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Derivation of the HL7 RIM Ontology

Derivation of the HL7 RIM Ontology. A Top-Down Methodology. Concept - “a thing in the minds eye”. Hmmm - “Frank needs an ace of hearts”. The Concept Challenge. marine animal eats smaller things nice to eat. Concept (1). Concept. Thing (1) Can’t put the “thing” on this slide

tallulah-williamson
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Derivation of the HL7 RIM Ontology

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  1. Derivation of the HL7 RIM Ontology A Top-Down Methodology

  2. Concept - “a thing in the minds eye” Hmmm - “Frank needs an ace of hearts”

  3. The Concept Challenge • marine animal • eats smaller things • nice to eat Concept (1) Concept Thing (1) Can’t put the “thing” on this slide since the instance exists only in physical space Symbols (Many) Thing “Frank the Shark” (in English) Adapted from Charlie Mead & the Semantic Triangle

  4. Predicate Logic in RDF, RIM, and SNOMED RDF: Subject Predicate Object RIM: Observ-ation has Participation Subject Patient SNOMED: Fracture of Femur has Finding Site Structure of Neck of Femur

  5. Subject Predicate Object Observ-ation has Participation Subject Patient HL7 RIM hasResult Fracture of Femur has Finding Site Structure of Neck of Femur has Associated Morphology Compression Fracture SNOMED SNOMED in the HL7 RIM

  6. hasResult Propositions & Assertions • Propositions in RDF triples • Subject | Predicate | Object • Propositions may be true or false • Assertions are believed by the author to be true Subject Predicate Object Observ-ation has Participation Subject Patient HL7 RIM Fracture of Femur has Finding Site Structure of Neck of Femur has Associated Morphology Compression Fracture SNOMED

  7. Ontologies: Mass & Energy Proposition: e=mc2

  8. Mass Mass and Energy (e=mc2) Energy

  9. Analogy: Mass to Entity/Energy to Act Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED 0…* qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Act id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> 0…* repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  10. Ontologies: Materials & Labor

  11. Proposition:Cost = Materials + Labor Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED 0…* qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Act id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> 0…* repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  12. Association Class Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED 0…* qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Act id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> 0…* repeatNumber : IVL<INT> Associations Class interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  13. RIM - Backbone • Entity • People, Places, Physical Things • Associations • Roles & Relationships • Act • Collections of Events

  14. AssociativeClasses Entity Role id : SET<II> classCode : CS classCode : CS player playedRole effectiveTime : IVL<TS> determinerCode : CS 1 0..* id : SET<II> importanceStatusText : ED statusCode : CS qty : SET<PQ> positionNumber : LIST<INT> telecom : SET<TEL> qty : PQ description : ED certificateText : ED statusCode : CS addr : SET<AD> scoper scopedRole code : CE telecom : SET<TEL> 0..1 0..* nm : SET<EN> code : CE riskCode : CE 1 0..* Act id : SET<II> Participation moodCode : CS typeCode : CS classCode : CS tmr : IVL<TS> txt : ED note_text : ED statusCode : CS signatureCode : CV activityTime : GTS functionCode : CD effectiveTime : GTS awarenessCode : CV confidentialityCode : SET<CV> 1 0..* 0..* signatureText : ED repeatNumber : IVL<INT> encounter_accommodationCode : CV interruptible_ind : BL statusCode : CS priorityCode : SET<CV> modeCode : CV independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  15. Review of UML Terms Entity “Classes” id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED 0…* “Attribute: value pair” qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> “Datatype” riskCode : CE Act id : SET<II> moodCode : CS classCode : CS txt : ED hierarchy or ‘IsA’ association symbol Simple or ‘hasA’ association symbol statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> 0…* repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV ‘cardinality’ or ‘multiplicity’ symbol

