1. 1
HL7 Version 3 at NCICB Overview
Session Details
Introduction
Reference Information Model (RIM)
HL7 Modeling Conventions
HL7 Process & Artifacts, Vocabulary & Data Types
HL7 Version 3 at NCI
Web Resources
3. 3
Session Details:
Presenters and Participants
<Presenter’s name here>
Who is in attendance?
– Name
– Title
– Cancer Center
– Reason for Attending
Note:
This training can also be used as a self-paced training. (See notes for each slide)
4. 4
Session Details:
Training Objectives
Objectives of this training are to:
– Provide an overview of HL7 version 3
– Define terms and concepts used in HL7
– Describe the HL7 modeling methodology
– Introduce reason for HL7 version 3 at NCICB
5. 5
Introduction
In this section, we will:
– Introduce the HL7 organization and the version 3 standard
– Discuss the goal of HL7
6. 6
Introduction:
What is HL7?
Heath Level Seven (HL7) is an ANSI-accredited Standards
Developing Organization (SDO) operating in healthcare arena
Provides standards for data exchange to allow interoperability
between healthcare information systems
HL7 focuses on the clinical and administrative data domains
It is a not-for-profit organization made up of volunteers –
providers, payers, vendors, government
Key goal is syntactic and semantic interoperability
7. 7
Introduction:
4 Pillars of Semantic Interoperability
The 4 pillars of semantic interoperability are:
1. A common Reference Information Model (RIM) spanning the
entire clinical, administrative and financial healthcare universe
2. A well-defined and tool-supported process for deriving data
exchange specifications ("messages") from the RIM
3. A formal and robust Data Type Specification upon which to
ground the RIM
4. A formal methodology for binding concept-based terminologies
to RIM attributes.
8. 8
Reference Information Model (RIM)
In this section, we will:
– Discuss the modeling concepts used in HL7 Version 3
– Describe the Backbone Classes of the HL7 RIM
9. 9
Reference Information Model (RIM):
Overview
Reference Information Model (RIM):
Follows object oriented developmental methodology based on a
UML model
The fundamental model from which all v3 messages are derived
is referred to as the Reference Information Model (RIM)
The RIM is a generic, abstract model that expresses the
information content of all the areas of healthcare
Defines all the information from which the data content of HL7
messages are drawn
Forms a shared view of the healthcare domain and is used
across all HL7 messages independent of message structure
10. 10
Reference Information Model (RIM):
Backbone Classes
A physical thing,
group of physical
things or an
organization capable
of participating in
Acts, while in a role.
A physical thing,
group of physical
things or an
organization capable
of participating in
Acts, while in a role.
A record of something
that is being done, has
been done, can be
done, or is intended or
requested to be done.
A record of something
that is being done, has
been done, can be
done, or is intended or
requested to be done.
A competency of the Entity
playing the Role as
identified, defined,
guaranteed, or
acknowledged by the Entity
that Scopes the Role.
A competency of the Entity
playing the Role as
identified, defined,
guaranteed, or
acknowledged by the Entity
that Scopes the Role.
An association between an
Act and a Role with an Entity
playing that Role. Each Entity
(in a Role) involved in
an Act in a certain way is
linked to the act by one
Participation-instance.
An association between an
Act and a Role with an Entity
playing that Role. Each Entity
(in a Role) involved in
an Act in a certain way is
linked to the act by one
Participation-instance.
Entity Role Participation Act
A connection between two
roles expressing a
dependency between those
roles.
A connection between two
roles expressing a
dependency between those
roles.
A directed association
between a source act and a
target act.
A directed association
between a source act and a
target act.
Role Link Act Relationship
0..1
0..n
1
0..n
0..n
1
0..1
0..n
0..n 0..n
1 1
0..n 0..n
1 1
11. 11
Reference Information Model (RIM)
Backbone Class: Entity
Entity
classCode : CS
determinerCode : CS
id : SET<II>
code : CE
quantity : SET<PQ>
name : BAG<EN>
desc : ED
statusCode : SET<CS>
existenceTime : IVL<TS>
telecom : BAG<TEL>
riskCode : CE
handlingCode : CE
Entity: a person, animal, organization or thing
A collection of classes related to the Entity class, its
specializations and related qualifying classes. The classes
represent health care stakeholders and other things of interest
to health care.
