Iterative Lifecycle
Domain
Analysis
Requirements
Analysis
Release 3.0
Message
Design
September 27, 1999
Message
Specification
© 1998,1999 Health Level 7
32
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
MDF Model Relationships
Analysis
Requirements
Analysis
Domain
Analysis
Voting
Design
Interaction
Design
Message
Design
2-nd Order
1 choice of
0-n Drug
0-1 Nursing
Use Case
Model
(UCM)
RIM
Domain
Information
Model
(DIM)
Interaction
Model
(IM)
Hierarchical
Message
Descriptions
(HMD)
Reference Model Repository
Approval



Ballots
Models developed in Phases
Develop Scope
Create
Use Cases
Identify
Actors &
Events
Information Model
Use Case Model
Spec
Spec
DIM Spec
Class Diagram State Diagram
Define
Interactions
Create
Conformance
Claims
Model new
concepts
UCM Spec
Use Case Diagram
Harmonize with
Reference
Information Model
Define Trigger
Events
Define Application
Roles
Draw initial
contents from
RIM
Interaction Model
Spec
Inter Spec
Interaction Diagram
Message Design
2-nd Order
1 choice of
0-n Drug
0-1 Nursing
h//mt:50”d”
…
…
…
Develop Message
Information Model
Develop
Message Object
Diagram
Specify HMD
Models are used to build the HMD
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Hierarchical
Message
Description
Person_name_for_IHCP
1
Person_as_IHCP
cd : CV
has
purpose_cd : CV
phon : TIL
1
type_cd : CV
nm : PN
is_for
takes_on_role_of
1
is_participant_for
0..*
Encounter_practitioner
is_associated_with
participation_type_cd
1..*
Exactly one
occurrence
1 participates_as
has_as_participant
1
1 Individual_healthcare_practitioner
is_a_role_of id : TII
Patient_encounter
id : TII
s tatus_cd : CV
encounter_classification_cd : CV
Person_as_Patient
0..1 is_the_primary_provider_for
start_dttm
birth_dttm : TS
involves end_dttm
birthplace_addr : ST
0..* has_a_primary_provider
expected_insurance_plan_qty : NM
1 deceased_dttm : TS
1 first_similar_illness_dttm
Patient
education_level_cd : CV
1..1
id : TII
gender_cd : CV
takes_on_role_of
has
1
s tatus_cd : CV
marital_s tatus_cd : CV
1..1 newborn_baby_ind
race_cd : CV
is_involved_in
is_a_role_of multiple_birth_ind
religious_affiliation_cd : CV
Inpatient_encounter
organ_donor_ind
phon : TIL
1
actual_days_qty
1..*
has
Patient_admission
estimated_days_qty
is_for
admission_dttm
Person_name_for_Patient
Patient_billing_account
admission_reason_cd
1
nm : PN
admission_referral_cd
id : TII
is_preceded_by
effective_dt : TS
admission_source_cd 1
s tatus_cd : CV
0..1
cd : CV
admission_type_cd
billing_s tatus_cd : CV
preceded
purpose_cd : CV
pre_admit_test_ind
patient_financial_class_cd : CV
belongs_to
termination_dt : TS
readmission_ind
price_schedule_id : TII
type_cd : CV
Common
Message
Element
Types
The HMD & ITS then give messages
Implementation
Technology
Specifications
"Send as ASCII
string in XML
format"
Hierarchical
Message
Definition
"Discontinue
pharmacy order"
ITS
Data
HL7
Message
Creation
HL7-Conformant
Application
Message
Instance
HL7
Message
Parsing
Data
HL7-Conformant
Application
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
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
RIM Harmonization Process
Change Proposal Preparation
Review RIM
Change Proposal
w/ Stewards
Prepare RIM
Change Proposal
Document Rationale
for not supporting
RIM change proposal
Revise or Withdraw
RIM Proposal
Post RIM Change Proposals
Submit
RIM Change
Proposal
Post RIM
Change Proposal
Notify HL7 Members
of RIM Change
Proposal Posting
Provide Comment
on RIM Change
Proposals
Harmonization Meeting