  16. RoleLink source outboundLink effectiveTime : IVL<TS> 1 1 0..* typeCode : CS target inboundLink 1 1 0..* RecursiveAssociativeClasses Entity Role id : SET<II> classCode : CS classCode : CS player playedRole effectiveTime : IVL<TS> determinerCode : CS 1 0..* id : SET<II> importanceStatusText : ED statusCode : CS qty : SET<PQ> positionNumber : LIST<INT> telecom : SET<TEL> qty : PQ description : ED certificateText : ED statusCode : CS addr : SET<AD> scoper scopedRole code : CE telecom : SET<TEL> 0..1 0..* nm : SET<EN> code : CE riskCode : CE 1 0..* Act ActRelationship is_source_for outboundLink id : SET<II> typeCode : CS Participation moodCode : CS inversion_ind : BL 1 0..* typeCode : CS classCode : CS sequenceNumber : INT tmr : IVL<TS> txt : ED priorityNumber : INT note_text : ED statusCode : CS pauseQty : PQ target has_target signatureCode : CV activityTime : GTS checkpointCode : CS functionCode : CD effectiveTime : GTS splitCode : CS 1 0..* awarenessCode : CV confidentialityCode : SET<CV> joinCode : CS 1 0..* 0..* signatureText : ED repeatNumber : IVL<INT> negation_ind : BL encounter_accommodationCode : CV interruptible_ind : BL conjunctionCode : CS statusCode : CS priorityCode : SET<CV> modeCode : CV independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  17. RoleLink source outboundLink effectiveTime : IVL<TS> 1 1 0..* typeCode : CS target inboundLink 1 1 0..* ActRelationship is_source_for outboundLink typeCode : CS inversion_ind : BL 1 0..* sequenceNumber : INT priorityNumber : INT pauseQty : PQ target has_target checkpointCode : CS splitCode : CS 1 0..* joinCode : CS negation_ind : BL conjunctionCode : CS Act-Relationship Recursion Entity Role id : SET<II> classCode : CS classCode : CS player playedRole effectiveTime : IVL<TS> determinerCode : CS 1 0..* id : SET<II> importanceStatusText : ED statusCode : CS qty : SET<PQ> positionNumber : LIST<INT> telecom : SET<TEL> qty : PQ description : ED certificateText : ED statusCode : CS addr : SET<AD> scoper scopedRole code : CE telecom : SET<TEL> 0..1 0..* nm : SET<EN> code : CE riskCode : CE 1 0..* Act id : SET<II> Participation moodCode : CS typeCode : CS classCode : CS tmr : IVL<TS> txt : ED note_text : ED statusCode : CS signatureCode : CV activityTime : GTS functionCode : CD effectiveTime : GTS awarenessCode : CV confidentialityCode : SET<CV> 1 0..* 0..* signatureText : ED repeatNumber : IVL<INT> encounter_accommodationCode : CV interruptible_ind : BL statusCode : CS priorityCode : SET<CV> modeCode : CV independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  18. ActRelationship Recursions*Classes, Instances of Classes, & Instance Diagrams Act ActRelationship Act is_source_for outboundLink id : SET<II> typeCode : target has_target moodCode : Event id : SET<II> has component code : Chem 4 moodCode : Event code : Glucose ActRelationship Act is_source_for outboundLink typeCode : target has_target id : SET<II> has component moodCode : Event code : Total Cholesterol ActRelationship Act is_source_for outboundLink typeCode : target has_target id : SET<II> has component moodCode : Event code : Sodium ActRelationship Act is_source_for outboundLink typeCode : target has_target id : SET<II> has component moodCode : Event code : Potassium

