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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

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

Common Information Model

First Cut

May 2012

Project scope
Project Scope Immunizations

“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
Project Work Space Immunizations

  • Wiki

  • Artefacts

    • Identified standards documents to use and found links

    • Download spreadsheet from wiki

Common information model
Common Information Model Immunizations

  • First pass

    • V2

    • IHE Immunization Content

    • Consolidated CDA

  • After

    • Immunization DAM.

    • EHR FIM

    • POIZ

Version 2
Version 2 Immunizations

  • 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 Immunizations

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    • Mapped V2 data elements and NVAC elements to CareRecord and POIZ – see (outdated) wiki workspace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

Could no longer find our data elements!

Understanding templates
Understanding Immunizations Templates

Chasing the cascade of template ids
Chasing the cascade of template IDs Immunizations

  • See spreadsheet at:

Consolidated cda
Consolidated CDA Immunizations

  • 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
Consolidated CDA Templates Immunizations

  • 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
    Templates and data elements Immunizations

    • See

    Lessons so far
    Lessons ImmunizationsSo 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 far1
    Lessons ImmunizationsSo 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
    Returning to Common Information Model Immunizations

    • 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
    Need for implementation guide Immunizations

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

    Discussion Immunizations

    • 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