Discuss the RIM
Change Proposal
Revise, withdraw,
or Table RIM
Change Proposal
Vote on RIM
Change Proposal
Apply Approved
Changes to RIM
Post Harmonization Meeting Review
Present RIM
Harmonization Report
to TSC
Hold TSC and/or
Board Appeals
Finalize
Revised RIM
Apply Technical
Corrections
Sources of Models for
Harmonization
Others
Information Model
Use Case Model
HL7
Technical
Committees
Spec
Spec
DIM Spec
Class Diagram State Diagram
UCM Spec
Use Case Diagram
Interaction Model
Spec
Inter Spec
Interaction Diagram
2-nd Order
1 choice of
0-n Drug
0-1 Nursing
Other Standard Development
Organizations
HL7
Member
Organizations
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
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
Message Design
Develop Scope
Create
Use Cases
Identify
Actors &
Events
Information Model
Use Case Model
Spec
Spec
DIM Spec
Class Diagram State Diagram
Define
Interactions
Create
Conformance
Claims
Model new
concepts
UCM Spec
Use Case Diagram
Harmonize with
RIM
Define Trigger
Events
Define Application
Roles
Draw initial
contents from
RIM
Interaction Model
Spec
Inter Spec
Interaction Diagram
Message Design
2-nd Order
1 choice of
0-n Drug
0-1 Nursing
h//mt:50”d”
…
…
…
Develop Message
Information Model
Develop
Message Object
Diagram
Specify HMD
Message Specification
Domain
Information
Model
Use Case
Model
Reference
Information
Model
Hierarchical
Message
Description
Person_name_for_IHCP
1
Person_as_IHCP
cd : CV
has
purpose_cd : CV
phon : TIL
1
type_cd : CV
nm : PN
is_for
takes_on_role_of
1
is_participant_for
0..*
Encounter_practitioner
is_associated_with
participation_type_cd
1..*
Exactly one
occurrence
1 participates_as
1 Individual_healthcare_practitioner
is_a_role_of id : TII
Message
Information
Model
has_as_participant
1
Patient_encounter
id : TII
s tatus_cd : CV
encounter_classification_cd : CV
Person_as_Patient
0..1 is_the_primary_provider_for
start_dttm
birth_dttm : TS
involves end_dttm
birthplace_addr : ST
0..* has_a_primary_provider
expected_insurance_plan_qty : NM
1 deceased_dttm : TS
1 first_similar_illness_dttm
Patient
education_level_cd : CV
1..1
id : TII
gender_cd : CV
takes_on_role_of
has
1
s tatus_cd : CV
marital_s tatus_cd : CV
1..1 newborn_baby_ind
race_cd : CV
is_involved_in
is_a_role_of multiple_birth_ind
religious_affiliation_cd : CV
Inpatient_encounter
organ_donor_ind
phon : TIL
1
actual_days_qty
1..*
has
Patient_admission
estimated_days_qty
is_for
admission_dttm
Person_name_for_Patient
Patient_billing_account
admission_reason_cd
1
nm : PN
admission_referral_cd
id : TII
is_preceded_by
effective_dt : TS
admission_source_cd 1
s tatus_cd : CV
0..1
cd : CV
admission_type_cd
billing_s tatus_cd : CV
preceded
purpose_cd : CV
pre_admit_test_ind
patient_financial_class_cd : CV
belongs_to
termination_dt : TS
readmission_ind
price_schedule_id : TII
type_cd : CV
Interaction
Model
Message Information Model (MIM)
Person_name_for_IHCP
1
Person_as_IHCP
cd : CV
has
purpose_cd : CV
phon : TIL
1
type_cd : CV
nm : PN
is_for
takes_on_role_of
1
is_participant_for
0..*
Encounter_practitioner
is_associated_with
participation_type_cd
1..*
Exactly one
occurrence
1 participates_as
1 Individual_healthcare_practitioner
is_a_role_of id : TII
has_as_participant
1
Patient_encounter
id : TII
s tatus_cd : CV
encounter_classification_cd : CV
start_dttm
involves end_dttm
expected_insurance_plan_qty : NM
1 first_similar_illness_dttm
Person_as_Patient
0..1 is_the_primary_provider_for
birth_dttm : TS
