Hl7 V3 Reference Models 20091123

Health Level Seven Version 3 Reference ModelsA Brief Introduction

Abdul-Malik ShakirPrincipal Consultant, Shakir Consulting

November 23, 2009

About Me

Abdul-Malik Shakir

• Principal Consultant with Shakir Consulting

• Information Management Strategist with City of Hope

• HL7 Member since 1991

• Co-Chair of the HL7 Education Workgroup

• Member of the HL7:

Architectural Review Board

Public Health and Emergency Response Workgroup

Regulated Clinical Research Information Management Workgroup

Modeling and Methodology Workgroup

HL7 v3.0 Foundational Artifacts

ReferenceInformation

Model

ReferenceInformation

Model

DatatypeSpecification

DatatypeSpecification

VocabularySpecificationVocabulary

Specification

Reference Models

The HL7 Reference Information Model is the information model from which all other information models and message specifications are derived.

The HL7 Vocabulary Specification defines the set of all concepts that can be taken as valid values in an instance of a coded attribute or data type property.

The HL7 Datatype Specification defines the structural format of the data carried in an attribute and influences the set of allowable values an attribute may assume.

HL7 Version 3.0 Reference Models

Reference Information ModelReference Information Model

Data TypeSpecification


VocabularySpecification


HL7 Version 3.0 Reference Information Model

The HL7 Reference Information Model is the information model from which all other information models and message specifications are derived.

The HL7 Reference Information Model

• The HL7 Reference Information Model (RIM) is a static model of health and health care information as viewed within the scope of HL7 standards development activities.

• It is the combined consensus view of information from the perspective of the HL7 working group and the HL7 international affiliates.

• The RIM is the ultimate source from which the information-related content of all HL7 version 3.0 protocol specification standards is drawn.

• The RIM is modeled using the modeling syntax defined by the Object Management Group’s Unified Modeling Language (UML).

HL7 RIM Class Diagram

Reference Information Model History

• Development of the HL7 Reference Information Model began in April 1996.

• The first draft of the RIM was created by consolidating data models developed

by HL7 Technical Committees, contributed by HL7 Member Organizations,

and published by national and international standards organizations and

government bodies.

• The first release of the RIM (v0.80) was adopted by the HL7 Technical

Steering Committee at the January 1997 working group meeting.

• The next two working group meetings focused on gaining familiarity with the

draft RIM and implementing a process for obtaining and reconciling proposed

enhancements to the model.

• The RIM maintenance process became known as "RIM harmonization.” The

first RIM harmonization meeting was held July 1997 in Indianapolis, Indiana.

RIM Harmonization Illustration

Model I Model II Model III

B

X F

E

C A D

G

1

0..*

0..* 1 0..* 1

0..* 0..1 0..*1

A

C

B

0..*

0..*

0..* 1 X

C

B

0..*

0..*

0..* 1

D

A B0..* 0..*

0..*

1

HL7 RIM Normative Specification

• Nine harmonization meetings were held between 1998 and 2000 culminating in version 1.0 of the RIM ratified during the January 2001 HL7 Working Group Meeting.

• The RIM continues to be refined via ongoing harmonization meeting but has been extremely stable in its content since January 2001.

• Version 1.25 of the RIM was submitted for ballot in 2002.

• In June 2003 it was published as an American National Standard.

Major RIM Harmonization Themes

• Ensure coverage of HL7 version 2.x. This set of change proposals introduced content to the draft model to ensure that it included all the information content of HL7 version 2.x.

• Remove unsubstantiated content from the model. This set of change proposals focused on removing content from the draft model that the steward technical committee did not originate and could find no rationale for retaining.

• Unified service action model. This set of change proposals introduced a concise, well-defined set of structures and vocabularies that address the information needs of a wide variety of clinical scenarios. This collection of proposals, known as USAM, involved the combined effort of multiple technical committees.

• Ensure quality. This set of change proposals addressed inconsistencies in the draft model and conflicts between the model and the modeling style guide. It began the practice of recording and tracking open issues in the model.

• Address the "left hand side" of the model. This set of change proposals introduced powerful structures and vocabularies for the non-clinical portions of the model (patient administration, finance, scheduling). Like the unified service action model, this proposal involved the combined effort of multiple technical committees.

USAM’s Influence on the RIM

• The Universal Service Action Model (USAM) proposal was a major influence on the current style of the RIM

• USAM was a joint project involving multiple HL7 Technical Committees and Special Interest Groups

• The USAM Material / Service construct is the predecessor to the current RIM Entity / Act construct

• USAM introduced the concept of activity mood as a means of distinguishing between act instances, definition, plans, orders, and criterion.

• The RIM concepts of entity determiner and entity roles are based upon concepts first introduced in the USAM proposal.

The Unified Service Action Model

Observation

value : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>

SubstanceAdministration

routeCode : CEapproachSiteCode : SET<CD>doseQuantity : IVL<PQ>rateQuantity : IVL<PQ>doseCheckQuantity : SET<RTO>maxDoseQuantity : SET<RTO>

Procedure

methodCode : SET<CE>approachSiteCode : SET<CD>targetSiteCode : SET<CD>

Supply

quantity : PQexpectedUseTime : IVL<TS>

Diet

energyQuantity : PQcarbohydrateQuantity : PQ

Document

setId : IIversionNumber : INTcompletionCode : CEstorageCode : CEcopyTime : TS

Container

capacityQuantity : PQheightQuantity : PQdiameterQuantity : PQcapTypeCode : CEseparatorTypeCode : CEbarrierDeltaQuantity : PQbottomDeltaQuantity : PQ

Access

approachSiteCode : CDtargetSiteCode : CDgaugeQuantity : PQ

Device

manufacturerModelName : SCsoftwareName : SClocalRemoteControlStateCode : CEalertLevelCode : CElastCalibrationTime : TS