Entity has the following sub-classes:
Container
Device
LanguageCommunication
LivingSubject
ManufacturedMaterial
Material
NonPersonLivingSubject
Organization
Person
Place
12. 12
Reference Information Model (RIM):
Backbone Class: Role
Role
classCode : CS
id : SET<II>
code : CE
negationInd : BL
addr : BAG<AD>
telecom : BAG<TEL>
statusCode : SET<CS>
effectiveTime : IVL<TS>
certificateText : ED
quantity : RTO
positionNumber : LIST<INT>...
Roles:
A responsibility or part played by an entity (e.g. Person in a role
of patient, employee, etc.) – different faces of an Entity
A collection of classes related to the Role class and its
specializations. These classes focus on the roles participants
may play in health care.
Role has the following sub-classes:
Access
Employee
LicensedEntity
Patient
13. 13
Reference Information Model (RIM):
Backbone Class: RoleLink
RoleLink
typeCode : CS
effectiveTime : IVL<TS>
Role
0..n outboundLink
0..n
source
0..n
inboundLink
0..n
RoleLink:
A connection between two roles expressing a dependency
between those roles.
RoleLink has no sub-classes.
14. 14
Reference Information Model (RIM):
Backbone Class: Participation
Participation
typeCode : CS
functionCode : CD
contextControlCode : CS...
sequenceNumber : INT
negationInd : BL
noteText : ED
time : IVL<TS>
modeCode : CE
awarenessCode : CE
signatureCode : CE
signatureText : ED
performInd : BL
substitutionConditionCode : CE
Participation:
An association between an Act and a Role with an Entity
playing that Role.
Participation has the following sub-class:
ManagedParticipation
15. 15
Reference Information Model (RIM):
Backbone Class: Act
Act
classCode : CS
moodCode : CS
id : SET<II>
code : CD
negationInd : BL
derivationExpr : ST
text : ED
title : ST
statusCode : SET<CS>
effectiveTime : GTS
activityTime : GTS
availabilityTime : TS
priorityCode : SET<CE>
confidentialityCode : SET<CE>
repeatNumber : IVL<INT>
interruptibleInd : BL
levelCode : CE
independentInd : BL
uncertaintyCode : CE
reasonCode : SET<CE>
languageCode : CE
Act:
A collection of classes including the Act class and its
specializations. These relate to the actions and events that
constitute health care services. A record of something that is
being done, has been done, can be done, or is intended or
requested to be done.
Act has the following sub-classes:
Account
ControlAct
DeviceTask
DiagnosticImage
Diet
FinancialContract
FinancialTransaction
InvoiceElement
Observation
Participation
PatientEncounter
Procedure
PublicHealthCase
SubstanceAdministration
Supply
WorkingList
Note: Sub-classes also include Core Infrastructure, Message
Communications Control and Structured Documents classes not
shown here.
16. 16
Reference Information Model (RIM):
Backbone Class: ActRelationship
ActRelationship
typeCode : CS
inversionInd : BL
contextControlCode : CS
contextConductionInd : BL
sequenceNumber : INT
priorityNumber : INT
pauseQuantity : PQ
checkpointCode : CS
splitCode : CS
joinCode : CS
negationInd : BL
conjunctionCode : CS
localVariableName : ST
seperatableInd : BL
Act
0..n
outboundRelationship
0..n
source
inboundRelationship
0..n
target
1
ActRelationship:
A directed association between a source Act and a
target Act. A point from a later instance to a earlier
instance OR point from collector instance to
component instance.
ActRelationship has no sub-classes.
17. 17
Reference Information Model (RIM):
The Complete RIM
11
11
Observation
...
SubstanceAdministration
routeCode :CE
...
Procedure
...
Supply
...
Diet
...
Document
...
Container
capacityQuantity : PQ
heightQuantity :PQ
diameterQuantity :PQ
capTypeCode :CE
...
Access
approachSiteCode : CD...
...
Device
manufacturerModelName :SC
softwareName :SC
localRemoteControlStateCode :CE...
...
Employee
jobCode : CE
jobTitleName :SC
jobClassCode :CE
salaryTypeCode :CE
...
LivingSubject
administrativeGenderCode : CE...
birthTime :TS
deceasedInd: BL
deceasedTime : TS
...
