3, T is Domestic Partner. 106757021 Intermountain Healthcare/GE Clinical Element Models Disability o An indication of the disabilities this patient may have. o This maps to HL7 v3 disabilityCode. o This maps to HL7 2.x PD1-6. o Data type is CWE. o Cardinality is 0-1. o Disability Value Set: 46a886ed-aa1d-4400-a723-00a2ea42381c o Start Concept: Disability (424baff9-f93a-45a5-892c-fda0ae4c88a6) o V3 has values from PersonDisabilityType [2.16.840.1.113883.5.93] HL7 Suggested Values for Disability in V3 Value Description CB Requires Crib CR Requires Crutches G Comment Requires Gurney WC Requires Wheelchair WK Requires Walker 1 Vision Impaired 2 Hearing Impaired 3 Speech Impaired 4 Mentally Impaired Religion o This maps to HL7 2.x segment 17. o Data type is CWE. o Cardinality is 0-1. o Religion Value Set: a049d27d-64ec-4e7a-b3bb-e79714252091 o Start Concept: Religion (d374d42d-dffc-4d92-87b5-01ab8944fba8) HL7 Suggested Values for PID17 (Religion) *Note: In V3, this data set varies greatly. 03-06-2016 Value Description AGN ATH BAH BRE BUD BMA BTH BTA BOT Agnostic Atheist Baha'i Brethren Buddhist Buddhist: Mahayana Buddhist: Theravada Buddhist: Tantrayana Buddhist: Other Comment Page 13 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models HL7 Suggested Values for PID17 (Religion) *Note: In V3, this data set varies greatly. 03-06-2016 Value Description CFR CHR ABC AMT AME ANG AOG BAP Chinese Folk Religionist Christian Christian: American Baptist Church Christian: African Methodist Episcopal Christian: African Methodist Episcopal Zion Christian: Anglican Christian: Assembly of God Christian: Baptist Comment CRR CHS CMA COC COG COI COM COL EOT EVC EPI FWB FRQ FUL GRE JWN MOM LUT LMS MEN MET Christian: Christian Reformed Christian: Christian Science Christian: Christian Missionary Alliance Christian: Church of Christ Christian: Church of God Christian: Church of God in Christ Christian: Community Christian: Congregational Christian: Eastern Orthodox Christian: Evangelical Church Christian: Episcopalian Christian: Free Will Baptist Christian: Friends Christian: Full Gospel Christian: Greek Orthodox Christian: Jehovah's Witness Christian: Latter-day Saints Christian: Lutheran Christian: Lutheran Missouri Synod Christian: Mennonite Christian: Methodist NAZ ORT Christian: Church of the Nazarene Christian: Orthodox PEN COP PRE PRO PRC Christian: Pentecostal Christian: Other Pentecostal Christian: Presbyterian Christian: Protestant Christian: Other Protestant REC REO CAT SAA SEV SOU UCC UMD UNI Christian: Reformed Church Christian: Reorganized Church of Jesus Christ-LDS Christian: Roman Catholic Christian: Salvation Army Christian: Seventh Day Adventist Christian: Southern Baptist Christian: United Church of Christ Christian: United Methodist Christian: Unitarian Page 14 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models HL7 Suggested Values for PID17 (Religion) *Note: In V3, this data set varies greatly. 03-06-2016 Value Description UNU WES WMC COT CNF DOC ERL HIN HSH HVA Christian: Unitarian Universalist Christian: Wesleyan Christian: Wesleyan Methodist Christian: Other Confucian Disciples of Christ Ethnic Religionist Hindu Hindu: Shaivites Hindu: Vaishnavites Comment HOT JAI JEW JCO JOR Hindu: Other Jain Jewish Jewish: Conservative Jewish: Orthodox JRC JRF JRN JOT MOS Jewish: Reconstructionist Jewish: Reform Jewish: Renewal Jewish: Other Muslim MSH MSU MOT NAM NRL NOE Muslim: Shiite Muslim: Sunni Muslim: Other Native American New Religionist Nonreligious SHN SIK SPI OTH VAR Shintoist Sikh Spiritist Other Unknown Page 15 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models Congregation o The local group a patient meets with when attend religious ceremonies (Parish, Ward, Mosque, Temple and etc.) o This