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Health Level Seven Version 3.0 and the Reference Information Model

Health Level Seven Version 3.0 and the Reference Information Model. V3 Methodology Mission. To bring modern software engineering practices, such as Object Oriented Analysis and Design and formal modeling, to the standards development process

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Health Level Seven Version 3.0 and the Reference Information Model

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  1. Health Level Seven Version 3.0 and the Reference Information Model

  2. V3 Methodology Mission • To bring modern software engineering practices, such as Object Oriented Analysis and Design and formal modeling, to the standards development process • To bring the highest level of quality, understandability, and flexibility to a messaging standard • Incorporate concept abstractions and behavior modeling using roles in a rigorous set of work products • Express the standard in widely accepted UML notation

  3. 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”

  4. Version 3 is a change to the HL7 Architecture • The HL7 2.x specifications have: • Segments that imply information entities • Events that indicate implied behaviors • Descriptive content that suggests use cases • but never formally documents these • Version 3 seeks to formalize this by applying object analytic methods and style • 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

  5. Description of the HL7 2.x Standard • The Application Protocol for Electronic Data Exchange in Healthcare Environments is an HL7 messaging standard that enables disparate healthcare applications to exchange data. • The standard provides the layout of messages that are exchanged between two or more applications based upon a particular trigger event. • A message is comprised of an ordered collection of segments. • A segment is an ordered collection of data elements that typically share a common subject. • The HL7 standard specifies which data elements are to be sent, the data type and suggested length of each, and indicates whether the data element is required or optional and whether it may repeat. • The message specification includes a declaration of the delimiters used to separate message segments, elements, and element components.

  6. HL7 Version 3.0 • HL7 version 3.0 will be the most definitive HL7 standard to date, incorporating more trigger events and message formats with very little optionality. • Version 3.0 uses an object-oriented development methodology and a Reference Information Model (RIM) to create message specifications. • The RIM is an essential part of the HL7 Version 3.0 development methodology, as it provides an explicit representation of the semantic and lexical connections that exist between the information carried in the fields of HL7 messages. • As part of version 3.0, the HL7 Vocabulary Technical Committee is developing methods that will allow HL7 messages to draw upon codes and vocabularies from a variety of sources. • The V3.0 vocabulary work will assure that the systems sending and receiving V3.0 HL7 messages have an unambiguous understanding of the code sources and code value domains they are using. • HL7’s primary goal for version 3.0 is to offer a standard that is definite and testable, and to provide certification of vendor’s conformance.

  7. History of HL7 V3 Activities 1996 Introduce modeling to TC Chairs First V3 Tutorial to general membership Vocabulary SIG established 1997 Roll-out of first RIM, version 0.80 First Message Development Framework First RIM Harmonization meetings 1998 Adopted Rational Rose for modeling Work begins on V3 XML ITS First RoseTree tools appear 1999 V3 Data type proposal reviewed Notion of R-MIM added to MDF Vocabulary enters the V3 MDF 2000 V3 data types out to ballot First vocabulary harmonization V3 Acceleration Project started 2001 (projected) XML and Datatype ballots complete RIM and Vocabulary stabilized Message specifications balloted

  8. An HL7 Version 3.X Spec Chapter-Specific Specs Message Model Information Model Use Case Model Interaction Model 2-nd Order 1 choice of 0-n Drug 0-1 Nursing HL7 Reference Model Common Specs *Future Consideration Implementable Message Specification XML/ER7/… Implementable Message Specification OLE/CORBA Implementable Message Specification EDIFACT*