birthplace_addr : ST
0..* has_a_primary_provider
deceased_dttm
:
TS
1
Patient
education_level_cd : CV
1..1
id
:
TII
gender_cd : CV
takes_on_role_of
has
1
s tatus_cd : CV
marital_s tatus_cd : CV
1..1 newborn_baby_ind
race_cd : CV
is_involved_in
is_a_role_of multiple_birth_ind
religious_affiliation_cd : CV
Inpatient_encounter
organ_donor_ind
phon : TIL
1
actual_days_qty
1..*
has
Patient_admission
estimated_days_qty
is_for
admission_dttm
Person_name_for_Patient
Patient_billing_account
admission_reason_cd
1
nm : PN
admission_referral_cd
id : TII
is_preceded_by
effective_dt : TS
admission_source_cd 1
s tatus_cd : CV
0..1
cd : CV
admission_type_cd
billing_s tatus_cd : CV
preceded
purpose_cd : CV
pre_admit_test_ind
patient_financial_class_cd : CV
belongs_to
termination_dt : TS
readmission_ind
price_schedule_id : TII
type_cd : CV
This example will
include those
messages requiring
data from Patient and
Patient_admission
Information Model Mapping
MIM and R-MIM
Person_name_for_IHCP
1
Person_as_IHCP
cd : CV
has
purpose_cd : CV
phon : TIL
1
type_cd : CV
nm : PN
is_for
takes_on_role_of
1
is_participant_for
0..*
Encounter_practitioner
is_associated_with
participation_type_cd
1..*
Exactly one
occurrence
1 participates_as
1 Individual_healthcare_practitioner
is_a_role_of id : TII
has_as_participant
1
Patient_encounter
id : TII
s tatus_cd : CV
encounter_classification_cd : CV
start_dttm
involves end_dttm
expected_insurance_plan_qty : NM
1 first_similar_illness_dttm
Person_as_Patient
0..1 is_the_primary_provider_for
birth_dttm : TS
birthplace_addr : ST
0..* has_a_primary_provider
deceased_dttm : TS
Patient
education_level_cd : CV
1..1
id : TII
gender_cd : CV
takes_on_role_of
has
1
s tatus_cd : CV
marital_s tatus_cd : CV
1..1 newborn_baby_ind
race_cd : CV
is_involved_in
is_a_role_of multiple_birth_ind
religious_affiliation_cd : CV
Inpatient_encounter
organ_donor_ind
phon : TIL
1
actual_days_qty
1..*
has
Patient_admission
estimated_days_qty
is_for
admission_dttm
Person_name_for_Patient
Patient_billing_account
admission_reason_cd
1
nm : PN
admission_referral_cd
id : TII
is_preceded_by
effective_dt : TS
admission_source_cd 1
s tatus_cd : CV
0..1
cd : CV
admission_type_cd
billing_s tatus_cd : CV
preceded
purpose_cd : CV
pre_admit_test_ind
patient_financial_class_cd : CV
belongs_to
termination_dt : TS
readmission_ind
price_schedule_id : TII
type_cd : CV
1
rmim
class
attr
assoc
assoc
class
assoc
assoc
assoc
assoc
class
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
attr
C04_RIM_0092
Micro
A
TP_for_order_subject Target_participation
participation_type_cd participation_type_cd
has_as_target
has_as_target
is_target_of
is_target_of
Patient
is_a_role_of
is_source_for
is_target_of
is_target_of
Person as patient
Person
military_branch_of_service_cd
birth_dttm
student_cd
status_cd
religious_affiliation_cd
race_cd
nationality_cd
military_rank_nm
very_important_person_cd
marital_status_cd
deceased_dttm
birthplace_addr
military_status_cd
confidentiality_constraint_cd
language_cd
deceased_ind
disability_cd
education_level_cd
ethnic_group_cd
gender_cd
citizenship_country_cd
credit_rating_cd
Stakeholder as HCP
type_cd
Stakeholder as HCP
0..*
CV
1..1
Patient
1..1
Observation_intent_or_order_as_service_order
1..1
Person as patient
CSS_as_original_specimen
TP_for_order_subject
TP_for_superservice_subject
{7821B3D3-731A-11D3-AD23-005004953E1E}
{FB409E54-7242-11D3-AD20-005004953E1E}
{FB409E56-7242-11D3-AD20-005004953E1E}
{FB409E60-7242-11D3-AD20-005004953E1E}
