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

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Presentation on theme: "Derivation of the HL7 RIM Ontology A Top-Down Methodology."— Presentation transcript:

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 Thing Concept marine animal eats smaller things nice to eat Symbols (Many) Thing (1) Cant put the thing on this slide since the instance exists only in physical space Concept (1) Adapted from Charlie Mead & the Semantic Triangle Frank the Shark (in English)

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

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

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

7 Ontologies: Mass & Energy Proposition: e=mc 2

8 Mass and Energy (e=mc 2 ) Energy Mass

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

10 Ontologies: Materials & Labor

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

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

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

14 Entity id : SET classCode : CS determinerCode : CS importanceStatusText : ED qty : SET telecom : SET description : ED statusCode : CS code : CE nm : SET riskCode : CE 1 playedRoleplayer scopedRolescoper * Participation typeCode : CS tmr : IVL note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* Role classCode : CS effectiveTime : IVL id : SET statusCode : CS positionNumber : LIST qty : PQ certificateText : ED addr : SET telecom : SET code : CE 0..* 1 Act id : SET moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET repeatNumber : IVL interruptible_ind : BL priorityCode : SET independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV 1 Associative Classes

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

16 Entity id : SET classCode : CS determinerCode : CS importanceStatusText : ED qty : SET telecom : SET description : ED statusCode : CS code : CE nm : SET riskCode : CE 1 playedRoleplayer scopedRolescoper * Participation typeCode : CS tmr : IVL note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* Role classCode : CS effectiveTime : IVL id : SET statusCode : CS positionNumber : LIST qty : PQ certificateText : ED addr : SET telecom : SET code : CE RoleLink effectiveTime : IVL typeCode : CS 1 outboundLink 0..* source 1 1 inboundLink 0..* target 1 0..* 1 Act id : SET moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET repeatNumber : IVL interruptible_ind : BL priorityCode : SET independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV 1 Recursive Associative Classes ActRelationship typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS outboundLinkis_source_for 10..* has_target 0..* target 1

17 Entity id : SET classCode : CS determinerCode : CS importanceStatusText : ED qty : SET telecom : SET description : ED statusCode : CS code : CE nm : SET riskCode : CE 1 playedRoleplayer scopedRolescoper * Participation typeCode : CS tmr : IVL note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* Role classCode : CS effectiveTime : IVL id : SET statusCode : CS positionNumber : LIST qty : PQ certificateText : ED addr : SET telecom : SET code : CE RoleLink effectiveTime : IVL typeCode : CS 1 outboundLink 0..* source 1 1 inboundLink 0..* target 1 0..* 1 Act id : SET moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET repeatNumber : IVL interruptible_ind : BL priorityCode : SET independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV 1 ActRelationship typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS outboundLinkis_source_for 10..* has_target 0..* target 1 Act- Relationship Recursion

18 ActRelationship Recursions *Classes, Instances of Classes, & Instance Diagrams ActRelationship typeCode : has component Act id : SET moodCode : Event code : Chem 4 outboundLinkis_source_for has_targettarget Act id : SET moodCode : Event code : Glucose ActRelationship typeCode : has component outboundLinkis_source_for has_targettarget Act id : SET moodCode : Event code : Total Cholesterol ActRelationship typeCode : has component outboundLinkis_source_for has_targettarget Act id : SET moodCode : Event code : Sodium ActRelationship typeCode : has component outboundLinkis_source_for has_targettarget Act id : SET moodCode : Event code : Potassium

19 Entity id : SET classCode : CS determinerCode : CS importanceStatusText : ED qty : SET telecom : SET description : ED statusCode : CS code : CE nm : SET riskCode : CE 1 playedRoleplayer scopedRolescoper * Participation typeCode : CS tmr : IVL note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* Role classCode : CS effectiveTime : IVL id : SET statusCode : CS positionNumber : LIST qty : PQ certificateText : ED addr : SET telecom : SET code : CE RoleLink effectiveTime : IVL typeCode : CS 1 outboundLink 0..* source 1 1 inboundLink 0..* target 1 0..* 1 Act id : SET moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET repeatNumber : IVL interruptible_ind : BL priorityCode : SET independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV 1 ActRelationship typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS outboundLinkis_source_for 10..* has_target 0..* target 1 Infinite Nesting

20 HL7 RIM Act Hierarchy SubstanceAdministration routeCode : CE approachSiteCode : SET doseQuantity : IVL rateQuantity : IVL doseCheckQuantity : SET maxDoseQuantity : SET potencyQuantity : PQ substitutionCode : CE Procedure methodCode : SET approachSiteCode : SET targetSiteCode : SET Supply quantity : PQ expectedUseTime : IVL Account name : ST currencyCode : CE interestRateQuantity : RTO allowedBalanceQuantity : IVL FinancialAct netAmt : MO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET specialCourtesiesCode : SET urgencyCode : CE DiagnosticImage subjectOrientationCode : CE FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO InvoiceElement modifierCode : SET unitQuantity : RTO unitPriceAmt : RTO factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL FinancialContract paymentTermsCode : CE DeviceTask parameterValue : LIST WorkingList ownershipLevelCode : CE structureTypeId : II responseCode : CS 1 0..* 1 Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 Observation value : ANY interpretationCode : SET methodCode : SET targetSiteCode : SET derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ ControlAct