  9. HL7 V3 Message Development Lifecycle C Code c Codea artb bluec color Analysis Design Application Messaging Message Types for use with XML, ER7, etc (MET) Requirements Analysis Use Case Model (UCM) Domain Analysis Information Model &Vocabulary (RIM) Interaction Design Interaction Model (IM) Message Design HierarchicalMessageDescriptions (HMD) Documents Document Types forHL7 PRA (DTD) Medical logic Variable definition for Arden syntax (AVD) TYPE MPSLOC CONTAINS { id[id].TYPE IID nm[name].TYPE ST ad[addr].TYPE XAD ph[phon].TYPE XTN email_address [emlAdr].TYPE XTN } 2-nd Order 1 choice of 0-n Drug 0-1 Nursing <!ENTITY %DT_MPSLOC“MPSLOC.id, MPSLOC.name?, MPSLOC.addr?, MPSLOC.phon?, MPSLOC.emlAdr?"> data:location_of_action := READ LAST MPSLOC ; ‘ {patient location} Reference Model Repository

  10. HL7 Modeling Dispense Medications Manage Care Perform Lab Tests Review Utilization By demanding analysis of the requirements and information content, Version 3 assures consistency in and enhances the value of the resulting messages. Encounter Account Provider Patient Order HAL HL7 message HL7 message Finance ADT Pharmacy Abstractions: Version 2.x focused its energies at the communication level and covered the other abstractions only loosely in the specifications. Activities(Use Case Model) Objects (Information Model) Communication (Interaction and Message Models)

  11. The Reference Information Model (RIM) • Expresses the information content for the collective work of the HL7 Working Group in UML notation. • 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

  12. Information Model Components Subject Area Subject Area: a major partition of a information model. Class: something about which information is collected. Relationship: an affiliation between twoclasses. Attribute: information about a class. Data Type: a specification of the formatof an attribute. Class Attribute :: Datatype Attribute :: Datatype Attribute :: Datatype Attribute :: Datatype Relationship Class Attribute :: Datatype Attribute :: Datatype Attribute :: Datatype Attribute :: Datatype