Employee

jobCode : CEjobTitleName : SCjobClassCode : CEsalaryTypeCode : CEsalaryQuantity : MOhazardExposureText : EDprotectiveEquipmentText : ED

LivingSubject

administrativeGenderCode : CEbirthTime : TSdeceasedInd : BLdeceasedTime : TSmultipleBirthInd : BLmultipleBirthOrderNumber : INTorganDonorInd : BL

Material

formCode : CE

LicensedEntity

recertificationTime : TSPlace

mobileInd : BLaddr : ADdirectionsText : EDpositionText : EDgpsText : ST

ManufacturedMaterial

lotNumberText : STexpirationTime : IVL<TS>stabilityTime : IVL<TS>

NonPersonLivingSubject

strainText : EDgenderStatusCode : CE

Patient

confidentialityCode : CEveryImportantPersonCode : CE

Organization

addr : BAG<AD>standardIndustryClassCode : CE

Account

name : STbalanceAmt : MOcurrencyCode : CEinterestRateQuantity : RTO<MO,PQ>allowedBalanceQuantity : IVL<MO>

Person

addr : BAG<AD>maritalStatusCode : CEeducationLevelCode : CEraceCode : SET<CE>disabilityCode : SET<CE>livingArrangementCode : CEreligiousAffiliationCode : CEethnicGroupCode : SET<CE>

WorkingList

ownershipLevelCode : CE

PublicHealthCase

detectionMethodCode : CEtransmissionModeCode : CEdiseaseImportedCode : CE

PatientEncounter

preAdmitTestInd : BLadmissionReferralSourceCode : CElengthOfStayQuantity : PQdischargeDispositionCode : CEspecialCourtesiesCode : SET<CE>specialAccommodationCode : SET<CE>acuityLevelCode : CE

Other

Acts

Infrastructure (Structured documents)

HEALTH LEVEL 7 REFERENCE INFORMATION MODEL VERSION 1.25 (RIM_0125)

Reflects changes to RIM in RIM Harmonization Through 06/30/2003.

Billboard produced by:Rochester Outdoor Advertising

Roles

DiagnosticImage

subjectOrientationCode : CE

QueryAck

queryResponseCode : CSresultTotalQuantity : INTresultCurrentQuantity : INTresultRemainingQuantity : INT

QueryContinuation

startResultNumber : INTcontinuationQuantity : INT

Table

summary : STwidth : STrules : CScellspacing : STcellpadding : STborder : INTframe : CS

TableStructure

char : STcharoff : SThalign : CSvalign : CS

TableColumnStructure

span : INTwidth : ST

TableCell

scope : CSabbr : STaxis : STcolspan : INTheaders : SET<ED>rowspan : INT

LocalAttr

name : STvalue : ST

LocalMarkup

descriptor : STrender : STignoreCode : CS

LinkHtml

href : EDname : STrel : SET<CE>rev : SET<CE>title : ST

ContextStructure

localId : ST

Infrastructure (Structured documents)

Infrastructure (Communications)

Enitites

Message Control

FinancialTransaction

amt : MOcreditExchangeRateQuantity : REALdebitExchangeRateQuantity : REAL

InvoiceElement

modifierCode : SET<CE>unitQuantity : RTO<PQ,PQ>unitPriceAmt : RTO<MO,PQ>netAmt : MOfactorNumber : REALpointsNumber : REAL

FinancialContract

paymentTermsCode : CE

RoleHeir

EntityHeir

SortControl

sequenceNumber : INTelementName : SCdirectionCode : CS

QuerySpec

modifyCode : CSresponseElementGroupId : SET<II>responseModalityCode : CSresponsePriorityCode : CSinitialQuantity : INTinitialQuantityCode : CEexecutionAndDeliveryTime : TS

0..n

1

0..n

1

RelationalExpression

elementName : SCrelationalOperatorCode : CSvalue : ST

QueryBySelectionSelectionExpression

0..n

1

0..n

1

LogicalExpression

relationalConjunctionCode : CS

0..n

0..1

userAsRight

0..n

rightSide 0..1

0..n

0..1

userAsLeft0..n

leftSide0..1

QueryByParameter

ParameterList

Parameter

id : II 0..n 0..10..n 0..1

0..1

0..n

0..1

0..n

ParameterItem

value : ANYsemanticsText : ST

DeviceTask

parameterValue : LIST<ANY>

ManagedParticipation

id : SET<II>statusCode : SET<CS>

ActHeir

ActRelationship

typeCode : CSinversionInd : BLcontextControlCode : CScontextConductionInd : BLsequenceNumber : INTpriorityNumber : INTpauseQuantity : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegationInd : BLconjunctionCode : CSlocalVariableName : STseperatableInd : BL

Act

classCode : CSmoodCode : CSid : SET<II>code : CDnegationInd : BLderivationExpr : STtext : EDstatusCode : SET<CS>effectiveTime : GTSactivityTime : GTSavailabilityTime : TSpriorityCode : SET<CE>confidentialityCode : SET<CE>repeatNumber : IVL<INT>interruptibleInd : BLlevelCode : CEindependentInd : BLuncertaintyCode : CEreasonCode : SET<CE>languageCode : CE

0..n1

inboundRelationship

0..n

target

10..n1

outboundRelationship

0..n

source

1

Participation

typeCode : CSfunctionCode : CDcontextControlCode : CSsequenceNumber : INTnegationInd : BLnoteText : EDtime : IVL<TS>modeCode : CEawarenessCode : CEsignatureCode : CEsignatureText : EDperformInd : BLsubstitutionConditionCode : CE

0..n 10..n 1

RoleLink

typeCode : CSeffectiveTime : IVL<TS>

Role

classCode : CSid : SET<II>code : CEnegationInd : BLaddr : BAG<AD>telecom : BAG<TEL>statusCode : SET<CS>effectiveTime : IVL<TS>certificateText : EDquantity : RTOpositionNumber : LIST<INT>

