CIMI Modelling Taskforce Report
Dr Linda Bird
11th April 2013
Agenda
• Background
• CIMI Modelling Approach
• CIMI Modelling Foundations
1.
2.
3.
4.
CIMI Reference Model
Archetype Object Model
Modelling Patterns
Modelling Style Guides
• Laboratory Results models
•
•
Review of models
Model specialisations
• Demographics Models
• Future Work
• Terminology Binding
BACKGROUND
Taskforce Members
Core Members:
• Linda Bird (chair)
• Tom Beale
• Dave Carlson
• Stephen Chu
• Stan Huff
• Mike Lincoln
• Rahil Qamar Siddiqui
• Gerard Freriks
• Josh Mandel
• Mark Shafarman
• Michael van der Zel
Secretary:
• Eithne Keelaghan
Technical Resources:
• Peter Hendler
• Galen Mulrooney
• Daniel Karlsson
• Cecil Lynch
• Joey Coyle
• Grahame Grieve
• Dipak Kalra
• David Moner
Clinical Modelling Resource:
• William Goossen
• Jay Lyle
• Ian McNicoll
• Anneke Goossen
• Heather Leslie
• Sarah Ryan
• Harold Solbrig
• Marcelo Rodrigues dos Santos
Mission
To develop a CIMI modelling
methodology, style guide and a set of
models, which together demonstrate and
test the approach to CIMI clinical
modelling.
Terms of Reference
This taskforce has been established to:
• Further develop CIMI's modelling methodology;
• Create an initial set of CIMI clinical models;
• Further test and develop CIMI technical models,
including:
– CIMI reference model
– Archetype Object Model 1.5, and
– CIMI terminology.
Modelling Taskforce History (2012)
May 10 - 12
May to Sep
Sept 14 - 16
Oct to Dec
Dec 2 – 4
Meeting in Pleasanton  Modelling Taskforce established
Taskforce infrastructure and planning; Modelling
methodology; Observation modelling pattern; Heart rate
model
Meeting in Rockville  Modelling priorities: Lab Results
Report (followed by Immunizations and Body Temperature)
Design Lab Results model structure and modelling patterns
Establish terminology binding methodology & reference sets
Begin to review CIMI Demographics RM
Begin designing specialised Lab models
Taskforce meeting in Groningen
Modelling Taskforce History (2013)
Jan 18 – 20
Meeting in Scottsdale
Feb – Apr 4
Terminology and Modelling Tooling (led by Harold)
CIMI Modelling Style Guides (TOC)
Comparative Analysis Spreadsheet template
Laboratory Results Models
Example Terminology bindings
Lab Specialisation Models – CBC & Gas and CM Panels
Demographics models
Finalisation of CIMI Reference Model Review
Implementation work
CIMI RM BMM, ADL 1.5 generation
CIMI MODELLING APPROACH
CIMI’s Modeling Approach
•
•
•
•
•
•
•
•
Modular for reusability
Composable to meet use-cases
Pattern-based for consistency
Constraint-based to allow specialisation
Logical for implementation in multiple formats
Maximal for completeness
Extensible for local requirements
Bound to terminology for isosemanticity
& interoperability
CIMI Architectural Overview
Modelling Methodology
• Foundations
1.
2.
3.
4.
CIMI Reference Model
Archetype Object Model
CIMI Modelling Patterns
CIMI Style Guide
• Modelling Approach
1.
2.
3.
4.
5.
6.
Analyse clinical models submitted (with value sets)
Identify maximal set of data elements
Remove ‘out of scope’ data elements (Style Guide)
Select appropriate CIMI Modelling Patterns(Style Guide)
Define CIMI model (Mindmap, ADL, UML)
Add Terminology bindings
o
o
7.
8.