  13. RIM Class Diagram V1.00 HEALTH LEVEL 7 REFERENCE INFORMATION MODEL RIM_0100 released January 2001 reflects RIM changes through Harmonization on 11/17/2000 Enitites Acts (Services) Participation Roles 0..* 0..* Message_control Act has_as_participant Entity 1 1 type_cd : CS Act_relationship Role participates_in id : SET<II> tmr : IVL<TS> id : SET<II> is_played_by plays_a_role type_cd : CS type_cd : cc note_text : ED mood_cd : CS Entity_name type_cd : CC is_source_of effective_tmr : IVL<TS> inversion_ind : BL 0..* 0..* signature_cd : CV is_source_for has_source 0..1 0..1 type_cd : CC determiner_cd : CS Role-role relationships Appointments & has addr : SET<AD> is_target_for for sequence_nbr : INT effective_tmr : IVL<TS> 1 1 1 1 function_cd : CD importance_status_txt : ED txt : ED scheduling telecom : SET<TEL> priority_nbr : INT nm : EN 1 1 1 1 0..* 0..* awareness_cd : CV qty status_cd : CS is_for 0..* 0..* purpose_cd : CV has pause_qty : PQ signature_txt : ED telecom : SET<TEL> activity_time : GTS checkpoint_cd : CS encounter_accommodation_cd : CV Healthcare_finances desc 0..* 0..* 1 1 critical_time : GTS is_target_for split_cd : CS Billboard produced by: has_target status_cd : CS status_cd : CS confidentiality_cd : SET<CV> Rochester Outdoor Advertising join_cd : CS sends 1..1 1..1 1 1 max_repeat_nmr : IVL<INT> 0..* 0..* negation_ind : BL shall_receive 1..* 1..* interruptible_ind : BL conjunction_cd : CS priority_cd : SET<CV> orderable_ind : BL originates_in_context_of 1..* 1..* Military_person availability_dttm : TS Healthcare_provider Notary_public military_branch_of_service_cd : CV specialty_cd : CV military_rank_nm : ST notary_county_cd : CE military_status_cd : CV notary_state_cd : CE Place gps_txt : ST position_txt addr : AD Health_chart directions_txt 1 1 Financial_act 0..* 0..* provides_context_for Individual_healthcare_practitioner has_an_assessment_of effective_tmr : IVL<TS> fellowship_field_cd : CE reason_cd : CE Medication Act_context Living_subject graduate_school_nm : ON Working_list status_dttm form_cd : CD level_cd birth_dttm : TS graduation_dttm : TS ownership_level_cd route_cd : CD Patient_encounter deceased_dttm : TS board_certified_ind : BL dose_qty : PQ Material deceased_ind : BL discharge_disposition_cd : CV strength_qty : PQ is_assessed_against administrative_gender_cd : CE Organization form_cd : CV acuity_level_cd : CV rate_qty : PQ Referral organ_donor_ind : BL danger_cd : CE 0..* 0..* org_nm : SET<ON> birth_encounter_ind : BL dose_check_qty : PQ Supply multiple_birth_ind : BL effective_tmr : IVL<TS> authorized_visits_qty : REAL standard_industry_class_cd : CE status_reason_cd : CV Consent Health_chart_deficiency method_cd : SET<CV> Healthcare_facility handling_cd : CE Healthcare_benefit_product_policy qty : PQ desc : ED addr : SET<AD> classification_cd : CV body_site_cd : SET<CD> Diagnostic_related_group_definition assessment_dttm : TS licensed_bed_nbr : REAL reason_txt : ED Patient_billing_account assignment_of_benefits_ind : BL encounter_classification_cd : CV substitution_cd : CV desc : ED base_rate_qty : MO mobile_ind : BL benefit_product_desc : ED adjustment_cd : CV practice_setting_cd : CV Healthcare_benefit_coverage_item level_cd : CV capital_reimbursement_qty : MO benefit_product_nm : ST certification_required_ind : BL valuables_desc : ED type_cd : CV cost_weight_qty : MO service_category_cd : CV 1 1 benefit_product_type_cd : CE current_unpaid_balance_qty : MO 1 1 pre_admit_test_ind : BL major_diagnostic_category_cd : CE service_cd : CE is_site_for is_utilized_during Transportation benefits_coordination_ind : BL expected_insurance_plan_qty : REAL Procedure 1 1 Document_service source_cd : CV operating_reimbursement_qty : MO 0..* 0..* service_modifier_cd : CE utilizes Role_relationship cob_priority_nbr : REAL expected_payment_source_cd : CV Message_interaction special_courtesies_cd : CV entry_site_cd : SET<CD> completion_cd : CV 0..* 0..* reimbursement_qty : MO authorization_ind : BL has_parts type_cd : CC combine_baby_bill_ind : BL notice_of_admission_dttm : TS valuables_location_desc : ED method_cd : SET<CV> set_id : II standard_day_qty : PQ network_ind : BL effective_tmr : IVL<TS> notice_of_admission_ind : BL group_benefit_ind : BL effective_tmr has_as_target 1 1 body_site_cd : SET<CD> storage_cd : CV 0..1 0..1 standard_total_charge_qty : MO assertion_cd : CE id : SET<II> uses patient_financial_class_cd : CV mail_claim_party_cd : CE version_nbr : INT Person trim_high_day_qty : PQ is_communicated_as covered_parties_cd : CE status_cd : CS price_schedule_id : II release_information_cd : CE copy_dttm : TS Non_Person_living_subject trim_low_day_qty : PQ disability_cd : CE qty : REAL is_authorized_by responsibility_cd : SET<CE> report_of_eligibility_dttm : TS status_cd : CS origination_dttm : TS ethnic_group_cd : CE taxonomic_classification_cd : CE quantity_qualifier_cd : CE is_part_of position_nbr : LIST<INT> coverage_type_cd : CE retention_ind : BL has_as_source race_cd : CE breed_cd : CE 1 1 time_period_qualifier_cd : CE defines qty : PQ agreement_type_cd : CE signature_on_file_dttm : TS ambulatory_status_cd : CV strain_txt : ED 0..