HL 7 Clinical Interoperability Council (CIC) Clinician Orientation January 2009 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 1 Aug 2008
Introductions • Tell us a bit about yourself Ø Your name and organization Ø Why you are here today/this week Ø What you hope to gain from today’s session © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 2 Aug 2008
Welcome! © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 3 Aug 2008
Objectives for Today • Convey mission and purpose of the HL 7 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 HL 7 and how workgroup meetings function © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 4 Aug 2008
Introduction to HL 7 Crystal Kallem © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 5 Aug 2008
Health Level Seven, Inc. (HL 7) • 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 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 6 Aug 2008
HL 7 Vision/Mission Vision To create the best and most widely used standards in healthcare. Mission HL 7 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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 7 Aug 2008
Why Standards? • Standards enable interoperability of healthcare information • Three aspects of interoperability Ø Technical: Moving data from system A to system B Ø Semantic: Ensuring that system A and system B understand the data in the same way Ø Process: Enabling business processes at organizations housing system A and system B to work together © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 8 Aug 2008
HL 7 Workgroups • Multiple workgroups function within HL 7 today addressing various aspects of standards development • The Clinical Interoperability Council (CIC) is an official workgroup of HL 7 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 9 Aug 2008
HL 7 Workgroup Meetings • HL 7 face-to-face workgroup meetings occur in January, May and September each year • Workgroup meetings offer Ø A chance to meet face-to-face to work on standards and conduct administrative work Ø An opportunity to exchange knowledge and ideas that lead to advancement in healthcare information technology utilization © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 10 Aug 2008
Introduction to the Clinical Interoperability Council (CIC) Crystal Kallem © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 11 Aug 2008
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 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 12 Aug 2008
The Problem Data Collected or Generated During Patient Care Data Used 13 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 13 Aug 2008
Po p en em ur t y as afe Me t S ty en ali ati Qu & P ula Re tion po H rtin eal g th Uses of Data Have Significant Overlap t Reimbursement Management Research Clinical Data © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 14 Aug 2008
Goal: Exchange and Use of Data Healthcare Data Systems Data Uses • Patient care • Quality Improvement • Research • Reimbursement • Post Marketing Safety • Decision Support • Administration & Mgt. • Population Health Reporting • … Clinician Patient Single Source © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off Multiple Uses 15 Aug 2008
Data Element: chest x-ray result Surveillance Funding & Development Partners Research Patient Care Regulatory © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 16 Aug 2008
Data Element: chest x-ray result Surveillance Funding & Development Partners Research Data Mapping = = Patient Care Regulatory © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 17 Aug 2008
Data Element: chest x-ray result Surveillance Funding & Development Partners Research Global Data Standards: An agreed upon set of common data elements, how they are defined, and how they “look” electronically Patient Care Regulatory © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 18 Aug 2008
Where are the Gaps? • No clinical content standards • Siloed approaches for: Ø Ø Ø Terminology Guidelines Performance measures EHR development & implementation Research … • Clinician involvement © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 19 Aug 2008
History of the CIC • Initiated by HL 7 in May 2006 • Initial focus: Survey the landscape of clinically oriented standards efforts Ø Many presentations providing a wealth of information, all available on the CIC web page • CIC objectives are now a strategic priority for HL 7 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 20 Aug 2008
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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 21 Aug 2008
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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 22 Aug 2008
CIC’s Role 1. Actively engage clinicians in standardizing their domains 2. Provide a community for those standardizing their domain 3. Provide a forum and process for harmonization of data elements and clinical information model 4. Maintain awareness of, employ, and teach the best methodology for clinical content representation 5. Provide a process for clinical content representation and access to experience 6. Provide infrastructure, process and imprimatur associated with an international SDO 7. Access port through which clinical content can be made available to HL 7 technical community, i. e. , for development of messages, documents, profile, services, etc. Near-term products with a long-term outlook © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 23 Aug 2008
Questions/comments? © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 24 Aug 2008
Methodology for Developing Standards and DAMs Anita Walden © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 25 Aug 2008
Terms You May Hear © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 26 Aug 2008
Version 2. x • APPROVED AS AN ANSI STANDARD JUNE 26, 2003. • The HL 7 version 2 standard has the aim to support hospital workflows. • HL 7 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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 27 Aug 2008
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 HL 7 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 HL 7 messages. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 29 Aug 2008
• 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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 31 Aug 2008