  19. RoleLink source outboundLink effectiveTime : IVL<TS> 1 1 0..* typeCode : CS target inboundLink 1 1 0..* InfiniteNesting Entity Role id : SET<II> classCode : CS classCode : CS player playedRole effectiveTime : IVL<TS> determinerCode : CS 1 0..* id : SET<II> importanceStatusText : ED statusCode : CS qty : SET<PQ> positionNumber : LIST<INT> telecom : SET<TEL> qty : PQ description : ED certificateText : ED statusCode : CS addr : SET<AD> scoper scopedRole code : CE telecom : SET<TEL> 0..1 0..* nm : SET<EN> code : CE riskCode : CE 1 0..* Act ActRelationship is_source_for outboundLink id : SET<II> typeCode : CS Participation moodCode : CS inversion_ind : BL 1 0..* typeCode : CS classCode : CS sequenceNumber : INT tmr : IVL<TS> txt : ED priorityNumber : INT note_text : ED statusCode : CS pauseQty : PQ target has_target signatureCode : CV activityTime : GTS checkpointCode : CS functionCode : CD effectiveTime : GTS splitCode : CS 1 0..* awarenessCode : CV confidentialityCode : SET<CV> joinCode : CS 1 0..* 0..* signatureText : ED repeatNumber : IVL<INT> negation_ind : BL encounter_accommodationCode : CV interruptible_ind : BL conjunctionCode : CS statusCode : CS priorityCode : SET<CV> modeCode : CV independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV

  20. HL7 RIM Act Hierarchy Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE Diet energyQuantity : PQ carbohydrateQuantity : PQ 0..* 1 1 PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL WorkingList dischargeDispositionCode : CE ownershipLevelCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> SubstanceAdministration specialCourtesiesCode : SET<CE> routeCode : CE urgencyCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> ControlAct maxDoseQuantity : SET<RTO> structureTypeId : II potencyQuantity : PQ responseCode : CS substitutionCode : CE DeviceTask Procedure parameterValue : LIST<ANY> methodCode : SET<CE> Supply FinancialAct approachSiteCode : SET<CD> quantity : PQ netAmt : MO targetSiteCode : SET<CD> expectedUseTime : IVL<TS> FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST FinancialTransaction InvoiceElement Account creditExchangeRateQuantity : REAL modifierCode : SET<CE> name : ST debitExchangeRateQuantity : REAL unitQuantity : RTO<PQ,PQ> currencyCode : CE interestRateQuantity : RTO unitPriceAmt : RTO<MO,PQ> interestRateQuantity : RTO<MO,PQ> factorNumber : REAL allowedBalanceQuantity : IVL<MO> DiagnosticImage PublicHealthCase pointsNumber : REAL subjectOrientationCode : CE detectionMethodCode : CE coverageSourceCode : CE transmissionModeCode : CE notifySubjectInd : BL diseaseImportedCode : CE

  21. Bottom-Up Modeling Artifacts Entity “Classes” id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED 0…* “Attribute: value pair” qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> “Datatype” riskCode : CE Act id : SET<II> moodCode : CS classCode : CS txt : ED hierarchy or ‘IsA’ association symbol Simple or ‘hasA’ association symbol statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> 0…* repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV ‘cardinality’ or ‘multiplicity’ symbol

  22. The Meaning of Hierarchy Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE Diet energyQuantity : PQ carbohydrateQuantity : PQ 0..* 1 1 PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL WorkingList dischargeDispositionCode : CE ownershipLevelCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> SubstanceAdministration specialCourtesiesCode : SET<CE> routeCode : CE urgencyCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> ControlAct maxDoseQuantity : SET<RTO> structureTypeId : II potencyQuantity : PQ responseCode : CS substitutionCode : CE DeviceTask Procedure parameterValue : LIST<ANY> methodCode : SET<CE> Supply FinancialAct approachSiteCode : SET<CD> quantity : PQ netAmt : MO targetSiteCode : SET<CD> expectedUseTime : IVL<TS> FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST FinancialTransaction InvoiceElement Account creditExchangeRateQuantity : REAL modifierCode : SET<CE> name : ST debitExchangeRateQuantity : REAL unitQuantity : RTO<PQ,PQ> currencyCode : CE interestRateQuantity : RTO unitPriceAmt : RTO<MO,PQ> interestRateQuantity : RTO<MO,PQ> factorNumber : REAL allowedBalanceQuantity : IVL<MO> DiagnosticImage PublicHealthCase pointsNumber : REAL subjectOrientationCode : CE detectionMethodCode : CE coverageSourceCode : CE transmissionModeCode : CE notifySubjectInd : BL diseaseImportedCode : CE

