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The Relationship between ebXML, Archetypes, Templates, Terminology and the HL7 RIM

This article explores the semantic interoperability enabled by the combination of ebXML, archetypes, templates, terminology, and the HL7 RIM in the exchange of healthcare data. It discusses the unambiguous concept representation and object-oriented view of knowledge representation. It also delves into the use of Clinical Document Architecture (CDA) and OWL language for clinical document architecture and archetype development.

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The Relationship between ebXML, Archetypes, Templates, Terminology and the HL7 RIM

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  1. The Relationship between ebXML, Archetypes, Templates, Terminology and the HL7 RIM By Peter L. Elkin, MD Associate Professor of Medicine and Medical Informatics Mayo Clinic, School of Medicine

  2. Interoperable exchange of Healthcare Data Enabling distributed Semantic Interoperability Semantically empowering the ebXML Standard Unambiguous Concept Representation

  3. Many concepts are composite concepts with a defined structure Blood Pressure (BP) Systolic BP Diastolic BP Orthostatic Blood Pressures Lying BP Sitting BP Standing BP Object Oriented View of Knowledge Representation

  4. Health Expression Archetype Language (HEAL)

  5. CDA Level 1 Document Structure and Metadata ADL Archetypes Constraints on a Model Templates Formal Definitions Suggested Schema Comparable Data OWL Language

  6. Clinical Document Architecture CDA Level One DTD shown in “XML Authority” from Extensibility CDA Level One document shown in “Internet Explorer” from Microsoft

  7. Clinical Document Architecture

  8. Clinical Document Architecture

  9. Clinical Document Architecture

  10. archetype openehr-ehr-observation.bp_measurement.draft concept [at0000] -- blood pressure measurement description author = <"Sam Heard <s.heard@littlerock.com>"> submission = < organisation = <"openEHR Foundation"> date = <2003-06-10> > version = <"version"> status = <"draft"> revision = <"1.0"> description("en") = < purpose = <"Describe systemic blood pressure measurement result and protocol"> use = <""> misuse = <""> > adl_version = <"0.9"> rights = <"">

  11. HL7 - CDA - XML

  12. The R-MIM fragment (graphically represented here) can be converted to OWL Abstract Syntax (next slide), and used as a definition model for template development and validation. HL7 Templates R-MIM Fragment

  13. <axiom> ::= Class(ex:R-MIM Individual (ex:ID "12345")) Defines the entire Restricted MessageInformation Model <axiom> ::= Class(ex:R-MIM_Fragment Individual (ex:Frag_ID "67890") unionOf(ex:Observation ex:hasComponent) ) Defines the R-MIM Fragment as being the union of the Observation Class with the hasComponent Class (previous slide, and below) <axiom> ::= SubClassOf(sub=ex:R-MIM_Fragment super=ex:R-MIM) Specifies that the R-MIM fragment is a subclass of the entire R-MIM <axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0) ) ) Defines the Class Observation as a complete Act with defined restrictions (previous slide for reference) <axiom> ::= Class(ex:hasComponent (ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Defines the Class hasComponent as being a complete Observation within the COMP domain (previous slide for reference) <axiom> ::= ObjectProperty(ex:typeCode (Individual(ex:codeValue) ) ) <axiom> ::= ObjectProperty(ex:class_cd (Individual(ex:codeValue) ) ) <axiom> ::= ObjectProperty(ex:moodCode (Individual(ex:codeValue) ) ) Defines the Object Properties used in the above Class definitions <axiom> ::= DatatypeProperty(ex:codeValue xsd:integer) Defines the Data Type Properties for the Object Properties R-MIM Fragment OWL Syntax

  14. The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. R-MIM Fragment mapping to XML <owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> </owl:Class> <axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) Combined with <axiom> ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Can be used to validate.

  15. R-MIM Fragment mapping to XML • The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. <owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> </owl:Class> <axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) Combined with <axiom> ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Can be used to validate.

  16. R-MIM Fragment mapping to XML • The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. <owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> </owl:Class> <axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) Combined with <axiom> ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Can be used to validate.

  17. CBC is a subClassOf LabTest <owl:Class rdf:ID="CBC"> <owl:subClassOf rdf:resource="#LabTest"/> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:hasValue rdf:resource="#CBC_class_cd"/> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>1</owl:minCardinality> </owl:Restriction> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:hasValue rdf:resource="#CBC_moodCode"/> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:hasValue rdf:resource="#Hemoglobin"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:cardinality>1</owl:cardinality> </owl:Restriction> </owl:Restriction> …… continued on next slide ….. <owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction></owl:Class> Can be used to validate.

  18. CBC is a subClassOf LabTest <owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction></owl:Class> • …… continued from previous slide ….. • <owl:Restriction><owl:onProperty rdf:resource="# hasComponent"/> <owl:hasValue rdf:resource="#Hematocrit"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:maxCardinality>1</owl:maxCardinality> </owl:Restriction></owl:Restriction><owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:hasValue rdf:resource="#PlatletCount"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:cardinality>1</owl:cardinality> </owl:Restriction></owl:Restriction> • </owl:Class> Can be used to validate.

  19. Show Blood Pressure Archetype

  20. Show Blood Pressure Archetype / XML Output

  21. Show Blood Pressure OWL:Archetype Formal Definition

  22. Both the R-MIM Fragment and the full OWL_CBC.xml Template can be stored, with meta-data in ebXML. This will allow automated Template validation, and ease of retrieval and submission of Templates and Fragments. The following slides are snapshots of the ebXML Registry browser showing the XML R-MIM_ Fragment.xml Object, and it’s associations with the OWL_CBC.xml Template ebXML Registry

  23. ebXML Registry Object Browser

  24. Extrinsic Object Meta-Data Model

  25. Select groups can submit valid R-MIM Fragments in OWL:Archetypes syntax to the ebXML Registry. Develop software for HL7 Template Validation in ebXML. Allow groups to submit HL7 Templates composed in OWL:Archetypes/XML to be validated against registered R-MIM Fragments. Develop software to validate instances of an HL7 Template against the registered HL7 Template in OWL:Archetypes/XML syntax. Allow groups to validate their HL7 messages against registered instances of HL7 Templates in OWL:Archetypes/XML. Next Steps

  26. Join the ongoing development of the ebXML Registry Standard and the HL7 Templates SIG Where the Action is… Where the Rubber Meets the Road… Looking for hard working creative individuals to dedicate themselves to making interoperability a reality Discussion: ……… Thank You for Your Kind Attention! Conclusion:

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