1 aug 2008 © 2002-2008 health level seven ®, inc. all rights reserved. hl7 and health level seven...
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11Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
January 2009
Clinician Orientation
HL7 Clinical Interoperability Council (CIC)
22Aug 2008
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Introductions
• Tell us a bit about yourself Your name and organization Why you are here today/this week What you hope to gain from today’s session
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Welcome!
44Aug 2008
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Objectives for Today
• Convey mission and purpose of the HL7 Clinical Interoperability Council (CIC)
• Discuss how standards can support the clinical community
• Discuss how CIC conducts work• Describe what standards look like• Understand how to get involved• Understand general information about HL7
and how workgroup meetings function
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Introduction to HL7
Crystal Kallem
66Aug 2008
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Health Level Seven, Inc. (HL7)
• An international standards development organization (SDO) established more than 20 years ago
• Creates standards for the exchange, management and integration of electronic healthcare information
• Develops specifications that enable disparate healthcare applications to exchange key sets of clinical and administrative data
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HL7 Vision/Mission
VisionTo create the best and most widely used standards in healthcare.
MissionHL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all of our stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients. In all of our processes we exhibit timeliness, scientific rigor and technical expertise without compromising transparency, accountability, practicality, or our willingness to put the needs of our stakeholders first.
88Aug 2008
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Why Standards?
• Standards enable interoperability of healthcare information
• Three aspects of interoperability Technical: Moving data from system A to system B Semantic: Ensuring that system A and system B
understand the data in the same way Process: Enabling business processes at
organizations housing system A and system B to work together
99Aug 2008
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HL7 Workgroups
• Multiple workgroups function within HL7 today addressing various aspects of standards development
• The Clinical Interoperability Council (CIC) is an official workgroup of HL7
1010Aug 2008
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HL7 Workgroup Meetings
• HL7 face-to-face workgroup meetings occur in January, May and September each year
• Workgroup meetings offer A chance to meet face-to-face to work on standards
and conduct administrative work An opportunity to exchange knowledge and ideas
that lead to advancement in healthcare information technology utilization
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Introduction to the Clinical Interoperability Council (CIC)
Crystal Kallem
1212Aug 2008
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A Bit of History
• Early standards addressed what was needed as part of hospital information systems and departmental system
• Most current standards are transparent to the clinical community
• The needs for standards change as we progress with information technology
• The future must be different
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The Problem
Data Collected or Generated During
Patient Care
Data Used
1414Aug 2008
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Uses of Data Have Significant Overlap
ReimbursementManagementResearch
Quality M
easurement
& Patient Safety P
opul
atio
n H
ealth
Rep
ortin
g
Clinical Data
1515Aug 2008
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Goal: Exchange and Use of Data
Patient
Clinician
Healthcare Data Systems
• Patient care• Quality Improvement• Research• Reimbursement• Post Marketing Safety• Decision Support• Administration & Mgt.• Population Health Reporting
• …
Data Uses
Single Source Multiple Uses
1616Aug 2008
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Funding &Development
Partners
ResearchSurveillance
Patient CareRegulatory
Data Element: chest x-ray result
1717Aug 2008
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Funding &Development
Partners
ResearchSurveillance
Patient CareRegulatory
Data Element: chest x-ray result
= = = =
Data Mapping
1818Aug 2008
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Funding &Development
Partners
ResearchSurveillance
Patient CareRegulatory
Data Element: chest x-ray result
Global Data Standards:An agreed upon set of common data elements, how they are defined, and how they “look” electronically
1919Aug 2008
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Where are the Gaps?
• No clinical content standards• Siloed approaches for:
Terminology Guidelines Performance measures EHR development & implementation Research …
• Clinician involvement
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History of the CIC
• Initiated by HL7 in May 2006• Initial focus: Survey the landscape of
clinically oriented standards efforts Many presentations providing a wealth of
information, all available on the CIC web page
• CIC objectives are now a strategic priority for HL7
2121Aug 2008
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CIC Mission
This Council provides the standards development framework, organizational processes and forums to collaborate with the clinical community to define content, flow and other domain requirements necessary to the development of robust health data standards. The Council will provide mechanism for clinical domains to develop common approaches to standards-related activities and form consensus on issues of interest among multiple groups. This Council will be unique to Health Level Seven in that the focus is on the clinical content, not the technology of the standards.