  23. Act-Supply-Diet Hierarchy Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE Diet energyQuantity : PQ carbohydrateQuantity : PQ 0..* 1 1 Supply quantity : PQ expectedUseTime : IVL<TS>

  24. Diet Act Combines Attributes in Hierarchy 0..* 1 1 Diet Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> From Supply substitutionConditionCode : CE levelCode : CE From Diet uncertaintyCode : CE quantity : PQ expectedUseTime : IVL<TS> energyQuantity : PQ carbohydrateQuantity : PQ

  25. The Meaning of Hierarchy Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE Diet energyQuantity : PQ carbohydrateQuantity : PQ 0..* 1 1 PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL WorkingList dischargeDispositionCode : CE ownershipLevelCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> SubstanceAdministration specialCourtesiesCode : SET<CE> routeCode : CE urgencyCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> ControlAct maxDoseQuantity : SET<RTO> structureTypeId : II potencyQuantity : PQ responseCode : CS substitutionCode : CE DeviceTask Procedure parameterValue : LIST<ANY> methodCode : SET<CE> Supply FinancialAct approachSiteCode : SET<CD> quantity : PQ netAmt : MO targetSiteCode : SET<CD> expectedUseTime : IVL<TS> FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST FinancialTransaction InvoiceElement Account creditExchangeRateQuantity : REAL modifierCode : SET<CE> name : ST debitExchangeRateQuantity : REAL unitQuantity : RTO<PQ,PQ> currencyCode : CE interestRateQuantity : RTO unitPriceAmt : RTO<MO,PQ> interestRateQuantity : RTO<MO,PQ> factorNumber : REAL allowedBalanceQuantity : IVL<MO> DiagnosticImage PublicHealthCase pointsNumber : REAL subjectOrientationCode : CE detectionMethodCode : CE coverageSourceCode : CE transmissionModeCode : CE notifySubjectInd : BL diseaseImportedCode : CE

  26. Observation Act = Act Attributes + Observation Attributes 0..* 1 1 Observation Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE value : ANY From Observation interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST

  27. Observation.code / Observation.valueWhat is the Question? / What is the Answer? 0..* 1 1 Observation Act id : SET<II> moodCode : CS classCode : CS ‘White Blood Count’ CTP code ‘xyz’ 10,000 ‘Established Diagnosis’ SNOMED code ‘14657009’ ‘Malig Tumor of Breast’ SNOMED code ‘254837009’ code : CD text : ED statusCode : CS 1 1 confidentialityCode : SET<CE> effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET<CE> repeatNumber : IVL<INT> reasonCode : SET<CE> substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE value : ANY From Observation interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST

  28. Sample Glossary

  29. What is an Information Model? • Describes Relationships Between Concepts (in UML) • Class concepts • Attribute concepts • Association concepts • Data-type concepts • Provides Data-type Links to Vocabulary Concepts • SNOMED • LOINC • ICNP • ….. • Not a Data Model! • Not concerned with application performance in a relational database • Not concerned with ease of application programming • Is concerned with communicating knowledge of domain

  30. -code -vocabulary -vtext -stext -code Indirect Object -vocabulary -vtext -stext What is an Information Model? • Describes Relationships Between Concepts (in UML) • Class concepts • Attribute concepts • Association concepts • Data-type concepts • Provides Data-type Links to Vocabulary Concepts • SNOMED • LOINC • ICNP • ….. Action +timing -onBehalfOf

  31. Identify Basic Concepts Define Basic Concepts in Glossary Identify Relationships Between Concepts Attributes Multiplicities Associations Abstract Basic Concepts into Hierarchies Identify attributes that can be shared Define Abstract Concepts in Glossary Building an Information Model--an iterative process