* 0..* 0..* 0..* range_low_qty : PQ certificate_txt : ED policy_category_cd : CE special_program_cd : CV birth_order_nbr : INT Diet euthanasia_ind : BL is_defined_by range_high_qty : PQ Observation access_protocol_desc : ED stoploss_limit_ind : BL 0..* 0..* education_level_cd : CV production_class_cd : CE energy_qty : PQ range_units_cd : CV value : ANY suspend_charges_ind : BL Encounter_drg living_arrangement_cd : CV gender_status_cd : CE carbohydrate_qty : PQ eligibility_cd : CE derivation_expr : ST Inpatient_encounter total_adjustment_qty : MO marital_status_cd : CV approval_ind : BL policy_source_cd : CE method_cd : SET<CV> total_charge_qty : MO religious_affiliation_cd : CV confidential_ind : BL length_of_stay_qty : PQ eligibility_source_cd : CE body_site_cd : SET<CD> student_cd : CV total_payment_qty : MO cost_outlier_qty : MO copay_limit_ind : BL credit_rating_cd : CV Access interpretation_cd : SET<CS> separate_bill_ind : BL desc : ED Clinical_document_header 0..1 0..1 addr : SET<AD> bad_debt_recovery_qty : MO grouper_review_cd : CE gauge_qty : PQ availability_status_cd : CV Specimen Champus_coverage special_accommodation_cd : SET<CV> grouper_version_id : II bad_debt_transfer_qty : MO entry_site_cd : CD change_reason_cd : CV body_site_cd : CE Manufactured_material handicapped_program_cd : CE outlier_days_nbr : REAL completion_status_cd : CV body_site_cd : CD outlier_reimbursement_qty : MO non_avail_cert_on_file_ind : BL expiration_dttm : TS confidentiality_status_cd : CV Schedule 1 1 Public_health_case outlier_type_cd : CV retirement_dttm : TS lot_nbr : ST content_presentation_cd : CV status_cd : CS station_id : II detection_method_cd document_creation_dttm : TS communicates_in slot_size_increment_qty transmission_mode_cd file_nm : ST disease_imported_cd last_edit_dttm : TS is_communicated_by Financial_transaction 1 1 reporting_priority_cd : CE manages results_report_dttm : TS extended_qty : MO Practitioner_Certifier Unmapped_financial_classes storage_status_cd : CV 0..* 0..* fee_schedule_cd : CE board_certification_type_cd : CV (from RIM_Healthcare_finances) Employee_Employer Person_Language transcription_dttm : TS insurance_qty : MO certification_dttm : TS document_change_cd : CV Patient_Provider posting_dttm : TS addr : SET<AD> recertification_dttm : TS Outbreak version_nbr : INT hazard_exposure_txt : ED qty : MO 1 1 residency_field_cd : CE version_dttm : TS tmr job_class_cd : CV transaction_batch_id : II is_specified_by job_title_nm : ST unit_qty : MO is_managed_by telecom : SET<TEL> unit_cost_qty : MO 0..* 0..* Insurance_certification 0..* 0..* 1 1 has_coverage_affirmed_by Billing_information_item protective_equipment_txt : ED Guarantor_contract 0..* 0..* specifies_ability_in Resource_slot certification_duration_qty : PQ salary_qty : MO condition_cd : CE billing_hold_ind : BL Language_ability effective_tmr : IVL<TS> status_cd : CS salary_type_cd : CV occurrence_cd : CE Preauthorization Practitioner_provider billing_media_cd : CE affirms_insurance_coverage_for mode_cd : CV id : II time_slot : GTS status_cd : CS occurrence_dttm : TS charge_adjustment_cd : CE authorized_encounters_qty : REAL position_cd : CV proficiency_level_cd : CV insurance_verification_dttm : TS job_cd : CE Container 0..* 0..* occurrence_span_cd : CE contract_duration_cd : CE authorized_period_begin_tmr : IVL<TS> primary_care_ind : BL modification_dttm : TS occurrence_span_from_dttm : TS capacty_qty : PQ is_sited_at contract_type_cd : CE id : II Device Clinical_document non_concur_cd : CE occurrence_span_thru_dttm : TS height_qty : PQ effective_tmr : IVL<TS> issued_dttm : TS manufacturer_model_nm : ST non_concur_effective_dttm : TS quantity_nbr : REAL diameter_qty : PQ Encounter_facility_association interest_rate_nbr : REAL requested_dttm : TS last_calibration_dttm : TS 0..1 0..1 penalty_qty : MO quantity_type_cd : CV barrier_delta_qty : PQ effective_tmr : IVL<TS> periodic_payment_qty : MO restriction_desc : ED software_nm : ST report_of_eligibility_dttm : TS value_amt bottom_delta_qty : PQ is_used_by authorizes status_cd : CS priority_ranking_cd : CV local_remote_control_state_cd : CE status_cd : CS value_cd : CE report_of_eligibility_ind : BL separator_type_cd : CD transfer_reason_cd : CV alert_level_cd : CE status_change_dttm : TS cap_type_cd : CD 0..* 0..* • 6 Primary Subject Areas • 64 Classes • 348 Attributes • 73 Relationships • 45 Data types