Material
formCode :CE...
LicensedEntity
recertificationTime :TS...Place
mobileInd :BL
addr :AD
directionsText: ED...
...
ManufacturedMaterial
lotNumberText:ST
...
NonPersonLivingSubject
...
Patient
...
Organization
...
Account
...
Person
addr :BAG<AD>...
maritalStatusCode: CE...
...
Wor kingList
ownershipLevelCode :CE...
PublicHealthCase
...
PatientEncounter
pr eAdmitTestInd:BL
admissionReferralSourceCode : CE
lengthOfStayQuantity :PQ
dischargeDispositionCode :CE
specialCour tesiesCode :SET<CE>
...
Other
Acts
Infrastructure (Structureddocuments)
HEALTH LEVEL 7
REFERENCE INFORMATION MODEL
VERSION 1.23 (RIM_0123)
Reflects changes to RIM inRIM Harmonization Meeting03/20/2003.
Bi l l boar d produced by:
Rochest er O ut door Adverti si ng
Roles
DiagnosticImage
subjectOrientationCode : CE...
QueryAck
...
QueryContinuation
...
Table
summary :ST...
...
TableStructure
...
TableColumn
Str ucture
spa
n :
TableCell
scope : CS
...
LocalAttr
...
LocalMarkup
...
LinkHtml
...
ContextStructure
localId:ST
Infrastructure (Structured
documents)
Infrastructure
(Communications)
Enitites
Message Control
FinancialTransaction
...
InvoiceElement
modifierCode :SET<CE>...
...
FinancialContract
paymentTer msCode : CE...
RoleHeir
EntityHeir
SortControl
sequenceNumber :INT...
...
QuerySpec
modifyCode :CS
responseElementGroupId :SET<II>...
responseModalityCode :CS
responsePriorityCode :CS
...
0..n
1
0..n
1
RelationalExpression
...
QueryBySelection
SelectionExpression
0..n
1
0..n
1
LogicalExpression
relationalConjunctionCode :CS...
0..n
0..1
user AsRight
0..n
r ightSide 0..1
0..n
0..1
user AsLeft0..n
leftSide0..1
QueryByPa
rameter
ParameterList
Paramet
er
id:II
0..n 0..10..n 0..1
0..1
0..n
0..1
0..n
ParameterItem
...
DeviceTask
parameterValue :LIST<ANY>...
ManagedParticipation
...
ActHeir
ActRelationship
typeCode :CS
inversionInd: BL...
contextControlCode : CS...
contextConductionInd :BL...
...
Act
classCode : CS
moodCode :CS
id:SET<II>
code :CD
negationInd :BL
derivationExpr :ST...
...
0. .n
1
inboundRelat ionship
0. .n
t arget
1
0. .n1
out boundRelat ionship
0. .n
source
1
Participation
typeCode : CS
functionCode :CD
contextControlCode : CS
sequenceNumber :INT
negationInd :BL
noteText: ED
time :IVL<TS>
modeCode :CE
...
0. . n
1
0. . n
1
RoleLink
...
Role
classCode :CS
id: SET<II>
code :CE
negationInd:BL
addr :BAG<AD>
telecom : BAG<TEL>
statusCode : SET<CS>
...
0. . n
1
0. . n
1
0. . n1
out boundLink
0. . n
sour ce
1
0. . n1
inboundLink
0. . n
t ar get
1
LanguageCommunication
languageCode : CE
modeCode: CE
...
AttentionLine
...
Batch
referenceControlId: II
name : SC
...
Entity
classCode : CS
deter minerCode :CS
id: SET<II>
code :CE
quantity :SET<PQ>
name : BAG<EN>
desc :ED
statusCode :SET<CS>
...
0.. n0. . 1
playedRole
0.. n
player
0. . 1
0. . n0. . 1
scopedRole
0. . n
scoper
0. . 1
10..n 10..n
Transmission
id: II
...
0..n
1
0..n
1
0..1
0..n
0..1
0..n
Communicatio
nFunction
typeCode :CS
telecom :TEL
1..n
0..*
1..n
0..*
1..*
0..*
1..*
0..*
InfrastructureRoot
...
QueryEvent
...
ControlAct
...
