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US Standards for Health Record Systems. James J. Cimino, M.D. Columbia University, New York For the Health Information Management Systems Society (HIMSS). The Need for Standards. Patient Safety Quality of Care Cost Effectiveness Patient Involvement Performance Evaluation Research

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Us standards for health record systems

US Standards for Health Record Systems

James J. Cimino, M.D.

Columbia University, New York

For the Health Information Management Systems Society (HIMSS)


The need for standards

The Need for Standards

  • Patient Safety

  • Quality of Care

  • Cost Effectiveness

  • Patient Involvement

  • Performance Evaluation

  • Research

  • Health Surveillance

  • Disaster Response


Current state of standards

Current State of Standards

  • Reporting – mandatory, intrusive

  • Terminology – incomplete, not mandatory

  • Messaging – incomplete, not mandatory

  • Integration – not at all


A look at some us efforts

A Look at Some US Efforts

  • Bottom-Up: Health Level 7 (HL7)

  • Top-Down: Integrating the Healthcare Enterprise (IHE)


Bottom up health level 7 hl7

Bottom-Up: Health Level 7 (HL7)

  • Need for information exchange standard

  • Message is the unit of information

  • One actor tells another actor about an event

  • Began in 1986 with 14 members, now with 2000 members and worldwide chapters


Hl7 version 2 message

HL7 Version 2 Message

MSH|^~\&|MENDONC|UPLAB|CICSU9|20000209025800||ORU|0000000001|P|2.1|||

PID|||3131313||SANDIEGO^CARMEN|||F|||||||||||||

OBR|||M09000HABC0000^1|59058^TROPONINI^L^32506|||20000209025800|||||||20000209025800|^|NOR||||||||HE|F||^^^^^R|^^|||||||||

OBX|1|NM|59058^TROPONIN I^MED|0|0.1|ng/ml|0-0.4|||||||||||||||


Us standards for health record systems

Patient

ambulatory_status_cd

birth_order_amt

living_arrangement_cd

1

living_dependency_cd

multiple_birth_ind

Person

newborn_baby_ind

birth_dttm

birthplace_addr

citizenship_country_cd

confidentiality_constraint_cd

deceased_dttm

deceased_ind

disability_cd

organ_donor_ind

education_level_cd

ethnic_group_cd

1

gender_cd

language_cd

marital_status_cd

military_branch_of_service_cd

military_rank_nm

preferred_pharmacy_id

military_status_cd

nationality_cd

primary_name_representation_cd

primary_name_type_cd

primary_nm

race_cd

religious_affiliation_cd

takes_on_role_of

student_cd

very_important_person_cd

is_a_role_of

0..1

Reference Information Model for HL7 Version 3 (RIM)


Us standards for health record systems

Person

birth_dttm

birthplace_addr

citizenship_country_cd

confidentiality_constraint_cd

deceased_dttm

deceased_ind

disability_cd

education_level_cd

Patient

ambulatory_status_cd

ethnic_group_cd

birth_order_amt

gender_cd

living_arrangement_cd

language_cd

1

living_dependency_cd

marital_status_cd

multiple_birth_ind

military_branch_of_service_cd

newborn_baby_ind

military_rank_nm

organ_donor_ind

military_status_cd

preferred_pharmacy_id

nationality_cd

1

1

is_a_role_of

takes_on_role_of

primary_name_representation_cd

primary_name_type_cd

0..1

primary_nm

race_cd

religious_affiliation_cd

student_cd

very_important_person_cd

Reference Information Model for HL7 Version 3 (RIM)