  14. RIM Primary Subject Areas HEALTH LEVEL 7 REFERENCE INFORMATION MODEL RIM_0100 released January 2001 reflects RIM changes through Harmonization on 11/17/2000 Enitites Acts (Services) Participation Roles 0..* 0..* Message_control Act has_as_participant Entity 1 1 type_cd : CS Act_relationship Role participates_in id : SET<II> tmr : IVL<TS> id : SET<II> is_played_by plays_a_role type_cd : CS type_cd : cc note_text : ED mood_cd : CS Entity_name type_cd : CC is_source_of effective_tmr : IVL<TS> inversion_ind : BL 0..* 0..* signature_cd : CV is_source_for has_source 0..1 0..1 type_cd : CC determiner_cd : CS Role-role relationships Appointments & has addr : SET<AD> is_target_for for sequence_nbr : INT effective_tmr : IVL<TS> 1 1 1 1 function_cd : CD importance_status_txt : ED txt : ED scheduling telecom : SET<TEL> priority_nbr : INT nm : EN 1 1 1 1 0..* 0..* awareness_cd : CV qty status_cd : CS is_for 0..* 0..* purpose_cd : CV has pause_qty : PQ signature_txt : ED telecom : SET<TEL> activity_time : GTS checkpoint_cd : CS encounter_accommodation_cd : CV Healthcare_finances desc 0..* 0..* 1 1 critical_time : GTS is_target_for split_cd : CS Billboard produced by: has_target status_cd : CS status_cd : CS confidentiality_cd : SET<CV> Rochester Outdoor Advertising join_cd : CS sends 1..1 1..1 1 1 max_repeat_nmr : IVL<INT> 0..* 0..* negation_ind : BL shall_receive 1..* 1..* interruptible_ind : BL conjunction_cd : CS priority_cd : SET<CV> orderable_ind : BL originates_in_context_of 1..* 1..* Military_person availability_dttm : TS Healthcare_provider Notary_public military_branch_of_service_cd : CV specialty_cd : CV military_rank_nm : ST notary_county_cd : CE Act Act military_status_cd : CV notary_state_cd : CE Place gps_txt : ST position_txt addr : AD Health_chart directions_txt 1 1 Financial_act 0..* 0..* provides_context_for Individual_healthcare_practitioner has_an_assessment_of effective_tmr : IVL<TS> fellowship_field_cd : CE reason_cd : CE Medication Act_context Living_subject graduate_school_nm : ON Working_list status_dttm form_cd : CD level_cd birth_dttm : TS graduation_dttm : TS ownership_level_cd route_cd : CD Patient_encounter deceased_dttm : TS board_certified_ind : BL dose_qty : PQ Material deceased_ind : BL discharge_disposition_cd : CV strength_qty : PQ is_assessed_against administrative_gender_cd : CE Organization form_cd : CV acuity_level_cd : CV rate_qty : PQ Referral organ_donor_ind : BL danger_cd : CE 0..* 0..* org_nm : SET<ON> birth_encounter_ind : BL dose_check_qty : PQ Supply multiple_birth_ind : BL effective_tmr : IVL<TS> authorized_visits_qty : REAL standard_industry_class_cd : CE status_reason_cd : CV Consent Health_chart_deficiency method_cd : SET<CV> Healthcare_facility handling_cd : CE Healthcare_benefit_product_policy qty : PQ desc : ED addr : SET<AD> classification_cd : CV body_site_cd : SET<CD> Diagnostic_related_group_definition assessment_dttm : TS licensed_bed_nbr : REAL reason_txt : ED Patient_billing_account assignment_of_benefits_ind : BL encounter_classification_cd : CV substitution_cd : CV desc : ED base_rate_qty : MO mobile_ind : BL benefit_product_desc : ED adjustment_cd : CV practice_setting_cd : CV Healthcare_benefit_coverage_item level_cd : CV capital_reimbursement_qty : MO benefit_product_nm : ST certification_required_ind : BL valuables_desc : ED type_cd : CV cost_weight_qty : MO service_category_cd : CV 1 1 benefit_product_type_cd : CE current_unpaid_balance_qty : MO 1 1 pre_admit_test_ind : BL major_diagnostic_category_cd : CE service_cd : CE is_site_for is_utilized_during Transportation benefits_coordination_ind : BL expected_insurance_plan_qty : REAL Procedure 1 1 Document_service source_cd : CV operating_reimbursement_qty : MO 0..* 0..* service_modifier_cd : CE utilizes Role_relationship cob_priority_nbr : REAL expected_payment_source_cd : CV Message_interaction special_courtesies_cd : CV entry_site_cd : SET<CD> completion_cd : CV 0..* 0..* reimbursement_qty : MO authorization_ind : BL has_parts type_cd : CC combine_baby_bill_ind : BL notice_of_admission_dttm : TS valuables_location_desc : ED method_cd : SET<CV> set_id : II standard_day_qty : PQ network_ind : BL effective_tmr : IVL<TS> notice_of_admission_ind : BL group_benefit_ind : BL effective_tmr has_as_target 1 1 body_site_cd : SET<CD> storage_cd : CV 0..1 0..1 standard_total_charge_qty : MO assertion_cd : CE id : SET<II> uses patient_financial_class_cd : CV mail_claim_party_cd : CE version_nbr : INT Person trim_high_day_qty : PQ is_communicated_as covered_parties_cd : CE status_cd : CS price_schedule_id : II release_information_cd : CE copy_dttm : TS Non_Person_living_subject trim_low_day_qty : PQ disability_cd : CE qty : REAL is_authorized_by responsibility_cd : SET<CE> report_of_eligibility_dttm : TS status_cd : CS origination_dttm : TS ethnic_group_cd : CE taxonomic_classification_cd : CE quantity_qualifier_cd : CE is_part_of position_nbr : LIST<INT> coverage_type_cd : CE retention_ind : BL has_as_source race_cd : CE breed_cd : CE 1 1 time_period_qualifier_cd : CE defines qty : PQ agreement_type_cd : CE signature_on_file_dttm : TS ambulatory_status_cd : CV strain_txt : ED 0..