Data Element • In metadata, the term data element is an atomic unit of data that has: Ø An identification such as a data element name Ø A clear data element definition Ø One or more representation terms Ø Optional enumerated values Code (metadata) Ø A list of synonyms to data elements in other metadata registries Synonym ring © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 32 Aug 2008
Data Element Example Data Element Name Identification of Patient TB Status Clinical Data Definition Permissible Values Set Identification of Patient's Status Suspected case of active TB; Confirmed case of active TB; LTBI; Contact of case of TB; © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 33 Aug 2008
Reference Information Model (RIM) • The Reference Information Model (RIM) is the cornerstone of the HL 7 Version 3 development process. Ø 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. Ø It is a shared model between all the domains and as such is the model from which all domains create their messages. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 34 Aug 2008
Other Terms You May Hear • • Balloting – Voting process. Before a standard is ANSI-approved, it must be balloted by the HL 7 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 HL 7 to review approve official HL 7 projects that may be balloted as an official HL 7 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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 35 Aug 2008
Domain Analysis Model • The DAM is a set of requirements which are submitted to design and implementation procedures and processes (e. g. , HL 7 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 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 36 Aug 2008
DAM Methodology and Process © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 37 Aug 2008
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 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 38 Aug 2008
Storyboard/Scenario Example Darlene 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, S 057864389, 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 Master. Card debit card and gives the card to the license clerk. The clerk enters the Master. Card number and expiration date. The registry system sends an electronic request to Master. Card 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 Master. Card 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. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 39 Aug 2008
Use Case © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. Requirements Analysis: Building a Domain Analysis Model. Level Seven are 1, 2007, Norman Daoust, of HL 7 and Health HL 7 Training; May registered trademarks HDF Contributor Health Level Seven, Inc. Reg. U. S. Pat & TM Off for Ioana Singureanu, 40 Aug 2008
CV Activity Model © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 41 Aug 2008
CV Class Model Example © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 42 Aug 2008
Methodology for Developing DAMs • Gather existing information Ø Data Elements/Definitions Ø Forms/Data Dictionaries • Engage and meet w/ Stakeholders to discuss project and gather additional existing information Ø Initial Face to Face meeting with Domain Stakeholders • Create small working group to define data elements and definitions Ø Weekly-Bi/Weekly Teleconferences or webinars, Ø 2 - Face 2 Face mtgs a year to accomplish largest amount of work • Subset work- break up data elements into smaller chunks of work Ø Some domains are too large to accomplish all at once Ø 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 Ø Have webinars to review work with broader community • Publicize activities • Develop a standards and DAM maintenance plan © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 43 Aug 2008
Methodology for Developing DAMs (cont. ) • Identify tools used to develop UML /Activity. Models • Use common class models examples Ø CV Ø TB • Platform independent © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 44 Aug 2008
Roles • Stakekholders –provide clinical content and information • Project Manager – facilitate process • Data Manager or Informaticists – gather requirements, create artifacts • Modeler – design models © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 45 Aug 2008
Key to Success • Identify a Project Manager Ø Keeps the process moving Ø Ensures all key stakeholders are involved Ø Identifies scope Ø Communicates needs, status Ø Facilitates meetings Ø Ensures products are produced w/in timeframe Ø Keeps project within budget and scope © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 46 Aug 2008
Meetings Recommendations • Initial kick of meeting of all stakeholders Ø Inform them of project Ø Gather information Ø Identify stakeholder working groups participants • Weekly or bi-weekly Web/Teleconferences Ø Created and Define Data Elements Ø Participants – stakeholders, project manager, informaticists/data manager Ø 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 HL 7 CIC Data Element Facilitation mtgs Ø Biweekly mtg to assist groups with the process, monitor status and keep consistency between DAMs 47 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off Aug 2008
Tooling Recommendations • Communication tools Ø Conference phone # Ø Web Conferencing system • Modeling tools Ø Examples: Visio/Enterprise Architecture/Rational Software Model • Spreadsheet - data gathering Ø Excel • Website for accessing data standard © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 48 Aug 2008
Helpful Hints for a Sound Process • Providing stakeholders with information to respond to will speed up the process. Ø Giving them blank slate will take more time for decision making Ø Scope Ø Data Elements/Definitions • Identify where data elements and DAMs will be stored for public access Ø Engage those groups early on • Be aware other standards development activities and their direction • Hold meetings on a consistent schedule Ø Inconsistency reduces participation • Use Ontologies • Keep DAMs General not specific to a tool or process © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 49 Aug 2008
Work Done to Date Meredith Nahm © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 50 Aug 2008
