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among unrelated, heterogeneous sites can only be accomplished through the use of a common information reference mode; most commonly-used is the HL7 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
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
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 Role examples
patient, member, healthcare facility, practitioner, practitioner assignment, specimen, and location
HL7 RIM ACT examples
referral, transportation, supply, procedure, consent, observation, medication, administrative act, financial act
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?
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
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
a single, common reference information model to be used across HL7; v3 has as its goal and purpose interoperability
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
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