* 0..* 0..* 0..* range_low_qty : PQ certificate_txt : ED policy_category_cd : CE special_program_cd : CV birth_order_nbr : INT Diet euthanasia_ind : BL is_defined_by range_high_qty : PQ Observation access_protocol_desc : ED stoploss_limit_ind : BL 0..* 0..* education_level_cd : CV production_class_cd : CE energy_qty : PQ range_units_cd : CV value : ANY suspend_charges_ind : BL Encounter_drg living_arrangement_cd : CV gender_status_cd : CE carbohydrate_qty : PQ eligibility_cd : CE derivation_expr : ST Inpatient_encounter total_adjustment_qty : MO marital_status_cd : CV approval_ind : BL policy_source_cd : CE method_cd : SET<CV> total_charge_qty : MO religious_affiliation_cd : CV confidential_ind : BL length_of_stay_qty : PQ eligibility_source_cd : CE body_site_cd : SET<CD> student_cd : CV total_payment_qty : MO cost_outlier_qty : MO copay_limit_ind : BL credit_rating_cd : CV Access interpretation_cd : SET<CS> separate_bill_ind : BL desc : ED Clinical_document_header 0..1 0..1 addr : SET<AD> bad_debt_recovery_qty : MO grouper_review_cd : CE gauge_qty : PQ availability_status_cd : CV Specimen Champus_coverage special_accommodation_cd : SET<CV> grouper_version_id : II bad_debt_transfer_qty : MO entry_site_cd : CD change_reason_cd : CV body_site_cd : CE Manufactured_material handicapped_program_cd : CE outlier_days_nbr : REAL completion_status_cd : CV body_site_cd : CD outlier_reimbursement_qty : MO non_avail_cert_on_file_ind : BL expiration_dttm : TS confidentiality_status_cd : CV Schedule 1 1 Public_health_case outlier_type_cd : CV retirement_dttm : TS lot_nbr : ST content_presentation_cd : CV status_cd : CS station_id : II detection_method_cd document_creation_dttm : TS communicates_in slot_size_increment_qty transmission_mode_cd file_nm : ST disease_imported_cd last_edit_dttm : TS is_communicated_by Financial_transaction 1 1 reporting_priority_cd : CE manages results_report_dttm : TS extended_qty : MO Practitioner_Certifier Unmapped_financial_classes storage_status_cd : CV 0..* 0..* fee_schedule_cd : CE board_certification_type_cd : CV (from RIM_Healthcare_finances) Employee_Employer Person_Language transcription_dttm : TS insurance_qty : MO certification_dttm : TS document_change_cd : CV Patient_Provider posting_dttm : TS addr : SET<AD> recertification_dttm : TS Outbreak version_nbr : INT hazard_exposure_txt : ED qty : MO 1 1 residency_field_cd : CE version_dttm : TS tmr job_class_cd : CV transaction_batch_id : II is_specified_by job_title_nm : ST unit_qty : MO is_managed_by telecom : SET<TEL> unit_cost_qty : MO 0..* 0..* Insurance_certification 0..* 0..* 1 1 has_coverage_affirmed_by Billing_information_item protective_equipment_txt : ED Guarantor_contract 0..* 0..* specifies_ability_in Resource_slot certification_duration_qty : PQ salary_qty : MO condition_cd : CE billing_hold_ind : BL Language_ability effective_tmr : IVL<TS> status_cd : CS salary_type_cd : CV occurrence_cd : CE Preauthorization Practitioner_provider billing_media_cd : CE affirms_insurance_coverage_for mode_cd : CV id : II time_slot : GTS status_cd : CS occurrence_dttm : TS charge_adjustment_cd : CE authorized_encounters_qty : REAL position_cd : CV proficiency_level_cd : CV insurance_verification_dttm : TS job_cd : CE Container 0..* 0..* occurrence_span_cd : CE contract_duration_cd : CE authorized_period_begin_tmr : IVL<TS> primary_care_ind : BL modification_dttm : TS occurrence_span_from_dttm : TS capacty_qty : PQ is_sited_at contract_type_cd : CE id : II Device Clinical_document non_concur_cd : CE occurrence_span_thru_dttm : TS height_qty : PQ effective_tmr : IVL<TS> issued_dttm : TS manufacturer_model_nm : ST non_concur_effective_dttm : TS quantity_nbr : REAL diameter_qty : PQ Encounter_facility_association interest_rate_nbr : REAL requested_dttm : TS last_calibration_dttm : TS 0..1 0..1 penalty_qty : MO quantity_type_cd : CV barrier_delta_qty : PQ effective_tmr : IVL<TS> periodic_payment_qty : MO restriction_desc : ED software_nm : ST report_of_eligibility_dttm : TS value_amt bottom_delta_qty : PQ is_used_by authorizes status_cd : CS priority_ranking_cd : CV local_remote_control_state_cd : CE status_cd : CS value_cd : CE report_of_eligibility_ind : BL separator_type_cd : CD transfer_reason_cd : CV alert_level_cd : CE status_change_dttm : TS cap_type_cd : CD 0..* 0..* Entity Entity Role Role Participation Participation Act Relationship Act Relationship Role Relationship Role Relationship