0..n1

0..n1

0..n1

outboundLink

0..n

source

1 0..n1

inboundLink

0..n

target

1

LanguageCommunication

languageCode : CEmodeCode : CEproficiencyLevelCode : CEpreferenceInd : BL

AttentionLine

keyWordText : SCvalue : ST

Entity

classCode : CSdeterminerCode : CSid : SET<II>code : CEquantity : SET<PQ>name : BAG<EN>desc : EDstatusCode : SET<CS>existenceTime : IVL<TS>telecom : BAG<TEL>riskCode : CEhandlingCode : CE

0..n0..1

playedRole

0..n

player

0..1

0..n0..1

scopedRole

0..n

scoper

0..1

10..n 10..n

Transmission

id : IIcreationTime : TSsecurityText : ST

0..n

1

0..n

1

CommunicationFunction

typeCode : CStelecom : TEL

1..n

0..*

1..n

0..*1..*

0..*

1..*

0..* InfrastructureRoot

templateId : SET<OID>realmCode : SET<CS>typeID : SET<OID>nullFlavor : CS

QueryEvent

queryId : IIstatusCode : CS

ControlAct

0..1

1

0..1

1

Message

versionCode : CSinteractionId : IIprofileId : SET<II>processingCode : CSprocessingModeCode : CSacceptAckCode : CSattachmentText : SET<ED>responseCode : CSsequenceNumber : INT

0..1

0..n

0..1

payload

0..n

Acknowledgement

typeCode : CSmessageWaitingNumber : INTmessageWaitingPriorityCode : CEexpectedSequenceNumber : INT

0..n

1

acknowledgedBy0..n

acknowledges1

0..1

1

conveyedAcknowledgement 0..1

conveyingMessage1

AcknowledgementDetail

typeCode : CScode : CEtext : EDlocation : SET<ST>

1

0..n

1

0..n

Batch

referenceControlId : IIname : SCbatchComment : SET<ST>transmissionQuantity : INTbatchTotalNumber : SET<INT>

0..1

0..n

0..1

0..n

RoleEntity

Participation

Acts

The RIM After USAM

Infrastructure

Entity and Act

• Entity

a physical thing or an organization/group of physical things capable of participating in Acts. This includes living subjects, organizations, material, and places.

• Act

a discernible action of interest in the healthcare domain. An instance of Act is a record of that action. Acts definitions (master files), orders, plans, and performance records (events) are all represented by an instance of Act.

Entity Act

Entity

classCode : CSdeterminerCode: CScode: CEstatusCode : CSid : II

Act

classCode : CSmoodCode: CScode: CDstatusCode : CSeffectiveTime : GTSid : II

RIM Core Classes

• Entity - a physical thing or an organization/group of physical things capable of participating in Acts. This includes living subjects, organizations, material, and places.

• Act – a discernible action of interest in the healthcare domain. An instance of Act is a record of that action. Acts definitions (master files), orders, plans, and performance records (events) are all represented by an instance of Act.

0..* 0..*

Entity


Role

classCode : CScode: CEeffectiveTime : IVL<TS>statusCode : CSid : II

Act


RIM Core Classes

0..* 0..*1 0..*plays

0..10..*

0..10..*

plays

scopes

Entity


Role


Act


RIM Core Classes

• Role – a classification/specialization of an Entity defined by the relationship of the playing Entity to a scoping Entity. An example of Role is “Employee”. An employee is a classification attributed to a person which has an employment relationship with an organization (Employer).

0..* 0..*

Entity


Role


Participation

typeCode : CStime : IVL<TS>statusCode : CS

Act


0..1

0..* 1

0..*

1

0..*

RIM Core Classes

• Participation – an association between a Role and an Act representing the function assumed by the Role within the context of the Act. A single Role may participate in multiple Acts and a single Act may have multiple participating Roles. A single Participation is always an association between a particular Role and a particular Act.

0..1

0..*

plays

scopes

Entity


Role


Participation


Act


0..1

0..*1

0..*

1

0..*

Act Relationship

typeCode : CS

1 1

0..* 0..*

RIM Core Classes

• Act relationship – an association between two Acts. This includes Act to Act associations such as collector/component, predecessor/successor, and cause/outcome. The semantics of the association is captured by the Act Relationship attributes.

0..1

0..*

plays

scopes

• Role Link – An association between two Roles. It is used to capture relationships that exists between Entities other than the scoping relationships. A

Entity


Role


Participation


Act


0..1

0..*1

0..*

1

0..*

Role Link


Act Relationship

typeCode : CS

RIM Core Classes

0..1

0..*

plays

scopes

single Role may have a Role Link with multiple other Roles. A single Role Link is always between two distinct instances of Role.

1 1

0..* 0..*

1 1

0..* 0..*

Definition of RIM Core Classes

• Act – a discernible action of interest in the healthcare domain. An instance of Act is a record of that action. Acts definitions (master files), orders, plans, and performance records (events) are all represented by an instance of Act.

• Act relationship – an association between two Acts. This includes Act to Act associations such as collector/component, predecessor/successor, and cause/outcome. The semantics of the association is captured by the Act Relationship attributes.

• Entity - a physical thing or an organization/group of physical things capable of participating in Acts. This includes living subjects, organizations, material, and places.

• Participation – an association between a Role and an Act representing the function assumed by the Role within the context of the Act. A single Role may participate in multiple Acts and a single Act may have multiple participating Roles. A single Participation is always an association between a particular Role and a particular Act.

• Role – a classification/specialization of an Entity defined by the relationship of the playing Entity to a scoping Entity. An example of Role is “Employee”. An employee is a classification attributed to a person which has an employment relationship with an organization (Employer).

• Role Link – An association between two Roles. It is used to capture relationships that exists between Entities other than the scoping relationships. A single Role may have a Role Link with multiple other Roles. A single Role Link is always between two distinct instances of Role.