  32. Subjects (actors) Patient Nurse Physician Patient care aide … Verbs Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Identify Basic Concepts • Objects • Patient • Strategies • Breast cancer • Nausea • Vomiting • Intervention • Video • …

  33. Subjects (actors) Patient Nurse Physician Patient care aide … Verbs Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Identify Abstract Concepts Subjects = “Persons” Verbs = “Actions” Objects = “?” Subjects = “Do’ers” • Objects • Patient • Strategies • Breast cancer • Nausea • Vomiting • Intervention • Video • …

  34. Define Abstract Concepts in Glossary • Do’er is someone who performs an action • Action is a word that describes what a do’er is doing to the object • Object is a direct object or an indirect object of a sentence • A direct object of a sentence is the thing being done to • An indirect object of a sentence is the ….

  35. -code -vocabulary -vtext -stext Data-Types Action +timing • What “kinds of” values can an attribute have? • Timing (date-timestamps; frequency text; etc) • Code (alphanumeric text strings from code field of published vocabulary) • Vocabulary (string with official identifier for published vocabulary) • Vtext (string with English text corresponding to code in published vocabulary) • Stext (string with exact text from storyboard)

  36. -code -code -code -vocabulary -vocabulary -vocabulary -vtext -vtext -vtext -code -stext -stext -stext -vocabulary -vtext -code Indirect Object Direct Object -vocabulary -vtext -stext • Objects (direct & indirect) • Patient • Strategies • Breast cancer • Nausea • Vomiting • Intervention • Video • … • Do’ers • Patient • Nurse • Physician • Patient care aide • … • Actions • Asked • Reviewed • Decided • Printed • Moved • Documented • Spoke • Verbalized • Assess • … Identify Relationships Between Concepts Object of Action Do’er -actsOn -name -role Action +timing

  37. -code -code -vocabulary -vocabulary -vtext -vtext -code -stext -stext -vocabulary -vtext -code Indirect Object -vocabulary -vtext -stext • Objects (direct & indirect) • Patient • Strategies • Breast cancer • Nausea • Vomiting • Intervention • Video • … • Do’ers • Patient • Nurse • Physician • Patient care aide • … • Actions • Asked • Reviewed • Decided • Printed • Moved • Documented • Spoke • Verbalized • Assess • … Identify Relationships Between Concepts Object of Action Do’er -actsOn -name -role Action +timing -onBehalfOf

  38. Storyboard Information Model Instance Diagrams • Test the combination of Information Model and vocabularies against the storyboard • Use the Storyboard Glossary to provide the vocabulary for the instance diagrams

  39. Nursing Domain Information Model Object of Action Provider Role -code -actsOn -name -vocabulary Finding includes the -role -vtext concepts of Goal and Recipient of Care -code -stext Outcome depending Action -vocabulary -hasRecipientOfCare -name on relationship timing +timing -vtext -role and other actions -code -code -vocabulary -vocabulary -hasSupply -vtext * -vtext -stext -hasSite -has Means Focus Finding OtherObjects -hasRoute -hasFocus -timing -Result -focusType Route Means Supply Site -code -code -code -code -vocabulary -vocabulary -vocabulary -vocabulary -has Judgement -vtext -vtext -vtext -vtext Judgement -stext -stext -stext -stext -degree Diagnosis -potentiality -hasSite -acuity -timing Subject of information focusType Value Set = Subject is coded for -code individual, family, -vocabulary • Patient Functioning • Environment or other physical entity -vtext -hasSubjec tOfInformation -stext • ICF and other similar • concepts in other • vocabularies