Meaning (nodes, node relationships)
Value sets (maximal set from submitted models)
Add Example Model Data Instances
Technical Validation
o
ADL, UML
9. Clinical Validation / Review
10. Confirm mappings from submitted models
FOUNDATION 1:
CIMI REFERENCE MODEL
CIMI Reference Model - Core
class CIMI Core Model
LOCATABLE
LINK
link
meaning :TEXT
source
0..*
ARCHETYPED
archetype_details
archetype_node_id :String
target name :String
0..1
archetype_id :String
rm_version :String = 1.0.11 {readOnly}
1
PARTICIPATION
participation
function :CODED_TEXT
0..*
details :ITEM [0..*]
1..1
COMPOSITION
category :CODED_TEXT
language :CODED_TEXT
jurisdiction :CODED_TEXT
content
0..*
CONTENT_ITEM
0..*
item
SECTION
1..*
data
ENTRY
ITEM
language :CODED_TEXT
1..*
item
Name:
Author:
Version:
Created:
Updated:
CIMI Core Model
CIMI MTF
1.0.10
30/11/2012 8:32:29 PM
9/04/2013 1:29:40 PM
PARTY
party
CORE_LOCATABLE
CLUSTER
structure_type :CODED_TEXT [0..1]
ELEMENT
null_flavor :CODED_TEXT [0..1]
value :DATA_VALUE [0..1]
details :ITEM [0..*]
CIMI Reference Model – Data Values
class CIMI Data Value Types
IDENTIFIER
URI
+
+
+
YESNO
+
value :Boolean
EHR_URI
id :String
type :CODED_TEXT
issuer :String
CODED_TEXT
+
+
+
+
+
TEXT
STRING_VALUE
+
PARSABLE
+
+
+
language :CODED_TEXT [0..1]
value :String
code :String
terminology_id :TERMINOLOGY_ID
terminology_version :String [0..1]
term :String [0..1]
term_id :String [0..1]
formalism :CODED_TEXT
value :String
+target
DATA_VALUE
1..1
+mapping
0..*
PLAIN_TEXT
ENCAPSULATED
TERM_MAPPING
MULTIMEDIA
+
+
+
+
+
+
T : ORDERED_VALUE
alternate_text :String [0..1]
data :Byte [0..*] (Array)
media_type :CODED_TEXT
uri :URI [0..1]
0..1+upper<T>
ORDERED_VALUE
INTERVAL_VALUE
+
+
+
+
+lower<T>
0..1
symbol :CODED_TEXT
value :Integer
+
«enumeration»
TermMappingMatchEnum
>
=
<
?
value_status :String [0..1]
String
AMOUNT
+
+
Character
upper_unbounded :Boolean
lower_unbounded :Boolean
upper_included :Boolean
lower_included :Boolean
QUANTIFIED
ORDINAL
+
+
match :Character
purpose :CODED_TEXT [0..1]
«enumeration»
QuantifiedValueStatusEnum
accuracy :Real [0..1]
accuracy_is_percent :Boolean [0..1]
DATE_TIME
-
value :String
=
<
>
<=
>=
~
COUNT
+
Name:
Author:
Version:
Created:
Updated:
value :Integer
CIMI Data Value Types
CIMI MTF
1.0.10
22/03/2013 9:00:10 AM
22/03/2013 9:08:49 AM
PROPORTION
+
+
+
+
numerator :Real
denominator :Real
precision :Integer [0..1]
type :CODED_TEXT
QUANTITY
+
+
+
value :Double
units :CODED_TEXT
precision :Integer [0..1]
+
duration_text :String [0..1]
DURATION
DATE
{units constrained to
units of time}
TIME
CIMI Reference Model – Party Model
class CIMI Participation Model
«archetype_parent»
LOCATABLE
+
+
PARTY_RELATIONSHIP
+
+
type :CODED_TEXT
details :ITEM [0..*]
archetype_node_id :String
name :String
+relationship
0..*
+source
PARTY
+target +
details :ITEM [0..*]
1..1
Name:
Author:
Version:
Created:
Updated:
CIMI Participation Model
CIMI MTF
1.0.10
25/04/2012 7:04:30 AM
9/04/2013 1:34:38 PM
ROLE
+
type :CODED_TEXT
ACTOR
+role
0..*
+
type :CODED_TEXT
FOUNDATION 2:
ARCHETYPE OBJECT MODEL
Archetype Object Model (AOM) 1.5
AOM 1.5 Archetype
AOM 1.5 Constraint Model
AOM 1.5 Primitive
AOM 1.5 Assertion
AOM 1.5 Ontology
Archetype Definition Language 1.5
archetype (adl_version=1.5) CIMI-RM-CLUSTER.anatomical_location.v1
concept
[at0000]
-- Anatomical location
language
original_language = <[ISO_639-1::en]>
description
original_author = <
["name"] = <"Ian McNicoll">
["date"] = <"29/11/2012“>
>
details = < ["en"] = < language = <[ISO_639-1::en]>