  15. RIM Core Classes Role Relationship Act Relationship 0..1 0..1 0..1 0..1 0..* 0..* 0..* 0..* 1 1 0..* 0..* Role Entity Participation Act 1 0..*

  16. RIM Core Attributes 0..1 0..1 0..1 0..1 0..* 0..* 0..* 0..* 1 1 0..* 0..* Role Relationship Act Relationship Type_CD : CS Effective_TMR : IVL<TS> Status_CD : CS Type_CD : CS Entity Role Participation Act Type_CD : CC Determiner_CD : CS Status_CD : CS Type_CD : CS Effective_TMR : IVL<TS> Type_CD : CS TMR : IVL<TS> Status_CD : CS Type_CD : CC Mood_CD : CS Status_CD : CS Activity_Time : GTS 1 0..*

  17. RIM Core Attribute Value Sets • Observation • Procedure • Supply • Medication • Financial • ... • Patient • Provider • Guarantor • Specimen • Home • ... • Living Subject • Person • Organization • Material • Place • ... • Performer • Author • Witness • Beneficiary • Destination • ... Act Type Code Role Type Code Entity Type Code Participation Type Code 1 1 0..* 0..* • Definition • Intent • Order • Event • Criterion • ... • Class • Instance • QualifiedGroup Entity Determiner Code Act Mood Code Entity Role Participation Act Type_CD : CC Determiner_CD : CS Status_CD : CS Type_CD : CS Effective_TMR : IVL<TS> Type_CD : CS TMR : IVL<TS> Status_CD : CS Type_CD : CC Mood_CD : CS Status_CD : CS Activity_Time : GTS 1 0..*