1

1


Us standards for health record systems

HEALTH LEVEL 7

REFERENCE INFORMATION MODEL

RIM_0088

Master_service

released January, 1999

allowable_processing_priority_cd

has_as_participant

0..*

0..*

Producer_of_master_service

0..*

0..*

produces

is_produced_by

0..1

0..1

service_producing_department_type_cd

Financial_transaction

allowable_reporting_priority_cd

reflects agreements made through harmonization in November, 1998

alternate_desc

billing_reference_txt

is_categorized_by

desc

0..*

0..*

challenge_information_txt

extended_amt

1

1

confidentiality_cd

is_requested_by

Healthcare_finances

Healthcare_finances

Master_tables

Healthcare_finances

fee_schedule_cd

0..*

0..*

is_associated_with

effective_dt

insurance_amt

factors_that_may_affect_observation_desc

posting_dt

fee_amt

Patient_encounters

Healthcare_finances

Healthcare_stakeholders

Healthcare_finances

qty

fixed_canned_message_cd

0..*

0..*

pertains_to

1

1

transaction_batch_id

is_target

imaging_measurement_modality_cd

is_entered_by

transaction_cd

incompatible_change_dttm

has_target

0..*

0..*

transaction_dt

Authentication

0..*

0..*

instrument_identifier_coding_system_nm

0..*

0..*

is_related_to

authentication_dt

transaction_id

Master_service_relationship

instrument_identifier_nm

1

1

0..*

0..*

Clinical_document_header

type_cd

relationship_type_cd

transaction_type_cd

0..*

0..*

documents

authentication_dt

interpretation_considerations_desc

is_related_to

is_related_to

is_associated_with

reflex_testing_trigger_rules_desc

unit_amt

availability_status_cd

kind_of_quantity_observed_cd

constraint_txt

0..*

0..*

unit_cost_amt

change_reason_cd

last_update_dttm

0..*

0..*

quantitytiming_qt

1..*

1..*

is_covered_by

is_related_to

completion_status_cd

method_cd

Resource_request

is_related_to

allowable_substitutions_cd

confidentiality_status_cd

method_desc

duration_qty

1

1

content_presentation_cd

nature_of_service_cd

Healthcare_document_authenticator

has_source

0..*

0..*

Appointment_request

is_the_purchaser_of

1

1

start_dttm

document_header_creation_dt

observation_id_suffix_txt

appointment_rqst_reason_cd

is_source

1

1

Health_benefit_plan_purchaser

is_requested_by

1

1

0..*

0..*

requests

start_offset_qty

file_nm

orderable_service_ind

has_as_a_contact

Patient_information_disclosure

appointment_rqst_type_cd

0..1

0..1

is_a

0..1

0..1

disclosure_dttm

status_cd

id

patient_preparation_desc

equip_selection_criteria_pv

0..1

0..1

info_disclosed_desc

of

has_been_originated_by

0..*

0..*

0..1

0..1

last_edit_dt

point_versus_interval_cd

Originator

id

is_delivered_during

info_requested_desc

is_a_role_of

origination_dt

1

1

portable_device_ind

location_selection_criteria_pv

reason_cd

reporting_priority_cd

preferred_ordering_method_txt

pertains_to

occurence_id

is_a

0..1

0..1

requested_dttm

results_report_dttm

Stakeholder_identifier

requests

preferred_scheduling_method_txt

1

1

1

1

is_instantiated_as

priority_cd

effective_dt

0..*

0..*

urgency_cd

storage_status_cd

procedure_medication_cd

repeating_interval_duration_qty

is_issued_by

id

Document_recipient

of

transcription_dt

0..1

0..1

has_been_received_by

0..*

0..*

report_display_order_txt

requested_ri

identifier_type_cd

requests

0..*

0..*

type_cd

is_requested_by

required_credentials_desc

rqst_event_reason_cd

issued_dt

1..*

1..*

0..*

0..*

0..*

0..*

service_alternate_id

is_transcribed_by

0..*

0..*

0..1

0..1

rqsted_duration_qty

is_a

0..1

0..1

qualifying_information_txt

Durable_medical_equipment_request

Patient_appointment_request

Patient_service_location_request

service_alternate_identifier_coding_system_nm

Individual_healthcare_practitioner_request

start_dt

Service_scheduling_request

quantity_amt

type_cd

is_provided_to

termination_dt

practitioner_type_cd

is_parent_document_for

0..*

0..*

allowable_substitutions_cd

service_alternate_identifier_nm

time_selection_criteria_pv

type_cd

0..*

0..*

duration_qty

service_alternate_name_use_cd

0..*

0..*

transcribes

may_be_contained_in

issues

1

1

requests

start_dttm

service_alternate_nm

0..1

0..1

Master_specimen_requirement

0..*

0..*

0..*

0..*

0..*

0..*

0..*

0..*

additive_cd

0..*

0..*

start_offset_qty

service_contraindication_cd

Identifier_issuing_authority

0..*

0..*

requests

is_assigned_to

Transcriptionist

0..*

0..*

requests

effective_dt

may_request

container_desc

may_request

status_cd

service_desc

has_as_a_parent_document

may_request

requests

termination_dt

1

1

takes_on_role_of

container_preparation_desc

service_performance_schedule_cd

Stakeholder

addr

container_volume_amt

0..1

0..1

is_requested_by

service_primary_nm

takes_on_role_of

1

1

credit_rating_cd

derived_specimen_cd

is_assigned

1

1

is_identified_as

1

1

is_the_recipient_of

0..1

0..1

service_requirement_desc

may_act_as_a

1

1

email_address_txt

is_a_role_of

0..1

0..1

minimum_collection_volume_amt

service_type_cd

is_a_role_of

0..1

0..1

Patient_information_recipient

Individual_healthcare_practitioner_group

1

1

takes_on_role_of

takes_on_role_of

1

1

Stakeholder_affiliation

phon

normal_collection_volume_amt

id

1

1

standard_time_to_perform_dttm

is_requested_by

affiliation_type_cd

Durable_medical_equipment

type_cd

id

1

1

takes_on_role_of

special_handling_desc

target_anatomic_site_cd

desc

participates_as_primary_in

1

1

0..*

0..*

has_as_primary_participant

slot_size_increment_qty

specimen_priorities_cd

target_of_service_cd

effective_dt

belongs_to

0..1

0..1

1..*

1..*

participates_in

type_cd

specimen_retention_time_amt

1

1

contains

takes_on_role_of

0..*

0..*

universal_service_id

termination_dt

0..*

0..*

refers_to_person_by

specimen_type_cd

is_used_by

universal_service_identifier_coding_system_nm

0..*

0..*

is_requested_by

0..1

0..1

contains

takes_on_role_of

1

1

1

1

collects

Resource_slot

0..*

0..*

universal_service_identifier_nm

offset_qty

is_a_role_of

0..1

0..1

Durable_medical_equipment_group

takes_on_role_of

1

1

1

1

1

1

takes_on_role_of

quantitytiming_qt

id

quantity_amt

Person_alternate_name

0..*

0..*

effective_dt

is_scheduled_by

is_specified_for

Service_intent_or_order_relationship

Accident_information_source

0..*

0..*

join_cd

resource_type_cd

relationship_type_cd

has_as_secondary_participant

cd

slot_state_cd

reflex_testing_trigger_rules_desc

nm

start_dttm

0..1

0..1

constraint_txt

0..*

0..*

is_reserved_by

reason_cd

Master_numeric_range

has_as_target

0..*

0..*

Stakeholder_affiliate

quantitytiming_qt

is_the_source_of

range_type_cd

Health_chart

0..*

0..*

is_managed_by

termination_dt

family_relationship_cd

health_chart_id

is_a_role_of

is_ordered_on

0..*

0..*

belongs_to

condition_desc

participates_as_secondary_in

1

1

type_cd

health_chart_type_cd

high_range_amt

0..1

0..1

0..1

0..1

status_cd

contains

0..1

0..1

high_gestation_age_amt

Master_treatment_service

0..*

0..*

0..*

0..*

is_housed_at

Master_observation_service

has_as_source

is_an_instance_of

contains

1

1

dea_level_cd

high_value_amt

instrument_id

0..*

0..*

is_for

1

1

drug_category_cd

is_target_for

low_age_amt

permitted_data_type_cd

0..*

0..*

Schedule

Durable_medical_equipment_slot

Individual_healthcare_practitioner_slot

has

takes_on_

1

1

Patient_slot

Patient_service_location_slot

contains

id

1

1

formulary_status_cd

low_gestation_age_amt

processing_time_qty

0..1

0..1

categorizes

role_of

Service_intent_or_order

Health_chart_deficiency

has_an_assessment_of

Organization

0..*

0..*

medication_form_cd

low_value_amt

specimen_required_ind

charge_type_cd

1..*

1..*

is_basis_for

assessment_dt

0..*

0..*

0..*

0..*

0..*

0..*

organization_name_type_cd

1

1

takes_on_role_of

Employer

1

1

0..*

0..*

pharmaceutical_class_cd

1

1

race_subspecies_txt

typical_turnaround_time_qty

clarification_phon

is_a_scheduleable_unit_for

desc

effective_dt

organization_nm

is_a_scheduleable_unit_for

is_a_scheduleable_unit_for

0..1

0..1

is_a_role_of

1

1

assigns

0..*

0..*

applies_to

is_a_scheduleable_unit_for

route_cd

sex_txt

end_condition_cd

level_cd

termination_dt

standard_industry_class_cd

0..*

0..*

has_as_a_contact

is_source_for

1

1

takes_on_role_of

therapeutic_class_cd

species_txt

entering_device_cd

type_cd

1

1

is_employer_of

0..1

0..1

is_assessed_against

0..*

0..*

escort_required_ind

0..*

0..*

expected_performance_time_qty

takes_on_role_of

1

1

has_as_basis

0..1

0..1

filler_order_id

is_a_contact_for

0..*

0..*

has_as_a_subdivision

filler_txt

is_a_contact_for

0..*

0..*

Contact_person

is_a_contact_for

0..*

0..*

is_a_subdivision_of

conforms_to

order_control_cd

contact_reason_cd

1

1

involves

1

1

participates_in

Appointment_contact_person

participates_in

order_control_reason_cd

role_cd

is_a_contact_for

0..*

0..*

Master_continuous_observation

0..1

0..1

is_a_role_of

0..*

0..*

Master_categorical_observation

Master_calculated_observation

order_effective_dttm