purpose = <" Identification of a single anatomical structure, or area, of the human body">
use = <"">
misuse = <"">
copyright = <"“>
>
>
lifecycle_state = <"AuthorDraft">
other_contributors = <>
other_details = <>
definition
CLUSTER[at0000] matches {
-- Anatomical location
items matches { ELEMENT[at0001] occurrences matches {0..1} matches {
-- Body site name
value matches { TEXT matches {*}
}
}
ELEMENT[at0002] occurrences matches {0..1} matches { -- Body site description
value matches { TEXT matches {*}
}
}
ELEMENT[at0003] occurrences matches {0..1} matches { -- Body side
value matches { TEXT matches {*}
}
}}}}
ontology
term_definitions = <
["en"] = <
items = < ["at0000"] = < text = <"Anatomical location">
description = <" Identification of a single anatomical structure, or area, of the human
body“>>
["at0001"] = < text = <"Body site name">
description = <"Name of anatomical location, as specific as is possible.“> >
["at0002"] = < text = <"Body site description">
description = <"Description of anatomical location.“> >
["at0003"] = < text = <"Body side">
FOUNDATION 3: CIMI
MODELLING PATTERNS
CIMI Modelling Layers
CLUSTER
ENTRY
SECTION
COMPOSITION
Implementation
Purpose Context
Laboratory Test
Result Item API
Laboratory Test
Observation GUI
Current
Medication List in
EHR
Laboratory Report
Message
Care Setting
Context
Inpatient
Laboratory Test
Result Item
Outpatient
Laboratory Test
Observation
Outpatient Clinic
Current
Medication List
Inpatient
Laboratory
Results Report
Use Case
Context
Full Blood
Count Test
Result Item
Current
Medication List
Full Blood Count
Results Report
Specialty
Context
Biochemistry
Test Result Item
Gas and Carbon
Monoxide Panel
Observation
Microbiology
Test
Observation
Cardiology
Medication List
Biochemistry
Laboratory
Results Report
Clinical Models
Laboratory Test
Result Item,
Refernce Range
Laboratory Test
Observation
Medication List
Laboratory
Results Report
Patterns
Observable,
Finding, Action,
Material Entity
Observation,
Clinical Activity
Request
Clinical List
Clinical Report
Reference Model
COMPOSITION modelling patterns
COMPOSITION
constrains
Clinical Report
CIMI-COMPOSITION.clinical_report
class CIMI Core Model
LOCATABLE
LINK
link
meaning :TEXT
source
archetype_node_id :String
target name :String
0..*
archetype_details
0..1
ARCHETYPED
archetype_id :String
rm_version :String = 1.0.11 {readOnly}
1
participation
CORE_LOCATABLE
COMPOSITION
category :CODED_TEXT
language :CODED_TEXT
jurisdiction :CODED_TEXT
content
0..*
CONTENT_ITEM
constrains
PARTICIPATION
PARTY
party
function :CODED_TEXT
0..*
details :ITEM [0..*]
1..1
details :ITEM [0..*]
ENTRY modelling patterns
ENTRY
constrains
Clinical Entry
constrains
constrains
constrains
Clinical Report
Header
Clinical Activity
constrains
Request
constrains
Observation
Request
Observation
CIMI-ENTRY.clinical_entry
class CIMI Core Model
LOCATABLE
LINK
meaning :TEXT
link
source
archetype_details
archetype_node_id :String
target name :String
0..*
0..1
ARCHETYPED
archetype_id :String
rm_version :String = 1.0.11 {readOnly}
1
PARTICIPATION
participation
function :CODED_TEXT
0..*
details :ITEM [0..*]
CONTENT_ITEM
ENTRY
PARTY
party
CORE_LOCATABLE
data
1..*
ITEM
language :CODED_TEXT
constrains
1..1
details :ITEM [0..*]
CIMI-ENTRY.clinical_report_header
ENTRY
constrains
Clinical
Entry
constrains
CIMI-ENTRY.clinical_activity
ENTRY
constrains
Clinical
Entry
constrains
CIMI-ENTRY.request & observation_request
ENTRY
constrains
Clinical
Entry
constrains
Clinical
Activity
constrains
constrains
CIMI-ENTRY.observation
ENTRY
constrains
Clinical
Entry
constrains
