Health level seven version 3 0 and the reference information model
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Health Level Seven Version 3.0 and the Reference Information Model. V3 Methodology Mission. To bring modern software engineering practices, such as Object Oriented Analysis and Design and formal modeling, to the standards development process

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Health level seven version 3 0 and the reference information model

Health Level Seven Version 3.0

and the

Reference Information Model


V3 methodology mission

V3 Methodology Mission

  • To bring modern software engineering practices, such as Object Oriented Analysis and Design and formal modeling, to the standards development process

  • To bring the highest level of quality, understandability, and flexibility to a messaging standard

  • Incorporate concept abstractions and behavior modeling using roles in a rigorous set of work products

  • Express the standard in widely accepted UML notation


Version 3 goals

Version 3 Goals

  • Provide a framework for coupling events, data elements and messages

  • Improve clarity and precision of specification

  • Improve adaptability of standards to change

  • Begin to approach “plug and play”


Version 3 is a change to the hl7 architecture

Version 3 is a change to the HL7 Architecture

  • The HL7 2.x specifications have:

    • Segments that imply information entities

    • Events that indicate implied behaviors

    • Descriptive content that suggests use cases

    • but never formally documents these

  • Version 3 seeks to formalize this by applying object analytic methods and style

    • to improve the internal consistency of HL7

    • to provide sound semantic definitions

    • to enable future architectures

    • to produce an evolution not a revolution

    • Done by applying MODELING to the HL7 process


Description of the hl7 2 x standard

Description of the HL7 2.x Standard

  • The Application Protocol for Electronic Data Exchange in Healthcare Environments is an HL7 messaging standard that enables disparate healthcare applications to exchange data.

  • The standard provides the layout of messages that are exchanged between two or more applications based upon a particular trigger event.

  • A message is comprised of an ordered collection of segments.

  • A segment is an ordered collection of data elements that typically share a common subject.

  • The HL7 standard specifies which data elements are to be sent, the data type and suggested length of each, and indicates whether the data element is required or optional and whether it may repeat.

  • The message specification includes a declaration of the delimiters used to separate message segments, elements, and element components.


Hl7 version 3 0

HL7 Version 3.0

  • HL7 version 3.0 will be the most definitive HL7 standard to date, incorporating more trigger events and message formats with very little optionality.

  • Version 3.0 uses an object-oriented development methodology and a Reference Information Model (RIM) to create message specifications.

  • The RIM is an essential part of the HL7 Version 3.0 development methodology, as it provides an explicit representation of the semantic and lexical connections that exist between the information carried in the fields of HL7 messages.

  • As part of version 3.0, the HL7 Vocabulary Technical Committee is developing methods that will allow HL7 messages to draw upon codes and vocabularies from a variety of sources.

  • The V3.0 vocabulary work will assure that the systems sending and receiving V3.0 HL7 messages have an unambiguous understanding of the code sources and code value domains they are using.

  • HL7’s primary goal for version 3.0 is to offer a standard that is definite and testable, and to provide certification of vendor’s conformance.


History of hl7 v3 activities

History of HL7 V3 Activities

1996

Introduce modeling to TC Chairs

First V3 Tutorial to general membership

Vocabulary SIG established

1997

Roll-out of first RIM, version 0.80

First Message Development Framework

First RIM Harmonization meetings

1998

Adopted Rational Rose for modeling

Work begins on V3 XML ITS

First RoseTree tools appear

1999

V3 Data type proposal reviewed

Notion of R-MIM added to MDF

Vocabulary enters the V3 MDF

2000

V3 data types out to ballot

First vocabulary harmonization

V3 Acceleration Project started

2001 (projected)

XML and Datatype ballots complete

RIM and Vocabulary stabilized

Message specifications balloted


An hl7 version 3 x spec

An HL7 Version 3.X Spec

Chapter-Specific Specs

Message Model

Information Model

Use Case Model

Interaction Model

2-nd Order

1 choice of

0-n Drug

0-1 Nursing

HL7 Reference Model

Common Specs

*Future Consideration

Implementable Message Specification

XML/ER7/…

Implementable Message Specification

OLE/CORBA

Implementable Message Specification

EDIFACT*


Hl7 v3 message development lifecycle

HL7 V3 Message Development Lifecycle

C Code c Codea artb bluec color

Analysis

Design

Application

Messaging

Message Types

for use with

XML, ER7, etc

(MET)

Requirements

Analysis

Use Case

Model

(UCM)

Domain

Analysis

Information Model &Vocabulary

(RIM)

