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) Symbols (Many) “Frank the Shark” (in English) Can’t put the “thing” on this slide Thing since the instance exists only in physical space Adapted from Charlie Mead & the Semantic Triangle Predicate Logic in RDF, RIM, and SNOMED RDF: Subject Predicate Object has Participation Subject Patient has Finding Site Structure of Neck of Femur RIM: Observation SNOMED: Fracture of Femur SNOMED in the HL7 RIM Subject Predicate Object Observation has Participation Subject Patient HL7 RIM hasResult Fracture of Femur has Finding Site Structure of Neck of Femur has Associated Morphology Compression Fracture SNOMED 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 hasResult Fracture of Femur HL7 RIM has Finding Site Structure of Neck of Femur has Associated Morphology Compression Fracture SNOMED Ontologies: Mass & Energy Proposition: e=mc2 Mass and Energy (e=mc2) Mass Energy Analogy: Mass to Entity/Energy to Act Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE 0…* Act 0…* id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV Ontologies: Materials & Labor Proposition: Cost = Materials + Labor Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE 0…* Act 0…* id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV Association Class Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE 0…* Act Associations Class 0…* id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV RIM - Backbone Entity Associations People, Places, Physical Things Roles & Relationships Act Collections of Events Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Role player playedRole 1 0..* scoper scopedRole 0..1 0..* classCode : CS effectiveTime : IVL<TS> id : SET<II> statusCode : CS positionNumber : LIST<INT> qty : PQ certificateText : ED addr : SET<AD> telecom : SET<TEL> code : CE 1 0..* Act Participation typeCode : CS tmr : IVL<TS> note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* 1 id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV Associative Classes Review of UML Terms Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE “Classes” 0…* “Attribute: value pair” “Datatype” Act hierarchy or ‘IsA’ association symbol Simple or ‘hasA’ association symbol 0…* ‘cardinality’ or ‘multiplicity’ symbol id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Role player playedRole 1 0..* scoper scopedRole 0..1 0..* source classCode : CS 1 effectiveTime : IVL<TS> target id : SET<II> 1 statusCode : CS positionNumber : LIST<INT> qty : PQ certificateText : ED addr : SET<AD> telecom : SET<TEL> code : CE 0..* inboundLink Recursive Associative Classes Act Participation typeCode : CS tmr : IVL<TS> note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV effectiveTime : IVL<TS> typeCode : CS 0..* 1 0..* RoleLink outboundLink 0..* 1 id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV ActRelationship is_source_for 1 target 1 outboundLink 0..* has_target 0..* typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Role player playedRole 1 0..* scoper scopedRole 0..1 0..* source classCode : CS 1 effectiveTime : IVL<TS> target id : SET<II> 1 statusCode : CS positionNumber : LIST<INT> qty : PQ certificateText : ED addr : SET<AD> telecom : SET<TEL> code : CE 1 0..* 0..* inboundLink effectiveTime : IVL<TS> typeCode : CS 0..* ActRelationship Recursion Act Participation typeCode : CS tmr : IVL<TS> note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV RoleLink outboundLink 0..* 1 id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV ActRelationship is_source_for 1 target 1 outboundLink 0..* has_target 0..* typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS ActRelationship Recursions *Classes, Instances of Classes, & Instance Diagrams Act ActRelationship is_source_for id : SET<II> moodCode : Event code : Chem 4 outboundLink is_source_for outboundLink typeCode : has component Act target has_target id : SET<II> moodCode : Event code : Glucose ActRelationship typeCode : has component Act target has_target id : SET<II> moodCode : Event code : Total Cholesterol ActRelationship is_source_for outboundLink typeCode : has component Act target has_target id : SET<II> moodCode : Event code : Sodium ActRelationship is_source_for outboundLink typeCode : has component Act target has_target id : SET<II> moodCode : Event code : Potassium Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE Role player playedRole 1 0..* scoper scopedRole 0..1 0..* source classCode : CS 1 effectiveTime : IVL<TS> target id : SET<II> 1 statusCode : CS positionNumber : LIST<INT> qty : PQ certificateText : ED addr : SET<AD> telecom : SET<TEL> code : CE RoleLink outboundLink 0..* inboundLink effectiveTime : IVL<TS> typeCode : CS 0..* Infinite Nesting 1 0..