Entity


Role


Participation


Act


0..1

0..*1

0..*

1

0..*

Role Link


Act Relationship

typeCode : CS

RIM Backbone Classes

0..1

0..*

plays

scopes

1 1

0..* 0..*

1 1

0..* 0..*


Entity


Role


Participation


Act


0..1

0..*1

0..*

1

0..*

0..1

0..*

plays

scopes


Entity


Role


Participation


Act


1

0..*1

0..*

1

0..*

1

0..*

plays

scopes

Living Subject

Place

Organization

Material

Licensed Entity

Patient

Access

Employee

Managed Participation

Observation

Supply

Patient Encounter

Procedure

Device Task

Substance Administration

Financial Transaction

Invoice Element

Financial Contract

Account

Working List

Control Act

HL7 RIM Class Diagram

Entity

classCode : CCdeterminerCode : CSstatusCode : CScode: CE

Role

classCode : CSeffectiveTime : IVL<TS>code: CE

Participation


Act

classCode : CCmoodCode : CSstatusCode : CScode: CDeffectiveTime : GTS

0..1

0..* 1

0..*

1

0..*

RIM Core Attribute Value Sets

EntityClass Code

• Living Subject• Person• Organization• Material• Place• ...

RoleClass Code

• Patient• Provider• Employee• Specimen• Certified Practitioner• ...

ParticipationType Code

• Performer• Author• Witness• Subject• Destination• ...

ActMood Code

• Definition• Intent• Order• Event• Criterion• ...

ActClass Code

• Observation• Procedure• Supply• Substance Admin• Financial• ...

EntityDeterminerCode

• Kind• Instance• Quantified

Group

0..1

0..*

plays

scopes

Act.classCode

3.1.1.1 Act.classCode :: CS (1..1) Mandatory

Vocabulary domain: ActClass (CNE)

Attribute description:

A code specifying the major type of Act that this Act-instance represents.

Constraints:

The classCode domain is a tightly controlled vocabulary, not an external or user-defined vocabulary.

Every Act-instance must have a classCode. If the act class is not further specified, the most general Act.classCode (ACT) is used.

The Act.classCode must be a generalization of the specific Act concept (e.g., as expressed in Act.code), in other words, the Act concepts conveyed in an Act must be specializations of the Act.classCode. Especially, the classCode is not a "modifier" or the Act.code that can alter the meaning of a class code. (See Act.code for contrast.)

Act.moodCode

3.1.1.2 Act.moodCode :: CS (1..1) Mandatory

Vocabulary domain: ActMood (CNE)


A code distinguishing whether an Act is conceived of as a factual statement or in some other manner as a command, possibility, goal, etc.

Constraints:

An Act-instance must have one and only one moodCode value. The moodCode of a single Act-instance never changes. Mood is not state. To describe the progression of a business activity from defined to planned to executed, etc. one must instantiate different Act-instances in the different moods and link them using ActRelationship of general type "sequel". (See ActRelationship.typeCode.)

Discussion:

The Act.moodCode includes the following notions: (1) event, i.e., factual description of an actions that occurred; (2) definition of possible actions and action plans (the master file layer); (3) intent, i.e., an action plan instantiated for a patient as a care plan or order; (4) goal, i.e., an desired outcome attached to patient problems and plans; and (5) criterion, i.e., a predicate used to evaluate a logical expression

Act.code

3.1.1.4 Act.code :: CD (0..1)

Vocabulary domain: ActCode (CWE)


A code specifying the particular kind of Act that the Act-instance represents within its class.

Constraints:

The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc. Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure.

ActRelationship.typeCode

3.1.2.1 ActRelationship.typeCode :: CS (1..1) Mandatory

Vocabulary domain: ActRelationshipType (CNE)


A code specifying the meaning and purpose of every ActRelationship instance. Each of its values implies specific constraints to what kinds of Act objects can be related and in which way.

Discussion:

The types of act relationships fall under one of 5 categories:

1.) (De)-composition, with composite (source) and component (target).

2.) Sequel which includes follow-up, fulfillment, instantiation, replacement, transformation, etc. that all have in common that source and target are Acts of essentially the same kind but with variances in mood and other attributes, and where the target exists before the source and the source refers to the target that it links back to.

3.) Pre-condition, trigger, reason, contraindication, with the conditioned Act at the source and the condition or reason at the target.

4.) Post-condition, outcome, goal and risk, with the Act at the source having the outcome or goal at the target.

5.) A host of functional relationships including support, cause, derivation, etc. generalized under the notion of "pertinence".

Participation.typeCode

3.1.3.1 Participation.typeCode :: CS (1..1) Mandatory

Vocabulary domain: ParticipationType (CNE)


A code specifying the kind of Participation or involvement the Entity playing the Role associated with the Participation has with regard to the associated Act.

Constraints:

The Participant.typeCode contains only categories that have crisp semantic relevance in the scope of HL7. It is a coded attribute without exceptions and no alternative coding systems allowed.

Entity.classCode

3.2.1.1 Entity.classCode :: CS (1..1) Mandatory

Vocabulary domain: EntityClass (CNE)


An HL7 defined value representing the class or category that the Entity instance represents.

Examples:

Person, Animal, Chemical Substance, Group, Organization

Rationale:

Due to the extremely large number of potential values for a code set representing all physical things in the universe, the class code indicates both the subtype branch of the Entity hierarchy used as well as a high level classifier to represent the instance of Entity. This can be used to constrain the eligible value domains for the Entity.code attribute.

Entity.determinerCode

3.2.1.2 Entity.determinerCode :: CS (1..1) Mandatory

Vocabulary domain: EntityDeterminer (CNE)


An HL7 defined value representing whether the Entity represents a kind-of or a specific instance.