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

22 The Meaning of Hierarchy SubstanceAdministration routeCode : CE approachSiteCode : SET doseQuantity : IVL rateQuantity : IVL doseCheckQuantity : SET maxDoseQuantity : SET potencyQuantity : PQ substitutionCode : CE Procedure methodCode : SET approachSiteCode : SET targetSiteCode : SET Supply quantity : PQ expectedUseTime : IVL Account name : ST currencyCode : CE interestRateQuantity : RTO allowedBalanceQuantity : IVL FinancialAct netAmt : MO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET specialCourtesiesCode : SET urgencyCode : CE DiagnosticImage subjectOrientationCode : CE FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO InvoiceElement modifierCode : SET unitQuantity : RTO unitPriceAmt : RTO factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL FinancialContract paymentTermsCode : CE DeviceTask parameterValue : LIST WorkingList ownershipLevelCode : CE structureTypeId : II responseCode : CS 1 0..* 1 Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 Observation value : ANY interpretationCode : SET methodCode : SET targetSiteCode : SET derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ ControlAct

23 Act-Supply-Diet Hierarchy Supply quantity : PQ expectedUseTime : IVL 1 0..* 1 Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 Diet energyQuantity : PQ carbohydrateQuantity : PQ

24 Diet Act Combines Attributes in Hierarchy 1 0..* 1 Diet Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 energyQuantity : PQ carbohydrateQuantity : PQ quantity : PQ expectedUseTime : IVL From Supply From Diet

25 The Meaning of Hierarchy SubstanceAdministration routeCode : CE approachSiteCode : SET doseQuantity : IVL rateQuantity : IVL doseCheckQuantity : SET maxDoseQuantity : SET potencyQuantity : PQ substitutionCode : CE Procedure methodCode : SET approachSiteCode : SET targetSiteCode : SET Supply quantity : PQ expectedUseTime : IVL Account name : ST currencyCode : CE interestRateQuantity : RTO allowedBalanceQuantity : IVL FinancialAct netAmt : MO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET specialCourtesiesCode : SET urgencyCode : CE DiagnosticImage subjectOrientationCode : CE FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO InvoiceElement modifierCode : SET unitQuantity : RTO unitPriceAmt : RTO factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL FinancialContract paymentTermsCode : CE DeviceTask parameterValue : LIST WorkingList ownershipLevelCode : CE structureTypeId : II responseCode : CS 1 0..* 1 Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 Observation value : ANY interpretationCode : SET methodCode : SET targetSiteCode : SET derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ ControlAct

26 Observation Act = Act Attributes + Observation Attributes 1 0..* 1 Observation Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 From Observation value : ANY interpretationCode : SET methodCode : SET targetSiteCode : SET derivationExpr : ST

27 Observation.code / Observation.value What is the Question? / What is the Answer? 1 0..* 1 Observation Act id : SET moodCode : CS classCode : CS code : CD text : ED statusCode : CS confidentialityCode : SET effectiveTime : GTS activityTime : GTS interruptibleInd : BL availabilityTime : TS contextLockInd : BL independentInd : BL interruptibleInd : BL negationInd : BL priorityCode : SET repeatNumber : IVL reasonCode : SET substitutionConditionCode : CE levelCode : CE uncertaintyCode : CE 11 From Observation value : ANY interpretationCode : SET methodCode : SET targetSiteCode : SET derivationExpr : ST White Blood Count CTP code xyz 10,000 Established Diagnosis SNOMED code Malig Tumor of Breast SNOMED code

28 Sample Glossary

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

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

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

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

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

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

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

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

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

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

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

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

41 Mapping from Nursing to HL7 From Nursing Domain To HL7 RIM Provider Role Entity (Person) + Role Care Recipient Entity (Person) + Role Action + Object of Action Act SupplyMaterial Diagnosis.resultObservation.value Finding.resultObservation.value RouteSubstAdmin.routeCode

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

43 Entity id : SET classCode : CS determinerCode : CS importanceStatusText : ED qty : SET telecom : SET description : ED statusCode : CS code : CE nm : SET riskCode : CE 1 playedRoleplayer scopedRolescoper * Participation typeCode : CS tmr : IVL note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* --adapted from RIM V1.18 RoleLink effectiveTime : IVL typeCode : CS Role classCode : CS effectiveTime : IVL id : SET statusCode : CS positionNumber : LIST qty : PQ certificateText : ED addr : SET telecom : SET code : CE 1 outboundLink 0..* source 1 1 inboundLink 0..* target 1 0..* 1 ActRelationship typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS Act id : SET moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET repeatNumber : IVL interruptible_ind : BL priorityCode : SET independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV 1 outboundLinkis_source_for 10..* has_target 0..* target 1 Mapping to the RIM Susan RN S Registered Nurse 2B PatientICNP Medical Record Review S Reviewed Chart Christine


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