CLUSTER modelling patterns
CLUSTER
constrains
constrains
constrains
Observable
Material Entity
Finding
Action
CLUSTER modelling patterns
CLUSTER
constrains
constrains
constrains
Observable
Material Entity
Finding
Action
constrains
Finding Group
Finding Item
Request Action
CIMI-CLUSTER.observable
class CIMI Core Model
LOCATABLE
LINK
link
meaning :TEXT
source
archetype_node_id :String
target name :String
0..*
archetype_details
0..1
ARCHETYPED
archetype_id :String
rm_version :String = 1.0.11 {readOnly}
1
participation
CORE_LOCATABLE
PARTICIPATION
ITEM
1..*
item
CLUSTER
structure_type :CODED_TEXT [0..1]
constrains
PARTY
party
function :CODED_TEXT
0..*
details :ITEM [0..*]
1..1
details :ITEM [0..*]
CIMI-CLUSTER.finding
class CIMI Core Model
LOCATABLE
LINK
link
meaning :TEXT
source
archetype_node_id :String
target name :String
0..*
archetype_details
0..1
ARCHETYPED
archetype_id :String
rm_version :String = 1.0.11 {readOnly}
1
participation
CORE_LOCATABLE
PARTICIPATION
ITEM
1..*
item
CLUSTER
structure_type :CODED_TEXT [0..1]
constrains
PARTY
party
function :CODED_TEXT
0..*
details :ITEM [0..*]
1..1
details :ITEM [0..*]
CIMI-CLUSTER.finding_group
CLUSTER
Finding
constrains
CIMI-CLUSTER.finding_item
CLUSTER
Finding
constrains
CIMI-CLUSTER.action
CLUSTER
constrains
CIMI-CLUSTER.materal_entity
CLUSTER
constrains
FOUNDATION 4:
STYLE GUIDES
CIMI Modelling Style Guides
•
•
•
•
User Guide
Editorial Guide
Terminology Binding Guide
Technical Guide
User Guide
•
Introduction
–
–
–
–
•
Modelling Framework
–
–
–
–
•
Overview
CIMI Reference Model
Archetype Object Model
CIMI Modelling Patterns
Modelling Methodology
–
–
–
–
–
–
–
–
–
–
•
Background
Definitions
Objectives and Benefits
Document Overview
Analyse Source Clinical Models
Identify Maximal Data Elements
Remove Out of Scope Data Elements
Identify Modelling Patterns
Define CIMI Model
Add Terminology Bindings
Add Example Data Instances
Technical Validation
Clinical Validation
Model Transformations
Modelling Examples and Use Cases
– Examples
– Use Cases
Editorial Guide
•
Introduction
–
–
–
–
–
•
Modelling Principles
–
–
–
–
–
–
–
–
–
–
•
Background
Definitions
Modelling Framework
Modelling Objectives and Benefits
Document Overview
General Principles
Quality Criteria
Scope of Models
Granularity of Models
Consistency and Reuse
Context and Model Layers
Isosemantic Models (boundary of structure and terminology)
Representing the Subject of a Record
Terminology Bindings
Mappings and Transformations
Modelling Patterns
–
–
–
–
–
Overview
Composition Modelling Patterns
Section Modelling Patterns
Entry Modelling Patterns
Cluster Modelling Patterns
Terminology Binding Guide
•
Introduction
–
–
–
–
–
•
Types of Terminology Bindings
–
–
–
–
–
–
•
Background
Definitions
Objectives and Benefits
Terminology Binding Requirements
Document Overview
Overview
Value Set Bindings
Relationship Bindings
Object Bindings
Modifier Bindings
Terminology Design Patterns (SNOMED CT)
Terminology Binding Rules
–
–
–
–
–
–
General Binding Rules
Modifier Binding Rules
Terminology Design Pattern Rules
Model Specialisation
Filling Model Slots and References
Terminology Focal Nodes
•
Terminology Binding Patterns
–
–
–
–
–
•
Overview
Composition Binding Patterns
Section Binding Patterns
Entry Binding Patterns
Cluster Binding Patterns
Terminology Binding Examples and
Use Cases
–
–
Examples
Use Cases
Technical Guide
•
Introduction
–
–
–
–
–
•
CIMI Reference Model
–
–
–
•
•
•
•
•
Background
Definitions
Architectural Framework
Objectives and Benefits
Document Overview
Core Reference Model
Data Types
