catalogue,synthesise

Templates, forms, data setsused in real, diverse health settings Formal representation of

clinical “business object”REQUIREMENTS

developHL7 constraint

formalisms

develop and useimport and export tools

FormalHL7 constraintspecification

for static models

Templates SIG M & M TC

Agreed requirementsfor constraints

Share with clinical and other non-HL7 communities

Agreed approach withTerminfo and

Clinical Statement

Archetype & Template requirements

• Definition• Description sets• Publication status• Node constraints• Term and concept bindings• Attributes, associations and context• Data value constraints• References to EHR instances

Definition

globally unique identifierid of repository maintaining this archetypehealth informatics domain (e.g. EHR)underlying RMconcept (scope) code or phrase natural languageparent archetypepredecessor, reason for revision, successor

Description sets (multiple)

providing party & organisationnatural languagescope: concept code, clinical speciality, types of patients, keywordsintended use, potential erroneous usesreference to knowledge source (e.g. url)detailed explanation of purpose, notesurl or references to explanatory materials

Publication status

TentativeDraftPrivatePublicPreferredFormerDeprecatedsuggest adding Test

date, authorising party & organisationreview or validity date

Node constraints

Explicit nodeReference:

to part or all of another archetypeinternal

external

constraints defining an inclusion or exclusion set

Explicit Node constraints

internally-unique idReference Model classinclusion or exclusion constraints (e.g. for existence, multiplicity)

logicalrelated to environmental parametersrelated to other EHR node values to be instantiated within the same archetyperelated to EHR instance data or workflow or care pathway processes

Binding to terms

Principal concept (mandatory: the “meaning”)Term bindingSynonym Language translation

for each term:code, rubric, coding system and version, language in which mapping made

Attributes and associations

common labelattribute/association nameoptionalitymultiplicityif orderedif uniquedata value constraintsother dependencies and constraints

Attributes and associations

includes constraints on contextual information e.g.

subject of information

potentiality (present, absent, possible, probable, risk, goal, expectation, etc.)

process (done, is in progress, is planned to be done, has not been done, should not be done, etc.)

data value constraints

inclusion and/or exclusion criterianull, null flavour valuesdefault valuefixed valuelist of valuesdata type specific constraints e.g. value range, units, term set, date ranges logical conditions and other constraint rules (and formalism used)

References to EHR data (1)

the archetype identifierthe archetype node identifierthe attribute or association namethe occurrence in the instance hierarchy e.g. first, most-recent, any, n ordered by y, highest value, lowest value, one or more instances within a (definable) recent time interval

References to EHR data (2)

the intended relationship between this specified instance value and the data value being constrained e.g.

the same value asa subset or substring ofgreater than, greater than or equal to, less than, less than or equal to earlier than, later than, etc.if ... then...must not be the same as

13606-1 profile for archetypes

HL7 Templates draft 28 Feb 05• 4.1 Template Architecture

The Template Architecture that governs the normative HL7 V3.0 Templates must satisfy a series of requirements from the HL7 Standard V3 HDF Static Model: 4.1.1 Templates shall represent syntactically and semantically structured aggregation of data, including coded vocabulary or numerical data, as defined by domain experts or organizations.4.1.3 The template architecture shall support structured aggregations of archetypes.4.1.4 The template architecture shall support structured aggregation and composition of templates resulting in conformant Templates.4.1.5 The template architecture shall support the re-use and import of archetypes into an authoring environment (including constraints expressed within those archetypes).4.1.6 Templates may take the form of HL7-conformant balloted RMIM’s, local information models or LIMs expressed in HL7-conformant structural notations, and HL7-conformant clinical document specifications.4.1.7 An HL7 Template Library shall provide the ability to associate each template instance with relevant referenced HL7 specifications that contained within its components. 4.1.8 The HL7 Template Library shall provide the ability to query for all HL7 specifications components suitable for reference or inclusion in an HL7 Template 4.1.9 Registered HL7 V3 Templates shall include collected metadata about the Templates, such as the components that have been constrained.4.1.10 Templates must allow for the recursive representation and traversal of associations in support of constructs with zero or more instances. Templates can include by reference other templates in an object oriented fashion.