{FB409E64-7242-11D3-AD20-005004953E1E}
{FB409E66-7242-11D3-AD20-005004953E1E}
{FB409E8C-7242-11D3-AD20-005004953E1E}
{FB409E7C-7242-11D3-AD20-005004953E1E}
{FB409E91-7242-11D3-AD20-005004953E1E}
{4457CB2F-72AB-11D3-AD21-00C04FFA6C93}
{FB409E9B-7242-11D3-AD20-005004953E1E}
{FB409EB5-7242-11D3-AD20-005004953E1E}
{FB409E9D-7242-11D3-AD20-005004953E1E}
{FB409EC3-7242-11D3-AD20-005004953E1E}
{FB409EC1-7242-11D3-AD20-005004953E1E}
{FB409EBF-7242-11D3-AD20-005004953E1E}
{FB409EBD-7242-11D3-AD20-005004953E1E}
{FB409EBB-7242-11D3-AD20-005004953E1E}
{FB409EB7-7242-11D3-AD20-005004953E1E}
{FB409EC5-7242-11D3-AD20-005004953E1E}
{FB409EB3-7242-11D3-AD20-005004953E1E}
{FB409EA5-7242-11D3-AD20-005004953E1E}
{FB409E9F-7242-11D3-AD20-005004953E1E}
{FB409EB9-7242-11D3-AD20-005004953E1E}
{FB409EA3-7242-11D3-AD20-005004953E1E}
{FB409EB1-7242-11D3-AD20-005004953E1E}
{FB409EA7-7242-11D3-AD20-005004953E1E}
{FB409EA9-7242-11D3-AD20-005004953E1E}
{FB409EAB-7242-11D3-AD20-005004953E1E}
{FB409EAD-7242-11D3-AD20-005004953E1E}
{FB409EAF-7242-11D3-AD20-005004953E1E}
{FB409EA1-7242-11D3-AD20-005004953E1E}
{FB409F0D-7242-11D3-AD20-005004953E1E}
{FB409F12-7242-11D3-AD20-005004953E1E}
CWE
CNE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
CWE
1..1
0..*
0..*
0..*
0..*
CV
TS
CV
CV
CV
CV
CV
ST
CV
CV
TS
AD
CV
CV
CV
BL
CV
CV
CV
CV
CV
CV
CV
Information Model Mapping
DATATYPES
<<Data_type>>
Any_data_type : ANY
<<Data_type>>
Quantity : QTY
<<Data_type>>
Discrete : DSCR
<<Data_type>>
Ordered : ORD
Message Elements
Common Constraints
Union:
Text
C00XMM011
Thing
0..*
Patient_service_location_request
type_cd
Patient_appointment_request
requests 0..*
0..* requests
requests 0..*
0..* requests
0..* requests
Patient_information_recipient
1
takes_on_role_of
Stakeholder
takes_on_role_of
1
addr
acts_as
1
participates_as_primary_in 1 credit_rating_cd
1
takes_on_role_of
email_address_txt
1
phon
takes_role_of
takes_on_role_of 1 type_cd
1..1 participates_in
real_id : SET<RWII> 0..* refers_to_person_by
takes_on_role_of 1
id : SET<TII>
1
collects
takes_on_role_of 1
1 takes_on_role_of
takes_on_role_of 1
0..* has_as_primary_participant
Real_world_instance_identifier
value_txt : ST
type_cd : CV
qualifier_txt : ST
valid_tmr : IVL<TS>
provides_contact 0..1
represents 0..*
Person_name
0..* effective_dt
cd
nm
purpose_cd
termination_dt
type_cd
contains 0..1
0..* contains
Accident_information_source
Health_chart
health_chart_id
is_the_source_of 0..1
health_chart_type_cd 0..* is_housed_at
status_cd
0..* belongs_to
1 enters
has_an_assessment_of 1
Health_chart_deficiency
assessment_dttm
desc
0..* is_assessed_against
level_cd
type_cd
is_for 0..*
Organization
organization_name_type_cd
organization_nm
standard_industry_class_cd
0..1 is_role_of
Employer
1..* is_represented_by
effective_tmr
1 is_employer_of
1 is_requested_by
Individual_healthcare_practitioner_group
id
is_a_role_of 0..1
issues 0..1
Stakeholder_affiliate
0..1 is_role_of
family_relationship_cd
is_requested_by 0..1
Entering_person
0..1 is_role_of
is_used_by
is_issued_by 0..*
participates_as_secondary_in 1
enters 0..1
0..1 is_a_role_of
0..1 categorizes
1
takes_on_role_of
assigns
1
takes_on_role_of
1
is_requested_by 0..1
Resource_slot
offset_qty
quantity_amt
resource_type_cd
slot_state_cd
0..* is_managed_by
start_dttm
0..* is_reserved_by
Durable_medical_equipment
belongs_to 1..*
id
slot_size_increment_qty
type_cd
0..* contains
Durable_medical_equipment_group
id
is_scheduled_by 1
Patient_service_location_slot