Party Model
Archetype Object Model
Archetype Definition Language
Archetype Modelling Language
Model Instance Representation
Model Transformation and Implementation
COMPARATIVE ANALYSIS
OF SOURCE MODELS
Comparative Analysis Template
• Purpose: To compare a set of existing clinical models,
and identify the maximal set of data items to be
included in the international CIMI models.
In so doing, it also documents the high-level mapping
from the CIMI data items to the source data models.
The spreadsheet is divided into worksheets, where
each worksheet refers to an individual, reusable data
model that may be composed together to describe a
more complex clinical concept (e.g. Laboratory Results
Report, Immunisation Record, Vital Signs Summary)
Comparative Analysis Template
Comparative Analysis Template
Comparative Analysis Template
LABORATORY MODELS
Submitted Models
•
•
•
•
•
•
•
•
FHIR
Intermountain
NEHTA
MOHH
HL7
Netherlands (NFU)
EN13606 Assoc
Canada InfoWay
Lab Report resource
Standard Lab Obs
Pathology Test Result
Investigation Composition
Clinical Care Document
Lab Results
Lab Test
HL7 v3 POLB_MT004000UV
Archetype Map for
Laboratory Results Report
Composition:
Laboratory
Results Report
Archetype Map for
Laboratory Results Report
Laboratory
Results Report
Composition:
Laboratory
Report Header
Entry:
Patient Encounter
Summary
Laboratory Test
Request Summary
Laboratory Test
Observation
Archetype Map for
Laboratory Results Report
Laboratory
Results Report
Composition:
Laboratory
Report Header
Patient Encounter
Summary
Entry:
Laboratory Test
Request Summary
Cluster:
Action
Action
Laboratory Test
Request
Laboratory Test
Observable
Action
Laboratory Test
Observation
Laboratory Test
Observable
Laboratory Test
Result Group
Specimen
Reference Range
Action
Composition
Laboratory Results Report
COMPOSITION
constrains
Clinical Report
constrains
Laboratory
Results Report
CIMI-COMPOSITION.laboratory_results_report
COMPOSITION
constrains
Clinical Report
constrains
Entry
Laboratory Report Header
ENTRY
constrains
Clinical Entry
constrains
Clinical Report
Header
constrains
Laboratory
Report Header
CIMI-ENTRY.laboratory_report_header
ENTRY
constrains
Clinical Entry
constrains
Clinical Report
Header
constrains
Entry
Patient Encounter Summary
ENTRY
constrains
Clinical Entry
constrains
Clinical Activity
constrains
Patient
Encounter
Summary
CIMI-ENTRY.patient_encounter_summary
ENTRY
constrains
Clinical Entry
constrains
Clinical Activity
constrains
Entry
Laboratory Test Request Summary
ENTRY
constrains
Clinical Entry
constrains
Clinical Activity
constrains
Request
constrains
Observation
Request
constrains
Laboratory Test
Request
Summary
CIMI-ENTRY.laboratory_test_request_
summary
ENTRY
constrains
Clinical Entry
constrains
Clinical Activity
constrains
Request
constrains
Observation
Request
constrains
Entry
Laboratory Test Observation
ENTRY
constrains
Clinical Entry
constrains
Observation
constrains
Laboratory Test
Observation
CIMI-ENTRY.laboratory_test_observation
ENTRY
constrains
Clinical Entry
constrains
Observation
constrains
Archetype Map for
Laboratory Results Report
Laboratory
Results Report
Composition:
Laboratory
Report Header
Patient Encounter
Summary
Entry:
Laboratory Test
Request Summary
Cluster:
Action
Action
Laboratory Test
Request
Laboratory Test
Observable
Action
Laboratory Test
Observation
Laboratory Test
Observable
Laboratory Test
Result Group
Specimen
Reference Range
Action
Cluster
Laboratory Test Observable
CLUSTER
constrains
Observable
constrains
Laboratory Test
Observable
CIMI-CLUSTER.