Interaction

Design

Interaction

Model

(IM)

Message

Design

HierarchicalMessageDescriptions

(HMD)

Documents

Document Types forHL7 PRA

(DTD)

Medical logic

Variable

definition for

Arden syntax

(AVD)

TYPE MPSLOC CONTAINS {

id[id].TYPE IID

nm[name].TYPE ST

ad[addr].TYPE XAD

ph[phon].TYPE XTN email_address [emlAdr].TYPE XTN

}

2-nd Order

1 choice of

0-n Drug

0-1 Nursing

<!ENTITY %DT_MPSLOC“MPSLOC.id, MPSLOC.name?, MPSLOC.addr?, MPSLOC.phon?, MPSLOC.emlAdr?">

data:location_of_action := READ LAST MPSLOC ;

‘ {patient location}

Reference Model Repository


Hl7 modeling

HL7 Modeling

Dispense Medications

Manage Care

Perform Lab Tests

Review Utilization

By demanding analysis of the requirements and information content, Version 3 assures consistency in and enhances the value of the resulting messages.

Encounter

Account

Provider

Patient

Order

HAL

HL7 message

HL7 message

Finance

ADT

Pharmacy

Abstractions:

Version 2.x focused its energies at the communication level and covered the other abstractions only loosely in the specifications.

Activities(Use Case Model)

Objects (Information Model)

Communication (Interaction and Message Models)


The reference information model rim

The Reference Information Model (RIM)

  • Expresses the information content for the collective work of the HL7 Working Group in UML notation.

  • A coherent, shared information model that is the source for the data content of all HL7 messages.

  • Maintained by a collaborative, consensus building process involving all Technical Committees and Special Interest Groups.

  • RIM change proposals are debated, enhanced, and reconciled by technical committee representatives and applied to the RIM during the model harmonization process


Information model components

Information Model Components

Subject Area

Subject Area: a major partition of a information model.

Class:something about which information is collected.

Relationship:an affiliation between twoclasses.

Attribute:information about a class.

Data Type:a specification of the formatof an attribute.

Class

Attribute :: Datatype

Attribute :: Datatype

Attribute :: Datatype

Attribute :: Datatype

Relationship

Class

Attribute :: Datatype

Attribute :: Datatype

Attribute :: Datatype

Attribute :: Datatype


Rim class diagram v1 00

RIM Class Diagram V1.00

HEALTH LEVEL 7

REFERENCE INFORMATION MODEL

RIM_0100

released January 2001 reflects RIM changes through

Harmonization on 11/17/2000

Enitites

Acts (Services)

Participation

Roles

0..*

0..*

Message_control

Act

has_as_participant

Entity

1

1

type_cd : CS

Act_relationship

Role

participates_in

id : SET<II>

tmr : IVL<TS>

id : SET<II>

is_played_by

plays_a_role

type_cd : CS

type_cd : cc

note_text : ED

mood_cd : CS

Entity_name

type_cd : CC

is_source_of

effective_tmr : IVL<TS>

inversion_ind : BL

0..*

0..*

signature_cd : CV

is_source_for

has_source

0..1

0..1

type_cd : CC

determiner_cd : CS

Role-role relationships

Appointments &

has

addr : SET<AD>

is_target_for

for

sequence_nbr : INT

effective_tmr : IVL<TS>

1

1

1

1

function_cd : CD

importance_status_txt : ED

txt : ED

scheduling

telecom : SET<TEL>

priority_nbr : INT

nm : EN

1

1

1

1

0..*

0..*

awareness_cd : CV

qty

status_cd : CS

is_for

0..*

0..*

purpose_cd : CV

has

pause_qty : PQ

signature_txt : ED

telecom : SET<TEL>

activity_time : GTS

checkpoint_cd : CS

encounter_accommodation_cd : CV

Healthcare_finances

desc

0..*

0..*

1

1

critical_time : GTS

is_target_for

split_cd : CS

Billboard produced by:

has_target

status_cd : CS

status_cd : CS

confidentiality_cd : SET<CV>

Rochester Outdoor Advertising

join_cd : CS

sends

1..1

1..1

1

1

max_repeat_nmr : IVL<INT>

0..*

0..*

negation_ind : BL

shall_receive

1..*

1..*

interruptible_ind : BL

conjunction_cd : CS

priority_cd : SET<CV>

orderable_ind : BL

originates_in_context_of

1..*

1..*

Military_person

availability_dttm : TS

Healthcare_provider

Notary_public

military_branch_of_service_cd : CV

specialty_cd : CV

military_rank_nm : ST

notary_county_cd : CE

military_status_cd : CV

notary_state_cd : CE

Place

gps_txt : ST

position_txt

addr : AD

Health_chart

directions_txt

1

1

Financial_act

0..*

0..*

provides_context_for

Individual_healthcare_practitioner

has_an_assessment_of

effective_tmr : IVL<TS>

fellowship_field_cd : CE

reason_cd : CE

Medication

Act_context

Living_subject

graduate_school_nm : ON

Working_list

status_dttm

form_cd : CD

level_cd

birth_dttm : TS

graduation_dttm : TS

ownership_level_cd

route_cd : CD

Patient_encounter

deceased_dttm : TS

board_certified_ind : BL

dose_qty : PQ

Material

deceased_ind : BL

discharge_disposition_cd : CV

strength_qty : PQ

is_assessed_against

administrative_gender_cd : CE

Organization

form_cd : CV

acuity_level_cd : CV

rate_qty : PQ

Referral

organ_donor_ind : BL

danger_cd : CE

0..*

0..*

org_nm : SET<ON>

birth_encounter_ind : BL

dose_check_qty : PQ

Supply

multiple_birth_ind : BL

effective_tmr : IVL<TS>

authorized_visits_qty : REAL

standard_industry_class_cd : CE

status_reason_cd : CV

Consent

Health_chart_deficiency

method_cd : SET<CV>

Healthcare_facility

handling_cd : CE

Healthcare_benefit_product_policy

qty : PQ

desc : ED

addr : SET<AD>

classification_cd : CV

body_site_cd : SET<CD>

Diagnostic_related_group_definition

assessment_dttm : TS

licensed_bed_nbr : REAL

reason_txt : ED

Patient_billing_account

assignment_of_benefits_ind : BL

encounter_classification_cd : CV

substitution_cd : CV

desc : ED

base_rate_qty : MO

mobile_ind : BL

benefit_product_desc : ED

adjustment_cd : CV

practice_setting_cd : CV

Healthcare_benefit_coverage_item

level_cd : CV

capital_reimbursement_qty : MO

benefit_product_nm : ST

certification_required_ind : BL

valuables_desc : ED

type_cd : CV

cost_weight_qty : MO

service_category_cd : CV

1

1

benefit_product_type_cd : CE

current_unpaid_balance_qty : MO

1

1

pre_admit_test_ind : BL

major_diagnostic_category_cd : CE

service_cd : CE

is_site_for

is_utilized_during

Transportation

benefits_coordination_ind : BL

expected_insurance_plan_qty : REAL

Procedure

1

1

Document_service

source_cd : CV

operating_reimbursement_qty : MO

0..*

0..*

service_modifier_cd : CE

utilizes

Role_relationship

cob_priority_nbr : REAL

expected_payment_source_cd : CV

Message_interaction

special_courtesies_cd : CV

entry_site_cd : SET<CD>

completion_cd : CV

0..*

0..*

reimbursement_qty : MO

authorization_ind : BL

has_parts

type_cd : CC

combine_baby_bill_ind : BL

notice_of_admission_dttm : TS

valuables_location_desc : ED

method_cd : SET<CV>

set_id : II

standard_day_qty : PQ

network_ind : BL

effective_tmr : IVL<TS>

notice_of_admission_ind : BL