corresponding_SI_unit_of_measure_cd

may_act_in_

0..*

0..*

abnormal_result_cd

derivation_rule_desc

order_group_id

customary_unit_of_measure

is_a_contact_for

0..*

0..*

the_role_of

allowed_value_type_cd

order_id

delta_check_numeric_change_computation_method_txt

critical_result_cd

1

1

1

1

has

order_placed_dttm

delta_check_numeric_change_threshold_amt

has_as_

normal_result_cd

Person

order_quantitytiming_qt

delta_check_numeric_high_value_amt

employer

Person_employment

birth_dttm

preferred_coding_system_cd

Administrative_birth_event

pertains_to

addr

1

1

has

placer_order_id

delta_check_numeric_low_value_amt

baby_detained_ind

birthplace_addr

valid_answer_cd

has_as_participant

0..*

0..*

effective_dt

placer_txt

delta_check_numeric_retention_days_qty

birth_certificate_id

citizenship_country_cd

0..*

0..*

0..1

0..1

hazard_exposure_txt

Notary_public

planned_patient_transport_cd

Administrative_patient_death

length_and_decimal_precision_amt

birth_method_cd

confidentiality_constraint_cd

effective_dt

death_certificate_id

Active_participation

is_a_role_of

0..1

0..1

job_class_cd

report_results_to_phon

minimum_meaningful_increment_amt

birth_recorded_county_cd

begin_dttm

deceased_dttm

notary_county_cd

death_certificate_recorded_dt

job_title_nm

response_requested_cd

si_conversion_factor_txt

birth_recorded_dt

Guarantor

end_dttm

deceased_ind

notary_state_cd

death_classification_cd

financial_class_cd

phon

has

service_body_site_cd

1

1

newborn_days_qty

duration_tm

disability_cd

termination_dt

has_as_a

has_as_a_contact

guarantees_

death_dttm

0..*

0..*

is_billed_to

household_annual_income_amt

protective_equipment_txt

service_body_site_modifier_cd

stillborn_ind

participation_type_cd

education_level_cd

Patient

has_as_participant

0..1

0..1

_contact

issues

payment_under

death_location_nm

household_size_qty

0..1

0..1

salary_amt

ambulatory_status_cd

service_body_source_cd

1

1

1

1

takes_on_role_of

ethnic_group_cd

has

1

1

death_notification_source_nm

0..1

0..1

0..*

0..*

salary_type_cd

participates_in

target_of_service_cd

birth_order_amt

1

1

gender_cd

0..*

0..*

is_part_of

is_a_role_of

is_scheduled_by

0..1

0..1

1

1

death_verification_cd

status_cd

transport_arranged_ind

living_arrangement_cd

Insurer

language_cd

0..*

0..*

may_be_referred_to_in

participates_in

0..1

0..1

death_verification_dt

1

1

is_requested_by

effective_dt

termination_dt

has_as_

0..1

0..1

transport_arrangement_responsibility_cd

living_dependency_cd

marital_status_cd

death_verification_nm

termination_dt

occupation_cd

1

1

a_contact

takes_on_role_of

transport_mode_cd

enters

multiple_birth_ind

1

1

0..*

0..*

is_entered_at

military_branch_of_service_cd

is_a_role_of

0..1

0..1

job_status_cd

when_to_charge_dttm

newborn_baby_ind

military_rank_nm

0..1

0..1

has_as_target

organ_donor_ind

when_to_charge_txt

military_status_cd

0..1

0..1

pertains_to

has_as_employee

issues

0..*

0..*

1

1

1

1

has

1

1

preferred_pharmacy_id

results_status_cd

is_fulfilled_by

0..1

0..1

nationality_cd

0..1

0..1

is_a_contact_for

is_target_of

offers

1..*

1..*

0..1

0..1

Insurance_certification_contact

intent_or_order_cd

1

1

0..1

0..1

is_a_role_of

takes_on_role_of

participation_type_cd

primary_name_representation_cd

is_a_role_of

has_as_target

join_cd

is_employee_in

0..1

0..1

has_as_reason

0..*

0..*

1

1

is_issued_by

1

1

has_as_a_contact

primary_name_type_cd

has

1

1

1

1

is_a_role_of

takes_on_role_of

0..*

0..*

primary_nm

Billing_information_item

pertains_to

Employee

0..*

0..*

Insurance_certification

Episode

participates_in

1

1

condition_cd

appeal_reason_cd

0..1

0..1

desc

race_cd

Target_participation

1

1

occurrence_cd

has

begin_dttm

1

1

certification_day_qty

has_payment_

has

episode_type_cd

religious_affiliation_cd

has_as_target

0..*

0..*

occurrence_dt

end_dttm

effective_dt

guaranteed_by

1..*

1..*

is_target_of

id

student_cd

1

1

has

is_source_for

0..1

0..1

occurrence_span_cd

Guarantor_contract

duration_tm

id

is_issued_by

list_closed_ind

very_important_person_cd

0..*

0..*

1..*

1..*

billing_hold_ind

has_as_target

0..*

0..*

Patient_billing_account

is_involved_in

occurrence_span_from_dt

participation_type_cd

1

1

0..*

0..*

insurance_verification_dttm

0..*

0..*

affirms_insurance_coverage_for

has_as_primary_facility

outcome_txt

account_id

0..1

0..1

billing_media_cd

specfies

Preauthorization

occurrence_span_thru_dt

modification_dttm

authorized_encounters_amt

recurring_service_ind

adjustment_cd

charge_adjustment_cd

Administrative_patient_accident

has_coverage_affirmed_by

Observation_intent_or_order

1

1

Referral

has_a_primary_provider

quantity_amt

0..*

0..*

Dietary_intent_or_order

accident_death_ind

Treatment_intent_or_order

non_concur_cd

0..*

0..*

patient_hazard_cd

provides_validation_for

authorized_visits_qty

authorized_period_begin_dt

1

1

authorization_information_txt

contract_duration_cd

diet_type_cd

takes_on_role_of

dosage_txt

quantity_type_cd

accident_desc

non_concur_effective_dttm

is_target_of

reason_for_study_cd

desc

authorized_period_end_dt

0..*

0..*

billing_status_cd

contract_type_cd

dietary_instruction_desc

earliest_dispense_dt

value_amt

has

1

1

accident_dttm

penalty_amt

relevant_clinical_information_txt

reason_txt

id

certification_required_ind

effective_dt

dietary_tray_type_cd

Indication_cd

is_validated_by

1

1

1

1

value_cd

accident_location_desc

reporting_priority_cd

termination_dt

issued_dttm

is_obtained_from

0..*

0..*

current_unpaid_balance_amt

interest_rate_amt

service_period_cd

has_parts

non_form_authorized_ind

has_parts

accident_state_cd

Healthcare_benefit_product

0..*

0..*

specimen_action_cd

report_of_eligibility_dt

fulfills

requested_dttm

delete_dt

periodic_payment_amt

service_type_cd

providers_treatment_instruction_txt

assignment_of_benefits_ind

authorizes

0..1

0..1

0..1

0..1

Disability

accident_type_cd

has_as_target

1

1

has

report_of_eligibility_ind

restriction_desc

deleted_account_reason_cd

priority_ranking_cd

effective_dt

Service_event

1

1

rejection_reason_cd

benefit_product_desc

job_related_accident_ind

orders

0..*

0..*

attestation_dttm

status_cd

0..*

0..*

expected_insurance_plan_qty

0..1

0..1

termination_dt

pertains_to

has_as_active_participant

0..*

0..*

return_to_work_auth_dt

pertains_to

has_payment_guaranteed_by

requested_give_rate_amt

is_part_of

id

0..*

0..*

assessment_dttm

attestation_due_dt

status_change_dttm

expected_payment_source_cd

1

1

Treatment_intent_or_order_revision

termination_dt

requested_give_strength_amt

benefit_plan_nm

provides_payment_guarantee_for

delivers

0..*

0..*

0..*

0..*

dispense_package_method_cd

Healthcare_benefit_coverage

begin_dttm

includes

1

1

0..*

0..*

notice_of_admission_dt

unable_to_work_effective_dt

is_target_for

substitution_allowed_ind

annual_limit_amt

benefit_plan_type_cd

0..*

0..*

belongs_to

1

1

is_associated_with

1

1

dispense_package_size_amt

charge_to_practice_amt

has_parts

is_part_of

1..*

1..*

notice_of_admission_ind

0..*

0..*

is_present_in

supplier_special_dispensing_instruction_cd

benefit_desc

benefits_coordination_ind

provides_opinion_on

give_indication_cd

is_documented_by

0..*

0..*

charge_to_practice_cd

0..*

0..*

patient_financial_class_cd

is_a_role_of

has_as_target

0..*

0..*

verification_required_ind

benefit_product_nm

cob_priority_amt

0..1

0..1

is_assigned

1

1

give_per_time_unit_cd

Bad_debt_collection_agency

patient_sensitivity_cd

price_schedule_id

Certification_second_opinion

has_parts

dependent_coverage_ind

combine_baby_bill_ind

0..1

0..1

0..*

0..*

effective_dt

is_charged_to

Service_event_relationship

give_rate_amt

consent_cd

purge_status_cd

relationship_type_cd

dependent_coverage_limit_amt

effective_dt

0..1

0..1

status_cd

is_associated_with

last_refilled_dttm

declined_ind

1

1

has_charges_for

purge_status_dt

effective_dttm

eligibility_source_cd

max_give_amt

service_desc

1..*

1..*

report_of_eligibility_dt

is_part_of

is_authorized_by

1..*

1..*

lifetime_limit_amt

group_benefit_ind

0..1

0..1

0..*

0..*

has_as_source

min_give_amt

end_dttm

Diagnostic_related_group

is_provided_by

retention_ind

0..*

0..*

0..*

0..*

termination_dttm

mail_claim_party_cd

0..1

0..1

has_assigned_to_it

is_assigned_to

base_rate_amt

Patient_encounter

Preferred_provider_participation

needs_human_review_ind

is_part_of

is_billed_from

filler_id

1

1

signature_on_file_dt

administrative_outcome_txt

role_cd

1

1

agreement_type_cd

policy_source_cd

has_parts

is_assigned_as

is_performed_at

0..*

0..*

capital_reimbursement_amt

order_revision_PTcomp

is_reason_for

filler_order_status_cd

0..*

0..*

special_program_cd

cancellation_reason_cd

effective_dt

baby_coverage_ind

release_information_cd

is_governed_by

is_source_for

0..1

0..1

governs

cost_weight_amt

order_revision_PTrout

filler_order_status_dttm

0..*

0..*

1

1