Examples:

1 human being (an instance), 3 syringes (quantified kind) or the population of Indianapolis (kind of group)

Rationale:

An Entity may at times represent information concerning a specific instance (the most common), a quantifiable group with common characteristics or a general type of Entity. This code distinguishes these different representations.

Entity.code

3.2.1.4 Entity.code :: CE (0..1)

Vocabulary domain: EntityCode (CWE)


A value representing the specific kind of Entity the instance represents.

Examples:

A medical building, a Doberman Pinscher, a blood collection tube, a tissue biopsy.

Rationale:

For each Entity, the value for this attribute is drawn from one of several coding systems depending on the Entity.classCode, such as living subjects (animal and plant taxonomies), chemical substance (e.g., IUPAC code), organizations, insurance company, government agency, hospital, park, lake, syringe, etc. It is possible that Entity.code may be so fine grained that it represents a single instance. An example is the CDC vaccine manufacturer code, modeled as a concept vocabulary, when in fact each concept refers to a single instance.

Role.classCode

3.3.1.1 Role.classCode :: CS (1..1) Mandatory

Vocabulary domain: RoleClass (CNE)


A code specifying the major category of a Role as defined by HL7 vocabulary.

Role.code

3.3.1.3 Role.code :: CE (0..1)

Vocabulary domain: RoleCode (CWE)


A code further specifying the kind of Role.

Discussion:

The Role.code must conceptually be a proper specialization of Role.classCode. Role.code does not modify Role.classCode. Rather, each is a complete concept or a Role-like relationship between two Entities, but Role.code may be more specific than Role.classCode.

The Role.code may not be coded if only an un-coded name for the type of role is commonly used.

RoleLink.typeCode

3.3.2.1 RoleLink.typeCode :: CS (1..1) Mandatory

Vocabulary domain: RoleLinkType (CNE)


A code specifying the kind of connection represented by this RoleLink, e.g., has-part, has-authority.

HL7 Version 3.0 Data Type Specification

The HL7 v3 Abstract Datatype Specification defines the structural format of the data carried in an attribute and influences the set of allowable values an attribute may assume.

HL7 Version 3.0 Data Types

• HL7 data types define the structure and constrain the allowable values of attributes in the RIM.

• The HL7 v3 abstract data type specification declares the set of data types, identifies components of complex types, and defines relationships between data types.

• The HL7 data type implementation technology specification defines constraints and operations for data types and describes how data types are to be represented in XML.

• Data types are reusable atomic building blocks used to create all HL7 V3 information structures.

• Each RIM attribute is assigned one data type; each data type is assigned to zero, one, or more RIM attribute.

HL7 Version 3.0 Data Types (Release 1)

• AD: Postal Address

• ANY: DataValue

• BAG: Bag

• BL: Boolean

• CD: Concept Descriptor

• CE: Coded With Equivalents

• CS: Coded Simple Value

• ED: Encapsulated Data

• EN: Entity Name

• GTS: General Timing Specification

• HIST: History

• II: Instance Identifier

• INT: Integer Number

• IVL: Interval

• LIST: Sequence

• MO: Monetary Amount

• ON: Organization Name

• PN: Person Name

• PPD: Parametric Probability Distribution

• PQ: Physical Quantity

• REAL: Real Number

• RTO: Ratio

• SC: Character String with Code

• SET: Set

• ST: Character String

• TEL: Telecommunication Address

• TN: Trivial Name

• TS: Point in Time

• UVP: Uncertain Value - Probabilistic

HL7 Data Type Packages

AddressDataTypes

+ AddressPart : ADXP+ PostalAndResidentialAddress : AD+ TelecommunicationAddress : TEL+ UniversalResourceLocator : URL

CharacterStringDatatypes

+ CharacterString : ST+ EncapsulatedData : ED

+ StringWithCode : SC

ConceptDescriptorDataTypes

+ CodedSimpleValue : CS+ CodedValue : CV

+ CodedWithEquivalents : CE+ ConceptDescriptor : CD

+ ConceptRole : CR

AnyDataType

+ DataValue : ANY

ParameterizedDataTypes

+ Bag : BAG+ Interval : IVL

+ Sequence : LIST+ Set : SET

IdentifierDataTypes

+ ISOObjectIdentifier : OID+ InstanceIdentifier : II

EntityNameDataTypes

+ EntityName : EN+ EntityNamePart : ENXP+ OrganizationName : ON+ PersonNameType : PN

+ TrivialName : TN

QuantityDataTypes

+ BinaryData : BIN+ Boolean : BL

+ IntegerNumber : INT+ MonetaryAmount : MO+ PhysicalQuantity : PQ

+ Quantity : QTY+ Ratio : RTO

+ RealNumber : REAL

TimingExpressionDatatypes

+ GeneralTimingSpecification : GTS+ GeneralTimingSpecificationTerm

+ PointInTime : TS

HL7 Version 3.0 Vocabulary Specification

The HL7 Vocabulary Specification defines the set of all concepts that can be taken as valid values in an instance of a coded attribute or message element.

HL7 V3 Vocabulary Specification

• The HL7 V3 Vocabulary Specification defines vocabulary domains used in RIM coded Attributes and coded data type properties.

• A vocabulary domain is an abstract collection of interrelated concepts. It describes the purpose or intent of a coded attribute.

• A value set is a collection of coded concepts drawn from one or more code systems. A vocabulary domain may be associated with many value sets (e.g. for use in different countries).

• A context expression provides a means of designating which value set for a given domain are applicable for a given usage context.

• A coded concept has a concept code assigned by the coding system and a concept designation which names the referenced concept.

• A coded concept may be a parent concept for a collection of additional concepts within the same code system.