2222Aug 2008
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CIC Mission
This Council provides the standards development framework, organizational processes and forums to collaborate with the clinical community to define content, flow and other domain requirements necessary to the development of robust health data standards. The Council will provide mechanism for clinical domains to develop common approaches to standards-related activities and form consensus on issues of interest among multiple groups. This Council will be unique to Health Level Seven in that the focus is on the clinical content, not the technology of the standards.
2323Aug 2008
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CIC’s Role
1. Actively engage clinicians in standardizing their domains2. Provide a community for those standardizing their domain3. Provide a forum and process for harmonization of data elements
and clinical information model4. Maintain awareness of, employ, and teach the best methodology
for clinical content representation5. Provide a process for clinical content representation and access
to experience6. Provide infrastructure, process and imprimatur associated with an
international SDO7. Access port through which clinical content can be made available
to HL7 technical community, i.e., for development of messages, documents, profile, services, etc.
Near-term products with a long-term outlook
2424Aug 2008
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Questions/comments?
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Methodology for Developing Standards and DAMs
Anita Walden
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Terms You May Hear
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Version 2.x
• APPROVED AS AN ANSI STANDARD JUNE 26, 2003.
• The HL7 version 2 standard has the aim to support hospital workflows.
• HL7 version 2 defines a series of electronic messages to support administrative, logistical, financial as well as clinical processes
• Most widely implemented standard for healthcare information in the world.
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Version 3.0
Uses an object-oriented development methodology and a Reference Information Model (RIM) to create messages. The RIM is an essential part of the HL7 Version 3 development methodology, as it provides an explicit representation of the semantic and lexical connections that exist between the information carried in the fields of HL7 messages.
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• Class : 1. A kind or category of things or concepts. 2. A definition of objects, in terms of properties (attributes, methods, and relationships) that all objects of the class have in common.
• Model : A representation of a problem or subject area that uses abstraction to express the relevant concepts. A model is often a collection of schema and other documentation.
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Data Element
• In metadata, the term data element is an atomic unit of data that has:An identification such as a data element name A clear data element definition One or more representation terms Optional enumerated values Code (metadata) A list of synonyms to data elements in other metadata
registries Synonym ring
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Data Element Example
Data Element Name
Clinical Data Definition
Permissible Values Set
Identification of Patient TB Status
Identification of Patient's Status
Suspected case of active TB; Confirmed case of active TB; LTBI; Contact of case of TB;
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Reference Information Model (RIM)
• The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3
methodology, the RIM is a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry.
It is a shared model between all the domains and as such is the model from which all domains create their messages.
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Other Terms You May Hear
• Balloting – Voting process. Before a standard is ANSI-approved, it must be balloted by the HL7 membership.
• Public Comment – Releasing developed standards to the community for review and comment
• CDISC – Clinical Data Interchange Standards Consortium – An organization that develops and supports standards for clinical research use
• EHR – Electronic Health Record• Message* – Atomic unit of data transferred between electronic systems. It
is comprised of a group of segments in a defined sequence.• Project Scope Statement – Form completed by project team to outline the
project. This form is used by HL7 to review approve official HL7 projects that may be balloted as an official HL7 standard
• SNOMED CT (Systematized Nomenclature of Medicine -- Clinical Terms)- Terminology for diseases, findings, procedures, microorganisms, pharmaceuticals. reducing the variability in the way data is captured, encoded and used for clinical care of patients and research.
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Domain Analysis Model
• The DAM is a set of requirements which are submitted to design and implementation procedures and processes (e.g., HL7 specification development). It is a structured way to describe and document the information requirements of a particular area of interest (or domain).
