This document provides a first draft of a content model for health information exchange (HIE). It describes reusable clinical information bits called archetypes organized following the CCR standard. International and local archetypes as well as extensions can be included. When creating HIE payloads, only relevant archetypes would be included. The document discusses developing content through grassroots and governance processes and demonstrates example HIE models and capabilities.

1. A First Stab at the
Content Model (for HIE)
Koray Atalag, MD, PhD
k.atalag@nihi.auckland.ac.nz
koray.atalag@openehrfoundation.org

4. What is it?
• A collection of reusable bits of clinical
information – Archetypes
• Top level organisation follows CCR
• Further detail provided by:
– Existing international Archetypes
– Extensions (of above)
– New Archetypes
• Each HIE payload will include a subset
• Don’t worry about Core/Minimum set (for now) –
creating a maximal set

6. Uniform Content Model > Payload

7. Extension: Archetype Specialisation
Problem
Local specialisation
Text or Term Diagnosis
Clinical description
Date of onset Term Diabetes
Date of resolution + diagnosis
No of occurrences Grading Term
Diagnostic criteria +
Stage Diagnostic criteria
• Fasting > 6.1
• GTT 2hr > 11.1
• Random > 11.1

8. Creating Payload
?

9. Content Development – How to?
• Should be grass-roots; e.g. clinician led
• Tight governance – consistency important
– Independent and multi-stakeholder
– Emphasis on alignment in all HIE Projects
• CKM: tool for collaborative development
• ? Trans-Tasman collaboration – use Nehta DCM
(http://dcm.nehta.org.au/ckm/)
• Terminology bindings: SNOMED RefSets and others
• Need: champions, upskilling and seed funding ;)

10. How to Align?
• Create a superset from all existing sources
• Identify exact matches (label, values etc.)
• Align similar items:
– Labels & descriptions
– Combine value sets
– Adjust granularity
– Adjust cardinalities
– Set terminology bindings

11. Content Localisation
• Localisation:
– Translation (Maori, Chinese, Korean, Indian etc.)
– Adaptation (extensions to NZ needs)
• Content independent of language – as many
languages can be fitted, good tooling
• openEHR Localisation Program (led by myself)
– Local Chapters in each jurisdiction
– Program Committee, Qualified Members, Local
Members
– NZ openEHR Chapter intended to work under HL7NZ

13. DEMONSTRATION
• eReferral (RSD revision) 5’
– HL7 v2.4 message – look at content
– openEHR eReferrals model – mapping & extension
• Community ePrescribing 3’
– Message content & Nehta ePrescribing
• PREDICT ‘15
– Dataset items and feeder data sources
– International Archetypes+Kiwi extensions+New
– Future-proofing: backwards data compatibility & AQL
querying
• Exchange Content Model – a first stab! 1’