laboratory_test_observable
CLUSTER
constrains
Observable
constrains
Cluster
Laboratory Test Result Group
CLUSTER
constrains
Finding
constrains
Finding Group
constrains
Laboratory Test
Result Group
CIMI-CLUSTER.
laboratory_test_result_group
CLUSTER
constrains
Finding
constrains
Finding Group
constrains
Cluster
Laboratory Test Result Item
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
Laboratory Test
Result Item
CIMI-CLUSTER.
laboratory_test_result_item
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
Cluster
Reference Range
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
Reference Range
CIMI-CLUSTER.reference_range
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
Cluster
Specimen
CLUSTER
constrains
Material Entity
constrains
Specimen
CIMI-CLUSTER.specimen
CLUSTER
constrains
Material Entity
constrains
Cluster
Specimen Collection Site
CLUSTER
constrains
Material Entity
constrains
Anatomical
Location
constrains
Specimen
Collection Site
CIMI-CLUSTER.specimen_collection_site
CLUSTER
constrains
Material Entity
constrains
Anatomical
Location
constrains
CLUSTER
Laboratory Actions
CLUSTER
Action
Encounter Action
Collect Action
Observe Action
Receive Action
Interpret Action
Author Action
Approve Action
Issue Action
Report Action
Cancel Action
Custodian Action
Request Action
Laboratory Test
Request Action
Requested Action
Cluster
Laboratory Test Request Action
CLUSTER
constrains
Action
constrains
Request Action
constrains
Laboratory Test
Request Action
CIMI-CLUSTER.
laboratory_test_request_action
CLUSTER
constrains
Action
constrains
Request Action
constrains
Cluster
Approve Action
CLUSTER
constrains
Action
constrains
Approve Action
CIMI-CLUSTER.approve_action
CLUSTER
constrains
Action
constrains
LABORATORY MODEL
SPECIALISATIONS
Laboratory Model Specialisations
1. Complete Blood Count with Manual
Differential Panel
2. Complete Blood Count with Auto
Differential Panel
3. Complete Blood Count without
Differential
4. Gas and Carbon Monoxide Panel
Complete Blood Count
ENTRY
constrains
Clinical Entry
constrains
Observation
constrains
Laboratory Test
Observation
constrains
Complete Blood Count
Complete Blood Count
Complete Blood Count
Complete Blood Count
Complete Blood Count
Specialisations
ENTRY
constrains
Clinical Entry
constrains
Observation
constrains
Laboratory Test
Observation
constrains
Complete Blood
Count
constrains
Complete Blood
Count Without
Differential
constrains
Complete Blood
Count With Auto
Differential
constrains
Complete Blood
Count With
Manual Differential
Complete Blood Count Without
Differential
Complete Blood Count Without
Differential
Complete Blood Count With Manual
Differential
Complete Blood Count With Manual
Differential Panel
Complete Blood Count With Manual
Differential Panel
Complete Blood Count With Manual
Differential Panel
Complete Blood Count With Auto
Differential
Complete Blood Count With Auto
Differential Panel
Complete Blood Count With Auto
Differential Panel
Complete Blood Count With Auto
Differential Panel
Gas and Carbon Monoxide Panel
DEMOGRAPHICS MODELS
Participation & Party Reference Model
class CIMI Core Model
PARTICIPATION
participation
PARTY
party
CORE_LOCATABLE
function :CODED_TEXT
0..*
details :ITEM [0..*]
1..1
details :ITEM [0..*]
class CIMI Participation Model
«archetype_parent»
LOCATABLE
+
+
PARTY_RELATIONSHIP
+
+
type :CODED_TEXT
details :ITEM [0..*]
archetype_node_id :String
name :String
+relationship
0..*
+source
PARTY
+target +
details :ITEM [0..*]
1..1
ROLE
+
type :CODED_TEXT
ACTOR
+role
0..*
+
type :CODED_TEXT
When is demographics demographics?