• A description of the domain or environment
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DAM Methodology and Process
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Domain Analysis Model Content
• Document Business Process - Clinicians• Storyboard- Patient Scenarios – Clinician • Glossary/data elements – Clinician/Data Manager• Activity diagram – Clinician/Data Manager• Use case model – Clinician/Modeler• Message content (data requirements)-Modeler• Class model (aka Domain Analysis Model)-Modelers • State diagram -Modeler• Business rules – Clinicians/Data Managers/Modelers
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Storyboard/Scenario ExampleDarlene Dobson goes to the local office of her state Department of Motor Vehicles to renew her drivers license and fills out a Drivers License Renewal form. The license clerk requests her current drivers license and using the drivers license number, S057864389, inquires on the status of her current drivers license, sees that it is active but scheduled to expire in three weeks, verifies that Darlene’s date of birth and current address are the same as the data currently in the system, enters Darlene’s responses from the form indicating that she has not been convicted of a moving motor vehicle violation in the previous three years and that she does not have any health issues that affect her driving ability. After that information is entered the system sends an inquiry to the state court system for moving motor vehicle violations in the previous three years and after receiving a response that there have been none, requests payment information. Darlene indicates she would like to pay with a MasterCard debit card and gives the card to the license clerk. The clerk enters the MasterCard number and expiration date. The registry system sends an electronic request to MasterCard to have the $35 drivers license renewal fee debited from Darlene’s account and credited to the Department’s bank account. After receiving an acceptance response from the MasterCard system, the registry system prints Darlene’s new drivers license good for three years and a payment receipt. Given that the entire visit only took 10 minutes, Darlene leaves the office with a smile on her face.
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Use Case
Requirements Analysis:Building a Domain Analysis Model HL7 Training;May 1, 2007,Norman Daoust,HDF Contributorfor Ioana Singureanu,
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act ACS Ev aluation
Interv iew & History Clinical Presentation
Perform cardiacbiomarker testing
Characterize Chest Pain
Ev aluate Results
Initiate ECG monitoring
Non-cardiacevent
SymptomsSuggestive
of ACS
Initiate Anti-IschemicMedical Therapy
ACSDiagnosis?
Repeat cardiac biomarkertesting
Observe
Perform stress test Ev aluate LV function
Not ACS,discontinue
ACSprotocol
Unstable Angina / NonST-Segment Elev ation MI
AdministerAntiplatelet/Anticoagulant
Therapy
Admit toHospital
ACSDiagnosis?
ACSDiagnosis?
Discharge Plan
Discharge
ST Segment Elev ation MI
FollowSTEMI
Guidelines
ECG Report
Lab Results
Stress Test
Report
LV Function Results
Stable Angina
Follow ChronicStable Angina
Guidelines
ST Elevation?
Monitor Patient
Continue to ACS
Treatment diagram
Transfer
Patient identified incommunity setting
Patient identified inclinical setting
[Yes]
[Possible orConfirmed]
[Undiagnosed]
[ACS]
[No]
[Yes]
[Yes]
[Ifordered]
[Ifordered]
[No][No]
[No]
[No]
CV Activity Model
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CV Class Model Example
class CV_Catheterization
CardiacCatheterizationLaboratoryVisit
- deathInLabIndicator: boolean- eventDateTime: DateTime
CardiacCatheterizationLaboratoryVisitDetail
- observationTypeCode: CodedElement- observationValue: ANY
CardiacCatheterizationProcedure
- pciDelayIndicator: boolean- pciDelayReason: CodedElement- pciIndicator: boolean- referringEmergencyDeptDateTime: DateTime- sTEMIPCIArrivalDateTime: DateTime- xferInForPrimaryPCIIndicator: boolean- xferOutForPrimaryPCIIndicator: boolean
CV_General::ProcedurePerformer
- name: string- uPIN: string
CV_General::Indication
- observationTypeCode: CodedElement- observationValue: ANY
LesionObserv ation
- observationTypeCode: CodedElement- observationValue: ANY
CV_General::Procedure
- procedureDate: Date- procedureTypeCode: CodedElement- urgencyStatus: CodedElement
Lesion
- bifurcationIndicator: boolean- dateOfMostRecentTreatment: Date- graftLocation: string- length: float- postStenosisPct: int- postTIMIflow: int- preStenosisPct: int- preTIMIflow: int- previouslyTreatedIndicator: boolean- risk: char- segmentLocation: string- thrombusIndicator: boolean
Segment
- segmentCode: CodedElementLesionTreatment
- reperfusionDateTime: DateTime- treatmentType: CodedElement