0..* is_scheduleable_unit_for
Schedule
books 1..*
id
Durable_medical_equipment_slot
is_scheduleable_unit_for 0..*
1 takes_on_role_of 0..1
has_as_a_subdivision
0..* is_contact_for
Contact_person 0..1 is_contact_for
0..1 is_a_contact_for
is_contact_for 0..* contact_reason_cd
0..* is_a_contact_for
is_issued_by 0..*
0..1 is_a_role_of
has 1 1 has 1
Person
acts_in_role_of
birth_dttm
1 takes_on_role_of
birthplace_addr
citizenship_country_cd
Administrative_patient_death
Notary_public
confidentiality_constraint_cd
death_certificate_id
deceased_dttm
effective_interval_tmr
death_certificate_recorded_dttm
notary_county_cd
takes_on_role_of 1 deceased_ind
death_classification_cd
disability_cd
notary_state_cd
death_dttm
education_level_cd
death_location_txt
ethnic_group_cd
Insured
0..1 is_a_role_of
death_notification_source_nm
gender_cd
death_verification_cd
language_cd
1 takes_on_role_of
0..1 is_role_of
death_verification_dttm
marital_status_cd
death_verification_nm
military_branch_of_service_cd
1 issues
0..1 pertains_to
military_rank_nm
1 takes_on_role_of
1 offers
takes_on_role_of 1 military_status_cd
0..* has_as_employee
Insurance_certification_contact
nationality_cd
race_cd
participation_type_cd
is_issued_by 0..*
takes_on_role_of 1 religious_affiliation_cd
Employee
Billing_information_item
takes_on_role_of
0..1 is_role_of
student_cd
Insurance_certification
is_employee_in 1
0..1 is_role_of
is_contact_for
condition_cd
1..*
very_important_person_cd
1
appeal_reason_cd
occurrence_cd
status_cd
0..* pertains_to
certification_duration_qty
occurrence_dttm
effective_tmr
occurrence_span_cd
1 has_contact
id
enters 1
occurrence_span_from_dttm
1..*
0..* belongs_to
has 1
insurance_verification_dttm
Guarantor_contract
occurrence_span_thru_dttm
provides_payment_guarantee_for
has_payment_guaranteed_by
modification_dttm
Patient_billing_account
quantity_nbr
billing_hold_ind
non_concur_cd
account_id
quantity_type_cd
billing_media_cd
0..*
non_concur_effective_dttm 0..* affirms_insurance_coverage_for
adjustment_cd
value_amt
has_coverage_affirmed_by 1 charge_adjustment_cd
penalty_amt
authorization_information_txt
Financial_transaction
value_cd
contract_duration_cd
report_of_eligibility_dttm
billing_status_cd
alternate_desc
contract_type_cd
0..* provides_validation_for
0..*
report_of_eligibility_ind
certification_required_ind
desc
effective_tmr
0..*
is_entered_by
has_payment_guaranteed_by 0..* current_unpaid_balance_qty
extended_amt
interest_rate_nbr
is_categorized_by fee_schedule_cd
delete_dttm
includes 1
periodic_payment_amt
insurance_amt
priority_ranking_cd
has 1 deleted_account_reason_cd
0..* provides_opinion_on
expected_insurance_plan_qty
posting_dt
0..* is_associated_with
expected_payment_source_cd
qty
Certification_second_opinion
notice_of_admission_dttm
transaction_batch_id
0..* is_provided_by
effective_dttm
notice_of_admission_ind
transaction_cd
status_cd
patient_financial_class_cd
transaction_dttm
Bad_debt_billing_account
price_schedule_id
0..* pertains_to
is_associated_with transaction_id
bad_debt_recovery_amt
purge_status_cd
transaction_type_cd
bad_debt_transfer_amt
0..* unit_amt
purge_status_dttm
transfer_to_bad_debt_dttm
report_of_eligibility_dttm
1 is_validated_by
unit_cost_amt
transfer_to_bad_debt_reason_cd
retention_ind
Coverage_item
signature_on_file_dttm
0..* is_for
service_category_cd
special_program_cd
0..* is_assigned_to
service_cd
stoploss_limit_ind
provides_contact 0..1
Bad_debt_collection_agency
service_modifier_cd
is_a_role_of 0..1
