Towards International Alignment Introduction to the Canadian Health Data Model and potential contribution to HL7 Harmonization processes

RIM Basics RIM Privileges Harmonization Process Facilitator Responsibilities International Committee Responsibilities RIM Influence Strategies Model Alignment Common Concept Model Canadian Health Data Model

Reference Information Model (RIM) Technical Committee A Technical Committee B Domain Information Model 2. Pink Steward Blue Steward RIM Basics

RIM Privileges Stewardship Submit Changes Attend Harmonization Vote on Changes

International Committee RIM Privileges Stewardship Submit Changes Attend Harmonization Vote on Changes (see M&M Minutes Sept. ‘98)

Harmonization Process 1.Document Proposed Changes 2.Discuss with Steward(s) 3.Post Changes on Website 4.Present Changes in Meeting 5.Vote on Changes 6.Refresh RIM with HL7 tooling 7.Technical Corrections 8Post new RIM Version on Website

Facilitator Responsibilities Coordinate Documentation and Justification Facilitate Discussions with Stewards Format RIM Change Proposals Submit for Posting Facilitate Pre-Meeting Discussions Represent Proposal during Harmonization Assist Stewards with Technical QA

International Committee Responsibilities for RIM Determine Information Needs Prioritize Information Needs Determine Influence Strategy Provide Domain Expertise for Content & Justification Recommend Specific RIM Changes Follow Version 3 Methodology for New Messages

RIM Influence Strategies Join a HL7 TC and influence changes by persuading the collective members of the TC and being present for all decisions Propose specific RIM changes to the harmonization process Align external models to the RIM for general information and raising awareness of different perspectives

Model Alignment Models can be aligned in 3 dimensions:  Vertically - From less detail to more detail  Horizontally - Across Jurisdictions (Perspectives)  Over Time - Multiple Versions Each model represents a congruent whole - i.e. is internally consistent Different organizations or jurisdictions have different perspectives and can have different models to represent their interests

Scoping Shared Understanding Specification Solution Implementation Construction Contextual Conceptual Logical Design Physical Design Physical Objects Deployed Objects What WhyWhoHow Where When

Common Concept Model Represents the key concepts that must be commonly understood to share meaning Has insufficient detail to construct messages or build information systems Provides a foundation structure for more detailed models or models representing different perspectives Provides an aid to aligning models via cross- references

Canadian Health Data Model Background Objectives Development Process What does it look like Significant Patterns Proposal

Background Canada has another “standards process “ - CIHI Partnership for Informatics and Telematics Partnership WG1 developed a Health Information Framework (1997) to describe the scope of information of interest to the entire health system (with an emphasis on population health) Data Model Project struck to identify primary data needed to meet Health Information Framework requirements

Objectives Comprehensive To reflect current knowledge and practice across jurisdictions. Flexible To provide a basis for integration of data across jurisdictions. Durable To be resilient to change. Universal Relevant to all jurisdictions in Canada and beyond

Development Process Working Group Representing multiple perspectives and jurisdictions Examined various models available Chose HL7 RIM as staring point Examined fit to Health Information Framework requirements Synthesized extensions from various models Tested against Scenarios Used Scenarios to develop extensions where information requirements weren’t met Abstracted/refined until reached congruence Tested against Scenarios and other perspectives

Significant Patterns 1) events affect the state of their respective classes 2) event linkage 3) governance constrains events and 4) governance events monitor the state of everything

Proposal Accepted Accepted the concept of a common conceptual model International Committee to work to synthesize common conceptual model (CCM) Canadian Health Data Model work in progress considered along with other jurisdiction’s models Map the RIM to the CCM Participate in a process to cross- reference to other models