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vMR – Virtual Medical Record

vMR – Virtual Medical Record. A RIM based model for clinical decision support Andrew McIntyre Medical-Objects. vMR – RIM based Models. Uses ISO 21090 Data types Need to add methods to classes for GELLO Uses GELLO (extended OCL) base types (iso21090 uses ocl )

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vMR – Virtual Medical Record

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  1. vMR – Virtual Medical Record A RIM based model for clinical decision support Andrew McIntyre Medical-Objects

  2. vMR – RIM based Models • Uses ISO 21090 Data types • Need to add methods to classes for GELLO • Uses GELLO (extended OCL) base types (iso21090 uses ocl) • Aiming for low hanging fruit eg: • Problem List (Past History) • Procedures (Surgical History) • Family History • Allergies • Current Medication • Medication History • Lab Observations • Social History (Alcohol/Tobacco)

  3. vMR – Base Model • CCD being used as source model • Transformable to and from CCR • Documented • Specified in US realm • Potential to develop v2 version (Australia) • Issues • Family History Model not as rich as desired • Allow extensions for Genomics data items (optional) • Currently using v1 datatypes • As is “Virtual” medical record can be mapped

  4. vMR - Uses • Designed for Decision Support • Little interest in display data • Demands terminology for safe usage • SNOMED-CT/ICD-9/ICD-10 • Several Use cases • Local decision support • Decision support services • Quality assessments • Gello uses it as its Model

  5. vMR - Example GELLO usage

  6. vMR – GELLO Examples

  7. vMR – UML Overview

  8. vMR – Why use “Simplified Model” • GELLO usability • Navigating to eg: patient would take complex statement • Identifying specific clinical data easily • GELLO should be written by clinical people • Simplify GELLO • Interfacing with “Legacy” systems • Allow CDS to occur with legacy data • Avoid overly complex transformations – “sweet spot hard to find” • Allow Clinicians to understand Model • Many attributes of RIM are not needed for a snapshot view

  9. vMR – Simplication Examples • Direct ACT<->Patient Link • vs Person playing role of patient • Also link Provider/Organisation • CCD has single patient • Excludes use on conjoined twins! • Current Medications • Medication History • CCD ACT relationships exposed as typed Properties • Family History exposed as object model with direct links to sub-observations • CCD could be reconstructed from vMR (except for text)

  10. vMR – Data sources • GELLO v1 described a simple vMR as example • Implemented against HL7 v2 data as trial • In real use in • GLIF • ISO 13606-2 Archetypes • Calculated results in editors

  11. RIMBA relationship • RIMBA is ultimate vMR • Only likely to need thin Facade to comply • Datatypes align • Your experience and input is welcome

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