was added for backwards compatibility with the GE Moxie project. o Data type is a string. o Cardinality 0-M. o There is no HL7 equivalent in v3 or 2.x. LanguageCommunication o A list of the languages the patient can speak, write or read. o This maps to HL7 2.x segment 15 o Data type is CWE. o Cardinality is 0-M. o Language Value Set: bd9ff479-84dd-41df-8f77-0ec1fbab7c40 o Start Concept: Human Language (6c1b6055-981b-4eb0-ab3b-fb3a3a5d3f3d) o HL&=7 2.x has no suggested values. HL7 V3 uses the HumanLanguage domain [2.16.840.1.113883.1.11.11526] Language Communication (modeled from HL7 V3) Item Cardinality CEM Datatype Description CommunicationM ode 0-1 cwe: Communication Mode Value Set: 3c1c70e0-24444566-a8290a2f2a15194f The method in which the patient uses this language (read, write, speak.) HL7 Field Start Concept: Communication Mode (2d03a639465f-402c-bfe01bc0ab1c8648) ProficiencyLevel 0-1 cwe: Proficiency Level Value set: 42355650-13774af7-876344bb284a6489 03-06-2016 Page 16 of 21 The level of proficiency the patient is at when using this language. 106757021 Intermountain Healthcare/GE Clinical Element Models Start Concept: Proficiency Level (b819e76f-5b7746da-86ce00c96f82d930) PreferenceInd 0-1 cne (Yes/No Indicator Value Set: b2304699-6dab4272-9df2534cef3ddac9 An indication of whether this is the preferred language or not. Start Concept: Yes/No Indicator (f53d9c1b-14ee4538-bcaec04725b3242a) PatientImportance o Indicates special considerations the organization gives the patient. o This maps to HL7 v3 veryImportantPersonCode in the patient class. o Data type is CWE. o Carinality is 0-1. o Patient Importance Value Set: 76887960-8512-4550-97bc-06ba8e15f777 o Start Concept: Patient Importance: afe0a946-1cbb-4729-9b38-7bf03d3a8621 o V3 uses the domain PatientImportance [2.16.840.1.113883.1.11.19265] Citizenship o The country to which the patient claims to be a citizen. o This maps to HL7 2.x segment 26. o Data type is CWE. o Cardinality is 0-M. o Country Value Set: 66a0d35e-6998-448c-8e72-04aeb7957e8a o Start Concept: Country (35661413-76da-4fb8-beb3-f9a147488df7) o HL7 V3 recommends using the ISO table 3166. Citizenship Model CEM Model 03-06-2016 Cardinality Datatype Page 17 of 21 Description HL7 Field 106757021 Intermountain Healthcare/GE Clinical Element Models StartTime 0-1 ts The date/time the patient became a citizen of this country. EndTime 0-1 ts The date/time the patient was no longer a citizen of this country. Nationality o The nation to which this patient belongs to by birth, naturalization or origin. This may be different from citizen. o This maps to HL7 2.x segment 28. o Data type is CWE. o Cardinality is 0-M. o Country Value Set: 66a0d35e-6998-448c-8e72-04aeb7957e8a o Start Concept: Country (35661413-76da-4fb8-beb3-f9a147488df7) o HL7 V3 recommends using the ISO table 3166. Nationality Model CEM Model Cardinality Datatype StartTime 0-1 ts EndTime 0-1 ts 03-06-2016 Description HL7 Field VeteranMilitaryStatus o The military status of a patient who is a veteran. o This maps to HL7 2.x segment 27. o Data type is CNE. o Cardinality is 0-1. o Veteran Military Status Value Set: 96b368a8-7b8f-4168-956b-9e7b4cbb5362 o Start Concept: Veteran Military Status (56a2133f-ef06-4df6-9d67-362ee85de5c9) o HL-7 2.x has no suggested values. CadavericDonorInd o A flag indicating that the subject is a cadaver acting as an organ donor. o Data type is CNE. Page 18 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models o Cardinality is 0-1. o Yes/No Indicator Value Set: b2304699-6dab-4272-9df2-534cef3ddac9 o Start Concept: : Yes/No Indicator (f53d9c1b-14ee-4538-bcae-c04725b3242a) o There is no HL7 2.x or V3 mapping for cadaveric donor. AdoptionInfo o An indication that this patient was adopted and the type of adoption