HL7 V3 Vocabulary Specification Conceptual Model

ParentConcept

VocabularyDomain

name : Stringdescription : String

CodedConcept

conceptCode : StringconceptDesignation : String

0..*0..*

ValueSet

name : Stringdescription : StringdefiningExpression : String

0..*

0..*

0..*

0..*0..*

0..*0..*

0..*

includes

CodeSystem

identifier : OIDname : Stringdescription : String

0..*0..*

0..*

0..1

0..*

0..1

based on

ValueSetContext

contextExpression : String

Vocabulary TermsInformation Model

Vocabulary Binding

Class

1

0..* 0..*

1

Vocabulary Binding

Vocabulary Domain

Value Set

0..*

0..1

0..10..*

0..*

0..*

0..* 0..*

0..*

0..1

Attribute CodedConcept

CodeSystem

Coded “Structural” Attributes

• Act.classCode

• Act.moodCode

• Act.statusCode

• ActRelationship.checkpointCode

• ActRelationship.conjunctionCode

• ActRelationship.joinCode

• ActRelationship.splitCode

• ActRelationship.Type

• ActRelationship.contextControlCode

• Entity.classCode

• Entity.determinerCode

• Entity.statusCode

• ManagedParticipation.statusCode

• Participation.contextControlCode

• Participation.typeCode

• Role.classCode

• Role.statusCode

• RoleLink.typeCode

HL7 Version 3.0 Message Development

Framework

HL7 V3 Message Constrained Information Models

• RIM: Reference Information Model

• D-MIM: Domain Message Information Model

• R-MIM: Refined Message Information Model

• HMD: Hierarchical Message Definition

RIM

Restrict

R-MIM

Serialize

HMD

D-MIM

Derive

HL7 V3 Message Development Framework

Use Case Modeling

Interaction Modeling

Message Design

Information Modeling

RIM

Restrict

R-MIM

Serialize

HMD

Restrict

MessageType

Example

Storyboard

StoryboardExample

D-MIM

Derive

ApplicationRole

Sender Receiver

TriggerEvent

Triggers

Content

InteractionReferences

Components of an HL7 Constrained Information Model

• The HL7 v3 methodology specifies the information content of transport datasets (messages or documents) as constrained information models (CIM).

• Each CIM is comprised of clone classes derived from HL7 RIM classes.

• Clone classes are associated with attributes and relationships also derived from corresponding RIM model elements.

• A CIM may include a choice structure derived from a root RIM class.

• Relationships in the CIM are composed of two traversal paths, each derived from association ends in RIM class relationships.

• Controlling attributes in clone classes are used to identify the specific specialization of the RIM class used to derive the CIM clone class.

Sample HL7 Constrained Information Model

A_AbnormalityAssessment(COCT_RM420000UV)

Description: assessment of clinical findings, including lab test results,for indications of the presence and severity of abnormal conditions

AbnormalityAssessment

classCode*: = "OBS"moodCode*: = "EVN"code*: CD CWE [1..1] <= V:ObservationType ("ADVERSE_REACTION")statusCode*: CS CNE [1..1] <= V:ActStatusAbortedCancelledCompletedactivityTime*: TS.DATETIME [1..1]value: CD CWE [0..1] <= V:AbnormalityAssessmentValuemethodCode: SET<CE> CWE [0..*] <= V:AbnormalityAssessmentMethod

1..* assessmentOutcome *

typeCode*: = "OUTC"contextConductionInd*: BL [1..1] ="true"

outcome

AssessmentException

classCode*: = "OBS"moodCode*: = "EVN"code*: CD CWE [1..1] <= V:ObservationType ("ASSERTION")value*: SC CWE [1..1] <= V:AssessmentExceptionValue

AbnormalityGrade

classCode*: = "OBS"moodCode*: = "EVN"code*: CD CWE [1..1] <= V:ObservationType ("SEV")uncertaintyCode: CE CNE [0..1] <= V:ActUncertaintyvalue*: CD CWE [1..1] <= V:AbnormalityGradeValue

AssessmentOutcome

0..* assessmentOutcomeAnnotation

typeCode*: = "APND"contextConductionInd*: BL [1..1] ="true"

appendageOf

AssessmentOutcomeAnnotation

classCode*: = "OBS"moodCode*: = "EVN"code*: CD CWE [1..1] <= V:ObservationType ("ASSERTION")value*: SC CWE [1..1] <= V:AssessmentOutcomeAnnotationValue

HL7 Constrained Information Model

«clone»Class

localName: charfixedName: charbusinessName: charcomment: AnnotationisEntryPointIndicator: booleanisStubIndicator: boolean

«RIM»Class

name: chardescription: Annotation

«clone»Attribute

businessName: chardatatype: DataTypecardinality: Cardinalityconformance: Conformancecomment: AnnotationinitialValue: charinitialValueRole: ValueRolemaximumLength: int

«RIM»Attribute

name: chardatatype: DataTypecardinality: CardinalitymandatoryInclusionIndicator: booleandescription: Annotation

«RIM»Relationship

name: charrelationshipType: RelationshipType

«clone»Relationship

ConstrainedInformationModel

name: chardescription: AnnotationmodelType: ModelType

ControllingAttribute

constraints{datatype = CS}{cardinality = (1..1)}{conformance = Mandatory}{codingStrength = CNE}{terminologyReference = CodeSystem}

«RIM»AssociationEnd

roleName: charmultiplicity: Cardinalitynavigabil ityIndicator: boolean

«clone»Trav ersalPath

name: charenabledIndicator: booleanrequiredIndicator: booleanmandatoryIndicator: booleanmultiplicity: Cardinality

«enumeration»Cardinality

0..10..n0..*11..11..n1..*n..mn..*

«enumeration»RelationshipType

GeneralizationAssociationCompositionAggregation

«clone»Choice

name: charnameExtension: char

«enumeration»Conformance

OptionalRequiredMandatory

«enumeration»ValueRole

FixedDefault

«enumeration»ModelType

DMIM = Domain Message ...RMIM = Refined Message...CMET = Common Message ...HMD = Hierarchical Me...