group_benefit_ind : BL

effective_tmr

has_as_target

1

1

body_site_cd : SET<CD>

storage_cd : CV

0..1

0..1

standard_total_charge_qty : MO

assertion_cd : CE

id : SET<II>

uses

patient_financial_class_cd : CV

mail_claim_party_cd : CE

version_nbr : INT

Person

trim_high_day_qty : PQ

is_communicated_as

covered_parties_cd : CE

status_cd : CS

price_schedule_id : II

release_information_cd : CE

copy_dttm : TS

Non_Person_living_subject

trim_low_day_qty : PQ

disability_cd : CE

qty : REAL

is_authorized_by

responsibility_cd : SET<CE>

report_of_eligibility_dttm : TS

status_cd : CS

origination_dttm : TS

ethnic_group_cd : CE

taxonomic_classification_cd : CE

quantity_qualifier_cd : CE

is_part_of

position_nbr : LIST<INT>

coverage_type_cd : CE

retention_ind : BL

has_as_source

race_cd : CE

breed_cd : CE

1

1

time_period_qualifier_cd : CE

defines

qty : PQ

agreement_type_cd : CE

signature_on_file_dttm : TS

ambulatory_status_cd : CV

strain_txt : ED

0..*

0..*

0..*

0..*

range_low_qty : PQ

certificate_txt : ED

policy_category_cd : CE

special_program_cd : CV

birth_order_nbr : INT

Diet

euthanasia_ind : BL

is_defined_by

range_high_qty : PQ

Observation

access_protocol_desc : ED

stoploss_limit_ind : BL

0..*

0..*

education_level_cd : CV

production_class_cd : CE

energy_qty : PQ

range_units_cd : CV

value : ANY

suspend_charges_ind : BL

Encounter_drg

living_arrangement_cd : CV

gender_status_cd : CE

carbohydrate_qty : PQ

eligibility_cd : CE

derivation_expr : ST

Inpatient_encounter

total_adjustment_qty : MO

marital_status_cd : CV

approval_ind : BL

policy_source_cd : CE

method_cd : SET<CV>

total_charge_qty : MO

religious_affiliation_cd : CV

confidential_ind : BL

length_of_stay_qty : PQ

eligibility_source_cd : CE

body_site_cd : SET<CD>

student_cd : CV

total_payment_qty : MO

cost_outlier_qty : MO

copay_limit_ind : BL

credit_rating_cd : CV

Access

interpretation_cd : SET<CS>

separate_bill_ind : BL

desc : ED

Clinical_document_header

0..1

0..1

addr : SET<AD>

bad_debt_recovery_qty : MO

grouper_review_cd : CE

gauge_qty : PQ

availability_status_cd : CV

Specimen

Champus_coverage

special_accommodation_cd : SET<CV>

grouper_version_id : II

bad_debt_transfer_qty : MO

entry_site_cd : CD

change_reason_cd : CV

body_site_cd : CE

Manufactured_material

handicapped_program_cd : CE

outlier_days_nbr : REAL

completion_status_cd : CV

body_site_cd : CD

outlier_reimbursement_qty : MO

non_avail_cert_on_file_ind : BL

expiration_dttm : TS

confidentiality_status_cd : CV

Schedule

1

1

Public_health_case

outlier_type_cd : CV

retirement_dttm : TS

lot_nbr : ST

content_presentation_cd : CV

status_cd : CS

station_id : II

detection_method_cd

document_creation_dttm : TS

communicates_in

slot_size_increment_qty

transmission_mode_cd

file_nm : ST

disease_imported_cd

last_edit_dttm : TS

is_communicated_by

Financial_transaction

1

1

reporting_priority_cd : CE

manages

results_report_dttm : TS

extended_qty : MO

Practitioner_Certifier

Unmapped_financial_classes

storage_status_cd : CV

0..*

0..*

fee_schedule_cd : CE

board_certification_type_cd : CV

(from RIM_Healthcare_finances)

