HL7 v3 教育訓練系列教材

1. 教育訓練委員會 Education Technical Committees HL7 v3教育訓練系列教材 版權所有：台灣健康資訊交換第七層協定協會 HL7 Taiwan 協會 秘書長 范士展 sjvann@gmail.com HL7 Taiwan Google論壇: http://groups.google.com/group/hl7-taiwan

2. Refine Message Information Model(2小時) R-MIM模型介紹 R-MIM術語說明 實作概念 上機操作

3. RMIM模型介紹

4. RIM於應用之缺憾 RIM為一般化抽象類別模型(Class)。 類別模型無法表達特定物件(Object)。 使用V3方法論 重新定義 RIM，使其能夠產生 特定功能目的之物件。

5. 擴展RIM資訊 **限制循環**

6. D-MIM • Domain Message Information Model • 延伸自RIM。 • 由特定領域(domain)負責建構。 • 例如“Patient Administration”。 • 會有多個“entry points”(XML Root Element)。 • 類別的部分屬性開始賦予內容值。

7. R-MIM • Refined Message Information Model • 衍生自RIM，是D-MIM之子集合。 • 類別的部分屬性會再多一些給定內容值。 • 只會有一個“Entry Point”連接到特定焦點或主題類別。 Patient Administration DMIM Active Emergency Encounter RMIM New Person RMIM

8. R-MIM範例Active Emergency Encounter Entry Point Focal Class

9. R-MIM術語說明

10. Participations: notificationContact attender consultant referrer subject location responsibleParty admitter Entities: E_Organization E_Place Roles: R_NotificationParty R_AssignedPerson R_AssignedEntity R_Patient ServiceDeliveryLocation R_AssignedOrganization ActRelationships: componentOf pertinentInformation2 Authorization pertinentInformation1 Reference sequelTo arrivedBy 讀懂R-MIM類別是複製與顏色編碼 Acts: EncounterEvent A_Encounter ValuablesLocation A_Consent A_ObservationDx A_Account AccomodationEvent PatientTransportation

11. 如何閱讀R-MIM • RMIMs are in an HL7 “proprietary” modeling format, not UML. • Classes cloned and renamed to improve readability • Color matters • ActRelationship and Participation represented as block arrows: makes models more compact. • Source points to target • Roles • Solid line = played • Dashed line = scoped • Special Choice Box Representation • Constraint boxes

12. 重要術語 EntryPoint Act & Entity Class

13. 重要術語 Role Class Relationship Classes

14. 重要術語 Recursive Relationships Non-Core Classes

15. 重要術語 Non-Core Associations Choice

16. 重要術語 CMETs(Common Message Element Type) Constraint Note

17. Bold means Mandatory Vocabulary Domain Default Value Cardinality Coding Strength Data Type 屬性內容

18. 實作概念

19. 方法論步驟 • HL7工具的應用可分成三種步驟： • Scope 範疇 • Dynamic Model 動態模型 • Static Model 靜態模型

20. 範疇 • 本步驟要回答下列三個問題： • What is communicated? • What happens? • Who is involved?

21. 假設情境 有位臨床醫師，使用辦公室支援系統為其病患開立一個檢驗醫令。 此檢驗所需的檢體是在他的辦公室收集的。 他利用派送者將檢體送出，並期望能收到對方的回覆，確認要執行此檢驗以及最後結果。 • A clinician, using a local medical office support system, orders a lab test for one of her patients. The test will be performed on a specimen collected at her office. She will send the specimen by courier, and expects to receive a confirmation that the test will be performed, and a result of the test.

22. 動態模型 • 動態模型包含兩個步驟： (a) Blocking out the Interactions (b) Documenting the Interactions

23. Blocking out the Interactions • 從情境故事中擷取出交互作用，應先回答下列問題： • Who sends and receives? • When to communicate? • What is sent? • Response obligations? The right information to the right person at the right time

24. Blocking out the Interactions • 情境故事 • Initial order from MdOffice to LabMgmt; when the order is ready; • Content: patient, orderer, specimen, performer (lab), test; expect confirmation • Confirmation from LabMgmt to MdOffice; upon receipt and acceptance; • Content: order reference; performer; expected completion • Result from LabMgmt to MdOffice; when test done; • Content: order reference; patient reference; findings; specimen status

25. Documenting the Interactions • 要完成事項包含： • 定義或找出發送端與接收端的應用角色 • 規範 “trigger event” 作為溝通啟始 • 給予交互作用特性化 • 訊息類型之需求文件化

26. Documenting the Interactions • 情境故事範例 • MdOffice -> 1) Lab Order Placer; 2) Lab Confirmation Receiver; 3) Lab Observation Event Tracker; LabMgmt -> 1) Lab order fulfiller; 2) Lab Promise confirmer; 3) Lab Observation Event Informer • 1) Order activate; 2) Promise activate; 3) Event complete • 1) Request for action; 2) Request response; 3) Event notification • 1) Lab observation order; 2) Lab observation promise; 3) Lab observation event

27. 情境假設

28. 靜態模型 • 靜態模型包含三個步驟： (a) Defining Subject-specific Information Model, (b) Defining Message Design in an HMD (c) Documenting the Message Design

29. Defining Subject-specific Information Model • 應完成： • 確認是屬於哪一個領域或則是使用哪一個R-MIM。 • 建立副本，設定其屬性與關連。 • 從D-MIM 中組合或收集。 • 參照 “Common”型態(共用模組） • R-MIM文件化 • 存入儲存庫

30. Defining Message Design in an HMD • 此步驟應包含： • Walking the graph to serialize the R-MIM • Defining message types based on (within) the HMD • Defining R-MIM constraints • Saving to repository • Expressing HMD as XML, and/or CSV files

31. Documenting the Message Design • 最後步驟： • Publish designs in Excel • Create schemas • Publish in HTML

32. 上機操作 詳細流程，請參考 HL7Tools_TheComprehensiveGuide.doc 第六章

33. Order Author 1 最後結果 Physician 2 Author Physician 3 Performer 4 Laboratory Order Laboratory 5 Performer 6 Subject 10 8 Specimen Subject 7 Specimen Record target 9 Record target Patient Patient Definition Definition 11 Ordered test Ordered Test

34. … of this order. This order … 哪些物件是需要的 …was authored by … … was the author … …a physician role played by… … in her role as a physician … • Act (order) – Order • Participation – Author • Role - Physician • Entity - Dr. Smith in the MD office • Participation – Performer • Role – Laboratory • Entity - The lab that will perform the test • Participation – Subject • Role – Specimen • Participation – Record target • Role – Patient in whose record the result goes • Act relationship – Definition • Act (definition) – Ordered Test Suzy Smith. Suzy Smith …

35. 1. 注意儲存庫的位置 2. 注意版本

41. 感謝聆聽Refine Message Information Model 下一場：使用LOINC、SNOMED與OID介紹