HL7 PublicationsThe Publication Process

Helen StevensSenior Project Manager – Architecture

McKesson Information Solutions

HL7 Publications Committee ChairHL7 Canada Implementation Committee ChairHL7 Orders/Observations Committee Co-Chair

Overview Artifacts, Contents and Naming Conventions

What are the parts of the HL7 ballot and their naming conventions?

HL7 technical committee input What are the forms of content submission from the HL7

technical committees?

Publication Process What is the process used to convert the committee

submissions into the publication?

Publication product What is the product of V3 Publication?

Why a naming convention? Artifacts are uniquely identified

Avoids conflicts/duplicates between committees or working groups

Artifact types and responsibilities are clearly defined and understood from the name Increases accuracy and efficiency in ensuring that

correct artifacts are published properly

High volume of artifacts and submissions being received from many committees to be coordinated centrally by publications

Artifact Naming All artifacts delivered for V3 must be named using the

following convention:SSUU_DD_AAnnnnn

SS = Section codeUU = Sub-Section codeDD = Domain codeAA = Artifact or Document codennnnn = Five digit zero-filled number assigned by

Domain. Domain may assign this number in any way they wish to organize their artifacts.

Example: HMPO_RX_AR00001

Health & Clinical Section, Practices & Operations Sub-Section, Pharmacy Domain, Application Role Artifact number 00001.

Section, Sub-Section & Domain Codes

HM Section: Health & Clinical Management

PO Sub-Section: Practice & Operations

LB Domain: Laboratory

RX Domain: Pharmacy

RE Sub-Section: Reasoning

PC Domain: Patient Care

RC Sub-Section: Records

MR Domain: Medical Records

AM Section: Administrative Management

PR Sub-Section: Practice

PA Domain: Patient Administration

SC Domain: Scheduling

FI Sub-Section: Financial

FM Domain: Financial Management

CR Domain: Claims & Reimbursement

AB Domain: Accounting & Billing

IM Section: Infrastructure Management

CO Sub-Section: Control

MC Domain: Message Control

MF Domain: Master File Update

QU Sub-Section: Query

QD Domain: Query

Applicable to all sub-sections

XX Non Domain Specific

CM CMET

Section, Sub-Section & Domain Codes

Code Sub-SectionCO ControlFI FinancialPA Patient AdministrationPO Practice & OperationsPR PracticeQU QueryRC RecordsRE Reasoning

Code Sub-SectionCO ControlFI FinancialPA Patient AdministrationPO Practice & OperationsPR PracticeQU QueryRC RecordsRE Reasoning

Code SectionAM Administrative ManagementHM Health & Clinical ManagementIM Infrastructure Management

Code SectionAM Administrative ManagementHM Health & Clinical ManagementIM Infrastructure Management

Code DomainAB Accounting & BillingCM CMET Domain CR Claims & ReimbursementFM Financial ManagementLB LaboratoryMC Message ControlMF Master File UpdateMR Medical Records PC Patient CareQD QueryRX PharmacySC SchedulingXX Non-Domain specific Domain

Code DomainAB Accounting & BillingCM CMET Domain CR Claims & ReimbursementFM Financial ManagementLB LaboratoryMC Message ControlMF Master File UpdateMR Medical Records PC Patient CareQD QueryRX PharmacySC SchedulingXX Non-Domain specific Domain

Artifact & Document Codes

Code ArtifactAR Application RoleCT Common Message TypeHD HMDIC Interaction CategoryIN Interaction NA Narrative ContentRM R-MIMST StoryboardSX Storyboard ExampleTE Trigger Event

Code ArtifactAR Application RoleCT Common Message TypeHD HMDIC Interaction CategoryIN Interaction NA Narrative ContentRM R-MIMST StoryboardSX Storyboard ExampleTE Trigger Event

Code DocumentBB BackboneDT Data TypesIT ITSPB Publication/Domain DatabaseRI RIMRP Repository DatabaseVG V3 GuideVO Vocabulary

Code DocumentBB BackboneDT Data TypesIT ITSPB Publication/Domain DatabaseRI RIMRP Repository DatabaseVG V3 GuideVO Vocabulary

Sample Committee Naming SchemeSubmitted by: Michael Van Campen, HL7 Canada

RIM

e-ClaimsDIM

[ RM00000 ]

E01 RMIM[ RM01000 ]

E02 RMIM[ RM02000 ]

Generic HMD[ HD01000 ]

RMIM:Digits 1,2[ 00 = Super RMIM 01 = E01 02 = E02etc. ]

HMD:Digit 3[ 0 = Generic 1 = Pharmacy 2 = Laboratoryetc. ]

MT:Digits 4,5[ 00 = Generic 01 = Payor1 02 = Payor2etc. ]

HL7

Pa

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T[

MT

01

20

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etc.

etc.

etc.

