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. Reference Model Repository RequirementsAnalysis Use Case Model(UCM)RequirementsAnalysis Model(UCM)DomainAnalysisDomain Information Model (DIM)DomainAnalysisDomain (DIM) AnalysisDesign InteractionDesignInteractionModel(IM)InteractionDesignInteractionModel(IM)MessageDesign Hierarchical Message Descriptions (HMD)MessageDesign (HMD)ApprovalBallotsApprovalBallots Voting RIMRIM   2-nd Order 1 choice of 1 choice of 0-n Drug 0-n Drug 0-1 Nursing 0-1 Nursing 2-nd Order 1 choice of 1 choice of 0-n Drug 0-n Drug 0-1 Nursing 0-1 Nursing MDF Model Relationships

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

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

8. The HMD & ITS then give messages

9. Committee Vs. HL7 RIM 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

10. Reference Information Model Domain Subject Areas 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

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

12. Information Model Spec DIM Spec Class DiagramState Diagram Use Case Model Use Case Diagram Spec UCM Spec Interaction Model Interaction Diagram Spec Inter Spec 2-nd Order 1 choice of 0-n Drug 0-1 Nursing HL7 Technical Committees HL7 Member Organizations Other Standard Development Organizations Others 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. Message Design Use Case Model Use Case Diagram Spec UCM Spec Information Model Spec DIM Spec State DiagramClass Diagram Message Design 2-nd Order 1 choice of 0-n Drug 0-1 Nursing h//mt:50”d” … Identify Actors & Events Develop Scope Create Use Cases Model new concepts Harmonize with RIM Draw initial contents from RIM Develop Message Information Model Develop Message Object Diagram Specify HMD Define Trigger Events Define Application Roles Define Interactions Create Conformance Claims Interaction Model Interaction Diagram Spec Inter Spec Develop Message Information Model Develop Message Object Diagram Specify HMD

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

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

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

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

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