0..1
1
0..1
1
Message
versionId: ST
interactionId:II
profileId :SET<II>
processingCode : CS
processingModeCode :CS
acceptAckCode :CS
applicationAckCode :CS
...
0.. 1
0. . n
0.. 1
payload
0. . n
Acknowledgement
...
0. . n
1
acknowledgedBy
0. . n
acknowledges
1
0. . 1
1
conveyedAcknowledgem ent
0. . 1
conveyingM essage
1
AcknowledgementDetail
...
1
0..n
1
0..n
Domain Related
Infrastructure Related Structured Documents
18. 18
Reference Information Model (RIM):
RIM-UML Instance Scenario
John DoeJohn Doe PatientPatient SubjectSubject
Entity Role Participation Act
Dr. SmithDr. Smith
HealthCare
Provider
HealthCare
Provider
Surgeon*Surgeon*
John DoeJohn Doe PatientPatient SubjectSubject
Has Pertinent InformationHas Pertinent Information
Act Relationship
(Clinical Trial Act)
Protocol ECOG 1112
(Clinical Trial Act)
Protocol ECOG 1112
XYZ HospitalXYZ Hospital
HealthCare
Facility*
HealthCare
Facility*
LocationLocation
(Procedure Act)
Prostectomy
(Procedure Act)
Prostectomy
19. 19
HL7 Version 3 Process & Artifacts
In this section, we will discuss:
– Domain Message Information Model (DMIM)
– Refined Message Information Model (RMIM)
– Hierarchal Message Definitions (HMDs)
– Message Type (MT)
20. 20
HL7 Version 3 Process & Artifacts:
Overall Process
RIM D-MIM R-MIM
1..* 1..*
1..*HMD
MT
1..*
22. 22
Reference Information Model (RIM):
HL7 Modeling Conventions
Color-coding – colors of classes in the model denote the type of
backbone class to which it belongs
Arrows – Participations, ActRelationships and RoleLinks are
directional arrows that have rather than being lines that connect
classes like in UML
Entry points – where to start reading the model; DMIMs have
one or more entry points, RMIMs have one
RMIMs are directional – all associations flow out from the entry
point to the remaining parts of the model
Labeling – associations in RMIMs are labeled on the distal end
only
23. 23
HL7 Process & Artifacts:
Domain Message Information Model (DMIM)
A DMIM is a refined subset
of the RIM that includes a
set of class clones,
attributes and relationships
that can be used to create
messages for a particular
domain (a particular area of
interest in healthcare).
24. 24
HL7 Process & Artifacts:
Refined Message Information Model (RMIM)
The RMIM is a subset of a
DMIM that is used to
express the information
content for a message or
set of messages with
annotations and
refinements that are
message specific.
25. 25
HL7 Process & Artifacts:
Hierarchal Message Definitions (HMDs)
A Hierarchal
Message
Definition (HMD)
is a serialized
version of the
RMIM in a
specific order.
26. 26
HL7 Process & Artifacts:
Message Type (MT)
The Message Type elements and attributes in an XML message instance
correspond to the sequence of data in the HMD
27. 27
Vocabulary & Data Types
In this section, we will discuss:
– HL7 Standard Vocabulary
• Structural Attributes – prescribed HL7 vocabulary
• Non-Structural Attributes – vocabulary chosen by organization
– Robust Data Types
28. 28
Vocabulary & Data Types:
Structural Attributes
Structural attributes are used to specify type and state of each RIM
class and what it means when used in a message. They use a
standard vocabulary defined and controlled by HL7.
An Act of the Class
Observation (OBS) with
a Mood of Event (EVN).
classCode and moodCode are
both Structural Attributes
29. 29
Vocabulary & Data Types :
Non-Structural Attributes
Other attributes don’t have an assigned vocabulary
Organizations can choose any industry standard vocabulary
For example, commonly used ones for Observation Acts are
LOINC, SNOMED, MedDRA, etc.
Must specify more than just the code value, other data is needed
for semantic interoperability…this is where data types come in
30. 30
Vocabulary & Data Types :
Data Types
What is a data type?
lengthOfStayQuantity
is attribute of the
EncounterProcess
class.
lengthOfStayQuantity
has a data type of
Physical Quantity (PQ).