Employee_Employer

Person_Language

transcription_dttm : TS

insurance_qty : MO

certification_dttm : TS

document_change_cd : CV

Patient_Provider

posting_dttm : TS

addr : SET<AD>

recertification_dttm : TS

Outbreak

version_nbr : INT

hazard_exposure_txt : ED

qty : MO

1

1

residency_field_cd : CE

version_dttm : TS

tmr

job_class_cd : CV

transaction_batch_id : II

is_specified_by

job_title_nm : ST

unit_qty : MO

is_managed_by

telecom : SET<TEL>

unit_cost_qty : MO

0..*

0..*

Insurance_certification

0..*

0..*

1

1

has_coverage_affirmed_by

Billing_information_item

protective_equipment_txt : ED

Guarantor_contract

0..*

0..*

specifies_ability_in

Resource_slot

certification_duration_qty : PQ

salary_qty : MO

condition_cd : CE

billing_hold_ind : BL

Language_ability

effective_tmr : IVL<TS>

status_cd : CS

salary_type_cd : CV

occurrence_cd : CE

Preauthorization

Practitioner_provider

billing_media_cd : CE

affirms_insurance_coverage_for

mode_cd : CV

id : II

time_slot : GTS

status_cd : CS

occurrence_dttm : TS

charge_adjustment_cd : CE

authorized_encounters_qty : REAL

position_cd : CV

proficiency_level_cd : CV

insurance_verification_dttm : TS

job_cd : CE

Container

0..*

0..*

occurrence_span_cd : CE

contract_duration_cd : CE

authorized_period_begin_tmr : IVL<TS>

primary_care_ind : BL

modification_dttm : TS

occurrence_span_from_dttm : TS

capacty_qty : PQ

is_sited_at

contract_type_cd : CE

id : II

Device

Clinical_document

non_concur_cd : CE

occurrence_span_thru_dttm : TS

height_qty : PQ

effective_tmr : IVL<TS>

issued_dttm : TS

manufacturer_model_nm : ST

non_concur_effective_dttm : TS

quantity_nbr : REAL

diameter_qty : PQ

Encounter_facility_association

interest_rate_nbr : REAL

requested_dttm : TS

last_calibration_dttm : TS

0..1

0..1

penalty_qty : MO

quantity_type_cd : CV

barrier_delta_qty : PQ

effective_tmr : IVL<TS>

periodic_payment_qty : MO

restriction_desc : ED

software_nm : ST

report_of_eligibility_dttm : TS

value_amt

bottom_delta_qty : PQ

is_used_by

authorizes

status_cd : CS

priority_ranking_cd : CV

local_remote_control_state_cd : CE

status_cd : CS

value_cd : CE

report_of_eligibility_ind : BL

separator_type_cd : CD

transfer_reason_cd : CV

alert_level_cd : CE

status_change_dttm : TS

cap_type_cd : CD

0..*

0..*

  • 6Primary Subject Areas

  • 64 Classes

  • 348 Attributes

  • 73 Relationships

  • 45 Data types


Rim primary subject areas

RIM Primary Subject Areas

HEALTH LEVEL 7

REFERENCE INFORMATION MODEL

RIM_0100

released January 2001 reflects RIM changes through

Harmonization on 11/17/2000

Enitites

Acts (Services)

Participation

Roles

0..*

0..*

Message_control

Act

has_as_participant

Entity

1

1

type_cd : CS

Act_relationship

Role

participates_in

id : SET<II>

tmr : IVL<TS>

id : SET<II>

is_played_by

plays_a_role

type_cd : CS

type_cd : cc

note_text : ED

mood_cd : CS

Entity_name

type_cd : CC

is_source_of

effective_tmr : IVL<TS>

inversion_ind : BL

0..*

0..*

signature_cd : CV

is_source_for

has_source

0..1

0..1

type_cd : CC

determiner_cd : CS

Role-role relationships

Appointments &

has

addr : SET<AD>

is_target_for

for

sequence_nbr : INT

effective_tmr : IVL<TS>

1

1

1

1

function_cd : CD

importance_status_txt : ED

txt : ED

scheduling

telecom : SET<TEL>

priority_nbr : INT

nm : EN

1

1

1

1

0..*

0..*

awareness_cd : CV

qty

status_cd : CS

is_for

0..*

0..*

purpose_cd : CV

has

pause_qty : PQ

signature_txt : ED

telecom : SET<TEL>

activity_time : GTS

checkpoint_cd : CS

encounter_accommodation_cd : CV

Healthcare_finances

desc

0..*

0..*

1

1

critical_time : GTS

is_target_for

split_cd : CS

Billboard produced by:

has_target

status_cd : CS

status_cd : CS

confidentiality_cd : SET<CV>

Rochester Outdoor Advertising

join_cd : CS

sends

1..1

1..1

1

1

max_repeat_nmr : IVL<INT>

0..*

0..*

negation_ind : BL

shall_receive

1..*

1..*

interruptible_ind : BL

conjunction_cd : CS

priority_cd : SET<CV>

orderable_ind : BL

originates_in_context_of

1..*

1..*

Military_person

availability_dttm : TS

Healthcare_provider

Notary_public

military_branch_of_service_cd : CV

specialty_cd : CV

military_rank_nm : ST

notary_county_cd : CE

Act

Act

military_status_cd : CV

notary_state_cd : CE

Place

gps_txt : ST

position_txt

addr : AD

Health_chart

directions_txt

1

1

Financial_act

0..*

0..*

provides_context_for

Individual_healthcare_practitioner

has_an_assessment_of

effective_tmr : IVL<TS>

fellowship_field_cd : CE

reason_cd : CE

Medication

Act_context

Living_subject

graduate_school_nm : ON

Working_list

status_dttm

form_cd : CD

level_cd

birth_dttm : TS

graduation_dttm : TS

ownership_level_cd

route_cd : CD

Patient_encounter

deceased_dttm : TS

board_certified_ind : BL

dose_qty : PQ

Material

deceased_ind : BL

discharge_disposition_cd : CV

strength_qty : PQ

is_assessed_against

administrative_gender_cd : CE

Organization

form_cd : CV

acuity_level_cd : CV

rate_qty : PQ

Referral

organ_donor_ind : BL

danger_cd : CE

0..*

0..*

org_nm : SET<ON>

birth_encounter_ind : BL

dose_check_qty : PQ

Supply

multiple_birth_ind : BL

effective_tmr : IVL<TS>

authorized_visits_qty : REAL

standard_industry_class_cd : CE

status_reason_cd : CV

Consent

Health_chart_deficiency

method_cd : SET<CV>

Healthcare_facility

handling_cd : CE

Healthcare_benefit_product_policy

qty : PQ

desc : ED

addr : SET<AD>

classification_cd : CV

body_site_cd : SET<CD>

Diagnostic_related_group_definition

assessment_dttm : TS

licensed_bed_nbr : REAL

reason_txt : ED

Patient_billing_account

assignment_of_benefits_ind : BL

encounter_classification_cd : CV

substitution_cd : CV

desc : ED

base_rate_qty : MO

mobile_ind : BL

benefit_product_desc : ED

adjustment_cd : CV

practice_setting_cd : CV

Healthcare_benefit_coverage_item

level_cd : CV

capital_reimbursement_qty : MO

benefit_product_nm : ST

certification_required_ind : BL

valuables_desc : ED

type_cd : CV

cost_weight_qty : MO

service_category_cd : CV

1

1

benefit_product_type_cd : CE

current_unpaid_balance_qty : MO

1

1

pre_admit_test_ind : BL

major_diagnostic_category_cd : CE

service_cd : CE

is_site_for

is_utilized_during

Transportation

benefits_coordination_ind : BL

expected_insurance_plan_qty : REAL

Procedure

1

1

Document_service

source_cd : CV

operating_reimbursement_qty : MO

0..*

0..*

service_modifier_cd : CE

utilizes

Role_relationship

cob_priority_nbr : REAL

expected_payment_source_cd : CV

Message_interaction

special_courtesies_cd : CV

entry_site_cd : SET<CD>

completion_cd : CV

0..*

0..*

reimbursement_qty : MO

authorization_ind : BL

has_parts

type_cd : CC

combine_baby_bill_ind : BL

notice_of_admission_dttm : TS

valuables_location_desc : ED

method_cd : SET<CV>

set_id : II

standard_day_qty : PQ

network_ind : BL

effective_tmr : IVL<TS>

notice_of_admission_ind : BL