Healthcare_benefit_service

stoploss_limit_ind

desc

termination_dt

blood_deductible_amt

status_cd

id

access_protocol_desc

order_revision_quantitytiming_qt

0..1

0..1

has

1..*

1..*

recurring_service_cd

0..*

0..*

Appointment

suspend_charges_ind

1

1

has

encounter_classification_cd

copay_limit_ind

termination_dt

Service_reason

major_diagnostic_category_cd

appointment_disposition_cd

capitation_ind

is_assigned_to

ordered_administration_method_cd

scheduled_start_dttm

reserves

is_evidence_for

determination_dttm

total_adjustment_amt

0..*

0..*

0..*

0..*

has_as_a_prior_account

end_dttm

daily_deductible_amt

operating_reimbursement_amt

appointment_duration_qty

coinsurance_ind

prescription_id

service_event_desc

documentation_dttm

0..*

0..*

total_charge_amt

0..1

0..1

has_as_evidence

expected_insurance_plan_qty

0..*

0..*

non_covered_insurance_cd

involves

0..*

0..*

0..*

0..*

reimbursement_amt

appointment_reason_cd

coinsurance_pct

providers_administration_instruction_cd

pertains_to

specimen_received_dttm

0..*

0..*

reason_txt

total_payment_amt

first_similar_illness_dt

has_as_care_provider

policy_amount_class_cd

are_booked_in

0..*

0..*

is_an_assignment_of

0..*

0..*

Bad_debt_billing_account

standard_day_qty

appointment_request_reason_cd

copayment_amt

refills_allowed_qty

specimen_action_cd

has_as_care_recipient

separate_bill_ind

Risk_management_incident

bad_debt_recovery_amt

follow_up_type_cd

policy_amt

standard_total_charge_amt

appointment_timing_tq

deductible_amt

incident_cd

refills_doses_dispensed_qty

nm

Encounter_drg

1

1

bad_debt_transfer_amt

id

involves

policy_category_cd

approval_ind

trim_high_day_qty

appointment_type_cd

lower_coverage_limit_amt

incident_dttm

Patient_departure

refills_remaining_qty

family_awareness_txt

has_as_reason

0..*

0..*

transfer_to_bad_debt_dt

patient_classification_cd

actual_discharge_disposition_cd

policy_deductible_amt

assigned_dttm

trim_low_day_qty

cancellation_dttm

pay_cap_limit_amt

incident_severity_cd

0..1

0..1

Patient_admission

substitution_status_cd

individual_awareness_cd

transfer_to_bad_debt_reason_cd

purpose_cd

0..1

0..1

is_reason_for

admission_dttm

discharge_dttm

policy_limit_day_qty

confidential_ind

cancellation_reason_cd

pcp_referral_ind

incident_type_cd

suppliers_dispensing_instruction_cd

confidential_ind

is_the_prior_account_for

record_signing_dttm

admission_reason_cd

discharge_location_id

policy_scope_cd

cost_outlier_amt

estimated_duration_amt

primary_care_provider_ind

total_daily_dose_amt

special_courtesies_cd

admission_referral_cd

expected_discharge_disp_cd

room_coverage_type_amount_cd

desc

0..*

0..*

is_for

event_reason_cd

review_ind

total_daily_dose_cd

start_dttm

1..*

1..*

admission_source_cd

is_scheduled_by

grouper_review_cd

expected_end_dttm

upper_coverage_limit_amt

0..*

0..*

schedules

is_assigned_by

status_cd

admission_type_cd

grouper_version_id

expected_service_desc

1

1

is_preceded_by

transport_requirement_cd

0..*

0..*

patient_valuables_desc

outlier_days_qty

0..1

0..1

expected_start_dttm

0..*

0..*

provides_coverage_for

is_offered_by

0..*

0..*

urgency_cd

1

1

has_as_participant

pre_admit_test_ind

outlier_reimbursement_amt

id

Collected_specimen_sample

terminates

triage_classification_cd

readmission_ind

has_as_purchaser

0..*

0..*

body_site_cd

outlier_type_cd

0..1

0..1

precedes

occurence_id

0..*

0..*

Consent

Care_event

medical_service_cd

valuables_location_desc

Assessment

collection_body_site_modifier_cd

is_collected_by

overbook_ind

Patient_arrival

confidentiality_constraint_cd

precedes

collection_end_dttm

acuity_level_cd

scheduling_begin_dttm

0..*

0..*

collection_method_modifier_cd

arrival_dttm

scheduling_completed_dttm

is_terminated_by

preceded

1

1

collection_scheduled_dttm

arrival_type_cd

scheduling_status_cd

0..*

0..*

is_sourced_from

1

1

1

1

has

follows

collection_start_dttm

0..1

0..1

medical_service_id

status_cd

Champus_coverage

Medicaid_coverage

Medicare_coverage

Healthcare_service_provider

is_preceded_by

1

1

collection_volume_amt

source_of_arrival_cd

handicapped_program_cd

aid_category_cd

effective_dt

urgency_cd

board_certification_type_cd

Inpatient_encounter

actual_days_qty

condition_cd

mode_cd

non_avail_cert_on_file_ind

eligibility_cd

visit_type_cd

board_certified_ind

is_assigned_to

0..*

0..*

estimated_days_qty

handling_cd

retirement_dt

id

wait_list_priority_amt

certification_dt

is_assigned

1

1

Advance_directive

Procedure

Treatment_service_event

Goal

Clinical_observation

id

station_id

Condition_node

lifetime_res_delay_day_qty

effective_dt

Allergy

competence_ind

anesthesia_cd

Health_issue

prescription_id

is_target_of

action_cd

0..1

0..1

abnormal_result_ind

actual_resolution_dttm

allergen_id

diagnosis_cd

method_of_collection_desc

lifetime_reserve_day_qty

license_id

directive_cd

anesthesia_minutes_qty

refills_remaining_qty

1

1

action_dttm

participates_as

last_observed_normal_values_dttm

0..*

0..*

is_collected_during

estimated_resolution_dttm

1

1

participates_in

allergy_cd

onset_dttm

number_of_sample_containers_qty

medicare_coverage_type_cd

recertification_dt

disclosure_level_cd

delay_reason_txt

notes_txt

classification_cd

nature_of_abnormal_testing_cd

life_cycle_status_dttm

allergy_reaction_cd

billing_priority_amt

specimen_additive_txt

program_type_cd

specialty_cd

life_quality_desc

incision_closed_dttm

PTrout

current_review_status_cd

clinically_relevant_begin_dttm

lifecycle_status_cd

1..*

1..*

allergy_reaction_description_txt

pertains_to

severity_cd

specimen_danger_cd

renal_cd

termination_dt

mortuary_preference_nm

incision_open_dttm

PTcomp

current_review_status_dttm

clinically_relevant_end_dttm

management_discipline_cd

allergy_severity_cd

classification_cd

specimen_source_cd

termination_dt

Location_encounter_role

notarization_dt

priority_amt

indication_cd

episode_of_care_id

observation_method_cd

onset_time_txt

allergy_type_cd

accommodation_cd

confirmation_status_cd

transport_logistics_cd

assessment_dttm

procedure_cd

expiration_dttm

established_dttm

observation_status_cd

onset_dttm

Master_patient_service_location

assessment_dttm

effective_dttm

persistence_cd

is_primary_facility_for

1

1

is_scheduled_by

employment_related_ind

procedure_dttm

substance_lot_number_txt

addr

evaluation_cd

observation_status_dttm

ranking_amt

employment_related_ind

location_role_cd

probability_amt

is_associated_with

0..1

0..1

closing_dt

procedure_functional_type_cd

substance_manufacturer_cd

evaluation_comment_txt

observation_sub_id

employment_related_ind

status_cd

probability_txt

1..*

1..*

procedure_minute_qty

desc

expected_achievement_dttm

0..*

0..*

observation_value_txt

pertains_to

1

1

has

termination_dttm

prognosis_desc

houses

1

1

modifier_cd

email_address

Encounter_practitioner

goal_list_priority_amt

probability_amt

transfer_reason_cd

participation_type_cd

prognosis_awareness_desc

id

life_cycle_dttm

references_range_txt

collects

0..1

0..1

provides_services_on_behalf_of

0..*

0..*

specified_in

transfer_reason_desc

cd

licensed_bed_qty

life_cycle_status_cd

universal_service_identifier_suffix_txt

usage_approved_ind

0..*

0..*

0..*

0..*

nm

management_discipline_cd

user_defined_access_check_txt

provides_patient_services_at

is_participant_for

opening_dt

next_review_dttm

value_type_cd

1..*

1..*

belongs_to

contains

0..*

0..*

1..*

1..*

Patient_service_location_group

is_requested_by

phon

0..1

0..1

previous_review_dttm

value_units_cd

is_a_role_of

id

is_included_in

0..*

0..*

service_specialty_cd

Healthcare_provider_organization

review_interval_cd

is_a_role_of

0..1

0..1

Treatment_service_give

slot_size_increment_qty

target_txt

0..1

0..1

1

1

is_requested_by

Treatment_service_dispense

administration_desc

Treatment_service_administration

dispense_package_method_cd

status_cd

target_type_cd

administered_rate_txt

give_per_time_unit_cd

Individual_healthcare_practitioner

dispense_package_size_amt

type_cd

is_entry_location_for

goal_cd

1

1

completion_status_cd

desc

give_quantitytiming_qt

needs_human_review_ind

equipment_type_cd

substance_refusal_reason_cd

fellowship_field_cd

0..1

0..1

is_target_for

give_rate_amt

rejection_reason_txt

0..1

0..1

substitution_cd

graduate_school_nm

includes

max_give_amt

is_location_for

0..1

0..1

substitution_cd

system_entry_dttm

graduation_dt

min_give_amt

provides

1

1

suppliers_special_dispensing_instruction_cd

is_the_primary_provider_for

0..1

0..1

position_cd

needs_human_review_ind

total_daily_dose_amt

practitioner_type_cd

substitution_status_cd

is_scheduled_by

1

1

primary_care_ind

supplier_special_administration_instruction_cd

1

1

participates_as

residency_field_cd

belongs_to

1..*

1..*

slot_size_increment_qty

is_requested_by

1

1

Reference Information Model for HL7 Version 3 (RIM)


Reference information model for hl7 version 3 rim

Reference Information Model for HL7 Version 3 (RIM)