HL7 Templates draft 28 Feb 05

• 4.2 Template AssertionsThe assertions of Templates as Static Models are governed by the HL7 V3 Standard HDF Static Model (3.2) requirements, including:4.2.1 Static assertions. 4.2.2 Co-Occurrence AssertionsNote that all co-occurrence assertions that are definitional shall result in the formation of new Static Model, in this case a particular kind of Template (termed an Archetype).4.2.3 Containment assertions4.2.4 Logic assertions4.2.5 Mathematical assertions

HL7 Templates draft 28 Feb 05• 4.3 Normative Template Representation• The normative representation of HL7 Standard V3

Templates is governed by the HL7 Standard V3 HDF Static model requirements. The required UML examples are provided in Section 5.0.

• The particular view by specific metalanguages (XML, OWL, and ADL) is detailed below in the Technical Specifications provided in the annexes

• 4.4 Template Declaration• When used in HL7 V3 instance:• 1. Template ID (infrastructure root) is used to assert

conformance to a Template.• 2. Template ID asserts Template binding to an instance.

HL7 Templates draft 28 Feb 05

• 4.5 Templates RegistrationThis section defines Templates registry and repository requirements.

4.5.1 Templates Repository...4.5.1.2. The repository shall be capable of supporting hierarchical relationships among two templates. For example, if a series of Echocardiography Templates were represented, each applying tighter and tighter constraints, this hierarchy can be captured and queried in the repository. ...

HL7 Templates draft 28 Feb 05• 4.5.2 Templates Metadata• 4.5.2.1 Template ID

4.5.2.2 Name of the Template (required)4.5.2.3 Description and scope of the Template (required)4.5.2.4 Balloted rMIM fragment ID against which Template is developed (required)4.5.2.5 Registering authority: organization, institution, committee, or individual (required) 4.5.2.6 Version number (required)4.5.2.7 Publication state4.5.2.8 Date of creation (required)4.5.2.9 Date first in effect4.5.2.10 Revision dates 4.5.3.11 Revision history4.5.2.9 Date of expiration (optional)4.5.2.10 Name of author, institutional affiliations(s) and contact information 4.5.2.11 Co-authors, institutional affiliations, and contact information (optional)4.5.2.12 Technical contact4.5.2.13 Administrative contact4.5.3.14 Format (optional): e.g. rdfs: OWL, ebXML, and SR-XML 4.5.3.14 URI to documentation4.5.3.15 URI of the package of templates

new CEN work item proposal

1.An archetype ontology to map individual archetypes to a generic knowledge framework - to enable their use alongside other knowledge resources

2.Domain Base Concept Models, enabling sharable archetypes to be written

3.Rules about binding co-ordinated terminology values to archetype nodes (the “TermInfo” problem)

4.A rich library of archetypes conforming to the above, held within a public-domain repository

5.Guidance on how to map EHR system data conforming to each archetype to EN13606-1 (and other RMs)

proposals

Formal representation of clinical “business object”

REQUIREMENTS

proposals1. Accept (refine) CEN archetype requirements (prEN13606-2, Annex A) as the requirements for formally representing clinical business objects in the Templates SIG, for communication with M&M

2. Agree that this clinical content synthesis work can be harmonised with CEN and openEHR, provided that no assumption is made about which Reference Model is to be used

3. Review CEN archetype model as a candidate for a data repository and authoring tools

4. Collaborate with M&M on mapping this to its evolving HL7 Template formalisms

catalogue,synthesiseTemplates, forms, data sets

used in real, diverse health settings Formal representation of clinical “business object”

REQUIREMENTS

developHL7 constraint

formalisms

develop and useimport and export tools

FormalHL7 constraintspecification

for static models

Templates SIG M & M TC

Agreed requirementsfor constraints

Agreed approach withTerminfo and

Clinical Statement

developguidelines &

rules for “good” archetypes

and templates

Undertake as a joint project with CEN and openEHR

catalogue,synthesiseTemplates, forms, data sets

used in real, diverse health settingsFormal representation of clinical “business object”

REQUIREMENTS

Joint projectopenEHR, CEN, HL7

developguidelines &

rules for “good” archetypes

and templatesData element inventory

Indexed repository

mapped to and used within:openEHR Reference Model

CEN 13606HL7 R-MIMs