31. 31
Vocabulary & Data Types :
Data Types
Data types in HL7 version 3 are complex
Each data type has attributes
Each attribute has a data type of its own
<lengthOfStayQuantity value=“10” unit=“hours"/>
Physical Quantity (PQ) example
The attributes ‘value’ and ‘unit’ are part of the
complex data type Physical Quantity (PQ).
Value is expressed as the data type of integer
(int).
32. 32
HL7 Version 3 at NCICB
In this section, we will discuss:
– Why HL7 at NCICB?
– NCICB Clinical Architecture Vision
– caAdapter
33. 33
HL7 Version 3 at NCICB:
Why HL7?
Recommended by the Health and Human Service (HHS) as the
messaging standard for electronic exchange of clinical data.
Over 90% of US hospitals have implemented some version of 2.x
HL7 messages.
Support for translational research requires integration of
research data with the clinical data.
– V3 offers the syntactic and semantic interoperability to make this
possible
34. 34
HL7 Version 3 at NCICB:
NCICB Clinical Architecture Vision
HL7 version 3
supports
messaging
within the
NCICB
Clinical
Architecture
Vision.
etc.
Tissues
Labs
JDBC 2
Analytical Applications
Analytical and Reporting
Tools (SAS, WebSDM,
ToxViewer, I-Review,
etc.)
Ad Hoc
Query
Tool
BIO-
gopher
Master Index
Message
Exchange
Services
(ebXML)
Translation Service
(CAM/caAdapter)
Electronic
Medical
Record (EMR)
HL7 v3
Excel, Text,
HL7 v2,
etc.
HL7 v3
HL7 v3
HL7
Transactional
Database
(HTB)
Extensions
(CDUS/CTM
S)
Base Janus
Model
BRIDG
Clinical/Clinical Trials Applications
C3D
caMATC
H C3PR SAE
Study Specific Analysis Data
Clinical
Data Sources
Patient Identifiable Clinical Environment
caGRID
caBIG
HL7 v3
Secure
Transport
Between
Sites
caBIO/CTOM
HL7 RIM
BRIDG
caBIO/CTOM
HL7 RIM
FDA
SPONSOR
CTEP
DCP
Other
External
Agencie
s
HL7 v3
HL7
v3
Common Security Module (CSM) Enterprise Vocabulary Service (EVS) Data Standards Repository (caDSR)
Secure
Transport
Between
Sites
Excel, Text,
HL7
v1, v2, etc.
De-Identification/
Re-Identification
Service
HL7 v3
eCTD
,
Excel,
Text,
HL7
v2,
etc.
Translation Service
(CAM/caAdapter)
HL7 v3
caPRI
FIREBIRD
CRIX Data Repository
35. 35
HL7 Version 3 at NCICB:
Highlights of the NCICB Clinical Architecture Vision
caAdapter – Open source toolkit which facilitates v3 message building,
parsing and validation
Message Exchange – Service supporting message transmission and
routing
HL7 Transactional Database - HL7 RIM-based transactional database
and data access service
De-identification Service – Service for de-identifying patient information
from HL7 messages
Analytical Applications - Applications for querying, reporting, mining
clinical data
Cancer Data Standards Repository (caDSR) - Shared metadata
repository
Enterprise Terminology Services (EVS) - Terminology service for hosting
controlled vocabulary, including HL7 registered terminology
36. 36
HL7 Version 3 at NCICB:
caAdapter
Facilitates the building, parsing, and validation of HL7 v3 messages
Components include:
– HL7 v3 Message Parser – parses HL7 version 3 messages to RIM object
graph
– HL7 v3 Message Builder – builds HL7 version 3 messages from the RIM
object graph
– HL7 v3 Artifacts – implements RIM objects, data types and metadata objects
– Metadata Loader – represents HL7 version 3 metadata in-memory
– Validation Services – integrates with NCICB caCORE components such as
Enterprise Vocabulary Service (EVS) and W3C XML schema validation
services
– Mapping Tool – maps clinical data to the HL7 version 3 message
specification currently, with extensible mapping and data transformation in the
near future
– caAdapter API – uses mappings to generate HL7 version 3 messages
– Message Service – integrates with message exchange services (future
plans)
37. 37
HL7 Version 3 at NCICB:
caAdapter
A platform to enable clinical applications to build and parse HL7
v3 messages based on specific schema definitions.