  • Consensus view of the healthcare world

  • Flexible structures

  • Emphasizes meanings of health information

  • Object-oriented


Us standards for health record systems

HEALTH LEVEL 7

REFERENCE INFORMATION MODEL

RIM_0088

Master_service

released January, 1999

allowable_processing_priority_cd

has_as_participant

0..*

0..*

Producer_of_master_service

0..*

0..*

produces

is_produced_by

0..1

0..1

service_producing_department_type_cd

Financial_transaction

allowable_reporting_priority_cd

reflects agreements made through harmonization in November, 1998

alternate_desc

billing_reference_txt

is_categorized_by

desc

0..*

0..*

challenge_information_txt

extended_amt

1

1

confidentiality_cd

is_requested_by

Healthcare_finances

Healthcare_finances

Master_tables

Healthcare_finances

fee_schedule_cd

0..*

0..*

is_associated_with

effective_dt

insurance_amt

factors_that_may_affect_observation_desc

posting_dt

fee_amt

Patient_encounters

Healthcare_finances

Healthcare_stakeholders

Healthcare_finances

qty

fixed_canned_message_cd

0..*

0..*

pertains_to

1

1

transaction_batch_id

is_target

imaging_measurement_modality_cd

is_entered_by

transaction_cd

incompatible_change_dttm

has_target

0..*

0..*

transaction_dt

Authentication

0..*

0..*

instrument_identifier_coding_system_nm

0..*

0..*

is_related_to

authentication_dt

transaction_id

Master_service_relationship

instrument_identifier_nm

1

1

0..*

0..*

Clinical_document_header

type_cd

relationship_type_cd

transaction_type_cd

0..*

0..*

documents

authentication_dt

interpretation_considerations_desc

is_related_to

is_related_to

is_associated_with

reflex_testing_trigger_rules_desc

unit_amt

availability_status_cd

kind_of_quantity_observed_cd

constraint_txt

0..*

0..*

unit_cost_amt

change_reason_cd

last_update_dttm

0..*

0..*

quantitytiming_qt

1..*

1..*

is_covered_by

is_related_to

completion_status_cd

method_cd

Resource_request

is_related_to

allowable_substitutions_cd

confidentiality_status_cd

method_desc

duration_qty

1

1

content_presentation_cd

nature_of_service_cd

Healthcare_document_authenticator

has_source

0..*

0..*

Appointment_request

is_the_purchaser_of

1

1

start_dttm

document_header_creation_dt

observation_id_suffix_txt

appointment_rqst_reason_cd

is_source

1

1

Health_benefit_plan_purchaser

is_requested_by

1

1

0..*

0..*

requests

start_offset_qty

file_nm

orderable_service_ind

has_as_a_contact

Patient_information_disclosure

appointment_rqst_type_cd

0..1

0..1

is_a

0..1

0..1

disclosure_dttm

status_cd

id

patient_preparation_desc

equip_selection_criteria_pv

0..1

0..1

info_disclosed_desc

of

has_been_originated_by

0..*

0..*

0..1

0..1

last_edit_dt

point_versus_interval_cd

Originator

id

is_delivered_during

info_requested_desc

is_a_role_of

origination_dt

1

1

portable_device_ind

location_selection_criteria_pv

reason_cd

reporting_priority_cd

preferred_ordering_method_txt

pertains_to

occurence_id

is_a

0..1

0..1

requested_dttm

results_report_dttm

Stakeholder_identifier

requests

preferred_scheduling_method_txt

1

1

1

1

is_instantiated_as

priority_cd

effective_dt

0..*

0..*

urgency_cd

storage_status_cd

procedure_medication_cd

repeating_interval_duration_qty

is_issued_by

id

Document_recipient

of

transcription_dt

0..1

0..1

has_been_received_by

0..*

0..*

report_display_order_txt

requested_ri

identifier_type_cd

requests

0..*

0..*

type_cd

is_requested_by

required_credentials_desc

rqst_event_reason_cd

issued_dt

1..*

1..*

0..*

0..*

0..*

0..*

service_alternate_id

is_transcribed_by

0..*

0..*

0..1

0..1

rqsted_duration_qty

is_a

0..1

0..1

qualifying_information_txt

Durable_medical_equipment_request

Patient_appointment_request

Patient_service_location_request

service_alternate_identifier_coding_system_nm

Individual_healthcare_practitioner_request

start_dt

Service_scheduling_request

quantity_amt

type_cd

is_provided_to

termination_dt

practitioner_type_cd

is_parent_document_for

0..*

0..*

allowable_substitutions_cd

service_alternate_identifier_nm

time_selection_criteria_pv

type_cd

0..*

0..*

duration_qty

service_alternate_name_use_cd

0..*

0..*

transcribes

may_be_contained_in

issues

1

1

requests

start_dttm

service_alternate_nm

0..1

0..1

Master_specimen_requirement

0..*

0..*

0..*

0..*

0..*

0..*

0..*

0..*

additive_cd

0..*

0..*

start_offset_qty

service_contraindication_cd

Identifier_issuing_authority

0..*

0..*

requests

is_assigned_to

Transcriptionist

0..*

0..*

requests

effective_dt

may_request

container_desc

may_request

status_cd

service_desc

has_as_a_parent_document

may_request

requests

termination_dt

1

1

takes_on_role_of

container_preparation_desc

service_performance_schedule_cd

Stakeholder

addr

container_volume_amt

0..1

0..1

is_requested_by

service_primary_nm

takes_on_role_of

1

1

credit_rating_cd

derived_specimen_cd

is_assigned

1

1

is_identified_as

1

1

is_the_recipient_of

0..1

0..1

service_requirement_desc

may_act_as_a

1

1

email_address_txt

is_a_role_of

0..1

0..1

minimum_collection_volume_amt

service_type_cd

is_a_role_of

0..1

0..1

Patient_information_recipient

Individual_healthcare_practitioner_group

1

1

takes_on_role_of

takes_on_role_of

1

1

Stakeholder_affiliation

phon

normal_collection_volume_amt

id

1

1

standard_time_to_perform_dttm

is_requested_by

affiliation_type_cd

Durable_medical_equipment

type_cd

id

1

1

takes_on_role_of

special_handling_desc

target_anatomic_site_cd

desc

participates_as_primary_in

1

1

0..*

0..*

has_as_primary_participant

slot_size_increment_qty

specimen_priorities_cd

target_of_service_cd

effective_dt

belongs_to

0..1

0..1

1..*

1..*

participates_in

type_cd

specimen_retention_time_amt

1

1

contains

takes_on_role_of

0..*

0..*

universal_service_id

termination_dt

0..*

0..*

refers_to_person_by

specimen_type_cd

is_used_by

universal_service_identifier_coding_system_nm

0..*

0..*

is_requested_by

0..1

0..1

contains

takes_on_role_of

1

1

1

1

collects

Resource_slot

0..*

0..*

universal_service_identifier_nm

offset_qty

is_a_role_of

0..1

0..1

Durable_medical_equipment_group

takes_on_role_of

1

1

1

1

1

1

takes_on_role_of

quantitytiming_qt

id

quantity_amt

Person_alternate_name

0..*

0..*

effective_dt

is_scheduled_by

is_specified_for

Service_intent_or_order_relationship

Accident_information_source

0..*

0..*

join_cd

resource_type_cd

relationship_type_cd

has_as_secondary_participant

cd

slot_state_cd

reflex_testing_trigger_rules_desc

nm

start_dttm

0..1

0..1

constraint_txt

0..*

0..*

is_reserved_by

reason_cd

Master_numeric_range

has_as_target

0..*

0..*

Stakeholder_affiliate

quantitytiming_qt

is_the_source_of

range_type_cd

Health_chart

0..*

0..*

is_managed_by

termination_dt

family_relationship_cd

health_chart_id

is_a_role_of

is_ordered_on

0..*

0..*

belongs_to

condition_desc

participates_as_secondary_in

1

1

type_cd

health_chart_type_cd

high_range_amt

0..1

0..1

0..1

0..1

status_cd

contains

0..1

0..1

high_gestation_age_amt

Master_treatment_service

0..*

0..*

0..*

0..*

is_housed_at

Master_observation_service

has_as_source

is_an_instance_of

contains

1

1

dea_level_cd

high_value_amt

instrument_id

0..*

0..*

is_for

1

1

drug_category_cd

is_target_for

low_age_amt

permitted_data_type_cd

0..*

0..*

Schedule

Durable_medical_equipment_slot

Individual_healthcare_practitioner_slot

has

takes_on_

1

1

Patient_slot

Patient_service_location_slot

contains

id

1

1

formulary_status_cd

low_gestation_age_amt

processing_time_qty

0..1

0..1

categorizes

role_of

Service_intent_or_order

Health_chart_deficiency

has_an_assessment_of

Organization

0..*

0..*

medication_form_cd

low_value_amt

specimen_required_ind

charge_type_cd

1..*

1..*

is_basis_for

assessment_dt

0..*

0..*

0..*

0..*

0..*

0..*

organization_name_type_cd

1

1

takes_on_role_of

Employer

1

1

0..*

0..*

pharmaceutical_class_cd

1

1

race_subspecies_txt

typical_turnaround_time_qty

clarification_phon

is_a_scheduleable_unit_for

desc

effective_dt

organization_nm

is_a_scheduleable_unit_for

is_a_scheduleable_unit_for

0..1

0..1

is_a_role_of

1

1

assigns

0..*

0..*

applies_to

is_a_scheduleable_unit_for

route_cd

sex_txt

end_condition_cd

level_cd

termination_dt

standard_industry_class_cd

0..*

0..*

has_as_a_contact

is_source_for

1

1

takes_on_role_of

therapeutic_class_cd

species_txt

entering_device_cd

type_cd

1

1

is_employer_of

0..1

0..1

is_assessed_against

0..*

0..*

escort_required_ind

0..*

0..*

expected_performance_time_qty

takes_on_role_of

1

1

has_as_basis

0..1

0..1

filler_order_id

is_a_contact_for

0..*

0..*

has_as_a_subdivision

filler_txt

is_a_contact_for

0..*

0..*

Contact_person

is_a_contact_for

0..*

0..*

is_a_subdivision_of

conforms_to

order_control_cd

contact_reason_cd

1

1

involves

1

1

participates_in

Appointment_contact_person

participates_in

order_control_reason_cd

role_cd

is_a_contact_for

0..*

0..*

Master_continuous_observation

0..1

0..1

is_a_role_of

0..*

0..*

Master_categorical_observation

Master_calculated_observation

order_effective_dttm

corresponding_SI_unit_of_measure_cd

may_act_in_

0..*

0..*

abnormal_result_cd

derivation_rule_desc

order_group_id

customary_unit_of_measure

is_a_contact_for

0..*

0..*

the_role_of

allowed_value_type_cd

order_id