Accomplishing the Goal Requires Standardizing the Clinical Domain* Information Model • Domain Analysis Model (what concepts & how grouped) • HL 7 RIM based models • Content for EHR screens Content Data Elements • Link concept to terminologies • Link concept to definition Inference Model Concept Model • Clinical Guidelines • Decision Support • Performance Measures • Ontology • Formal Logic Definitions Knowledge Language *Adapted from model in Rector, et al 2004 MEDINFO/IMIA. Full reference in slide notes. © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 51 Aug 2008
Example Inference Model* Information Model Decision Support: Inference Model Concept Model Confirmed cases of TB should be flagged for local health authority notification (from CDC) *In reality, these rules would be written in a syntax that resembles computer code © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 52 Aug 2008
Example Concept Model Information Model Inference Model Concept Model: Model Lower extremity part Foot part Toe © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 53 Aug 2008
Example Information Model Inference Model Concept Model © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 54 Aug 2008
Information Models & Level of Abstraction • Act • Procedure • Percutaneous Coronary Intervention © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 55 Aug 2008
Act. Relationship What is the RIM? Reference Information Model (RIM): Provides consistency across domains and levels of granularity type. Code inversion. Ind context. Control. Code context. Conduction. Ind sequence. Number priority. Number pause. Quantity checkpoint. Code split. Code join. Code negation. Ind outbound. Relationship conjunction. Code local. Variable. Name 0. . n seperatable. Ind 1 source Entity class. Code determiner. Code Id code quantity name desc status. Code existance. Time telecom risk. Code handling. Code Participation Role player class. Code 0. . n Id played. Role Code negation. Ind Addr telecom status. Code scoped. Role effective. Time 0. . n certificate. Text 0. . 1 Quantity position. Number scoper 0. . 1 1 target inbound. Link 0. . n 1 type. Code function. Code context. Control. Code 1 sequence. Number 0. . n negation. Ind note. Test time mood. Code awareness. Code signature. Code signatire. Text performed. Ind substitution. Conditionsource Code outbound. Link 0. . n Role. Link type. Code effective. Time inbound. Relationship Act 0. . n 1 class. Code mood. Code Id code negation. Ind derivation. Expr title text status. Code effective. Time activity. Time availability. Time priority. Code confidentiality. Code repeat. Number interruptablr. Ind level. Code independent. Ind uncertainty. Code reason. Code language. Code 0. . n target 1 HL 7 Reference Information Model, normative content, Version: V 02 -02 (11/22/2003), Model. ID: RIM_0202. available from hl 7. org © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 56 Aug 2008
Can be Represented in the HL 7 RIM HL 7 Reference Information Model, normative content, Version: V 02 -02 (11/22/2003), Model ID: RIM_0202. available from hl 7. org © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 57 Aug 2008
Important Take-Away Messages • Models must be consistent across clinical areas Ø For example, blood pressure must be represented and defined the same way. A gift of data elements and ontology! Ø Modeling should be consistent. A gift of the RIM! • Synchronization enables: Information Model Ø Computable guidelines Ø Information exchange and use • Challenges Inference Model Ø We use natural language imprecisely Ø Different areas need different granularity © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off Concept Model 58 Aug 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. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 59 Aug 2008
Participating in CIC Crystal Kallem © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 60 Aug 2008
How to Participate & Stay Informed • CIC meeting on January 18 th, 9 am-5 pm • Monthly conference calls Ø 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 Ø http: //www. hl 7. org/listservice/index. cfm • CIC web page Ø http: //www. hl 7. org/Special/committees/index. cfm? src=sig_fra mes. cfm&src 2=cic/index. cfm • CIC wiki (logon: wiki / wiki) Ø http: //wiki. hl 7. org/index. php? title=CIC © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 61 Aug 2008
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 © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 62 Aug 2008
How Can You Help • • Contribute clinical subject matter expertise Participate in CIC projects Advocate and endorse CIC activities Link related industry projects to CIC © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 63 Aug 2008
Benefits of a Partnership • Together, we can: Ø Enable each other Ø Create standards that are invisible in the success of clinical interoperability Ø Influence policy and politics Ø Share successes © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 64 Aug 2008
Tomorrow’s CIC Meeting Agenda Time Topic Location Q 1: 9: 00 -10: 30 Welcome/introductions Agenda review Instructions for co-chair elections Information sharing Discussion/Q&A Salon V 10: 30 -11: 00 Break Q 2: 11: 00 -12: 30 Information sharing (cont. ) Discussion/Q&A 12: 30 -1: 45 Lunch Q 3: 1: 45 -3: 00 Work session Framework for CIC Expected end products/services Discussion/Q&A 3: 00 -3: 30 Cookie Break! Q 4: 3: 30 -5: 00 Metadata registries Agenda planning for next meeting © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off Salon V 65 Aug 2008
Additional Information • Visit the HL 7 Clinical Interoperability Council (CIC) web site at: • CIC Co-chairs: http: //www. hl 7. org/Special/committees/index. cfm? src=sig_frames. cfm& src 2=cic/index. cfm Ø Sam Brandt, MD SIEMENS Medical Solutions sam. brandt@siemens. com Ø Ed Hammond, Ph. D Duke University Medical Center hammo 001@mc. duke. edu Ø Crystal Kallem, RHIA American Health Information Management Association crystal. kallem@ahima. org Ø Meredith Nahm Duke Translational Medicine Institute meredith. nahm@duke. edu © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 66 Aug 2008
Thank you for coming! Q&A © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 67 Aug 2008
Extra Slides (not active at this time) © 2002 -2008 Health Level Seven ®, Inc. All Rights Reserved. HL 7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U. S. Pat & TM Off 68 Aug 2008
Скачать презентацию HL 7 Clinical Interoperability Council CIC Clinician Orientation
5cf6a46b0fe74110e06082485399f33c.ppt