LesionTreatmentAdverseEvent
- treatmentEventCode: CodedElement- treatmentEventValue: ANY
CV_General::ProcedureInterpretation
- observationTypeCode: CodedElement- observationValue: ANY
Graft
- graftTypeCode: CodedElement
LesionTreatmentAdverseEventDetail
- observationTypeCode: CodedElement- observationvalue: ANY
Artery
- name: string
IntracoronaryDev ice
- barcode: string- devicePrimaryIndicator: boolean- deviceSequenceNumber: int- deviceTypeCode: CodedElement- diameter: float- length: float
Vessel
- typeCode: codedElement
CV_General::ProcedureFindings
- observationTypeCode: CodedElement- observationValue: ANY
CV_General::ProcedureAdv erseEv ents
- eventDateTime: DateTime- observationTypeCode: CodedElement- observationValue: ANY
CardiacCatheterizationLaboratoryInstruments
- instrumentTypeCode: CodedElement
CV_General::ProcedureGroup
- groupTypeCode: CodedElement
1
0..*
1
0..*
1..*
1
1 0..*
1 1..*
1
0..*
1
0..*
1 0..*
0..* 1..*
1
0..*
0..*0..*
1
0..*
10..*
1
0..*
1
1..*
0..1
0..*
1 0..*
1..*
0..1
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Methodology for Developing DAMs• Gather existing information
Data Elements/Definitions Forms/Data Dictionaries
• Engage and meet w/ Stakeholders to discuss project and gather additional existing information Initial Face to Face meeting with Domain Stakeholders
• Create small working group to define data elements and definitions Weekly-Bi/Weekly Teleconferences or webinars, 2- Face 2 Face mtgs a year to accomplish largest amount of work
• Subset work- break up data elements into smaller chunks of work Some domains are too large to accomplish all at once Focus on domain data elements only-General Data Elements are
developed by others groups• Public Comment – the entire community should have opportunity to
review defined data elements Have webinars to review work with broader community
• Publicize activities• Develop a standards and DAM maintenance plan
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• Identify tools used to develop UML /ActivityModels
• Use common class models examples CVTB
• Platform independent
Methodology for Developing DAMs (cont.)
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Roles
• Stakekholders –provide clinical content and information
• Project Manager – facilitate process• Data Manager or Informaticists – gather
requirements, create artifacts• Modeler – design models
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Key to Success
• Identify a Project Manager Keeps the process movingEnsures all key stakeholders are involved Identifies scopeCommunicates needs, status Facilitates meetingsEnsures products are produced w/in timeframeKeeps project within budget and scope
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Meetings Recommendations• Initial kick of meeting of all stakeholders
Inform them of project Gather information Identify stakeholder working groups participants
• Weekly or bi-weekly Web/Teleconferences Created and Define Data Elements Participants – stakeholders, project manager,
informaticists/data manager Modeler will attend once data elements have been developed
• 1-2 Face to Face mtgs a year to accomplish large chuncks of work
• Present work at conferences and working group mtgs• Attend HL7 CIC mtgs • Attend HL7 CIC Data Element Facilitation mtgs
Biweekly mtg to assist groups with the process, monitor status and keep consistency between DAMs
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Tooling Recommendations
• Communication toolsConference phone #Web Conferencing system
• Modeling toolsExamples: Visio/Enterprise Architecture/Rational
Software Model
• Spreadsheet - data gatheringExcel
• Website for accessing data standard
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Helpful Hints for a Sound Process • Providing stakeholders with information to respond to
will speed up the process. Giving them blank slate will take more time for decision
making Scope Data Elements/Definitions
• Identify where data elements and DAMs will be stored for public access Engage those groups early on
• Be aware other standards development activities and their direction
• Hold meetings on a consistent schedule Inconsistency reduces participation
• Use Ontologies• Keep DAMs General not specific to a tool or process
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Work Done to Date
Meredith Nahm
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Information Model• Domain Analysis Model (what concepts & how grouped)•HL7 RIM based models•Content for EHR screens
Inference Model•Clinical Guidelines•Decision Support•Performance Measures
Concept Model•Ontology•Formal Logic Definitions
*Adapted from model in Rector, et al 2004 MEDINFO/IMIA. Full reference in slide notes.
