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Interoperability

among unrelated, heterogeneous sites can only be accomplished through the use of a common information reference mode; most commonly-used is the HL7 RIM

RIM

this model is abstract, that is it is defined without regard to how it is represented in a message on the wire or in a service architecture method or in a clinical document

RIM defines

the basic things or nouns and the relationship or linkages among those things; at the basic level, it defines Entities and Acts and includes the Role of the Entity, the Participation of the Entity with the Act, and the Act Relationship; if it becomes the basis for the identification of data elements and is used in the exchange of data, two unconnected groups can, through the common this,understand and use the data; with it two groups given the same use case would derive similar messages to exchange the data; it permits the extension of concepts to support new domains without changing the old; it can be extended incrementally when new clinical information domains need to be added in a way that doesn't require changing what has already been created

HL7 v3 products based on the RIM

CDA, decision support, messages, and others

Domain analysis models define

information flow, work flow, and identify associated data elements within a clinical domain; communications between domains requires an abstract, domain-independent model as the HL7 RIM

v3 is based on the RIM to establish interoperability

the exchange of data starts with the reference information information mode, and ends with the reference information model; it is the link that establishes the structure for interoperability

Cross reference tables

build the mapping from the narrow world of the individual domain to the cross-domain interoperability supported by the HL7 RIM

HL7 RIM Entity examples

organization, place, person, living subject, and material

HL7 RIM Role examples

patient, member, healthcare facility, practitioner, practitioner assignment, specimen, and location

HL7 RIM Participation linkages include

author, reviewer, verifier, subject, target, tracker

HL7 RIM ACT examples

referral, transportation, supply, procedure, consent, observation, medication, administrative act, financial act

HL7 RIM ACT relationships include

has component and is supported by

HL7 Development framework

defines the methodology for mapping a local domain system into a common reference model; the mapping uses the UML-based Domain Analysis Model which is created by the Domain experts

Domain Analysis Model (DAM)

helps answer the questions, "What do you do? "What data elements do you use? "What is the data flow? and "What are the decision points?

RIM Harmonization

a continuous process although at this stage the changes to the RIM are slight and few; supports a standard way to add new domain requirments to the RIM in a way that doesn't invalidate the previously created models a feature of object-oriented paradigms

HL7 Framework includes

RIM, data types, data elements, vocabulary, templates, and clinical statements; all these elements involve defining the data in a semantic, interoperable way

Model based HL7 standards include

v3 messaging, CDA, GELLO, and System Oriented Architecture

GELLO language can be used to

- build up expressions to extract and manipulate data from medical records
- construct decision criteria by building up expressions to reason about particular data features/values; these criteria can be used in decision-support knowledge bases, such as those designed to provide alerts and reminders, guidelines, or other decision rules
- create expressions, formulae, etc. for other applications

Conceptual foundation

a single, common reference information model to be used across HL7; v3 has as its goal and purpose interoperability

Semantic foundation

explicitly defined concept domains drawn from the best terminologies; it is based on the RIM which provides the fundamental underpinnings for interoperability;

Abstract design methodology

that is technology neutral, able to be used with whatever is the technology def jour; the design methodology that creates the technology-neutral messages permits the use of different technologies and permits an evolution over time as technology varies

Maintain a repository

the semantic content to assure a single source and enable development of support tooling

HL7 Model Repository

database of common components for the semantic base are maintained in this; include such things as the RIM, vocabulary, storyboards, interaction models, message designs, and message contraints

Tool set

support the management of the HL7 model repository; also support semantic specifications, abstract information structures that are used in messages, templates, and documents; also support the publication of HL7 standards and implementation guides

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