Message Development Framework (MDF)

4. Message Development Framework (MDF) • Is a Methodology for building HL7 models • Is a description for defining HL7 standard messages • Full instruction book for HL7 participants • Basis for member training • Five years in development • Continues to evolve as we gain experience

5. MDF Model Relationships Analysis Design Voting Requirements Analysis Use Case Model (UCM) Domain Analysis Domain Information Model (DIM) Interaction Design Interaction Model (IM) Message Design HierarchicalMessageDescriptions (HMD) Approval Ballots 2-nd Order 1 choice of 0-n Drug 0-1 Nursing Reference Model Repository RIM

6. Draw initial contents from RIM Develop Scope Information Model Create Use Cases Use Case Model Spec Model new concepts Identify Actors & Events Spec DIM Spec Class Diagram State Diagram Harmonize withReference Information Model UCM Spec Use Case Diagram Define Trigger Events Develop MessageInformation Model Interaction Model Define Application Roles Message Design Develop Message Object Diagram Spec 2-nd Order 1 choice of 0-n Drug 0-1 Nursing h//mt:50”d” … … … DefineInteractions Inter Spec Interaction Diagram Create Conformance Claims Specify HMD Models developed in Phases

7. Domain Use Case Model Information Model Message Information Model Models are used to build the HMD Reference Information Model Interaction Model Common Hierarchical Message Message Element Description Types

8. The HMD & ITS then give messages

9. What is the RIM? A HL7-wide common reference model that integrates all Technical Committees’ domain views Why do we need a common model? To ensure consistency of concepts To ensure consistent vocabulary How will we coordinate these efforts? Iterative reviews Harmonization meetings Who controls the RIM? The M&M committee Format, syntax, style Revision histories The Technical Steering Committee Dispute resolution Overseer Committee Vs. HL7 RIM

10. Stakeholders Patient Person Stakeholder Healthcare_service_ provider Organization Healthcare finances Patient_billing_account Healthcare_benefit_plan Guarantor_contract Patient_encounters Pharmacy_service_event Scheduling Patient_service_location Patient_service_order Patient_encounter Patient_service_event Patient_clinical_pathway Master_tables Clinical_pathway_master Service_catalog_item Observation_service_ catalog_item Reference Information Model Domain Subject Areas

11. Change Proposal Preparation Post Harmonization Meeting Review Post RIM Change Proposals Harmonization Meeting Review RIM Change Proposal w/ Stewards Revise or Withdraw RIM Proposal Post RIM Change Proposal Notify HL7 Members of RIM Change Proposal Posting Provide Comment on RIM Change Proposals Submit RIM Change Proposal Discuss the RIM Change Proposal Revise, withdraw, or Table RIM Change Proposal Vote on RIM Change Proposal Apply Approved Changes to RIM Apply Technical Corrections Hold TSC and/or Board Appeals Finalize Revised RIM RIM Harmonization Process Prepare RIM Change Proposal Document Rationale for not supporting RIM change proposal Present RIM Harmonization Report to TSC

12. Others Information Model Spec Use Case Model HL7Technical Committees Spec DIM Spec HL7Member Organizations Class Diagram State Diagram UCM Spec Use Case Diagram 2-nd Order 1 choice of 0-n Drug 0-1 Nursing Interaction Model Spec Inter Spec Interaction Diagram Other Standard Development Organizations Sources of Models for Harmonization

13. Reference Information Model Subject Classes • The Subject Classes are those classes in the RIM that express the concepts that are central to managing healthcare, e.g. Patient, Order. • Subject Classes are the focus for trigger events, use cases & application roles. • State transition modeling of Subject Classes discovers potential trigger events. • Subject Classes capture the domain behaviors that the HL7 committee feels are most important

14. State Transition Modeling • Identify States • From Use Cases • Document States • Which attributes must be valued/unvalued? • What are the constraints on the values? • What associations must be established? • What associations must not exist? • Capture State Model • UML State Transition Model

15. Draw initial contents from RIM Develop Scope Information Model Create Use Cases Use Case Model Spec Model new concepts Identify Actors & Events Spec DIM Spec Class Diagram State Diagram Harmonize withRIM UCM Spec Use Case Diagram Define Trigger Events Develop MessageInformation Model Develop MessageInformation Model Interaction Model Define Application Roles Message Design Develop Message Object Diagram Develop Message Object Diagram Spec 2-nd Order 1 choice of 0-n Drug 0-1 Nursing h//mt:50”d” … … … DefineInteractions Inter Spec Interaction Diagram Create Conformance Claims Specify HMD Specify HMD Message Design

16. Domain Information Model Use Case Model Interaction Model Reference Information Model Hierarchical Message Description Message Information Model Message Specification

17. This example will include those messages requiring data from Patient and Patient_admission Message Information Model (MIM)

18. Hierarchical Message Descriptions Reference Information Model Information Model Mapping MIM and R-MIM

19. "Discontinue "Send as ASCII Implementation Hierarchical pharmacy order" string in XML Technology Message format" Specification Definition ITSforXML HL7 HL7 Message Message Message Data Data Creation Parsing Instance HL7-Conformant HL7-Conformant Application Application Putting the pieces together

20. How this is done • UML and the Rational Rose toolset is used to capture many models • HL7 has developed a large number of tools and templates to assist in the process • Detailed tools training tutorials are held during Work Group meetings and harmonization meetings • Model and Methods is the overseer of the tools and the process URL* to download Tooling: http://www.mcis.duke.edu:/standards/HL7/committees/methodology-modeling/Rose tooling/ *this includes a text file to describe what each downloadable file is