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Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”) - PowerPoint PPT Presentation

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Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”). Common Information Model First Cut May 2012. Project Scope.

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Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”)

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Cross-Paradigm Interoperability Implementation Guide for Immunizations(“X Paradigm”)

Common Information Model

First Cut

May 2012

Project Scope

“This implementation guide will explore the Service-Aware Interoperability Framework (SAIF) methodology to show how various HL7, IHE and OMG immunization-related artifacts can be deployed to satisfy immunization interoperability use cases. “

  • This presentation gives work so far on just the Common Information Model section

Project Work Space

  • Wiki

  • Artefacts

    • Identified standards documents to use and found links

    • Download spreadsheet from wiki

Common Information Model

  • First pass

    • V2

    • IHE Immunization Content

    • Consolidated CDA

  • After

    • Immunization DAM.

    • EHR FIM

    • POIZ

Version 2

  • 2.3.1 – since early 90s

  • 2.5.1 – recent

  • Very established in the U.S.

    • Meaningful Use standard Stage I

Background of Immunization Content

  • Background of Immunization Content

    • First drafts included V2 messaging models

    • Mapped V2 data elements and NVAC elements to CareRecord and POIZ – see (outdated) wiki workspace


    • Convinced in public comment phase to go with XDS solution only – i.e. CDA model

    • 4 Connectathons/Interoperability Showcases

    • Voted into Final Text

IHE Immunization Content

Could no longer find our data elements!

Understanding Templates

Chasing the cascade of template IDs

  • See spreadsheet at:

Consolidated CDA

  • Formed to resolve many HL7/IHE templates involved in Transfer of Care

  • Out-of-cycle ballot created to include MU Stage II NPRM elements

  • PHER project to add immunization elements

Consolidated CDA Templates

  • Continuity of Care Document (CCD)

  • Consultation Notes

  • Discharge Summary

  • Imaging Integration, and DICOM Diagnostic Imaging Reports

  • History and Physical

  • Operative Note

  • Progress Note

  • Procedure Note

  • Unstructured Documents

  • Immunization Content/PH not included

  • Templates and data elements

    • See

    Lessons So Far

    • CDA is designed to promote semantic interoperability

      • ResponsibleParty example

    • Promote inheritance

    • Facilitate integration of patient information

    • Their human-readable forms promote much easier access by non-technical users

    Lessons So Far

    • CDA solutions are a very deep technical dive

    • Template IDs are “magic numbers” and not easy to chase

    • Without additional tools, their specifications do not facilitate easy access by non-technical domain expertise

    Returning to Common Information Model

    • Need to determine model

      • RIM?

    • Finish the cross-reference

      • Based upon templates and not individual data elements?

    • Explore recent efforts

      • FHIR, Template registry, Green CDA, ???

    • Vet, vet, vet

      • Ideas?

    Need for implementation guide

    • There a document specifically showing public health or other non-CDA experts how to interpret the immunization CDA-related specs is needed


    • Track Patient Care projects and present to PC

    • Track CDA R3 vs R2

    • Include NVAC data elements in list of artefacts

      • Old version?

    • Look closely at use cases for what different players such as ACOs want out of them

      • AIRA functions

    • Map EHR public health functions into EHR functions

    • This project may inform FHIR and/or vice versa

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