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CIMI Modelling Taskforce Report. Dr Linda Bird 11 th April 2013. Laboratory models. Submitted Models. FHIRLab Report resource IntermountainStandard Lab Obs NEHTAPathology Test Result MOHH Investigation Composition HL7 Clinical Care Document Netherlands (NFU)Lab Results - PowerPoint PPT Presentation
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CIMI Modelling Taskforce ReportDr Linda Bird11th April 2013
LABORATORY MODELS
• FHIR Lab Report resource• Intermountain Standard Lab Obs• NEHTA Pathology Test Result• MOHH Investigation Composition• HL7 Clinical Care Document• Netherlands (NFU) Lab Results• EN13606 Assoc Lab Test• Canada InfoWay HL7 v3 POLB_MT004000UV
Submitted Models
Archetype Map forLaboratory Results Report
Laboratory Results Report
Composition:
Archetype Map forLaboratory Results Report
Laboratory Results Report
Composition:
Entry:
Laboratory Report Header
Patient Encounter Summary
Laboratory Test Request Summary
Laboratory Test Observation
Archetype Map forLaboratory Results Report
Laboratory Results Report
Composition:
Entry:
Cluster:
Laboratory Report Header
Patient Encounter Summary
Laboratory Test Request Summary
Laboratory Test Observation
Action
Laboratory Test Request
Laboratory Test Observable
Laboratory Test Result Group
Laboratory Test Observable
Action
Action
Reference Range
Specimen
Action
CompositionLaboratory Results Report
Laboratory Results Report
Clinical Report
COMPOSITION
constrains
constrains
CIMI-COMPOSITION.laboratory_results_report
Clinical Report
COMPOSITION
constrains
constrains
EntryLaboratory Report Header
Clinical Report Header
ENTRY
constrains
constrains
Clinical Entry
constrains
Laboratory Report Header
CIMI-ENTRY.laboratory_report_header
Clinical Report Header
ENTRY
constrains
constrains
Clinical Entry
constrains
EntryPatient Encounter Summary
Patient Encounter Summary
Clinical Activity
ENTRY
constrains
constrains
Clinical Entry
constrains
CIMI-ENTRY.patient_encounter_summary
Clinical Activity
ENTRY
constrains
constrains
Clinical Entry
constrains
EntryLaboratory Test Request Summary
Laboratory Test Request
Summary
Clinical Entry
Observation Request
Request
Clinical Activity
ENTRY
constrains
constrains
constrains
constrains
constrains
CIMI-ENTRY.laboratory_test_request_ summary
Clinical Entry
Observation Request
Request
Clinical Activity
ENTRY
constrains
constrains
constrains
constrains
constrains
EntryLaboratory Test Observation
Laboratory Test Observation
Observation
ENTRY
constrains
constrains
Clinical Entry
constrains
CIMI-ENTRY.laboratory_test_observation
Observation
ENTRY
constrains
constrains
Clinical Entry
constrains
Archetype Map forLaboratory Results Report
Laboratory Results Report
Composition:
Entry:
Cluster:
Laboratory Report Header
Patient Encounter Summary
Laboratory Test Request Summary
Laboratory Test Observation
Action
Laboratory Test Request
Laboratory Test Observable
Laboratory Test Result Group
Laboratory Test Observable
Action
Action
Reference Range
Specimen
Action
ClusterLaboratory Test Observable
Laboratory Test Observable
CLUSTER
constrains
Observable
constrains
CIMI-CLUSTER. laboratory_test_observable
CLUSTER
constrains
Observable
constrains
ClusterLaboratory Test Result Group
CLUSTER
constrains
Finding
constrains
Finding Group
constrains
Laboratory Test Result Group
CIMI-CLUSTER. laboratory_test_result_group
CLUSTER
constrains
Finding
constrains
Finding Group
constrains
ClusterLaboratory Test Result Item
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
Laboratory Test Result Item
CIMI-CLUSTER. laboratory_test_result_item
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
ClusterReference Range
Reference Range
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
CIMI-CLUSTER.reference_range
CLUSTER
constrains
Finding
constrains
Finding Item
constrains
ClusterSpecimen
Specimen
CLUSTER
constrains
Material Entity
constrains
CIMI-CLUSTER.specimen
CLUSTER
constrains
Material Entity
constrains
ClusterSpecimen Collection Site
CLUSTER
constrains
Material Entity
constrains
Anatomical Location
constrains
Specimen Collection Site
CIMI-CLUSTER.specimen_collection_site
CLUSTER
constrains
Material Entity
constrains
Anatomical Location
constrains
CLUSTER Laboratory Actions
Observe Action
Action
Interpret Action
Approve Action
Report Action
Cancel Action
Author Action
Issue Action
Custodian Action
Laboratory Test Request Action
Receive Action
Collect Action
Requested ActionRequest Action
Encounter Action
CLUSTER
ClusterLaboratory Test Request Action
Laboratory Test Request Action
CLUSTER
constrains
Action
constrains
Request Action
constrains
CIMI-CLUSTER. laboratory_test_request_action
CLUSTER
constrains
Action
constrains
Request Action
constrains
ClusterApprove Action
CLUSTER
constrains
Action
constrains
Approve Action
CIMI-CLUSTER.approve_action
CLUSTER
constrains
Action
constrains
LABORATORY MODELSPECIALISATIONS
Laboratory Model Specialisations
1. Complete Blood Count with Manual Differential Panel