* Act Participation typeCode : CS tmr : IVL<TS> note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* 1 id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV ActRelationship is_source_for 1 target 1 outboundLink 0..* has_target 0..* typeCode : CS inversion_ind : BL sequenceNumber : INT priorityNumber : INT pauseQty : PQ checkpointCode : CS splitCode : CS joinCode : CS negation_ind : BL conjunctionCode : CS HL7 RIM Act Hierarchy 0..* 1 Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 WorkingList ownershipLevelCode : CE SubstanceAdministration routeCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> maxDoseQuantity : SET<RTO> potencyQuantity : PQ substitutionCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> specialCourtesiesCode : SET<CE> urgencyCode : CE ControlAct structureTypeId : II responseCode : CS DeviceTask parameterValue : LIST<ANY> Procedure methodCode : SET<CE> approachSiteCode : SET<CD> targetSiteCode : SET<CD> Supply quantity : PQ expectedUseTime : IVL<TS> FinancialAct netAmt : MO FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE DiagnosticImage subjectOrientationCode : CE InvoiceElement modifierCode : SET<CE> unitQuantity : RTO<PQ,PQ> unitPriceAmt : RTO<MO,PQ> factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL Account name : ST currencyCode : CE interestRateQuantity : RTO<MO,PQ> allowedBalanceQuantity : IVL<MO> Bottom-Up Modeling Artifacts Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> riskCode : CE “Classes” 0…* “Attribute: value pair” “Datatype” Act hierarchy or ‘IsA’ association symbol Simple or ‘hasA’ association symbol 0…* ‘cardinality’ or ‘multiplicity’ symbol id : SET<II> moodCode : CS classCode : CS txt : ED statusCode : CS activityTime : GTS effectiveTime : GTS confidentialityCode : SET<CV> repeatNumber : IVL<INT> interruptible_ind : BL priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD transfer_reasonCode : CV The Meaning of Hierarchy 0..* 1 Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 WorkingList ownershipLevelCode : CE SubstanceAdministration routeCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> maxDoseQuantity : SET<RTO> potencyQuantity : PQ substitutionCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> specialCourtesiesCode : SET<CE> urgencyCode : CE ControlAct structureTypeId : II responseCode : CS DeviceTask parameterValue : LIST<ANY> Procedure methodCode : SET<CE> approachSiteCode : SET<CD> targetSiteCode : SET<CD> Supply quantity : PQ expectedUseTime : IVL<TS> FinancialAct netAmt : MO FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE DiagnosticImage subjectOrientationCode : CE InvoiceElement modifierCode : SET<CE> unitQuantity : RTO<PQ,PQ> unitPriceAmt : RTO<MO,PQ> factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL Account name : ST currencyCode : CE interestRateQuantity : RTO<MO,PQ> allowedBalanceQuantity : IVL<MO> Act-Supply-Diet Hierarchy 1 Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 Supply quantity : PQ expectedUseTime : IVL<TS> Diet energyQuantity : PQ carbohydrateQuantity : PQ 0..* Diet Act Combines Attributes in Hierarchy 0..* 1 Diet Act From Supply id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 quantity : PQ expectedUseTime : IVL<TS> energyQuantity : PQ carbohydrateQuantity : PQ From Diet The Meaning of Hierarchy 0..* 1 Act id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 WorkingList ownershipLevelCode : CE SubstanceAdministration routeCode : CE approachSiteCode : SET<CD> doseQuantity : IVL<PQ> rateQuantity : IVL<PQ> doseCheckQuantity : SET<RTO> maxDoseQuantity : SET<RTO> potencyQuantity : PQ substitutionCode : CE PatientEncounter acuityLevelCode : CE admissionSourceCode : CE birthEncounterInd : BL dischargeDispositionCode : CE lengthOfStayQuantity : PQ preAdmitTestInd : BL referralSourceCode : CE specialAccommodationCode : SET<CE> specialCourtesiesCode : SET<CE> urgencyCode : CE ControlAct structureTypeId : II responseCode : CS DeviceTask parameterValue : LIST<ANY> Procedure methodCode : SET<CE> approachSiteCode : SET<CD> targetSiteCode : SET<CD> Supply quantity : PQ expectedUseTime : IVL<TS> FinancialAct netAmt : MO FinancialContract paymentTermsCode : CE Observation value : ANY interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST Diet energyQuantity : PQ carbohydrateQuantity : PQ FinancialTransaction creditExchangeRateQuantity : REAL debitExchangeRateQuantity : REAL interestRateQuantity : RTO PublicHealthCase detectionMethodCode : CE transmissionModeCode : CE diseaseImportedCode : CE DiagnosticImage subjectOrientationCode : CE InvoiceElement modifierCode : SET<CE> unitQuantity : RTO<PQ,PQ> unitPriceAmt : RTO<MO,PQ> factorNumber : REAL pointsNumber : REAL coverageSourceCode : CE notifySubjectInd : BL Account name : ST currencyCode : CE interestRateQuantity : RTO<MO,PQ> allowedBalanceQuantity : IVL<MO> Observation Act = Act Attributes + Observation Attributes 0..