1. © Copyright 2005 dbMotion Ltd. By dbMotion RIM Based Semantic Interoperability Assaf Halevy, Co – Founder & VP Strategic Accounts Assaf@dbMotion.com

2. © Copyright 2005 dbMotion Ltd.

3. 2 Agenda The challenge of Interoperability Interoperable Data Model The Semantic Context and Vocabularies Business Services in use Demo

4. © Copyright 2005 dbMotion Ltd. Community Record Architecture 3 Data Displayed, Pulled or Published Back Organize Virtual Patient Utilize Applications & Tools Interoperable Patient Viewer Physician Results/Events App Population Manager Software Dev Kit PHR Connector Analytics Research NHIN/RHIO IHE Data Use Tools Examples Other Sources Publish EMR Sources

5. © Copyright 2005 dbMotion Ltd. HIN Multi-Hospital Organization Primary Care & Specialized Clinics Commercial Lab Pharmacies Tertiary Medical Center

6. © Copyright 2005 dbMotion Ltd. Architecture 5 Security Layer Shared Services System Management Layer Operational Environment Presentation Layer Business Layer Communication Layer – Message Bus Data Layer Data Integration Layer

7. © Copyright 2005 dbMotion Ltd. Longitudinal Patient Record Semantically Harmonized Discretely Consumable Standards Based Integration - CDA/CCD/CCR/XML - IHE - SOA 6 Architecture: Virtual Patient Object

8. © Copyright 2005 dbMotion Ltd. Unified Medical Schema

9. © Copyright 2005 dbMotion Ltd. 8 UMS Vision Define a data model that supports semantic clinical information sharing, while maintaining its meaning, standardization and context. The data model should provide any consumer with actionable, reusable data in a timely manner.

10. © Copyright 2005 dbMotion Ltd. 9 HL7 v3.0: What and Why Version 3.0 is a model-driven methodology described in UML diagrams The HL7 v3.0 development methodology includes - Use of a Reference Information Model (RIM) - Robust datatypes and vocabulary specifications - Modeling of the dynamic requirements of messages. HL7 v3.0 increases the quality and reduces the variability in HL7 standards enabling it to address the more complex and diverse needs of the HL7 members. v3.0 enables HL7 implementers to leverage emerging web services standards, conventions, and technologies

11. © Copyright 2005 dbMotion Ltd. 10 Patient Medical Schema

12. © Copyright 2005 dbMotion Ltd. 11 UMS Methodology HL7 RIM D-MIM Previous UMS CDM LDM Logical Data Model Contains subject areas, classes, atomic attributes, data types and associations. Tangible representation of dbMotion semantics

13. © Copyright 2005 dbMotion Ltd. UMS Domains - Summary Encounters Labs Diagnosis Imaging Substance Administration Procedures Allergies Clinical Documents …

14. © Copyright 2005 dbMotion Ltd. Medications from a Machine Perspective Therapeutic Duplication Medication Reconciliation Drugs Interaction MedicationDateSource system Coumadin 2 mg oral tablet07/15/2008 10:00CernerH1 Bactrim DS oral tablet01/11/2008 08:30CernerH2 PRAVACHOL 80 MG TAB09/06/2007 13:30EPIC WARFARIN 1 MG TAB04/27/2008 15:00EPIC Pravastatin 80 mg oral tablet07/15/2008 10:00CernerH1 LIPITOR 20 MG TAB04/27/2008 15:00EPIC Drug Allergy

15. © Copyright 2005 dbMotion Ltd. Diagnoses Local Medications Allergies Labs Adminst. dbMotion Ontology (Baseline) RxNorm (Subset) NDF-RTNDF-RT Conditi on SNOMED (Subset) Substa nce Allerge n Finding LOINC

16. © Copyright 2005 dbMotion Ltd. Diabetes Clinical View 15

17. © Copyright 2005 dbMotion Ltd. dbMotion SOA Services dbMotion Business Layer (SOA Based Clinical Business Domains) dbMotion Business Domains (Patient Admin, Labs, Meds, Proc, Diag, Problems … ) Business Methods Event Broker Business Processes Business Activities KFW + KNEO Get Labs Get Meds Get Encounters Get Anemia_Level Is_Hypertensive Get Liver Enzyme State

18. © Copyright 2005 dbMotion Ltd. Wireless Applications Other Uses & Apps Virtual Patient available to multiple applications & uses Agility with IT: Using the Interoperable Patient Record NHIN Hospitals - Clinics Registries IBM-Cognos Analytics Untethered PHR

19. © Copyright 2005 dbMotion Ltd. Thank you… Assaf Halevy Assaf@dbMotion.com