Superset of all HMDs

Superset of all RMIMs

Pharmacy HMD[ HD01100 ]

Laboratory HMD[ HD01200 ]

RIM - Reference Information ModelDIM (RM) - Domain Information ModelRMIM (RM) - Refined Message Info ModelHMD (HD) - Hierarchical Message Defn.MT (MT) - Message Type (message)

Naming convention: AARRHMM, where • AA is the artifact code (RM, HD, MT), • RR is the RMIM id,• H is the HMD id, • MM is the MT id.

Legend

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MT

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Overview Artifacts, Contents and Naming Conventions

What are the parts of the HL7 ballot and their naming conventions?

HL7 technical committee input What are the forms of content submission from the HL7

technical committees?

Publication Process What is the process used to convert the committee

submissions into the publication?

Publication product What is the product of V3 Publication?

Committee Deliverables1. Domain Database

Application Roles Interaction Categories

Storyboards & Examples Trigger Events Interactions

R-MIM, HMD and Message Type Descriptions2. Diagrams

Refined Message Information Models (R-MIM) Storyboard Interaction Diagrams Other Diagrams

3. Design Repository R-MIM Hierarchical Message Descriptors (HMD) Message Types

4. XML Narrative Introductions

Domain Database MS Access database developed by Austin

Kriesler (McKesson) for HL7 to help the technical committees to manage 3.0 artifacts and documentation

One database for each publication domain

Contains all content except for extended narratives, diagrams and Rose Tree generated messages

Domain introduction

Application Roles

RMIM Diagrams VISIO diagrams generated using HL7

Stencil developed by Lloyd McKenzie (HL7 Canada) to document RMIM designs

One diagram for each RMIM developed

General Orders Status Change RMIM

1..*

P_responsible_partiestype_cd <= AUT, VRF, SPV or ANT*tmr: (time of creation, verification, attestation or annotation)note_txt:mode_cd:signature_cd:signature_txt:status_cd <= ACTIVE or COMPLETE

0..1

P_entering_locationtype_cd <= ELOC*

0..1

P_entering_devicetype_cd <= ODV

0..*

P_call_back_contacttype_cd <= CBCtmr: (availability time)

0..1

P_data_entrytype_cd <= ENTtmr: (time recorded)

1..*

P_responsible_partiestype_cd <= AUTtmr: (time of creation)

1..*

P_patienttype_cd <= PAT

Choice

Choice

Choice

0..1

AR_targetstype_cd <= ITGT*

0..*AR_Reasontype_cd <= RSON

0..1

AR_encountertype_cd <= COMP

invariant( x) { x.;}At least one occurrence musthave a type_cd of AUT

Constraint:

invariant( x) { x.;}For 'change' orders:If Order.id is null, patient participation(with id or name, DOB, and Gender)and Order.code must be specified.Otherwise, this information is notrequired. If specified, it mustcorrespond with the specifiedOrder.id.

Constraint:

Implementation suggestion:If note_txt is present, anapplication should display anindicator, and allow the user toview the full text on request.

Confidentiality_cd; txtgone for tightly_coupled

0..1AR_instantiatestype_cd <= INST

Orderclass_cd <= ACT

mood_cd <= ORDid: SET<II> (placer number, filler number, etc.)cd:confidentiality_cd:txt:

Cntrl_msg_interactionclass_cd <= MSGE

mood_cd <= EVNcd: (Event code)effective_time:txt:id:priority_cd:language_cd:

Observationclass_cd <= OBS

mood_cd <= INT or EVNcd:id:value: (reason)txt: (additional information)

Substance_admin_masterclass_cd <= SBADM*

mood_cd <= DEFid: (catalogue #)

CMET: Location

CMET: Used_device

CMET: Detailed_patient

CMET: Ident_patient

CMET: Encounter_ref

CMET: Ident_IHCP

CMET: Detailed_IHCP

CMET: Ident_IHCP

CMET: Detailed_IHCP

Other Diagrams Storyboard interaction diagrams are

required to support each storyboard submitted

Other diagrams may also be developed to support narrative content or provide additional value to the content.

Recommend use of VISIO to build and maintain all diagrams

Storyboard Interaction Diagram

Repository Database MS Access database developed by

Woody Beeler (Beeler Consulting) to store message designs including RIM, RMIM, HMD, and Message Types that are generated by Rosetree

One or more databases for each domain

Repository Screenshot (Rosetree)

HMD Common HMD Message Types

Converting VISIO to Repository Using HL7 menu in VISIO R-MIM

diagrams can be automatically verified against current RIM and converted into Rosetree Repository

XML Narratives Narratives maintained and submitted

in XML for Sub-Section or Domain introductions. Publications committee will perform initial

conversion from Word to XML, but document must be maintained in XML unless specific arrangement made with publications.