* 1 Observation Act From Observation id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST Observation.code / Observation.value 0..* What is the Question? / What is the Answer? 1 Observation Act From Observation id : SET<II> moodCode : CS classCode : CS code : CD text : ED statusCode : CS 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 interpretationCode : SET<CE> methodCode : SET<CE> targetSiteCode : SET<CD> derivationExpr : ST ‘White Blood Count’ CTP code ‘xyz’ 10,000 ‘Established Diagnosis’ SNOMED code ‘14657009’ ‘Malig Tumor of Breast’ SNOMED code ‘254837009’ Sample Glossary Source Term Term Source Christine Storyboard Sentence Nominalized Verb General Dictionary Definition Domain Dictionary Definition Inferred Question Storyboard: Single-word Christine, age 46, was Term recently diagnosed with stage II breast cancer. not applicable Not Applicable What was the name? diagnosed Storyboard: Single-word Christine, age 46, was diagnosis Term recently diagnosed with stage II breast cancer. The act or process of determining the nature and cause of a disease or injury through examination of the patient Establish-ed diagnosis 14657009 breast cancer Storyboard: Multi-word Term none The act or What was the process of diagnosis? identifying or determining the nature and cause of a disease or injury through evaluation of patient history, examination, and review of laboratory data none What was the diagnosis? RN Activity Diagram: Role 224535009 Registered nurse reviews chart Activity Diagram: Action State chart review A nurse who has graduated from an accredited school of nursing and licensed to practice by a state authority Chart: A recording, in tabular form, of clinical data relating to a case requests education appointment Activity Diagram: Action State education appointment request request Activity Diagram: Flow Class Christine, age 46, was recently diagnosed with stage II breast cancer. A graduate trained nurse who has passed a state registration examination and has been licensed to practice nursing Review: An inspection or examination for purposes of evaluation SNOMED Lexical CT Match Meaning Match 254837009 Malignant tumour of breast Review of 55210009 medical records review, 31285300 8 Patient education 311401005 What is an Information Model? Describes Relationships Between Concepts (in UML) Provides Data-type Links to Vocabulary Concepts Class concepts Attribute concepts Association concepts Data-type 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 What is an Information Model? Describes Relationships Between Concepts (in UML) Class concepts Attribute concepts Association concepts Data-type concepts Action +timing -code -vocabulary -vtext -stext Indirect Object -onBehalfOf -code -vocabulary -vtext -stext Provides Data-type Links to Vocabulary Concepts SNOMED LOINC ICNP ….. Building an Information Model --an iterative process 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 Identify Basic Concepts Subjects (actors) Patient Nurse Physician Patient care aide … Verbs Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Objects Patient Strategies Breast cancer Nausea Vomiting Intervention Video … Identify Abstract Concepts Subjects = “Persons” Subjects = “Do’ers” Subjects (actors) Patient Nurse Physician Patient care aide … Verbs = “Actions” Verbs Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Objects = “?” Objects Patient Strategies Breast cancer Nausea Vomiting Intervention Video … 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 …. Action +timing -code -vocabulary -vtext -stext Data-Types 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) Identify Relationships Between Concepts Object of Action Do’er -name -role -code -vocabulary -vtext -code -vocabulary -vtext -stext -actsOn Action +timing -code -vocabulary -vtext -stext Do’ers Patient Nurse Physician Patient care aide … Indirect Object Direct Object -code -vocabulary -vtext -stext -code -vocabulary -vtext -stext Actions Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Objects (direct & indirect) Patient Strategies Breast cancer Nausea Vomiting Intervention Video … Identify Relationships Between Concepts Object of Action Do’er -name -role -code -vocabulary -vtext -code -vocabulary -vtext -stext -actsOn Action +timing -code -vocabulary -vtext -stext Indirect Object -code -vocabulary -vtext -stext -onBehalfOf Do’ers Patient Nurse Physician Patient care aide … Actions Asked Reviewed Decided Printed Moved Documented Spoke Verbalized Assess … Objects (direct & indirect) Patient Strategies Breast cancer Nausea Vomiting Intervention Video … 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 Nursing Domain Information Model Object of Action Provider Role Recipient of Care Action -hasRecipientOfCare +timing -code -vocabulary -vtext -stext -hasSupply * -hasSite -has