delta_check_numeric_change_computation_method_txt

critical_result_cd

1

1

1

1

has

order_placed_dttm

delta_check_numeric_change_threshold_amt

has_as_

normal_result_cd

Person

order_quantitytiming_qt

delta_check_numeric_high_value_amt

employer

Person_employment

birth_dttm

preferred_coding_system_cd

Administrative_birth_event

pertains_to

addr

1

1

has

placer_order_id

delta_check_numeric_low_value_amt

baby_detained_ind

birthplace_addr

valid_answer_cd

has_as_participant

0..*

0..*

effective_dt

placer_txt

delta_check_numeric_retention_days_qty

birth_certificate_id

citizenship_country_cd

0..*

0..*

0..1

0..1

hazard_exposure_txt

Notary_public

planned_patient_transport_cd

Administrative_patient_death

length_and_decimal_precision_amt

birth_method_cd

confidentiality_constraint_cd

effective_dt

death_certificate_id

Active_participation

is_a_role_of

0..1

0..1

job_class_cd

report_results_to_phon

minimum_meaningful_increment_amt

birth_recorded_county_cd

begin_dttm

deceased_dttm

notary_county_cd

death_certificate_recorded_dt

job_title_nm

response_requested_cd

si_conversion_factor_txt

birth_recorded_dt

Guarantor

end_dttm

deceased_ind

notary_state_cd

death_classification_cd

financial_class_cd

phon

has

service_body_site_cd

1

1

newborn_days_qty

duration_tm

disability_cd

termination_dt

has_as_a

has_as_a_contact

guarantees_

death_dttm

0..*

0..*

is_billed_to

household_annual_income_amt

protective_equipment_txt

service_body_site_modifier_cd

stillborn_ind

participation_type_cd

education_level_cd

Patient

has_as_participant

0..1

0..1

_contact

issues

payment_under

death_location_nm

household_size_qty

0..1

0..1

salary_amt

ambulatory_status_cd

service_body_source_cd

1

1

1

1

takes_on_role_of

ethnic_group_cd

has

1

1

death_notification_source_nm

0..1

0..1

0..*

0..*

salary_type_cd

participates_in

target_of_service_cd

birth_order_amt

1

1

gender_cd

0..*

0..*

is_part_of

is_a_role_of

is_scheduled_by

0..1

0..1

1

1

death_verification_cd

status_cd

transport_arranged_ind

living_arrangement_cd

Insurer

language_cd

0..*

0..*

may_be_referred_to_in

participates_in

0..1

0..1

death_verification_dt

1

1

is_requested_by

effective_dt

termination_dt

has_as_

0..1

0..1

transport_arrangement_responsibility_cd

living_dependency_cd

marital_status_cd

death_verification_nm

termination_dt

occupation_cd

1

1

a_contact

takes_on_role_of

transport_mode_cd

enters

multiple_birth_ind

1

1

0..*

0..*

is_entered_at

military_branch_of_service_cd

is_a_role_of

0..1

0..1

job_status_cd

when_to_charge_dttm

newborn_baby_ind

military_rank_nm

0..1

0..1

has_as_target

organ_donor_ind

when_to_charge_txt

military_status_cd

0..1

0..1

pertains_to

has_as_employee

issues

0..*

0..*

1

1

1

1

has

1

1

preferred_pharmacy_id

results_status_cd

is_fulfilled_by

0..1

0..1

nationality_cd

0..1

0..1

is_a_contact_for

is_target_of

offers

1..*

1..*

0..1

0..1

Insurance_certification_contact

intent_or_order_cd

1

1

0..1

0..1

is_a_role_of

takes_on_role_of

participation_type_cd

primary_name_representation_cd

is_a_role_of

has_as_target

join_cd

is_employee_in

0..1

0..1

has_as_reason

0..*

0..*

1

1

is_issued_by

1

1

has_as_a_contact

primary_name_type_cd

has

1

1

1

1

is_a_role_of

takes_on_role_of

0..*

0..*

primary_nm

Billing_information_item

pertains_to

Employee

0..*

0..*

Insurance_certification

Episode

participates_in

1

1

condition_cd

appeal_reason_cd

0..1

0..1

desc

race_cd

Target_participation

1

1

occurrence_cd

has

begin_dttm

1

1

certification_day_qty

has_payment_

has

episode_type_cd

religious_affiliation_cd

has_as_target

0..*

0..*

occurrence_dt

end_dttm

effective_dt

guaranteed_by

1..*

1..*

is_target_of

id

student_cd

1

1

has

is_source_for

0..1

0..1

occurrence_span_cd

Guarantor_contract

duration_tm

id

is_issued_by

list_closed_ind

very_important_person_cd

0..*

0..*

1..*

1..*

billing_hold_ind

has_as_target

0..*

0..*

Patient_billing_account

is_involved_in

occurrence_span_from_dt

participation_type_cd

1

1

0..*

0..*

insurance_verification_dttm

0..*

0..*

affirms_insurance_coverage_for

has_as_primary_facility

outcome_txt

account_id

0..1

0..1

billing_media_cd

specfies

Preauthorization

occurrence_span_thru_dt

modification_dttm

authorized_encounters_amt

recurring_service_ind

adjustment_cd

charge_adjustment_cd

Administrative_patient_accident

has_coverage_affirmed_by

Observation_intent_or_order

1

1

Referral

has_a_primary_provider

quantity_amt

0..*

0..*

Dietary_intent_or_order

accident_death_ind

Treatment_intent_or_order

non_concur_cd

0..*

0..*

patient_hazard_cd

provides_validation_for

authorized_visits_qty

authorized_period_begin_dt

1

1

authorization_information_txt

contract_duration_cd

diet_type_cd

takes_on_role_of

dosage_txt

quantity_type_cd

accident_desc

non_concur_effective_dttm

is_target_of

reason_for_study_cd

desc

authorized_period_end_dt

0..*

0..*

billing_status_cd

contract_type_cd

dietary_instruction_desc

earliest_dispense_dt

value_amt

has

1

1

accident_dttm

penalty_amt

relevant_clinical_information_txt

reason_txt

id

certification_required_ind

effective_dt

dietary_tray_type_cd

Indication_cd

is_validated_by

1

1

1

1

value_cd

accident_location_desc

reporting_priority_cd

termination_dt

issued_dttm

is_obtained_from

0..*

0..*

current_unpaid_balance_amt

interest_rate_amt

service_period_cd

has_parts

non_form_authorized_ind

has_parts

accident_state_cd

Healthcare_benefit_product

0..*

0..*

specimen_action_cd

report_of_eligibility_dt

fulfills

requested_dttm

delete_dt

periodic_payment_amt

service_type_cd

providers_treatment_instruction_txt

assignment_of_benefits_ind

authorizes

0..1

0..1

0..1

0..1

Disability

accident_type_cd

has_as_target

1

1

has

report_of_eligibility_ind

restriction_desc

deleted_account_reason_cd

priority_ranking_cd

effective_dt

Service_event

1

1

rejection_reason_cd

benefit_product_desc

job_related_accident_ind

orders

0..*

0..*

attestation_dttm

status_cd

0..*

0..*

expected_insurance_plan_qty

0..1

0..1

termination_dt

pertains_to

has_as_active_participant

0..*

0..*

return_to_work_auth_dt

pertains_to

has_payment_guaranteed_by

requested_give_rate_amt

is_part_of

id

0..*

0..*

assessment_dttm

attestation_due_dt

status_change_dttm

expected_payment_source_cd

1

1

Treatment_intent_or_order_revision

termination_dt

requested_give_strength_amt

benefit_plan_nm

provides_payment_guarantee_for

delivers

0..*

0..*

0..*

0..*

dispense_package_method_cd

Healthcare_benefit_coverage

begin_dttm

includes

1

1

0..*

0..*

notice_of_admission_dt

unable_to_work_effective_dt

is_target_for

substitution_allowed_ind

annual_limit_amt

benefit_plan_type_cd

0..*

0..*

belongs_to

1

1

is_associated_with

1

1

dispense_package_size_amt

charge_to_practice_amt

has_parts

is_part_of

1..*

1..*

notice_of_admission_ind

0..*

0..*

is_present_in

supplier_special_dispensing_instruction_cd

benefit_desc

benefits_coordination_ind

provides_opinion_on

give_indication_cd

is_documented_by

0..*

0..*

charge_to_practice_cd

0..*

0..*

patient_financial_class_cd

is_a_role_of

has_as_target

0..*

0..*

verification_required_ind

benefit_product_nm

cob_priority_amt

0..1

0..1

is_assigned

1

1

give_per_time_unit_cd

Bad_debt_collection_agency

patient_sensitivity_cd

price_schedule_id

Certification_second_opinion

has_parts

dependent_coverage_ind

combine_baby_bill_ind

0..1

0..1

0..*

0..*

effective_dt

is_charged_to

Service_event_relationship

give_rate_amt

consent_cd

purge_status_cd

relationship_type_cd

dependent_coverage_limit_amt

effective_dt

0..1

0..1

status_cd

is_associated_with

last_refilled_dttm

declined_ind

1

1

has_charges_for

purge_status_dt

effective_dttm

eligibility_source_cd

max_give_amt

service_desc

1..*

1..*

report_of_eligibility_dt

is_part_of

is_authorized_by

1..*

1..*

lifetime_limit_amt

group_benefit_ind

0..1

0..1

0..*

0..*

has_as_source

min_give_amt

end_dttm

Diagnostic_related_group

is_provided_by

retention_ind

0..*

0..*

0..*

0..*

termination_dttm

mail_claim_party_cd

0..1

0..1

has_assigned_to_it

is_assigned_to

base_rate_amt

Patient_encounter

Preferred_provider_participation

needs_human_review_ind

is_part_of

is_billed_from

filler_id

1

1

signature_on_file_dt

administrative_outcome_txt

role_cd

1

1

agreement_type_cd

policy_source_cd

has_parts

is_assigned_as

is_performed_at

0..*

0..*

capital_reimbursement_amt

order_revision_PTcomp

is_reason_for

filler_order_status_cd

0..*

0..*

special_program_cd

cancellation_reason_cd

effective_dt

baby_coverage_ind

release_information_cd

is_governed_by

is_source_for

0..1

0..1

governs

cost_weight_amt

order_revision_PTrout

filler_order_status_dttm

0..*

0..*

1

1

Healthcare_benefit_service

stoploss_limit_ind

desc

termination_dt

blood_deductible_amt

status_cd

id

access_protocol_desc

order_revision_quantitytiming_qt

0..1

0..1

has

1..*

1..*

recurring_service_cd

0..*

0..*

Appointment

suspend_charges_ind

1

1

has

encounter_classification_cd

copay_limit_ind

termination_dt

Service_reason

major_diagnostic_category_cd

appointment_disposition_cd

capitation_ind

is_assigned_to

ordered_administration_method_cd

scheduled_start_dttm

reserves

is_evidence_for

determination_dttm

total_adjustment_amt

0..*

0..*

0..*

0..*

has_as_a_prior_account