Accomplishing the Goal Requires Standardizing the Clinical Domain*
Data Elements•Link concept to terminologies•Link concept to definition
Content
LanguageKnowledge
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Example Inference Model*
*In reality, these rules would be written in a syntax that resembles computer code
InformationModel
ConceptModel
InferenceModelDecision Support:Decision Support:
Confirmed cases of TB should be flagged for local health authority notification (from CDC)
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Example Concept ModelInformation
Model
ConceptModel
InferenceModel
Concept Model:Concept Model:
FootFoot
ToeToe
part
Lower extremityLower extremity
part
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class Diagnosis
Common::RegistrationAsPatient
Specimen
+ bodySiteCode: char+ collectionDate: Date+ specimenTypeCode: char
TuberculosisDiagnosis
+ chestRadiographStatusCode: char+ computerAssistedTomographyIndicator: boolean+ confirmationMethodCode: char+ diagnosticConclusion: char+ effectiveDate: Date+ magneticResonanceImagingIndicator: boolean+ susceptibil ityTestingIndicator: boolean+ ultrasoundIndicator: boolean
BodySiteAffected
+ anatomicSiteCode: char+ primaryIndicator: boolean
Organism
+ genotypeCode: char+ mycobacteriumSpeciesCode: char
Common::SocialHistory ContactRelationship
+ contactTypeCode: char
ClinicalFindings
+ dateRecorded: Date+ durationOfCough: int+ durationOfFever: int+ underlyingPulmonaryDisease: char
BCGVaccination
+ mostRecentVaccinationDate: Date+ multipleVaccinationIndicator: boolean+ reportingMethodCode: char+ vaccinationTimingCode: char
Imaging::Image
Susceptibility
- isolateCultureMethodCode: int+ isolateLiquidMediaTypeCode: char [0..1]+ isolateSolidMediaTypeCode: char [0..1]
TuberculinSkinTest
+ blisteringStatus: char+ interpretationCode: char+ mantouxStrengtn: int+ quantitativeResult: int
Common::Patient
Common::PatientEncounter
Common::Clinician
Treatment
+ AdministrationEvent
+ AdministrationRecorder
+ CourseOfTreatment
+ DrugOrder
+ TreatmentInitiation
+ TreatmentInterruption
+ TreatmentTermination
(from Class Model)
HIVTesting
+ cd4AbsoluteCount: int+ cd4Percent: int+ specimenTypeCode: char+ testingDate: Date+ testTypeCode: char
SmearTest
+ InterpretationCode: char+ quantitativeResultCode: char+ SpecimenProcessingForSmearCode: char
InteferonGammaAssay
+ assayResultInterpretationCode: char+ elisaResult: int+ elispotResult: int
TuberculosisCulture
+ cultureMethodCode: char+ liquidMediaResultCode: char [0..1]+ liquidMediaTypeCode: char [0..1]+ SolidMediaResultCode: char+ SolidMediaTypeCode: char+ tuberculosisBacillusIndicator: boolean
Test
+ effectiveDateTime: int+ testingStatusCode: char+ typeCode: char