• Question: When is CIMI information modelled using the ‘PARTY’ model,
and when is it modelled using the core reference model?
• Proposed Criteria:
– Does the information relate to a specific healthcare event or not?
• Does it record the results of an observation, evaluation, assessment, or activity?
• If yes, then use Core Reference Model
• E.g. Age is specific to a point in time, Living Dependency is an assessment and Biologic Sex is
an observation
– Is this information only relevant to the Subject of Care, or do we need to record
this about other Parties participating in the record as well?
• If needed about other Parties, then usually use Party model
• E.g. Address may be relevant for Next of Kin; Disability may be relevant for a Dependent
– How is it commonly used in systems?
• Source models are used to determine common implementation practice
Demographics Source Models
•
•
•
•
•
•
•
•
•
•
•
HL7 v3 RIM
NHS LRA
NEHTA (Participation)
FHIM (Federal Health Information Model)
Demographics model
HL7 FHIR (Organisation, Person, Patient,
Agent, Group)
openEHR
ISO13606 (Standard and new draft)
ISO-22220
MOHH (Singapore)
DCM (The Netherlands)
Intermountain Healthcare
CIMI Demographics Models
• CLUSTER
–
–
–
–
Location
Address
Electronic Contact
Party Name
• PARTY
– ACTOR
• Person
• Organisation
– ROLE
• Person Role
• Healthcare Consumer
• Healthcare Provider
– Healthcare Provider Individual
– Healthcare Provider Organisation
Location
CLUSTER
constrains
Address
CLUSTER
constrains
Address Detailed
CLUSTER
constrains
Address
constrains
Electronic Contact
CLUSTER
constrains
Party Name
CLUSTER
constrains
constrains
Actor Name
constrains
Party Name
Person Name
constrains
Party
PARTY
constrains
Actor
PARTY: ACTOR
constrains
Party
constrains
Person
Party
constrains
Actor
constrains
Organisation
Party
constrains
Actor
constrains
Role
PARTY: ROLE
constrains
Party
constrains
Person Role
Party
constrains
Role
constrains
Healthcare Consumer
Party
constrains
Role
constrains
Person Role
constrains
Healthcare Provider
Party
constrains
Role
constrains
Healthcare Provider Individual
Party
constrains
Role
constrains
Healthcare
Provider
constrains
Healthcare Provider Organisation
Party
constrains
Role
constrains
Healthcare
Provider
constrains
FUTURE WORK
Future Work
•
Foundations
–
Reference model
•
–
Archetype object model
•
–
Laboratory Results models
•
–
–
Add instances, specialisations and complete terminology bindings
Immunization models
Temperature and other priorities
Implementation
–
–
–
–
•
Complete content
Models
–
•
Documentation and terminology bindings
Add new patterns to support new models
Style guides
•
•
Extensions to support terminology
Modelling patterns
•
•
–
Documentation and implementation
Generate ADL 1.5 for all modelling patterns and models
Build modelling foundations in tooling infrastructure
Create associated tooling, including instance generation and visualisations
Create transformations to priority implementation formats
Governance
–
Establish modelling development, review and publication processes and procedures
Online References
• CIMI Web Page
– http://informatics.mayo.edu/CIMI
• Google doc repository
– http://content.clinicalmodels.org
• Google groups email list (cimi-modelling-taskforce)
– http://groups.google.com/group/cimi-modellingtaskforce?hl=en-GB
• Issue tracking (github)
– https://github.com/clinicalmodels/cimi/
QUESTIONS