Capability to perform vocabulary validation of the RIM structural
attributes.
An open source solution for implementing an international
messaging standard allowing data to be exchanged between
disparate systems.
Integration with NCI metadata repository (caDSR) and
terminology services (EVS)
Facilitating the building and parsing of HL7 v3 messages from
source clinical systems will promote data exchange in a
standards based common format.
38. 38
Recommended Resources
Health Level Seven
www.hl7.org
HL7 Reference Information Model
https://www.hl7.org/library/data-model/RIM/C30202/rim.htm
HL7 Vocabulary Domains
http://www.hl7.org/library/data-model/RIM/C30123/vocabulary.htm
HL7 Version 3 Standard
http://www.hl7.org/v3ballot/html/welcome/environment/index.htm
NCICB caAdapter Project Site
trials.nci.nih.gov/projects/infrastructureProject/caAdapter
HL7 Version 3: Driving Interoperability & Transforming Healthcare Information
Management - Charles Mead, MD, MSc
NIHSeminar_Charlie Mead.ppt
Editor's Notes
Instructor: Introduce yourself
The notes provide you with additional information on slide topic.
At the end of this training you should:
Understand what HL7 is
Define terms and concepts used in HL7
Read HL7 RIM based models
HL7 at the NCI
In this section, we will:
Goal of HL7
4 Pillars of semantic interoperability
The goal of HL7 is
HL7 V3 is a standard for exchanging messages among information systems that implement healthcare applications. To accomplish this, HL7 uses an object-oriented development methodology and is based on a Reference Information Model (RIM) to create messages. The goal of HL7 is semantic interoperability.
What Does the Name HL7 Mean
&quot;Level Seven&quot; refers to the highest level of the International Standards Organization&apos;s (ISO) communications model for Open Systems Interconnection (OSI) - the application level. The application level addresses definition of the data to be exchanged, the timing of the interchange, and the communication of certain errors to the application. The seventh level supports such functions as security checks, participant identification, availability checks, exchange mechanism negotiations and, most importantly, data exchange structuring.
How is HL7 Organized
HL7 is managed by a Board of Directors, which is comprised of eight elected positions and three appointed positions. The organization is comprised of Technical Committees and Special Interest Groups that are responsible for defining the HL7 standard protocol. Each Technical Committee and Special Interest group is chaired by two or more co-chairs. Collectively, the co-chairs comprise the Technical Steering Committee, which votes on issues related to the standard. Votes of the Technical Steering Committee as passed as recommendations to the Board of Directors, who make the final decision. HL7 members are encouraged to participate in all of these committees.
The 4 Pillars:
The following slides will discuss these pillars.
The Reference Information Model (RIM)
The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry. It is a shared model between all the domains and as such is the model from which all domains create their messages. Explicitly representing the connections that exist between the information carried in the fields of HL7 messages, the RIM is essential to our ongoing mission of increasing precision and reducing implementation costs.
Data Types
Data types are the basic building blocks of attributes. They define the structural format of the data carried in the attribute and influence the set of allowable values an attribute may assume. Some data types have very little intrinsic semantic content and the semantic context for that data type is carried by its corresponding attribute. However HL7 also defines quite extensive data types such as PNMP, person Name Part, which provides all the structure and semantics to support a person name. Every attribute in the RIM is associated with one and only one data type, and each data type is associated with zero or many attributes.
Data Exchange Specifications
HL7 defines its messages at an abstract level. The &quot;7&quot; in HL7 stands for the Application level of the ISO communication model -- ISO level 7. The V3 abstract message model is based on the RIM. HL7 Version 3 messages can be thought of as the communication of graphs of RIM objects from sender to receiver.
Vocabulary
Within HL7, 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. For example, the Living_subject class has a coded attribute called administrative_gender_code. The administrative_gender_code attribute becomes part of an HMD, and a message instance is subsequently created as part of an implemented interface, one would expect the administrative_gender_code attribute to convey male or female. In this example, male and female are concepts and there may be several coding schemes that contain concepts for male and female.
The Health Level Seven (HL7) Reference Information Model (RIM) is a static model of health and health care information as viewed within the scope of HL7 standards development activities. It is the combined consensus view of information from the perspective of the HL7 working group and the HL7 international affiliates. The RIM is the ultimate source from which all HL7 version 3.0 protocol specification standards draw their information-related content.