NucleicAcidAmplification
+ InterpretationCode: char
Imaging
+ Image
+ ImageEvolution
+ ImagingDetail
(from Class Model)
StatusSummaryInformation
+ bacillusCalmetteGuerinStatusCode: char+ extrapulmonaryTuberculosisIndicator: boolean+ hivStatusIndicator: boolean+ hivStatusMethodCode: char+ hivTestingIndicator: boolean+ predisposingMedicalHistoryIndicator: boolean+ pulmonaryTuberculosisStatusCode: boolean+ statusEffectiveDate: Date+ studyEnrollmentIndicator: boolean+ treatmentStatusCode: char [0..1]+ tuberculosisCaseTypeCode: char
Name: DiagnosisAuthor: Mead WalkerVersion: 1.0Created: 7/1/2001 12:00:00 AMUpdated: 1/25/2008 10:57:25 AM
TuberculosisSymptom
+ dateOfOnsetOfTuberculosisSymptom: date+ tuberculosisSymptomCode: char
Common::MedicalHistory
SusceptibilityResult
+ compoundConcentration: int+ resultCode: char
ChallengedSubstance
+ tuberculosisDrug: char
IsolateTesting
+registrationAsPatient 1
+encounterCollection 0..*
+person1+specimenCollection 0..*
+person
1
+medicalHistoryCollection
0..*
+sourcePerson1
+contactRelationshipCollection
0..*
+person 1
+registrationAsPatientCollection 0..*
+person 1
+bcgVaccinationCollection0..*
+Person
1
+socialHistoryCollection
0..*
+person
1
+clinicalFindingsCollection
0..1
+Person1
+StatusSummaryInformation
0..1
+person
1
+tuberculosisDiagnosisCollection
0..*
+person 1
+hivTestingCollection
+susceptibil ity 1
+tuberculosisDrugCollection
0..*
+organismCollection 0..*
+IsolateTesting
1
+organism
1
Resistance Tested
+susceptibil ityResultCollection
0..*
+tuburculosisDiagnosis 1
+bodySiteAffectedCollection 0..*
+specimen 0..1
+testCollection 0..*
+targetPerson0..1
+contactRelationshipCollection
0..*
+clinician
1
+hivTestingCollection
0..*
+tuberculosisDrug 1
+susceptibil ityResultCollection 0..*
+susceptibil ityResultCollection 0..*
+susceptibil ity 1
+clinician
1
+testCollection
0..*
+testCollection 0..*
+person1
+person 1
+imageCollection
0..*
+clinician
1
+tuberculosisSymptomCollection
+clinician
1
+bcgVaccinationCollection
0..*
+clinician 1
Orderer
+ImageCollection 0..*
+clinician 1
Interpreter
+ImageCollection
+clinician
1
+clinicalFindings 0..1
+clinician
1
+tuberculosisDiagnosisCollection0..*
+cliniciancollection 1..*
+patientEncounterCollection 0..*
+clnician
1
+socialHistoryCollection 0..*
+patientEncounter
0..1
+testCollection
0..*
+person
1
+TuberculosisSymptomCollection
0..*
+clinician
1
+medicalHistoryCollection
0..*
Example Information Model
InformationModel
ConceptModel
InferenceModel
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Information Models & Level of Abstraction
• Act• Procedure• Percutaneous
Coronary Intervention
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What is the RIM?
