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HL7 RIM June 2010

0..*. 0..*. 0..*. 0..*. 1. 1. 1. 1. 1. 1. 0..*. 0..*. HL7 RIM June 2010. Role Link. Act Relationship. type_cd : CS effective_time : IVL<TS>. type_cd : CS. Entity. Role. Participation. Act. class_cd : CS cd: CE determiner_cd : CS status_cd : CS

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HL7 RIM June 2010

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  1. 0..* 0..* 0..* 0..* 1 1 1 1 1 1 0..* 0..* HL7 RIM June 2010 Role Link Act Relationship type_cd : CS effective_time : IVL<TS> type_cd : CS Entity Role Participation Act class_cd : CS cd: CE determiner_cd : CS status_cd : CS id : II class_cd : CS cd: CE effective_time : IVL<TS> status_cd : CS id : II type_cd : CS time : IVL<TS> status_cd : CS class_cd : CS cd: CD mood_cd : CS status_cd : CS effective_time : GTS id : II 0..1 plays 0..* 0..1 scopes 0..*

  2. HL7 RIM: Sample Observation Organization classCode* <=ORG determinerCode* <= INSTANCE Id*: II[1..1] 1..1 providerOrganization ObservationEvent classCode* <=OBS moodCode* <= EVN Id*: II[1..1] code*: CV CNE[1..1] < ObservationType effective Time*: TS[1..1] Patient classCode* <=PAT Id*: II[1..1] subject typeCode* <=SBJ 0..1 patientPerson Person classCode* <=PSN determinerCode* <= INSTANCE name: PN[0..1] Agent classCode* <=AGNT Id*: II[1..1] author typeCode* <=AUT Time*: TS [1..1] component typeCode* <=COMP component typeCode* <=COMP ObservationEvent classCode* <=OBS moodCode* <= EVN Id*: SET II[1..1] code*: CV CNE[1..1] < CPT4 value*: ST[1..1] ObservationEvent classCode* <=OBS moodCode* <= EVN Id*: SET II[1..1] code*: CV CNE[1..1] < CPT4 value*: ST[1..1]

  3. HL7 RIM: Simple Observation Observation classCode* <=OBS moodCode* <= EVN Id*: II[1..1] code*: CV CNE[1..1] < ObservationType effective Time*: TS[1..1] Value*: Patient classCode* <=PAT Id*: II[1..1] subject typeCode* <=SBJ 0..1 patientPerson Person classCode* <=PSN determinerCode* <= INSTANCE

  4. Mapping 11179 CDE to RIM: Ex 1 8 Object Class Diastolic Blood Pressure: C25299 9 Data Element Concept 7 Diastolic Blood Pressure Property 10 Data Element Assessment: C25367 Diastolic Blood Pressure First Dinamap Oscillometric Measurement 6 Value Domain First Dinamap Oscillometric Measurement 1 2 3 4 5 Conceptual domain Representation class Data type (added) Unit of measure (added) Value meanings (added) ASSESS_RESULTS N/A Number mmHg C25509:C69319:C25209 Measurement: Oscillometric Blood Pressure Monitor : First

  5. Mapping to RIM

  6. Problems with Ex 1 • The property Assessment does not really have any useful semantics – dangling concept • No context information – cannot infer entity, role and participation • “Measurement: Oscillometric Blood Pressure Monitor : First” – has to be parsed • Not easy to convert into a terminology expression • Hard to derive from the concept derivation rule that oscillometric blood pressure monitor is the methodCode • Leveling and context of information changes from CDE to CDE

  7. Mapping 11179 CDE to RIM: Ex 2 8 Object Class Person Blood Pressure: C25190:C54706 9 Data Element Concept 7 Person Blood Pressure Property 10 Data Element Assessment: C25367 Person Blood Pressure ?? 6 Value Domain 1 2 3 4 5 Conceptual domain Representation class Data type (added) Unit of measure (added) Value meanings (added) AE_RESULTS N/A Number mmHg N/A

  8. Mapping to RIM

  9. Problems with Ex 2 • The property Assessment is hard to map • Assessment is used to reference blood pressure but the concept itself links to “assessment”  semantics of assessment seam irrelevant • Leveling and context of information changes from CDE to CDE

  10. Mapping 11179 CDE to RIM: Ex 3 8 ObservationEvent classCode* <=OBS moodCode* <= EVN Id*: II[1..1] code*: CV CNE[1..1] < ObservationType effective Time*: TS[1..1] methodCode*: Object Class Blood Pressure : C54706 ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: CODE 9 Data Element Concept 7 Blood Pressure Start Measurement Property 10 Data Element Begin Measurement : C25431:C25209 ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: EFFECTIVETIME Blood Pressure Start Measurement Hour Minute Time 6 Value Domain Hour Minute Time 1 2 3 4 5 Conceptual domain Representation class Data type (added) Unit of measure (added) Value meanings (added) ASSESS_RESULTS N/A Time N/A C25529:C48154:C25207

  11. Problems with Ex 3 • The property Assessment is hard to map • Assessment is used to reference blood pressure but the concept itself links to “assessment”  semantics of assessment seam irrelevant • Mapping Time interval is challenging • Leveling and context of information changes from CDE to CDE

  12. Mapping 11179 CDE to RIM: Ex 4 8 ObservationEvent classCode* <=OBS moodCode* <= EVN Id*: II[1..1] code*: CV CNE[1..1] < ObservationType effective Time*: TS[1..1] methodCode*: Object Class Dental Professional Practice: C41136:C52673 ENT:LIV:POSN.ROL:PAT.DIR 9 Data Element Concept 7 Dental Professional Practice Blood Pressure Assessment Property 10 Data Element Blood Pressure Assessment : C54706:C25217 ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: CODE Dental Professional Practice Blood Pressure Assessment Ind-2 6 Value Domain Assessments Ind-2 1 2 3 4 5 Conceptual domain Representation class Data type (added) Unit of measure (added) Value meanings (added) ASSESS_RESULTS C38147 CHARACTER N/A CL307587, CL30586

  13. Mapping Challenges and Risks • Every mapping is a custom problem • Inferencing using concepts doesn’t work as same concepts are used differently • Context has to be provided manually in many cases • Post migration verification will take a lot of time and effort - as losing information will not be acceptable • All the CDE administrative constructs for lifecycle management have to be migrated – no placeholder in RIM • Creating forward and reverse transforms is not feasible – as the view will change from element to element • Identifying simple, medium and hard CDEs will require manual work as tooling cannot infer from the information

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