What is a information model?
An information model is a structured specification of the information within a specific domain of interest. It expresses the classes of information required and the properties of those classes, including attributes, relationships, constraints, and states. In HL7, the scope of a domain of interest ranges from the domain of the entire system of health services to the specific context of a set of information exchanges to meet a particular identified business purpose. HL7 defines different types of information models to represent the different contexts of interest
Information Model Components
The information model consists of the following components:
classes, their attributes, and relationships between the classes;
data types for all attributes and vocabulary domains for coded attributes;
state transition models for some classes.
HL7 information models are based upon the Unified Modeling Language (UML), and may be represented graphically using the UML style. UML is a modeling language that unifies the object-oriented modeling methods of Grady Booch, Jim Rumbaugh, Ivar Jacobson, and others. The UML is a rich, mainly graphical, means of expressing object-oriented concepts. To obtain more information about UML see http://www.rational.com/uml/ or the book UML Distilled by Martin Fowler (ISBN 0-201-32563-2).
Note:
RIM model is color coded based on the backbone class.
The HL7 RIM
The HL7 RIM is a critical component of the V3 development process. It is the root of all information models and structures. The HL7 V3 development process is a model-driven methodology. Inter-related models are developed that depict underlying semantics and business rules that govern them. The RIM provides a static view of the information needs of HL7 V3 standards. It includes class and state-machine diagrams and is accompanied by use case models, interaction models, data type models, terminology models, and other types of models.
The classes, attributes, state-machines, and relationships in the RIM are used to derive domain-specific information models. The HL7 V3 standard development process defines the rules governing the derivation of domain information models from the RIM and the refinement of those. The rules require that all information structures in derived models be traceable back to the RIM and that their semantic and related business. The RIM therefore is the ultimate source for all information content in HL7 V3 standards.
Examples of Subclasses of Foundation Classes:
Entity
- Organization
- Place
- Person
- Living Subject
- Material
Role
- Patient
- Member
- Healthcare facility
- Practitioner
- Practitioner assignment
- Specimen
- Location
Participation
- Author
- Reviewer
- Verifier
- Subject
- Target
- Tracker
- Performer
Act
- Referral
- Transportation
- Supply
- Procedure
- Consent
- Observation
- Medication
- Administrative act
- Financial act
Note: classes are not the only.. The only ones show are the ones that have unique attributes
Definition of Entity:
A physical thing, group of physical things or an organization capable of participating in Acts, while in a role.
Note: classes are not the only.. The only ones show are the ones that have unique attributes
Definition of Role:
A competency of the Entity playing the Role as identified, defined, guaranteed, or acknowledged by the Entity that scopes the Role.
Definition of RoleLink:
A connection between two roles expressing a dependency between those roles.
Examples: A role of assignment or agency depends on another role of employment, such that when the employment role is terminated, the assignments would be terminated as well. This is the dependency of the assignment role with the employment role, or in other words, the assignment is &quot;part of&quot; the employment.
Note: classes are not the only.. The only ones show are the ones that have unique attributes
Definition of Participation:
An association between an Act and a Role with an Entity playing that Role. Each Entity (in a Role) involved in an Act in a certain way is linked to the act by one Participation-instance. The kind of involvement in the Act is specified by the Participation.typeCode.
Note: classes are not the only.. The only ones show are the ones that have unique attributes
Definition of Act:
A record of something that is being done, has been done, can be done, or is intended or requested to be done.
Examples: The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.
Definition of ActRelationship:
A directed association between a source Act and a target Act. ActRelationship on the same source Act are called the &quot;outbound&quot; act relationships of that Act. ActRelationships on the same target Act are called the &quot;inbound&quot; relationships of that Act. The meaning and purpose of an ActRelationship is specified in the ActRelationship.typeCode attribute.
Understanding the RIM
The RIM uses a abstract modeling style. The back-bone classes of the RIM and their structural attributes are its core. An understanding of these classes and attributes are essential to understanding the RIM.