Entity
classCodedeterminerCodeIdcodequantitynamedescstatusCodeexistanceTimetelecomriskCodehandlingCode
Role
classCodeIdCodenegationIndAddrtelecomstatusCodeeffectiveTimecertificateTextQuantitypositionNumber
RoleLink
typeCodeeffectiveTime
source1
0.. n
1 target
0.. noutboundLink
inboundLink
player
playedRole
scoper
scopedRole
0.. n0.. 1
0.. n0.. 1
Participation
typeCodefunctionCodecontextControlCodesequenceNumbernegationIndnoteTesttimemoodCodeawarenessCodesignatureCodesignatireTextperformedIndsubstitutionCondition- Code
Act
classCodemoodCodeIdcodenegationIndderivationExprtitletextstatusCodeeffectiveTimeactivityTimeavailabilityTimepriorityCodeconfidentialityCoderepeatNumberinterruptablrIndlevelCodeindependentInduncertaintyCodereasonCodelanguageCode
ActRelationship
typeCodeinversionIndcontextControlCodecontextConductionIndsequenceNumberpriorityNumberpauseQuantitycheckpointCodesplitCodejoinCodenegationIndconjunctionCodelocalVariableNameseperatableInd
inboundRelationship
outboundRelationship0.. n
0.. n
source1
1
target
1
0.. n1
0.. n
Reference Information Model (RIM):Provides consistency across domains and levels of granularity
HL7 Reference Information Model, normative content, Version: V 02-02 (11/22/2003), ModelID: RIM_0202. available from hl7.org
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
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Can be Represented in the HL7 RIM
HL7 Reference Information Model, normative content, Version: V 02-02 (11/22/2003), Model ID: RIM_0202. available from hl7.org
5858Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
Important Take-Away Messages
• Models must be consistent across clinical areas For example, blood pressure must be represented
and defined the same way. A gift of data elements and ontology!
Modeling should be consistent. A gift of the RIM!
• Synchronization enables: Computable guidelines Information exchange and use
• Challenges We use natural language imprecisely Different areas need different granularity
InformationModel
ConceptModel
InferenceModel
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
59595959Aug 2008Aug 2008
How This Helps
• Reporting to quality improvement registries• Computable guidelines / Electronic updating
guideline changes to decision support• Joint Commission reporting• Aggregating data• Chart review
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
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Participating in CIC
Crystal Kallem
6161Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
How to Participate & Stay Informed
• CIC meeting on January 18th, 9am-5pm• Monthly conference calls
2009 schedule will soon be posted to the CIC web page and distributed through the CIC email list service
• CIC list service for email communications http://www.hl7.org/listservice/index.cfm
• CIC web page http://www.hl7.org/Special/committees/index.cfm?
src=sig_frames.cfm&src2=cic/index.cfm
• CIC wiki (logon: wiki / wikiwiki) http://wiki.hl7.org/index.php?title=CIC
6262Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
CIC Work in Progress
• Outreach to clinical professional societies• Ambassador program module to “get the word out”• Communication toolkit
• Clinical domain analysis models • Tuberculosis• Acute coronary syndrome• Diabetes• Mental health
• Master data element repository
6363Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
How Can You Help
• Contribute clinical subject matter expertise• Participate in CIC projects• Advocate and endorse CIC activities• Link related industry projects to CIC
6464Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
Benefits of a Partnership
• Together, we can: Enable each other Create standards that are invisible in the success of
clinical interoperability Influence policy and politics Share successes
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
65656565Aug 2008Aug 2008
Tomorrow’s CIC Meeting AgendaTime Topic Location
Q1: 9:00-10:30 Welcome/introductionsAgenda reviewInstructions for co-chair electionsInformation sharingDiscussion/Q&A
Salon V
10:30-11:00 Break
Q2: 11:00-12:30 Information sharing (cont.)Discussion/Q&A
Salon V
12:30-1:45 Lunch
Q3: 1:45-3:00 Work session Framework for CIC Expected end products/servicesDiscussion/Q&A
Salon V
3:00-3:30 Cookie Break!
Q4: 3:30-5:00 Metadata registriesAgenda planning for next meeting
Salon V
6666Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
Additional Information
• Visit the HL7 Clinical Interoperability Council (CIC) web site at: http://www.hl7.org/Special/committees/index.cfm?src=sig_frames.cfm&src2=cic/index.cfm
• CIC Co-chairs: Sam Brandt, MD
SIEMENS Medical [email protected]
Ed Hammond, PhDDuke University Medical [email protected]
Crystal Kallem, RHIAAmerican Health Information Management [email protected]
Meredith NahmDuke Translational Medicine [email protected]
6767Aug 2008
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
Thank you for coming!
Q & A
© 2002-2008 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
68686868Aug 2008Aug 2008
Extra Slides(not active at this time)