group_benefit_ind : BL

effective_tmr

has_as_target

1

1

body_site_cd : SET<CD>

storage_cd : CV

0..1

0..1

standard_total_charge_qty : MO

assertion_cd : CE

id : SET<II>

uses

patient_financial_class_cd : CV

mail_claim_party_cd : CE

version_nbr : INT

Person

trim_high_day_qty : PQ

is_communicated_as

covered_parties_cd : CE

status_cd : CS

price_schedule_id : II

release_information_cd : CE

copy_dttm : TS

Non_Person_living_subject

trim_low_day_qty : PQ

disability_cd : CE

qty : REAL

is_authorized_by

responsibility_cd : SET<CE>

report_of_eligibility_dttm : TS

status_cd : CS

origination_dttm : TS

ethnic_group_cd : CE

taxonomic_classification_cd : CE

quantity_qualifier_cd : CE

is_part_of

position_nbr : LIST<INT>

coverage_type_cd : CE

retention_ind : BL

has_as_source

race_cd : CE

breed_cd : CE

1

1

time_period_qualifier_cd : CE

defines

qty : PQ

agreement_type_cd : CE

signature_on_file_dttm : TS

ambulatory_status_cd : CV

strain_txt : ED

0..*

0..*

0..*

0..*

range_low_qty : PQ

certificate_txt : ED

policy_category_cd : CE

special_program_cd : CV

birth_order_nbr : INT

Diet

euthanasia_ind : BL

is_defined_by

range_high_qty : PQ

Observation

access_protocol_desc : ED

stoploss_limit_ind : BL

0..*

0..*

education_level_cd : CV

production_class_cd : CE

energy_qty : PQ

range_units_cd : CV

value : ANY

suspend_charges_ind : BL

Encounter_drg

living_arrangement_cd : CV

gender_status_cd : CE

carbohydrate_qty : PQ

eligibility_cd : CE

derivation_expr : ST

Inpatient_encounter

total_adjustment_qty : MO

marital_status_cd : CV

approval_ind : BL

policy_source_cd : CE

method_cd : SET<CV>

total_charge_qty : MO

religious_affiliation_cd : CV

confidential_ind : BL

length_of_stay_qty : PQ

eligibility_source_cd : CE

body_site_cd : SET<CD>

student_cd : CV

total_payment_qty : MO

cost_outlier_qty : MO

copay_limit_ind : BL

credit_rating_cd : CV

Access

interpretation_cd : SET<CS>

separate_bill_ind : BL

desc : ED

Clinical_document_header

0..1

0..1

addr : SET<AD>

bad_debt_recovery_qty : MO

grouper_review_cd : CE

gauge_qty : PQ

availability_status_cd : CV

Specimen

Champus_coverage

special_accommodation_cd : SET<CV>

grouper_version_id : II

bad_debt_transfer_qty : MO

entry_site_cd : CD

change_reason_cd : CV

body_site_cd : CE

Manufactured_material

handicapped_program_cd : CE

outlier_days_nbr : REAL

completion_status_cd : CV

body_site_cd : CD

outlier_reimbursement_qty : MO

non_avail_cert_on_file_ind : BL

expiration_dttm : TS

confidentiality_status_cd : CV

Schedule

1

1

Public_health_case

outlier_type_cd : CV

retirement_dttm : TS

lot_nbr : ST

content_presentation_cd : CV

status_cd : CS

station_id : II

detection_method_cd

document_creation_dttm : TS

communicates_in

slot_size_increment_qty

transmission_mode_cd

file_nm : ST

disease_imported_cd

last_edit_dttm : TS

is_communicated_by

Financial_transaction

1

1

reporting_priority_cd : CE

manages

results_report_dttm : TS

extended_qty : MO

Practitioner_Certifier

Unmapped_financial_classes

storage_status_cd : CV

0..*

0..*

fee_schedule_cd : CE

board_certification_type_cd : CV

(from RIM_Healthcare_finances)