Required when introductions includes diagrams, tables or formatted text that cannot be entered into the Domain Database directly.

TC SubmissionsSubmissions from TCs for V3 must be in files named as

follows: Repository Database SSUU_DD_RPnnnnn.mdb RMIM Diagram(s) SSUU_DD_RMnnnnn.vsd

(one diagram per file) Storyboard Diagram(s) SSUU_DD_STnnnnn.vsd

(one diagram per file) Publication/ Domain Database SSUU_DD_PBnnnnn.mdb Narrative Documents SSUU_DD_NAnnnnn.mdb

Submit Files to http: //www.hl7.org/v3If an update to a file must be submitted, then it should be

named exactly the same as the original file. HQ will automatically add a timestamp to received files and keep all historical files.

Overview Artifacts, Contents and Naming Conventions

What are the parts of the HL7 ballot and their naming conventions?

HL7 technical committee input What are the forms of content submission from the HL7

technical committees?

Publication Process What is the process used to convert the committee

submissions into the publication?

Publication product What is the product of V3 Publication?

Publication FormatPublication in two final formats:1. PDF

appropriate for printing, submission to ANSII and off-line viewing

Each document available as ‘stand alone’ or will be inter-linked *

2. HTML Appropriate for viewing online Each document can be downloaded

separately *

* Backbone is required

Using XML All documentation will be converted

from XML into PDF and HTML

Primary ‘source of truth’ for normative content is the HL7 Repository.

HL7 Repository is Microsoft Access database.

Publication Process1. Build the Master Repository Database2. Build the Master Domain Database

Note: currently publication uses two master databases, in future this may be merged to be the same database.

3. Convert Diagrams4. Generate Publication from Databases

Section content (Repository + Domain Db) Reference Information Model Vocabulary

5. Generate other publication documents

Visio filesVisio filesVisio filesVisio filesVisio files

Master Repository (DMIM/RMIM/HMD/MT)

Repository Database Repository Database Repository Database Repository Database Repository Database

Build Master Repository

Post

Merge repositories

Migrate repositories 3

1. Verify VISIO diagrams against repository database contents

2. Verify repository database is self-consistent (names, duplicates etc.)

3. Merge repositories and migrate to Master repository containing RIM & Vocabulary

2

Verify

1

Verify

Build Master Domain

Visio filesVisio filesVisio filesVisio filesVisio files

Master Domain Db

Post

RepLinker Importer

3

1. Verify VISIO & other diagrams against domain database contents

2. Verify domain database is self-consistent (names, duplicates etc.)

3. Use RepLinker to import domain databases into blank Master DomainDb

2

Verify

Domain Database

Domain Database

Domain Database

Domain Database

Domain Database

1

Verify

Convert Diagrams HL7 publishes using GIF format

diagrams All diagrams are saved-as GIF from

VISIO (or any other submitted format) and cropped appropriately

This is currently a manual process

Visio filesVisio filesVisio filesVisio filesVisio files

Save-As GIF filesGIF filesGIF filesGIF filesGIF filesCrop

HTML FilesFormatting Objects(fo) XML File

XML Document

Transform

Master Repository (DMIM/RMIM/HMD/MT)

XML Extract

DTD

Base HTML XSL

Document Specific HTML XSL

PDF Files

Transform

Document Specific fo (PDF) XSL

Base fo (PDF) XSL

Render

XEP* Program

*RenderX Corp.

Generating HTML and PDF

Master Repository – RMIM/HMD/MT

Generating HTML and PDFMaster Repository - RIM

HTML FilesFormatting Objects(fo) XML File

XML Document

Transform

XML Extract

DTD

Base HTML XSL

Document Specific HTML XSL

PDF Files

Transform

Document Specific fo (PDF) XSL

Base fo (PDF) XSL

Render

XEP* Program

*RenderX Corp.

Master Repository – RMIM/HMD/MT

Generating HTML and PDFMaster Repository - RIMMaster Repository - Vocabulary

HTML FilesFormatting Objects(fo) XML File

XML Document

Transform

XML Extract

DTD

Base HTML XSL

Document Specific HTML XSL

PDF Files

Transform

Document Specific fo (PDF) XSL

Base fo (PDF) XSL

Render

XEP* Program

*RenderX Corp.