record that is attached. o Data type is CNE. o Cardinality is 0-1. o Adoption Information Value Set: c882aade-e0bd-4989-b03e-001ec6845ae3 Start Concept: Adoption Information (aabfa8e3-df75-4d03-a135-b820eaeeaf2a) o 6.2 There is no HL7 2.x or V3 mapping for cadaveric donor. PatientExternalId o This is an identifier assigned to the patient by a system other than the ECIS system. o This CEM uses the ExternalId CEM as a base. o Data type II o Cardinality is 0-M. o Currently used to document social security number, but future plans are to create a NationalAssignedID CEM for social security number and other nationally assigned identifiers. o This CEM maps to several fields within HL7 messages. Some examples are: v2.X PID3 and PID4. Mapping to HL7 2x HL7 Element ID Element Name CEM Model Comment PID.1 Set ID - PID Not applicable This is the message identifier, I don't think it needs to be stored PID.2 Patient ID Not applicable This is handled outside of CEM PID.3 PID.4 Patient Identifier List Alternate Patient ID - PID PatientExternalId PatientExternalId PID.5 Patient Name PersonName PID.6 Mother's Maiden Name PersonName PID.7 Date/Time of Birth BirthDate PID.8 Administrative Sex AdministrativeGender 03-06-2016 This is retained for backward compatibility only. Page 19 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models PID.9 Patient Alias PersonName PID.10 Race Race PID.11 Patient Address Address PID.12 County Code Address.County PID.13 PID.14 Phone Number Home Phone Number Business Telecom Telecom PID.15 Primary Language LanguageCommunication PID.16 Marital Status MaritalStatus PID.17 Religion Religion PID.18 PID.19 PID.20 Patient Account Number SSN Number Patient Driver's License Number - Patient AdministrativeEncounterId PatientExternalId Currently stored in PatientExternalId, but NationalAssignedIdentifier will be added into the model in subsequent versions. This field is used, for example, as a link field for newborns. Typically a patient ID or account number may be used. This field can contain multiple identifiers for the same mother. PID.21 Mother's Identifier TBD PID.22 Ethnic Group EthnicGroup PID.23 Birth Place BirthPlace PID.24 Multiple Birth Indicator MultipleBirthInd PID.25 Birth Order BirthOrder PID.26 Citizenship Citizen.Citizenship PID.27 Veterans Military Status VeteranMilitaryStatus PID.28 Nationality Citizen.Nationality PID.29 PID.30 PID.31 PID.32 PID.33 Patient Death Date and Time Patient Death Indicator Identity Unknown Indicator Identity Reliability Code Last Update Date/Time DeceasedDate DeceasedIndicator ? Not sure if it is needed? ? Not sure if it is needed? ? This is sent on behalf of sender side, I don't think it needs to be stored. PID.34 Last Update Facility ? This is sent on behalf of sender side, I don't think it needs to be stored. PID.35 Species Code ? The species of living organism. PID.36 Breed Code ? The specific breed of animal. PID.37 Strain ? PID.38 Production Class Code ? PID.39 Tribal Citizenship ? 03-06-2016 This field contains the specific strain of animal. It can also be expanded to include strain of any living organism and is not restricted to animals. This field contains the code and/or text indicating the primary use for which the living subject was bred or grown. Not sure whether this can be combined into race/ethnicgroup Page 20 of 21 106757021 Intermountain Healthcare/GE Clinical Element Models 7. Technical Risks 8. Other Design Considerations 9. Module Organization 10. Testability of Design 11. Technical Exception Handling 12. Traceability Matrix 13. Revision History Revsion.Version Date 1.1 Reason For Change Author Initial draft CChe 1.2 2/18/2009 Added HL7 mappings. CChe 1.3 12/11/2009 Updated to reflect current model CTilley 03-06-2016 Page 21 of 21 106757021