end_dttm

daily_deductible_amt

operating_reimbursement_amt

appointment_duration_qty

coinsurance_ind

prescription_id

service_event_desc

documentation_dttm

0..*

0..*

total_charge_amt

0..1

0..1

has_as_evidence

expected_insurance_plan_qty

0..*

0..*

non_covered_insurance_cd

involves

0..*

0..*

0..*

0..*

reimbursement_amt

appointment_reason_cd

coinsurance_pct

providers_administration_instruction_cd

pertains_to

specimen_received_dttm

0..*

0..*

reason_txt

total_payment_amt

first_similar_illness_dt

has_as_care_provider

policy_amount_class_cd

are_booked_in

0..*

0..*

is_an_assignment_of

0..*

0..*

Bad_debt_billing_account

standard_day_qty

appointment_request_reason_cd

copayment_amt

refills_allowed_qty

specimen_action_cd

has_as_care_recipient

separate_bill_ind

Risk_management_incident

bad_debt_recovery_amt

follow_up_type_cd

policy_amt

standard_total_charge_amt

appointment_timing_tq

deductible_amt

incident_cd

refills_doses_dispensed_qty

nm

Encounter_drg

1

1

bad_debt_transfer_amt

id

involves

policy_category_cd

approval_ind

trim_high_day_qty

appointment_type_cd

lower_coverage_limit_amt

incident_dttm

Patient_departure

refills_remaining_qty

family_awareness_txt

has_as_reason

0..*

0..*

transfer_to_bad_debt_dt

patient_classification_cd

actual_discharge_disposition_cd

policy_deductible_amt

assigned_dttm

trim_low_day_qty

cancellation_dttm

pay_cap_limit_amt

incident_severity_cd

0..1

0..1

Patient_admission

substitution_status_cd

individual_awareness_cd

transfer_to_bad_debt_reason_cd

purpose_cd

0..1

0..1

is_reason_for

admission_dttm

discharge_dttm

policy_limit_day_qty

confidential_ind

cancellation_reason_cd

pcp_referral_ind

incident_type_cd

suppliers_dispensing_instruction_cd

confidential_ind

is_the_prior_account_for

record_signing_dttm

admission_reason_cd

discharge_location_id

policy_scope_cd

cost_outlier_amt

estimated_duration_amt

primary_care_provider_ind

total_daily_dose_amt

special_courtesies_cd

admission_referral_cd

expected_discharge_disp_cd

room_coverage_type_amount_cd

desc

0..*

0..*

is_for

event_reason_cd

review_ind

total_daily_dose_cd

start_dttm

1..*

1..*

admission_source_cd

is_scheduled_by

grouper_review_cd

expected_end_dttm

upper_coverage_limit_amt

0..*

0..*

schedules

is_assigned_by

status_cd

admission_type_cd

grouper_version_id

expected_service_desc

1

1

is_preceded_by

transport_requirement_cd

0..*

0..*

patient_valuables_desc

outlier_days_qty

0..1

0..1

expected_start_dttm

0..*

0..*

provides_coverage_for

is_offered_by

0..*

0..*

urgency_cd

1

1

has_as_participant

pre_admit_test_ind

outlier_reimbursement_amt

id

Collected_specimen_sample

terminates

triage_classification_cd

readmission_ind

has_as_purchaser

0..*

0..*

body_site_cd

outlier_type_cd

0..1

0..1

precedes

occurence_id

0..*

0..*

Consent

Care_event

medical_service_cd

valuables_location_desc

Assessment

collection_body_site_modifier_cd

is_collected_by

overbook_ind

Patient_arrival

confidentiality_constraint_cd

precedes

collection_end_dttm

acuity_level_cd

scheduling_begin_dttm

0..*

0..*

collection_method_modifier_cd

arrival_dttm

scheduling_completed_dttm

is_terminated_by

preceded

1

1

collection_scheduled_dttm

arrival_type_cd

scheduling_status_cd

0..*

0..*

is_sourced_from

1

1

1

1

has

follows

collection_start_dttm

0..1

0..1

medical_service_id

status_cd

Champus_coverage

Medicaid_coverage

Medicare_coverage

Healthcare_service_provider

is_preceded_by

1

1

collection_volume_amt

source_of_arrival_cd

handicapped_program_cd

aid_category_cd

effective_dt

urgency_cd

board_certification_type_cd

Inpatient_encounter

actual_days_qty

condition_cd

mode_cd

non_avail_cert_on_file_ind

eligibility_cd

visit_type_cd

board_certified_ind

is_assigned_to

0..*

0..*

estimated_days_qty

handling_cd

retirement_dt

id

wait_list_priority_amt

certification_dt

is_assigned

1

1

Advance_directive

Procedure

Treatment_service_event

Goal

Clinical_observation

id

station_id

Condition_node

lifetime_res_delay_day_qty

effective_dt

Allergy

competence_ind

anesthesia_cd

Health_issue

prescription_id

is_target_of

action_cd

0..1

0..1

abnormal_result_ind

actual_resolution_dttm

allergen_id

diagnosis_cd

method_of_collection_desc

lifetime_reserve_day_qty

license_id

directive_cd

anesthesia_minutes_qty

refills_remaining_qty

1

1

action_dttm

participates_as

last_observed_normal_values_dttm

0..*

0..*

is_collected_during

estimated_resolution_dttm

1

1

participates_in

allergy_cd

onset_dttm

number_of_sample_containers_qty

medicare_coverage_type_cd

recertification_dt

disclosure_level_cd

delay_reason_txt

notes_txt

classification_cd

nature_of_abnormal_testing_cd

life_cycle_status_dttm

allergy_reaction_cd

billing_priority_amt

specimen_additive_txt

program_type_cd

specialty_cd

life_quality_desc

incision_closed_dttm

PTrout

current_review_status_cd

clinically_relevant_begin_dttm

lifecycle_status_cd

1..*

1..*

allergy_reaction_description_txt

pertains_to

severity_cd

specimen_danger_cd

renal_cd

termination_dt

mortuary_preference_nm

incision_open_dttm

PTcomp

current_review_status_dttm

clinically_relevant_end_dttm

management_discipline_cd

allergy_severity_cd

classification_cd

specimen_source_cd

termination_dt

Location_encounter_role

notarization_dt

priority_amt

indication_cd

episode_of_care_id

observation_method_cd

onset_time_txt

allergy_type_cd

accommodation_cd

confirmation_status_cd

transport_logistics_cd

assessment_dttm

procedure_cd

expiration_dttm

established_dttm

observation_status_cd

onset_dttm

Master_patient_service_location

assessment_dttm

effective_dttm

persistence_cd

is_primary_facility_for

1

1

is_scheduled_by

employment_related_ind

procedure_dttm

substance_lot_number_txt

addr

evaluation_cd

observation_status_dttm

ranking_amt

employment_related_ind

location_role_cd

probability_amt

is_associated_with

0..1

0..1

closing_dt

procedure_functional_type_cd

substance_manufacturer_cd

evaluation_comment_txt

observation_sub_id

employment_related_ind

status_cd

probability_txt

1..*

1..*

procedure_minute_qty

desc

expected_achievement_dttm

0..*

0..*

observation_value_txt

pertains_to

1

1

has

termination_dttm

prognosis_desc

houses

1

1

modifier_cd

email_address

Encounter_practitioner

goal_list_priority_amt

probability_amt

transfer_reason_cd

participation_type_cd

prognosis_awareness_desc

id

life_cycle_dttm

references_range_txt

collects

0..1

0..1

provides_services_on_behalf_of

0..*

0..*

specified_in

transfer_reason_desc

cd

licensed_bed_qty

life_cycle_status_cd

universal_service_identifier_suffix_txt

usage_approved_ind

0..*

0..*

0..*

0..*

nm

management_discipline_cd

user_defined_access_check_txt

provides_patient_services_at

is_participant_for

opening_dt

next_review_dttm

value_type_cd

1..*

1..*

belongs_to

contains

0..*

0..*

1..*

1..*

Patient_service_location_group

is_requested_by

phon

0..1

0..1

previous_review_dttm

value_units_cd

is_a_role_of

id

is_included_in

0..*

0..*

service_specialty_cd

Healthcare_provider_organization

review_interval_cd

is_a_role_of

0..1

0..1

Treatment_service_give

slot_size_increment_qty

target_txt

0..1

0..1

1

1

is_requested_by

Treatment_service_dispense

administration_desc

Treatment_service_administration

dispense_package_method_cd

status_cd

target_type_cd

administered_rate_txt

give_per_time_unit_cd

Individual_healthcare_practitioner

dispense_package_size_amt

type_cd

is_entry_location_for

goal_cd

1

1

completion_status_cd

desc

give_quantitytiming_qt

needs_human_review_ind

equipment_type_cd

substance_refusal_reason_cd

fellowship_field_cd

0..1

0..1

is_target_for

give_rate_amt

rejection_reason_txt

0..1

0..1

substitution_cd

graduate_school_nm

includes

max_give_amt

is_location_for

0..1

0..1

substitution_cd

system_entry_dttm

graduation_dt

min_give_amt

provides

1

1

suppliers_special_dispensing_instruction_cd

is_the_primary_provider_for

0..1

0..1

position_cd

needs_human_review_ind

total_daily_dose_amt

practitioner_type_cd

substitution_status_cd

is_scheduled_by

1

1

primary_care_ind

supplier_special_administration_instruction_cd

1

1

participates_as

residency_field_cd

belongs_to

1..*

1..*

slot_size_increment_qty

is_requested_by

1

1


Rim class diagram v1 19

Act

ActRelationship

Participation

classCode : CS

typeCode : CS

moodCode : CS

typeCode : CS

outboundRelationship

inversionInd : BL

id : SET<II>

RoleLink

functionCode : CD

source

contextControlCode : CS

code : CD

contextControlCode :

...

0..n

0..n

1

1

sequenceNumber : INT

Role

negationInd : BL

CS

priorityNumber : INT

cla

text : ED

sequenceNumber :

0..n

0..n

pauseQuantity : PQ

ssC

statusCode : SET<CS>

INT

1

1

checkpointCode : CS

inboundRelationship

ode

effectiveTime : GTS

...

target

splitCode : CS

:

derivationExpr : ST

0..n

0..n

1

1

joinCode : CS

CS

0..n

availabilityTime : TS

negationInd : BL

...

priorityCode : SET<CE>

conjunctionCode : CS

activityTime : GTS

localVariableName : ST

repeatNumber : IVL<INT>

seperatableInd : BL

confidentialityCode : SET<CE>

ManagedParticipation

interruptibleInd : BL

...

levelCode : CE

independentInd : BL

uncertaintyCode : CE

reasonCode : SET<CE>

languageCode : CE

substitutionConditionCode : CE

LivingSubject

EntityHeir

Organization

RoleHeir

Patient

Material

Employee

ad

...