Master Repository – RMIM/HMD/MT

Generating HTML and PDFMaster Repository - RIMMaster Repository - VocabularyMaster Domain Database

HTML FilesFormatting Objects(fo) XML File

XML Document

Transform

XML Extract

DTD

Base HTML XSL

Document Specific HTML XSL

PDF Files

Transform

Document Specific fo (PDF) XSL

Base fo (PDF) XSL

Render

XEP* Program

*RenderX Corp.

XML Narratives

HTML FilesFormatting Objects(fo) XML File

XML Document

Transform

XML Extract

DTD

Base HTML XSL

Document Specific HTML XSL

PDF Files

Transform

Document Specific fo (PDF) XSL

Base fo (PDF) XSL

Render

XEP* Program

*RenderX Corp.

Master Repository – RMIM/HMD/MT

Generating HTML and PDFMaster Repository - RIMMaster Repository - VocabularyMaster Domain DatabaseXML Documents

Data Types 1 and 2XML Implementation Technology Spec

V3 Publication BackboneV3 Guide

Overview Artifacts, Contents and Naming Conventions

What are the parts of the HL7 ballot and their naming conventions?

HL7 technical committee input What are the forms of content submission from the HL7

technical committees?

Publication Process What is the process used to convert the committee

submissions into the publication?

Publication product What is the product of V3 Publication?

HL7 3.0 Core Publication Structure

V3 Backbone

•Welcome•Introduction•V3 Principles•Quick Start•Getting Started•Glossary

V3 Guide

ImplementableTechnology

Specifications

XML

Data Types

Data TypesPart I

Part II

Sub-sectionsSection

InfrastructureManagement

Sub-sectionsSection

AdministrativeManagement

Sub-sectionsSection

Health & ClinicalManagement

Normative: Content is balloted by general membership and is considered structural component of HL7 standard. Negative ballots MUST be resolved.

Reference: Content is harmonized during HL7 meetings or approved by the HL7 Board. It is not subject to ballot acceptance

Informative: Content is balloted by general membership; however, it is not considered to be a structural part of the standard, only supporting information. Vocabulary

Normative

Reference

Informative

Legend:

Reference Information

Model State Machines

Literary Expression

RIM Diagram

HL7 3.0 Section Publication Structure

Sub-sections

Domain

CMET

Storyboard

Application Roles

Interaction Category

R-MIM HMD Message Type

Interaction

Trigger Event

R-MIM HMD

StoryboardExamples

Message Type

Normative

Reference

Informative

Legend:

V3 Backbone1. Introduction2. Principles 3. Managing message development4. Quick Start5. Getting Started6. Glossary7. Links to all other documents & content.

Differing ‘entry points’ for different users: New Implementer Project Manager / Manager / Marketer Interface Developer / Analyst / Programmer Standards Developer

V3 Backbone

•Welcome•Introduction•Quick Start•Getting Started•Glossary

HL7 V3 Guide Instruction manual for understanding

the V3 Ballot and Specification1. Overview and Metamodel

2. Storyboards

3. Information Model

4. Vocabulary

5. Interaction Model

6. Conformance

7. Message Specification Replaces Message Development

Framework in publication. Focus on the ballot publication, not

development methodology.HL7 V3 Guide

SectionsHealth & Clinical Management of the health and clinical care of

individuals. Includes Orders/Observations, Reasoning (Patient Care/Decision Support) and Medical Records

Administrative Administrative management of health care

enterprises, assuming a separation of duties that distinguishes between the provision of health and clinical services and the management of the processes whereby those services are provided.

Infrastructure Information structures and communications tools to

support the interactions specified by the Health & Clinical and Administrative Sections.

Focus on the logical structures used to convey clinical and administrative information rather than on the clinical or administrative information itself.

SectionAdministrativeManagement

SectionHealth & Clinical

Management

SectionInfrastructureManagement

Final HTML Presentation

New HL7 ‘look & feel’ using green/blue colour scheme Pull down menus for quick navigation Specific help documentation and access to discussion boards to

support membership reviews

E-Claims Demonstration

Michael van Campen

E-claims TAG ChairTechnical Architecture Group

HL7 PAFM TC Co-chair (acting)Responsible for Financial Management

Next Release Plans Improved download/distribution system Improved faster menus Improved graphic presentation Improved HMD & Message Type

presentation PDF for Vocabulary and HMD Examples Increased hyper linking On-line help files Possibly on-line automated balloting tool

More… feedback and contributions welcome!

Salt Lake October 2001

San DiegoJanuary 2002

Atlanta April 2002

BaltimoreSeptember 2002

Anticipated Schedule

Committee Ballot #1 Review

Committee Ballot # 1

V3.0 Release

Membership Ballot Review

Membership Ballot

Committee Ballot #2 Review

Committee Ballot #2

Ballot 2 Development

Questions ?