Employee_Employer

Person_Language

transcription_dttm : TS

insurance_qty : MO

certification_dttm : TS

document_change_cd : CV

Patient_Provider

posting_dttm : TS

addr : SET<AD>

recertification_dttm : TS

Outbreak

version_nbr : INT

hazard_exposure_txt : ED

qty : MO

1

1

residency_field_cd : CE

version_dttm : TS

tmr

job_class_cd : CV

transaction_batch_id : II

is_specified_by

job_title_nm : ST

unit_qty : MO

is_managed_by

telecom : SET<TEL>

unit_cost_qty : MO

0..*

0..*

Insurance_certification

0..*

0..*

1

1

has_coverage_affirmed_by

Billing_information_item

protective_equipment_txt : ED

Guarantor_contract

0..*

0..*

specifies_ability_in

Resource_slot

certification_duration_qty : PQ

salary_qty : MO

condition_cd : CE

billing_hold_ind : BL

Language_ability

effective_tmr : IVL<TS>

status_cd : CS

salary_type_cd : CV

occurrence_cd : CE

Preauthorization

Practitioner_provider

billing_media_cd : CE

affirms_insurance_coverage_for

mode_cd : CV

id : II

time_slot : GTS

status_cd : CS

occurrence_dttm : TS

charge_adjustment_cd : CE

authorized_encounters_qty : REAL

position_cd : CV

proficiency_level_cd : CV

insurance_verification_dttm : TS

job_cd : CE

Container

0..*

0..*

occurrence_span_cd : CE

contract_duration_cd : CE

authorized_period_begin_tmr : IVL<TS>

primary_care_ind : BL

modification_dttm : TS

occurrence_span_from_dttm : TS

capacty_qty : PQ

is_sited_at

contract_type_cd : CE

id : II

Device

Clinical_document

non_concur_cd : CE

occurrence_span_thru_dttm : TS

height_qty : PQ

effective_tmr : IVL<TS>

issued_dttm : TS

manufacturer_model_nm : ST

non_concur_effective_dttm : TS

quantity_nbr : REAL

diameter_qty : PQ

Encounter_facility_association

interest_rate_nbr : REAL

requested_dttm : TS

last_calibration_dttm : TS

0..1

0..1

penalty_qty : MO

quantity_type_cd : CV

barrier_delta_qty : PQ

effective_tmr : IVL<TS>

periodic_payment_qty : MO

restriction_desc : ED

software_nm : ST

report_of_eligibility_dttm : TS

value_amt

bottom_delta_qty : PQ

is_used_by

authorizes

status_cd : CS

priority_ranking_cd : CV

local_remote_control_state_cd : CE

status_cd : CS

value_cd : CE

report_of_eligibility_ind : BL

separator_type_cd : CD

transfer_reason_cd : CV

alert_level_cd : CE

status_change_dttm : TS

cap_type_cd : CD

0..*

0..*

Entity

Entity

Role

Role

Participation

Participation

Act

Relationship

Act

Relationship

Role

Relationship

Role

Relationship


Rim core classes

RIM Core Classes

Role Relationship

Act Relationship

0..1

0..1

0..1

0..1

0..*

0..*

0..*

0..*

1

1

0..*

0..*

Role

Entity

Participation

Act

1

0..*


Rim core attributes

RIM Core Attributes

0..1

0..1

0..1

0..1

0..*

0..*

0..*

0..*

1

1

0..*

0..*

Role Relationship

Act Relationship

Type_CD : CS

Effective_TMR : IVL<TS>

Status_CD : CS

Type_CD : CS

Entity

Role

Participation

Act

Type_CD : CC

Determiner_CD : CS

Status_CD : CS

Type_CD : CS

Effective_TMR : IVL<TS>

Type_CD : CS

TMR : IVL<TS>

Status_CD : CS

Type_CD : CC

Mood_CD : CS

Status_CD : CS

Activity_Time : GTS

1

0..*


Rim core attribute value sets

RIM Core Attribute Value Sets

  • Observation

  • Procedure

  • Supply

  • Medication

  • Financial

  • ...

  • Patient

  • Provider

  • Guarantor

  • Specimen

  • Home

  • ...

  • Living Subject

  • Person

  • Organization

  • Material

  • Place

  • ...

  • Performer

  • Author

  • Witness

  • Beneficiary

  • Destination

  • ...

Act

Type Code

Role

Type Code

Entity

Type Code

Participation

Type Code

1

1

0..*

0..*

  • Definition

  • Intent

  • Order

  • Event

  • Criterion

  • ...

  • Class

  • Instance

  • QualifiedGroup

Entity

Determiner

Code

Act

Mood Code

Entity

Role

Participation

Act

Type_CD : CC

Determiner_CD : CS

Status_CD : CS

Type_CD : CS

Effective_TMR : IVL<TS>

Type_CD : CS

TMR : IVL<TS>

Status_CD : CS

Type_CD : CC

Mood_CD : CS

Status_CD : CS

Activity_Time : GTS

1

0..*


Vocabulary domains and codes

Vocabulary Domains and Codes

  • Coded attributes in the RIM must be associated with one and only one Vocabulary Domain prior to being used in a message specification.

  • A vocabulary domain is “The set of all concepts that can be taken as valid values in an instance of a coded field or attribute.”

  • Each concept in the vocabulary domain is represented using a code from a specific vocabulary.

  • A vocabulary is a defined set of coded concepts.

  • A vocabulary may be specified as an enumerated list of coded concepts (HL7 defined) or as a reference to an externally maintained list of coded concepts (e.g., SNOMED, LOINC, CPT, . . .).


Vocabulary domain specification

Vocabulary Domain Specification


Vocabulary codes definitions

Vocabulary Codes & Definitions


Rim implementation

RIM Implementation

RIMReference Information Model

RIM

  • Select a subset of the RIM classes

  • Select a subset of class relationships

  • Select a subset of class attributes

  • Select a subset of attribute datatypes

  • Select a subset of attribute domains and value sets

(1)

Define a

MIM

MIM

Message Information Model

MIM

  • Created clones of classes and attributes

  • Assign alias class and attribute names

  • Eliminate unnecessary class hierarchies

  • Finalize class relationships and multiplicity

  • Finalize attribute domains and value sets

(2)Define a

R-MIM

R-MIM

Refined Message Information Model

R-MIM

  • Select a root class for the message

  • Arrange classes and attributes hierarchically

  • Declare inclusion and repetition constraints

  • Declare domain value constraints

  • Assign message element names

(3)

Create

an HMD

HMD

Hierarchical Message Definition

HMD


Hierarchical message definition

Hierarchical Message Definition


Hmd components

HMD Components

  • The Information Model Mapping. The columns that are in this section describe classes and attributes of the R-MIM, organized in a sequence that describes a "walk" from class to class on the R-MIM.

  • The Message Elements. The columns in this section describe the message elements and define the Message Element Types. The message elements compose a hierarchy. This hierarchy is illustrated by indentation in the column Message Element Name.

  • General constraints and defaults. Describe specific constraints and defaults for the message element defined in the row. The columns are the same as the corresponding section of the R-MIM. The values in the columns may be the same or may be a more restrictive constraint.


Message specification

Message Specification

Reference Information Model

Use Case Model

Interaction Model

Message Information Model

Hierarchical Message Description

Refined

Message

Information Model


Additional questions

Additional Questions


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