0..*

associates source

1

«restrict»

1..*

0..*

associates target

1

0..*

associates target

1

0..*

associates source

1

0..*

isDerivedFrom

1

0..*{ordered}

1..*{ordered}

0..*

isDerivedFrom

1

0..*

isDerivedFrom

1

0..*

isDerivedFrom

root1

1..*

0..10..*

isDerivedFrom

1

2

2

CIM Terminology and Datatype Components

• Datatypes and terminology bindings are used to further describe CIM and RIM attributes.

• Attributes may be bound to a terminology reference (vocabulary domain, code system, or value set).

• A code system is composed of one or more code system terms.

• Code system terms may be aggregated as members of one or more value set.

• Code system terms may also be aggregated as subkinds of one or more parent code system term.

• Datatypes are may be composed of one or more datatype attributes.

• Datatype attributes may be bound to a terminology reference.

• Datatypes may be aggregated as subkinds of a parent datatype.

HL7 CIM Terminology and Datatype

«clone»Attribute

businessName: chardatatype: DataTypecardinality: Cardinalityconformance: Conformancecomment: AnnotationinitialValue: charinitialValueRole: ValueRolemaximumLength: int

«RIM»Attribute

name: chardatatype: DataTypecardinality: CardinalitymandatoryInclusionIndicator: booleandescription: Annotation

ControllingAttribute

constraints{datatype = CS}{cardinality = (1..1)}{conformance = Mandatory}{codingStrength = CNE}{terminologyReference = CodeSystem}

«RIM»TerminologyBinding

codingStrength: CodingStrength

«clone»TerminologyBinding


TerminologyReference{abstract}

name: chardescription: Annotation

VocabularyDomain

ValueSet

conceptIdentifier: char

CodeSystem

objectIdentifier: charreleaseIdentifier: charisExternalIndicator: boolean

CodeSystemTerm

code: char [0..1]designation: chardescription: AnnotationinternalIdentifier: char

DataType

longName: charshortName: chardescription: Annotation

DatatypeAttribute

name: chardatatype: DataTypedescription: Annotation

ParentDatatype

«datatype»TerminologyBinding


Annotation{abstract}

«enumeration»CodingStrength

CNECWE

ParentCodeSystemTerm

AnnotationSection

sectionRole: AnnotationSectionRolesectionText: char

«enumeration»AnnotationSectionRole

DescriptionRationaleDesign CommentIssueImplementation NoteHistoryMapping

0..*

binds

1

0..1

binds

1

0..1

binds

1

0..*

isDerivedFrom

1

«restrict»

0..*

isDerivedFrom

10..*

binds

1

1..*

subkind1..*

0..*

0..*

binds

1

0..1

binds

1

0..*

0..*

isBoundTo

1

member

1..*0..*

1..*

subkind1..*

0..1


Reference Information ModelReference Information Model






Account

name : STbalanceAmt : MOcurrencyCode : CEinterestRateQuantity : RTO<MO,PQ>allowedBalanceQuantity : IVL<MO>

DeviceTask

parameterValue : LIST<ANY>

DiagnosticImage

subjectOrientationCode : CE

Diet

energyQuantity : PQcarbohydrateQuantity : PQ

FinancialContract

paymentTermsCode : CE

FinancialTransaction

amt : MOcreditExchangeRateQuantity : REALdebitExchangeRateQuantity : REAL

InvoiceElement

modifierCode : SET<CE>unitQuantity : RTO<PQ,PQ>unitPriceAmt : RTO<MO,PQ>netAmt : MOfactorNumber : REALpointsNumber : REAL

ManagedParticipation

id : SET<II>statusCode : SET<CS>

Observation

value : ANYinterpretationCode : SET<CE>methodCode : SET<CE>targetSiteCode : SET<CD>

PatientEncounter

preAdmitTestInd : BLadmissionReferralSourceCode : CElengthOfStayQuantity : PQdischargeDispositionCode : CEspecialCourtesiesCode : SET<CE>specialAccommodationCode : SET<CE>acuityLevelCode : CE

Procedure

methodCode : SET<CE>approachSiteCode : SET<CD>targetSiteCode : SET<CD>

PublicHealthCase

detectionMethodCode : CEtransmissionModeCode : CEdiseaseImportedCode : CE

SubstanceAdministration

routeCode : CEapproachSiteCode : SET<CD>doseQuantity : IVL<PQ>rateQuantity : IVL<PQ>doseCheckQuantity : SET<RTO>maxDoseQuantity : SET<RTO>substitutionCode : CE

Supply

quantity : PQexpectedUseTime : IVL<TS>

WorkingList

ownershipLevelCode : CE

Container

capacityQuantity : PQheightQuantity : PQdiameterQuantity : PQcapTypeCode : CEseparatorTypeCode : CEbarrierDeltaQuantity : PQbottomDeltaQuantity : PQ

Device

manufacturerModelName : SCsoftwareName : SClocalRemoteControlStateCode : CE...alertLevelCode : CElastCalibrationTime : TS

LivingSubject

administrativeGenderCode : CEbirthTime : TSdeceasedInd : BLdeceasedTime : TSmultipleBirthInd : BLmultipleBirthOrderNumber : INTorganDonorInd : BL

ManufacturedMaterial

lotNumberText : STexpirationTime : IVL<TS>stabilityTime : IVL<TS>

Material

formCode : CENonPersonLivingSubject

strainText : EDgenderStatusCode : CE

Organization

addr : BAG<AD>standardIndustryClassCode : CE

Person

addr : BAG<AD>maritalStatusCode : CEeducationLevelCode : CEraceCode : SET<CE>disabilityCode : SET<CE>livingArrangementCode : CEreligiousAffiliationCode : CEethnicGroupCode : SET<CE>