  40. Example Instance Diagram“Susan , an RN , reviews Christine's chart” Object of Action Provider Role -code Susan -actsOn ICNP -name -vocabulary Finding includes the RN Record chart -role -vtext concepts of Goal and 224535009 chart Recipient of Care -code -stext Outcome depending S Action -vocabulary -hasRecipientOfCare Christine -name on relationship timing Registered Nurse +timing -vtext Patient -role and other actions 55210009 -code 2B.2.1.1.1.1.1.1.22 -code S -vocabulary ICNP -vocabulary -hasSupply Review of -vtext * -vtext Reviews -stext -hasSite -has Means Focus Finding OtherObjects -hasRoute -hasFocus -timing -Result -focusType Route Means Supply Site -code -code -code -code -vocabulary -vocabulary -vocabulary -vocabulary -has Judgement -vtext -vtext -vtext -vtext Judgement -stext -stext -stext -stext -degree Diagnosis -potentiality -hasSite -acuity -timing Subject of information focusType Value Set = Subject is coded for -code individual, family, -vocabulary • Patient Functioning • Environment or other physical entity -vtext -hasSubjec tOfInformation -stext • ICF and other similar • concepts in other • vocabularies

  41. Mapping from Nursing to HL7

  42. Example Instance Diagram“Susan , an RN , reviews Christine's chart” Object of Action Provider Role -code Susan -actsOn ICNP -name -vocabulary Finding includes the RN Record chart -role -vtext concepts of Goal and 224535009 chart Recipient of Care -code -stext Outcome depending S Action -vocabulary -hasRecipientOfCare Christine -name on relationship timing Registered Nurse +timing -vtext Patient -role and other actions 55210009 -code 2B.2.1.1.1.1.1.1.22 -code S -vocabulary ICNP -vocabulary -hasSupply Review of -vtext * -vtext Reviews -stext -hasSite -has Means Focus Finding OtherObjects -hasRoute -hasFocus -timing -Result -focusType Route Means Supply Site -code -code -code -code -vocabulary -vocabulary -vocabulary -vocabulary -has Judgement -vtext -vtext -vtext -vtext Judgement -stext -stext -stext -stext -degree Diagnosis -potentiality -hasSite -acuity -timing Subject of information focusType Value Set = Subject is coded for -code individual, family, -vocabulary • Patient Functioning • Environment or other physical entity -vtext -hasSubjec tOfInformation -stext • ICF and other similar • concepts in other • vocabularies

  43. Mappingto theRIM Entity Role RoleLink id : SET<II> source outboundLink classCode : CS effectiveTime : IVL<TS> classCode : CS 1 1 0..* player playedRole effectiveTime : IVL<TS> typeCode : CS determinerCode : CS 1 0..* target inboundLink id : SET<II> importanceStatusText : ED 1 1 0..* statusCode : CS qty : SET<PQ> positionNumber : LIST<INT> telecom : SET<TEL> qty : PQ description : ED certificateText : ED statusCode : CS addr : SET<AD> scoper scopedRole code : CE Registered Nurse Susan telecom : SET<TEL> 0..1 0..* nm : SET<EN> RN 224535009 S code : CE riskCode : CE 1 Patient 2B.2.1.1.1.1.1.1.22 ICNP Christine 0..* Act ActRelationship is_source_for outboundLink id : SET<II> typeCode : CS Participation moodCode : CS inversion_ind : BL 1 0..* typeCode : CS classCode : CS sequenceNumber : INT Reviewed Chart tmr : IVL<TS> txt : ED priorityNumber : INT note_text : ED statusCode : CS pauseQty : PQ target has_target signatureCode : CV activityTime : GTS checkpointCode : CS functionCode : CD effectiveTime : GTS splitCode : CS 1 0..* awarenessCode : CV confidentialityCode : SET<CV> joinCode : CS 1 0..* 0..* signatureText : ED repeatNumber : IVL<INT> negation_ind : BL encounter_accommodationCode : CV interruptible_ind : BL conjunctionCode : CS statusCode : CS priorityCode : SET<CV> modeCode : CV independent_ind : BL availability_dttm : GTS 312853008 Medical Record Review S code : CD transfer_reasonCode : CV --adapted from RIM V1.18

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