Means -code -vocabulary -vtext -stext Route -code -vocabulary -vtext -stext Means -code -vocabulary -vtext -stext Finding includes the concepts of Goal and Outcome depending on relationship timing and other actions -name -role -code -vocabulary -vtext Focus -hasRoute Site -code -vocabulary -vtext -stext -actsOn -name -role -code -vocabulary -vtext -timing -focusType Supply -code -vocabulary -vtext -stext -hasFocus OtherObjects -Result Judgement -hasSite Finding -degree -potentiality -acuity -timing -has Judgement Diagnosis Subject of information Subject is coded for individual, family, or other physical entity -code -vocabulary -vtext -stext focusType Value Set = -hasSubjec tOfInformation • Patient Functioning • Environment • ICF and other similar concepts in other vocabularies Example Instance Diagram “Susan , an RN , reviews Christine's chart” Object of Action Provider Role -name Susan -role RN -code 224535009 -vocabulary S -vtext Registered Nurse -hasSite Recipient of Care Action -hasRecipientOfCare +timing -code 55210009 -vocabulary S -vtext Review of -hasSupply * -stext Reviews -has Means -code -vocabulary -vtext -stext Route -code -vocabulary -vtext -stext Means -code -vocabulary -vtext -stext Finding includes the concepts of Goal and Outcome depending on relationship timing and other actions -name Christine -role Patient -code 2B.2.1.1.1.1.1.1.22 -vocabulary ICNP -vtext Focus -hasRoute Site -code -vocabulary ICNP -vtext Record chart -stext chart -actsOn -timing -focusType Supply -code -vocabulary -vtext -stext -hasFocus OtherObjects -Result Judgement -hasSite Finding -degree -potentiality -acuity -timing -has Judgement Diagnosis Subject of information Subject is coded for individual, family, or other physical entity -code -vocabulary -vtext -stext focusType Value Set = -hasSubjec tOfInformation • Patient Functioning • Environment • ICF and other similar concepts in other vocabularies Mapping from Nursing to HL7 From Nursing Domain Provider Role To HL7 RIM Entity (Person) + Role Care Recipient Entity (Person) + Role Action + Object of Action Act Supply Material Diagnosis.result Observation.value Finding.result Route Observation.value SubstAdmin.routeCode Example Instance Diagram “Susan , an RN , reviews Christine's chart” Object of Action Provider Role -name Susan -role RN -code 224535009 -vocabulary S -vtext Registered Nurse -hasSite Recipient of Care Action -hasRecipientOfCare +timing -code 55210009 -vocabulary S -vtext Review of -hasSupply * -stext Reviews -has Means -code -vocabulary -vtext -stext Route -code -vocabulary -vtext -stext Means -code -vocabulary -vtext -stext Finding includes the concepts of Goal and Outcome depending on relationship timing and other actions -name Christine -role Patient -code 2B.2.1.1.1.1.1.1.22 -vocabulary ICNP -vtext Focus -hasRoute Site -code -vocabulary ICNP -vtext Record chart -stext chart -actsOn -timing -focusType Supply -code -vocabulary -vtext -stext -hasFocus OtherObjects -Result Judgement -hasSite Finding -degree -potentiality -acuity -timing -has Judgement Diagnosis Subject of information Subject is coded for individual, family, or other physical entity -code -vocabulary -vtext -stext focusType Value Set = -hasSubjec tOfInformation • Patient Functioning • Environment • ICF and other similar concepts in other vocabularies Entity id : SET<II> classCode : CS determinerCode : CS importanceStatusText : ED qty : SET<PQ> telecom : SET<TEL> description : ED statusCode : CS code : CE nm : SET<EN> Susan riskCode : CE Role player playedRole 1 0..* scoper scopedRole 0..1 0..* source classCode : CS 1 effectiveTime : IVL<TS> target id : SET<II> 1 statusCode : CS positionNumber : LIST<INT> qty : PQ certificateText : ED addr : SET<AD> telecom : SET<TEL> code : CE RN 224535009 0..* inboundLink Registered Nurse Patient 2B.2.1.1.1.1.1.1.22 0..* Participation typeCode : CS tmr : IVL<TS> note_text : ED signatureCode : CV functionCode : CD awarenessCode : CV signatureText : ED encounter_accommodationCode : CV statusCode : CS modeCode : CV 0..* 1 effectiveTime : IVL<TS> typeCode : CS 0..* 1 Christine RoleLink outboundLink S Mapping to the RIM ICNP Act ActRelationship is_source_for outboundLink id : SET<II> typeCode : CS moodCode : CS 1 0..* inversion_ind : BL classCode : CS sequenceNumber : INT txt : ED Reviewed Chart priorityNumber : INT statusCode : CS target has_target pauseQty : PQ activityTime : GTS checkpointCode : CS effectiveTime : GTS 1 0..* splitCode : CS confidentialityCode : SET<CV> joinCode : CS repeatNumber : IVL<INT> negation_ind : BL interruptible_ind : BL conjunctionCode : CS priorityCode : SET<CV> independent_ind : BL availability_dttm : GTS code : CD 312853008 Medical Record Review S transfer_reasonCode : CV --adapted from RIM V1.18
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