Place

mobileInd : BLaddr : ADdirectionsText : EDpositionText : EDgpsText : ST

Access

approachSiteCode : CDtargetSiteCode : CDgaugeQuantity : PQ

Employee

jobCode : CEjobTitleName : SCjobClassCode : CEsalaryTypeCode : CEsalaryQuantity : MOhazardExposureText : EDprotectiveEquipmentText : ED

LicensedEntity

recertificationTime : TS

Patient

confidentialityCode : CEveryImportantPersonCode : CE

ActRelationship

typeCode : CSinversionInd : BLcontextControlCode : CScontextConductionInd : BLsequenceNumber : INTpriorityNumber : INTpauseQuantity : PQcheckpointCode : CSsplitCode : CSjoinCode : CSnegationInd : BLconjunctionCode : CSlocalVariableName : STseperatableInd : BL

Act

classCode : CSmoodCode : CSid : SET<II>code : CDnegationInd : BLderivationExpr : STtext : EDstatusCode : SET<CS>effectiveTime : GTSactivityTime : GTSavailabilityTime : TSpriorityCode : SET<CE>confidentialityCode : SET<CE>repeatNumber : IVL<INT>interruptibleInd : BLlevelCode : CEindependentInd : BLuncertaintyCode : CEreasonCode : SET<CE>languageCode : CE

0..n

1

outboundRelationship

0..n

source1

0..n

1

inboundRelationship

0..n

target

1

LanguageCommunication

languageCode : CEmodeCode : CEproficiencyLevelCode : CEpreferenceInd : BL

Participation

typeCode : CSfunctionCode : CDcontextControlCode : CSsequenceNumber : INTnegationInd : BLnoteText : EDtime : IVL<TS>modeCode : CEawarenessCode : CEsignatureCode : CEsignatureText : EDperformInd : BLsubstitutionConditionCode : CE...

0..n

1

0..n

1

Entity

classCode : CSdeterminerCode : CSid : SET<II>code : CEquantity : SET<PQ>name : BAG<EN>desc : EDstatusCode : SET<CS>existenceTime : IVL<TS>telecom : BAG<TEL>riskCode : CEhandlingCode : CE

1

0..n

1

0..n

RoleLink


Role

classCode : CSid : SET<II>code : CEnegationInd : BLaddr : BAG<AD>telecom : BAG<TEL>statusCode : SET<CS>effectiveTime : IVL<TS>certificateText : EDquantity : RTOpositionNumber : LIST<INT>

0..n

1

0..n

10..n0..1

playedRole0..n

player

0..1

0..n0..1

scopedRole

0..n

scoper

0..1

0..n

1

outboundLink 0..n

source1

0..n

1

inboundLink0..n

target1

ParentConcept

VocabularyDomain

name : Stringdescription : String

CodedConcept

conceptCode : StringconceptDesignation : String

0..*0..*

ValueSet

name : Stringdescription : StringdefiningExpression : String

0..*

0..*

0..*

0..*0..*

0..*0..*

0..*

includes

CodeSystem

identifier : OIDname : Stringdescription : String

0..*0..*

0..*

0..1

0..*

0..1

based on

ValueSetContext

contextExpression : String

T

Sequence : LIST

T

Set : SET

T

Bag : BAG

Quantity : QTY

IntegerNumber : INT

RealNumber : REAL

PhysicalQuantity : PQ

MonetaryAmount : MO

Ratio : RTO

PointInTime : TS

Boolean : BL

CharacterString : ST

ConceptDescriptor : CD

CodedValue : CV

InstanceIdentifier : II

TelecommunicationAddress : TEL

T

Interval : IVL

DataValue : ANY

BinaryData : BIN

List_of_Boolean : LIST<BL>

<<extends>>

EncapsulatedData : ED

<<extends>>

ConceptRole : CR

CodedSimpleValue : CS

<<restricts>>

CodedWithEquivalents : CE

ISO_object_identifier : OID

List_ADXP : LIST<ADXP>

PostalAndResidentialAddress : AD

<<extends>>

AddressPart : ADXP

PersonNameType : PN

List_ENXP : LIST<ENXP>

EntityNamePart : ENXP

T

PeriodicIntervalOfTime : PIVL

T

EventRelatedPeriodicIntervalOfTime : EIVL

GeneralTimingSpecification : GTS

Set_of_TS : SET<TS>

<<extends>>

T : T

T

Annotated : ANT

T

History_item : HXIT

T

History : HIST

Set_of_HXIT : SET<HXIT<T>>

T

UncertainValueNarrative : UVN

<<extends>>

T

UncertainValueProbabilistic : UVP

T

NonParametricProbabilityDistribution : NPPD

Set_UVP : SET<UVP<T>>

T

ParametricProbabilityDistribution : PPD

UniversalResourceLocator : URL

<<extends>>

OrganizationName : ON

<<extends>>

<<extends>><<extends>>


<<extends>>

<<extends>>

<<extends>>

<<extends>>

<<extends>>

<<extends>>

<<restricts>>

<<restricts>>

<<restricts>>

<<extends>>

<<extends>>





<<restricts>>

<<extends>>


<<extends>> <<extends>>

<<extends>>

Questions / Discussion / Feedback

Thank You

Abdul-Malik ShakirPrincipal Consultant

Shakir Consulting1407 Foothill Blvd., Suite 145

La Verne, CA 91750

Office: (909) 596-6790 Mobile: (626) 644-4491Email: [email protected]

Abdul-Malik Shakir Information Management Strategist

City of Hope1500 East Duarte RoadDuarte, CA 91010-3000

Office: (626) 256-4673 Mobile: (626) 644-4491Email: [email protected]

mailto:[email protected]

mailto:[email protected]

Hl7 V3 Reference Models 20091123

Technology

hl7 v3

draft model

hl7 rim class diagram

draft rim

information models

hl7 member organizations

information needs

hl7 international affiliates