HL7 Version 3

1. HL7 Version 3 Veli BICER

2. Agenda • HL7 • Problems with Version 2.x • HL7 Models • Use Case Model • Information Model • Interaction Model • Message Model

3. HL7 • founded in 1987 • To provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services.

4. Problems with version 2.x • Problem: misunderstanding of specifications • Result: Different implicit information models • Problem: Misleading conformance claims • Result: No vocabulary to describe conformance concepts

5. Problems with version 2.x • Implicit information model, not explicit • Need for controlled vocabularies • No explicit support for object technologies • No explicit support for security functions • Optionality is ubiquitous and troublesome

6. Contents of HL7 V2.3 • Trigger events • Actions or occurrences • Messages • Information content • Segments • Repeating structures • Data elements • Data representation

7. HL7 Version 3.X Specification • Version 3 Methodology - MDF • Conformance Claims • to improve the internal consistency of HL7

8. HL7 Models • A model is a collection of subject areas, scenarios, classes, attributes, use cases, actors, trigger events, interactions, etc. that depict the information needed to specify HL7 Version3 messages. • HL7 models are further divided into four specific models - a use case model, an information model, an interaction model, and a message design model.

9. HL7 Models

10. Use Case Model

11. Use Case Model • Describes specific situations in which communication between healthcare entities is needed.

12. Information Model

13. Information Model • A detailed and precise definition for the information from which all data content of HL7 messages are drawn. • Classes, Attributes, and Relationships • Documented in the Reference Information Model, the Domain Information Model, and the Message Information Model • State Transition Models for certain selected classes. • Data Types and Constraints.

14. Reference Information Model (RIM) • Root of all information models. • Provides a static view of the information. • A HL7-wide common reference model that integrates all Technical Committees’ domain views. • Committees and SIGs generally work with a small subset of the RIM - called Domain Information Model or DIM.

15. Reference Information Model (RIM) • Foundation Classes • Acts • Entities • Roles • Communication Infrastructure • Core Infrastructure • Message Communications Control • Structured Documents

16. Reference Information Model (RIM)

17. Reference Information Model (RIM)

18. Reference Information Model (RIM)

19. Interaction Model

20. Interaction Model • Specifies all Trigger Events and Message Flows. • Specifies the Application Roles.

21. Interaction Model • Each Interaction consists of: • Trigger event • Initiators of Interactions. • Message ID • Each interaction sends one particular message • Sender role • When trigger event detected, message is sent • Receiver role • Receiver responsibility

22. Application Role -identifies an information management responsibility for one of the subject classes. Responsibilities typically are: Creator, Manager, Tracker and Archivist. Healthcare applications are assumed to take on one or more application roles. Interaction Model Interaction

23. Interaction Model

24. Message Model

25. Domain Information Model Use Case Model Interaction Model Reference Information Model Hierarchical Message Description Message Information Model Message Specification

26. Subset the RIM  MIM • The RIM must first be refined by subsetting and constraining it • Create a MIM with RIM classes needed • Develop an R-MIM from these classes • Collection of classes with some constraints • Collection of attributes and associations to support the R-MIM

27. RIMcontent Fewerattributes MIMcontent (a proper subsetof the RIM)

28. Convert the MIM  R-MIM • Constrain cardinality on Associations • Constraints on Attributes • Some may be left out • Sub-components may be individually constrained • Classes are duplicated for different uses • May modify the Inheritance structure • Some specializations may subsume the generalization • Always inherit downwards to specializations

29. MIM

30. RMIM

31. 5 3 4 2a 2 1 0

34. Implementation Technology Specification • A method of encoding and sending HL7 messages. • XML represents one of several ITS to be developed

35. An HL7 V2.3 Message MSH|^~\&|LABGL1||DMCRES||199812300100||ORU^R01|LABGL1199510221838581|P|2.3|||NE|NE PID|||6910828^Y^C8||Newman^Alfred^E||19720812|M||W|25 Centscheap Ave^^Whatmeworry^UT^85201^^P||(555)777-6666|(444)677-7777||M||773789090 OBR||110801^LABGL|387209373^DMCRES|18768-2^CELL COUNTS+DIFFERENTIAL TESTS (COMPOSITE)^LN|||199812292128||35^ML|||||||IN2973^Schadow^Gunther^^^^MD^UPIN||||||||||^Once||||||CA20837^Spinosa^John^^^^MD^UPIN OBX||NM|4544-3^HEMATOCRIT (AUTOMATED)^LN||45||39-49||||F|||199812292128||CA20837 OBX||NM|789-8^ERYTHROCYTES COUNT (AUTOMATED)^LN||4.94|10*12/mm3|4.30-5.90||||F|||199812292128||CA20837

36. <Ballt> <dttm V="199912052357+0100"/> <vote V="A" S="HL7001" R="3.0" PN="Abstain"/> <votesOn_PropsdItm> <standrdLevlInd V='T'/> <propsdBy_OrgnztnAsCommtte> <nm V="Humble Task Group"/> <isAsubdvsnOf_OrgnztnAsCommtte> <nm V="Grand Committee"/> </isAsubdvsnOf_OrgnztnAsCommtte> <partcpesAsPrimryIn_StkhldrAffltn> <_StkhldrAffltn> <type V="X" S="HL7004" R="3.0" PN="XXX"/> <hasSecndryPartcpnt_PrsnAsCommtteContct> <has_PrsnName> <pnm><G V="George" CLAS="R"/><G V="Woody" CLAS="C"/> <G V="W." CLAS="RI"/> <F V="Beeler" CLAS="R"/> </pnm> </has_PrsnName> </hasSecndryPartcpnt_PrsnAsCommtteContct> </_StkhldrAffltn> </partcpesAsPrimryIn_StkhldrAffltn> </propsdBy_OrgnztnAsCommtte> </votesOn_PropsdItm>…

40. <ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" …> <id root="" /> <code code="11488-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" … /> <statusCode code="completed" /> <effectiveTime value="20030506230256" /> <confidentialityCode code="N" /> - <component> - <documentBody> - <component> - <documentSectionEvent> <code code="10164-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" … /> <text /> </documentSectionEvent> </component> - <component> - <documentSectionEvent> <code code="11384-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" … /> <text /> - <component> - <observation> <id root="2.16.840.1.113883.9876.368.2" … /> …..

41. Thanks for your attention