Guarantor

...

...

job

min

...

Cod

istr

e :

...

...

Supply

Procedure

Observation

SubstanceAdministration

AssignedEntity

quantity : PQ

methodCode : SET<CE>

ManufacturedMaterial

value : ANY

routeCode : CE

Place

ActHeir

...

expectedUseTime :

approachSiteCode :

PatientEncounter

lotN

interpretationCode : SET<CE>

approachSiteCode : SET<CD>

mo

IVL<TS>

...

...

preAdmitTestInd : BL

methodCode : SET<CE>

doseQuantity : IVL<PQ>

bileI

admissionReferralSourceCode : CE

targetSiteCode : SET<CD>

rateQuantity : IVL<PQ>

...

lengthOfStayQuantity : PQ

doseCheckQuantity : SET<RTO>

dischargeDispositionCode : CE

Access

maxDoseQuantity : SET<RTO>

...

substitutionCode : CE

app

LicensedEntity

...

WorkingList

Account

...

InvoiceElement

...

name : ST

modifierCode : SET<CE>

Person

balanceAmt : MO

NonPersonLivingSubject

Device

unitQuantity : RTO<PQ,PQ>

DeviceTask

currencyCode : CE

add

Container

unitPriceAmt : RTO<MO,PQ>

...

...

ma

parameterValue : LIST<ANY>

...

interestRateQuantity : RTO<MO,PQ>

r :

netAmt : MO

nuf

cap

Diet

allowedBalanceQuantity : IVL<MO>

BA

SchedulableResource

PublicHealthCase

factorNumber : REAL

...

acit

energyQuantity : PQ

G<

...

pointsNumber : REAL

yQ

detectionMethodCode : CE

carbohydrateQuantity :

...

DiagnosticImage

...

transmissionModeCode :

PQ

FinancialTransaction

subjectOrientationCode : CE

...

FinancialContract

amt : MO

creditExchangeRateQuantity : REAL

paymentTermsCode : CE

debitExchangeRateQuantity : REAL

Message Control

ControlAct

0..1

0..1

Infrastructure (Structured documents)

...

ContextStructure

1

1

...

0..1

0..1

QueryEvent

...

0..n

0..n

Message

HEALTH LEVEL 7

vers

payload

REFERENCE INFORMATION MODEL

ClinicalDocum

Table

ionI

VERSION 1.18 (RIM_0118)

QueryAck

ent

QuerySpec

d :

summary : ST

messageQueryCode : CE

setId : II

ST

width : ST

messageQueryCode : CE

queryResponseCode : CS

versionNumber : INT

...

...

rules : CS

SortControl

modifyCode : CS

Provisionsal version reflects changes to RIM naming conventions

TableStructure

resultTotalQuantity : INT

...

cellspacing :

responseElementGroupId :

approved in October 2002. Changes will be formally adopted in RIM

seq

...

char : ST

1

1

...

SET<II>

Harmonization Meeting 11/14-15/2002.

1

1

...

acknowledgingMessage

0..n

0..n

charoff :

acknowledgedMessage

1

1

responseModalityCode : CS

...

...

Enitites

Acts

QueryContinuation

LinkHtml

LocalAttr

payload

...

acknowledgement

1

1

1..*

1..*

href

Roles

Other

...

Acknowledgement

:

...

typ

eCo

...

Infrastructure (Structured

Parameter

1

1

SelectionExpression

Infrastructure (Message

0..n

0..n

QueryByParameter

QueryBySelection

documents)

control)

...

userAsRight

0..n

0..n

0..1

0..1

0..n

0..n

0..n

0..n

TableCell

TableColumnStructure

0..n

0..n

userAsLeft

sco

...

LocalMarkup

Billboard produced by:

Rochester Outdoor Advertising

pe :

des

CS

...

...

0..1

0..1

0..1

0..1

leftSide

rightSide

0..1

0..1

ParameterList

RelationalExpression

ParameterItem

LogicalExpression

...

ele

...

...

RIM Class Diagram V1.19

Living

Entity

Role

Entity

Patient

0..n

0..n

1

1

Entity

target

inboundLink

0..n

0..n

1

1

cla

LanguageCommunication

source

outboundLink

ssC

player

playedRole

lan

ode

0..1

0..1

gua

0..n

0..n

:

0..n

0..n

1

1

...

scoper

scopedRole

CS

0..n

1

1

det

0..1

0..1

0..n

0..n

1..n

1..n

erm

...

HasRole

CommunicationFunction

...

1..*

1..*

0..*

0..*

1

1

Transmission

AttentionLine

0..*

0..*

id :

...

0..n

0..n

...

0..n

0..n

Person

0..1

0..1

Batch

refe

ren

...

  • 6Primary Subject Areas

  • 72 Classes

  • 276 Attributes

  • 94 Relationships

  • 59Data types (approx)


Terminology and information model

Terminology and Information Model

Information Model

Terminology


Bottom up status of hl7

Bottom-Up: Status of HL7

  • Version 2 widely used

  • No standard for implementation

  • Not mandatory

  • RIM is in development

  • Common Document Architecture (CDA)


Us standards for health record systems

For more information:

www.hl7.org


Top down integrating the healthcare enterprise ihe

Top-Down: Integrating the Healthcare Enterprise (IHE)

  • Standards needed for implementing standards

  • IHE formed in 1997

    • Health Information Management and Systems Society (HIMSS)

    • Radiology Society of North America (RSNA)

  • International participation: Canada, France, Germany, Italy, Japan, Korea, Netherlands, Norway, Spain, United Kingdom

  • Includes: societies, users, vendors, consultants, standards development organizations


Ihe a standard process for adoption of standards

IHE: A Standard Process for Adoption of Standards

  • Interoperability Problem Identification: identify common interoperability problems (information access, clinical workflow, administration, underlying infrastructure)

  • Integration Profile Specification: chose standards that address the problems - document them in an IHE integration profile

  • Connect-a-thon Testing: Vendors implement one or more IHE integration profiles into their products and test them for mutual interoperability at the annual IHE Connect-a-thon

  • Integration Statements and Requests for Proposals (RFPs):

    • Vendors publish IHE integration statements to document IHE integration profiles supported by their products

    • Users can reference the IHE integration profiles in requests for proposals, greatly simplifying the systems acquisition process.


A proven standards adoption process

Product IHE IntegrationStatement

Requirements

IHEConnect-a-thon

IHEDemonstration

Product

With IHE

Easy to

Integrate

Products

Standards

(e.g. ASTM-CCR

HL7 CDA)

IHEIntegration

Profiles B

IHEIntegration

Profile A

RFP

A Proven Standards Adoption Process

IHE Connect-a-thonResults

User Site


Ihe integration profiles radiology

IHE Integration Profiles - Radiology

  • Scheduled Workflow

  • Patient information Reconciliation

  • Consistent Presentation of Images

  • Post-processing Workflow

  • Reporting Workflow

  • Evidence Documents

  • Other profiles:

    • information technology infrastructure

    • cardiology

    • laboratory


Ihe connect a thons

IHE Connect-a-thons

  • Centerpiece of the IHE testing process

  • Weeklong interoperability-testing event

  • Validation of the participants' integration work

  • Systems exchange information with complementary systems from multiple vendors

  • Support of functions in the Integration Profiles


Us standards for health record systems

IHE Connect-a-thons

Massive yearly events :

60-70 vendors

120-160 engineers

Over 100 systems

….integrated in 5 days

Vendors do not pass…

until an IHE Project Manager attests it !


Participating and contributing vendors america

Participating and Contributing Vendors (America)

GE Healthcare

Heartlab

Hitachi Medical Corporation

Hologic, Inc

IDX Systems Corporation

IMCO Technologies

InSiteOne

INFINITT

Konica Minolta

Marotech, Inc.

McKesson Information Solutions

Medcon

Medical Manager Health Systems

Mediface Co., Ltd.

Merge eFilm

Mortara

Procom

Philips Medical Systems

RASNA Imaging Systems

Sectra

Sentillion

Siemens Medical Solutions

Softmedical

Stentor, Inc

StorCOMM, Inc

Swissray International, Inc

Tiani Medgraph AG

Toshiba America Medical Systems

UltraVisual Medical Systems

Vital Images, Inc.

Voxar Limited

WebMD

XIMIS

Agfa HealthCare

Algotec Systems, Ltd.

Berdy

Camtronics

Canon Medical Systems

Carefx

Cedara Software Corporation

Cerner Corporation

CSIST

Dictaphone

DR Systems

Dynamic Imaging

Eastern Informatics

Eastman Kodak Company

Emageon

Eclipsys

Fujifilm Medical Systems


How to participate in ihe

How to participate in IHE?

As a User or Vendor Contributor

  • Become a member of a Technical Committee

  • Become a member of Regional/National Committees

    As a Vendor Participant

  • Comment on integration profiles

  • Attend Educational Workshops (September)

  • Participate to Connect-a-thons

    As a User/Consultant Participant

  • Comment on integration profiles

  • Attend Educational Workshops (September)

  • Attend Connect-a-thons

  • Include IHE Integration Profiles in your RFPs and Integration Projects.


Us standards for health record systems

W W W . I H E . N E T

Providers and Vendors

Working Together to Deliver

Interoperable Health Information Systems

in the Enterprise

and Across Care Settings


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