  18. Vocabulary Domains and Codes • Coded attributes in the RIM must be associated with one and only one Vocabulary Domain prior to being used in a message specification. • A vocabulary domain is “The set of all concepts that can be taken as valid values in an instance of a coded field or attribute.” • Each concept in the vocabulary domain is represented using a code from a specific vocabulary. • A vocabulary is a defined set of coded concepts. • A vocabulary may be specified as an enumerated list of coded concepts (HL7 defined) or as a reference to an externally maintained list of coded concepts (e.g., SNOMED, LOINC, CPT, . . .).

  19. Vocabulary Domain Specification

  20. Vocabulary Codes & Definitions

  21. RIM Implementation RIMReference Information Model RIM • Select a subset of the RIM classes • Select a subset of class relationships • Select a subset of class attributes • Select a subset of attribute datatypes • Select a subset of attribute domains and value sets (1) Define a MIM MIM Message Information Model MIM • Created clones of classes and attributes • Assign alias class and attribute names • Eliminate unnecessary class hierarchies • Finalize class relationships and multiplicity • Finalize attribute domains and value sets (2)Define a R-MIM R-MIM Refined Message Information Model R-MIM • Select a root class for the message • Arrange classes and attributes hierarchically • Declare inclusion and repetition constraints • Declare domain value constraints • Assign message element names (3) Create an HMD HMD Hierarchical Message Definition HMD

  22. Hierarchical Message Definition

  23. HMD Components • The Information Model Mapping. The columns that are in this section describe classes and attributes of the R-MIM, organized in a sequence that describes a "walk" from class to class on the R-MIM. • The Message Elements. The columns in this section describe the message elements and define the Message Element Types. The message elements compose a hierarchy. This hierarchy is illustrated by indentation in the column Message Element Name. • General constraints and defaults. Describe specific constraints and defaults for the message element defined in the row. The columns are the same as the corresponding section of the R-MIM. The values in the columns may be the same or may be a more restrictive constraint.

  24. Message Specification Reference Information Model Use Case Model Interaction Model Message Information Model Hierarchical Message Description Refined Message Information Model

  25. Additional Questions

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