2. Complete Blood Count with Auto Differential Panel
3. Complete Blood Count without Differential
4. Gas and Carbon Monoxide Panel
Complete Blood Count
Laboratory Test Observation
Observation
ENTRY
constrains
constrains
Clinical Entry
constrains
constrains
Complete Blood Count
Complete Blood Count
Complete Blood Count
Complete Blood Count
Complete Blood Count Specialisations
Laboratory Test Observation
Observation
ENTRY
constrains
constrains
Clinical Entry
constrains
constrains
Complete Blood Count
Complete Blood Count Without
Differential
Complete Blood Count With Auto
Differential
Complete Blood Count With
Manual Differential
constrainsconstrains
constrains
Complete Blood Count Without Differential
Complete Blood Count Without Differential
Complete Blood Count With Manual Differential
Complete Blood Count With Manual Differential Panel
Complete Blood Count With Manual Differential Panel
Complete Blood Count With Manual Differential Panel
Complete Blood Count With Auto Differential
Complete Blood Count With Auto Differential Panel
Complete Blood Count With Auto Differential Panel
Complete Blood Count With Auto Differential Panel
Gas and Carbon Monoxide Panel
DEMOGRAPHICS MODELS
Participation & Party Reference Model class CIMI Core Model
PARTICIPATION
function :CODED_TEXTdetails :ITEM [0..*]
CORE_LOCATABLEPARTY
details :ITEM [0..*]
participation
0..*party
1..1
class CIMI Participation Model
«archetype_parent»LOCATABLE
+ archetype_node_id :String+ name :String
PARTY_RELATIONSHIP
+ type :CODED_TEXT+ details :ITEM [0..*]
PARTY
+ details :ITEM [0..*]
ROLE
+ type :CODED_TEXT
ACTOR
+ type :CODED_TEXT
+role
0..*
+source+relationship
0..*+target
1..1
When is demographics demographics?
• Question: When is CIMI information modelled using the ‘PARTY’ model, and when is it modelled using the core reference model?
• Proposed Criteria:– Does the information relate to a specific healthcare event or not?
• Does it record the results of an observation, evaluation, assessment, or activity?• If yes, then use Core Reference Model• E.g. Age is specific to a point in time, Living Dependency is an assessment and Biologic Sex is
an observation– Is this information only relevant to the Subject of Care, or do we need to record
this about other Parties participating in the record as well?• If needed about other Parties, then usually use Party model• E.g. Address may be relevant for Next of Kin; Disability may be relevant for a Dependent
– How is it commonly used in systems?• Source models are used to determine common implementation practice
Demographics Source Models
• HL7 v3 RIM• NHS LRA• NEHTA (Participation)• FHIM (Federal Health Information Model)
Demographics model• HL7 FHIR (Organisation, Person, Patient,
Agent, Group)• openEHR• ISO13606 (Standard and new draft)• ISO-22220• MOHH (Singapore)• DCM (The Netherlands)• Intermountain Healthcare
CIMI Demographics Models
• CLUSTER– Location– Address– Electronic Contact– Party Name
• PARTY– ACTOR
• Person• Organisation
– ROLE• Person Role• Healthcare Consumer• Healthcare Provider
– Healthcare Provider Individual– Healthcare Provider Organisation
Location
CLUSTER
constrains
Address
CLUSTER
constrains
Address Detailed
Address
CLUSTER
constrains
constrains
Electronic Contact
CLUSTER
constrains
Party Name
CLUSTER
constrains
constrains
Actor Name
constrains
Party Name
Person Name
constrains
Party
PARTY
constrains
Actor
PARTY: ACTOR
constrains
Party
constrains
Person
Partyconstrains
Actor
constrains
Organisation
Partyconstrains
Actor
constrains
Role
PARTY: ROLE
constrains
Party
constrains
Person Role
Partyconstrains
Role
constrains
Healthcare Consumer
Partyconstrains
Role
constrains
constrains
Person Role
Healthcare Provider
Partyconstrains
Role
constrains
Healthcare Provider Individual
Partyconstrains
Role
constrains
constrains
Healthcare Provider
Healthcare Provider Organisation
Partyconstrains
Role
constrains
constrains
Healthcare Provider
FUTURE WORK
Future Work
• Foundations– Reference model
• Documentation and implementation– Archetype object model
• Extensions to support terminology– Modelling patterns
• Documentation and terminology bindings• Add new patterns to support new models
– Style guides• Complete content
• Models– Laboratory Results models
• Add instances, specialisations and complete terminology bindings– Immunization models– Temperature and other priorities
• Implementation– Generate ADL 1.5 for all modelling patterns and models– Build modelling foundations in tooling infrastructure– Create associated tooling, including instance generation and visualisations– Create transformations to priority implementation formats
• Governance– Establish modelling development, review and publication processes and procedures
• CIMI Web Page– http://informatics.mayo.edu/CIMI
• Google doc repository– http://content.clinicalmodels.org
• Google groups email list (cimi-modelling-taskforce)– http://groups.google.com/group/cimi-modelling-taskforce
?hl=en-GB• Issue tracking (github)
– https://github.com/clinicalmodels/cimi/
Online References
QUESTIONS