Defines all the information from which the data content of HL7 messages are drawn
Follows object-oriented modeling techniques, where the information is organized into classes that have attributes and that maintain associations with other classes
Forms a shared view of the information domain used across all HL7 messages independent of message structure
Provides a means for discovering and reconciling differences in data definition
Notes about HL7 processes … message are derived from the RIM. Focus on the model methodology of DMIM and RMIM. People will be looking at the RMIM.
color-coded
colors denotes type of backbone class
Red = Act
Blue = Participation
Yellow = Role
Green = Entity
Light red or pink = Act Relationship
Light Yellow = Role Link
Arrows
Participations, Role_Links and Act_Relationships are arrows that are directional have attributes rather than being lines that connect classes like in UML
Entry Point
Each D-MIM diagram will have at least one Entry Point. Entry Points designate the class(es) from which the messages begin for the particular domain. Since the D-MIM encompasses an entire domain, there may be several Entry Points, one for each R-MIM contained in the domain.
Entry Point
Each D-MIM diagram will have at least one Entry Point. Entry Points designate the class(es) from which the messages begin for the particular domain. Since the D-MIM encompasses an entire domain, there may be several Entry Points, one for each R-MIM contained in the domain.
RMIMs are directional
All associations flow out from the entry point toward the remaining parts of the message
labeling
HL7 diagrams are a little different in how they label associations (only on distal end, not bi-directional)
Normally in UML diagrams you have a label on both ends of an association and the association can be read both ways, but in an HL7 RMIM the association can only be read one way and thus there is only one label and it&apos;s on the distal (far) end of the association
HL7 Modeling Conventions
color-coded - colors mean type of backbone class
arrows - participations and actRelationships are arrows that are directional have attributes rather than being lines that connect classes like in UML
entry points - HL7 DMIMs and RMIMs have entry points (boxes with arrow pointing to a class); DMIMs can have more than one, RMIMs can only have one
RMIMs are directional - all associations flow out from the entry point toward the remaining parts of the message
labeling - HL7 diagrams are a little different in how they label associations (only on distal end, not bi-directional)
Hierarchal Message Definitions (HMDs) is a serialize version of the RIM in a specific order
The XML elements and attributes in a message instance correspond one-to-one with individual rows in the HMD. The names of the XML elements and attributes are taken from the &quot;element name&quot; column of the HMD.
Structural attributes
Structural attributes are used to specify more precisely what each RIM class means when used in a message.
For example,
Act has a class code. The class code states what sort of Act this is, such as an observation, an encounter, or the administration of a drug. Mood is analogous to the tense of a verb.
Coded Values
HL7 uses two main types of code. The first type covers the specialized codes used for structural attributes and are defined by HL7 itself. The second type covers externally defined terms and codes such as SNOMED CT (Clinical Terms).
Vocabulary
Vocabulary is the set of allowed values for a coded field.
All attributes with a code data type will have a vocabulary assigned to them.
The ‘code system’ must be identified for any coded value in a message.
NameTypeDescription
Code= The plain code symbol defined by the code system. For example, &quot;784.0&quot; is the code symbol of the ICD-9 code &quot;784.0&quot; for headache.
codeSystem= Specifies the code system that defines the code.
codeSystemName= A common name of the coding system.
codeSystemVersion= A version descriptor defined specifically for the given code system.
displayName= A name or title for the code, under which the sending system shows the code value to its users.
.
Coded Values
HL7 uses two main types of code. The first type covers the specialized codes used for structural attributes and are defined by HL7 itself. The second type covers externally defined terms and codes such as SNOMED CT (Clinical Terms).
Vocabulary
Vocabulary is the set of allowed values for a coded field.
All attributes with a code data type will have a vocabulary assigned to them.
The ‘code system’ must be identified for any coded value in a message.
NameTypeDescription
Code= The plain code symbol defined by the code system. For example, &quot;784.0&quot; is the code symbol of the ICD-9 code &quot;784.0&quot; for headache.
codeSystem= Specifies the code system that defines the code.
codeSystemName= A common name of the coding system.
codeSystemVersion= A version descriptor defined specifically for the given code system.
displayName= A name or title for the code, under which the sending system shows the code value to its users.
.
HL7 v3 Messaging Standard at NCICB
NCI’s Clinical Trials Architecture vision supports open sharing of clinical and research data across the cancer research and clinical care communities. Clinical systems supply trial data to a message exchange, using the HL7 Software Development Kit (SDK) to build HL7 V3 messages to carry the data. [NCICB Clinical Architecture Vision]