1 is_assigned
suspend_charges_ind
is_role_of 0..1 Health_benefit_product_purchaser
0..*
0..1 total_adjustment_qty
authorization_ind
provides_coverage_for
network_ind
has_as_a_prior_account total_charge_qty
Preferred_provider_participation
1 is_the_purchaser_of
assertion_cd
total_payment_qty
is_the_prior_account_for
0..1 governs
covered_parties_cd
is_governed_by role_cd
separate_bill_ind
has_as_care_recipient
effective_dt
qty
0..1
0..* termination_dt
quantity_qualifier_cd
0..*
0..1 has_charges_for
is_billed_from 0..1
time_period_qualifier_cd
range_low_qty
has_as_care_provider 0..*
range_high_qty
is_associated_with 0..1
range_units_cd
assertion_effective_tmr
Master_healthcare_benefit_product
has 0..* eligibility_cd
0..* assignment_of_benefits_ind
policy_source_cd
Collected_specimen_sample
benefit_product_desc
is_collected_by 0..*
eligibility_source_cd
body_site_cd
id
has_as_components
has_as_purchaser
copay_limit_ind
collection_body_site_modifier_cd
benefit_product_nm
non_covered_insurance_cd 0..1
collection_tmr
benefit_product_type_cd
0..* is_sourced from
participates_in 1
collection_method_modifier_cd
benefits_coordination_cd
Person_employment
addr
0..* effective_dt
has_as_employer hazard_exposure_txt
job_class_cd
job_title_nm
phon
protective_equipment_txt
salary_qty
salary_type_cd
status_cd
termination_dt
occupation_cd
job_status_cd
0..* is_contact_for
Guarantor
0..1 is_role_of
provides_contact 0..1 financial_class_cd
household_annual_income_amt
household_size_nbr
1 guarantees_payment_under
0..1 provides_contact
0..1 is_role_of
Insurer
effective_tmr 1 issues
0..*
cob_priority_nbr
combine_baby_bill_ind
effective_tmr
is_offered_by 0..*
group_benefit_ind
mail_claim_party_cd
release_information_cd
status_cd
coverage_type_cd
agreement_type_cd
policy_category_cd
access_protocol_desc
is_a_component_of
1 is_associated_with
Healthcare_service_provider
board_certification_type_cd
board_certified_ind
participates_as 1 certification_dttm
effective_tmr
license_id
identifies
recertification_dttm
1
specialty_cd
is_child_of
0..1
0..1
collection_scheduled_dttm
0..* is_sourced_from
collection_volume_qty
collectors_comment_cd
handling_cd
id
collection_method_desc
0..1 is_target_of
number_of_sample_containers_qty
additive_desc
0..* is_collected_during
danger_cd
source_cd
transport_logistics_cd
action_cd
type_cd
is_parent_of
is_role_of
Champus_coverage
handicapped_program_cd
non_avail_cert_on_file_ind
retirement_dttm
station_id
Healthcare_provider_organization
0..1
1..* provides_patient_services_at
Individual_healthcare_practitioner
is_role_of
desc
0..1
fellowship_field_cd
graduate_school_nm
graduation_dttm
position_cd
practitioner_type_cd
participates_as
1
provides 1 primary_care_ind
1..* belongs_to
residency_field_cd
is_requested_by
1
slot_size_increment_qty
0..1
is_the_primary_provider_for
is_scheduled_by 1
Living_subject
birth_dttm
birthplace_addr
origin_country_cd
taxonomic_classification_cd
is_source_for 0..1 breed_txt
strain_txt
eye_color_cd
is_schedu
coat_or_feather_coloring_txt
led_by
confidentiality_constraint_cd
1
deceased_dttm
has 1
deceased_ind
Patient
has 1
euthanasia_ind
ambulatory_status_cd gender_cd
has_as_a_contact 0..1
birth_order_nbr
has 1 living_arrangement_cd gender_status_cd
primary_name_type_cd
is_a_role_of 0..1 living_dependency_cd
primary_nm
multiple_birth_ind
has 1
importance_status_txt
newborn_baby_ind
qty
0..1
participates_in 1 organ_donor_ind
production_class_cd
preferred_pharmacy_id
has 1 status_cd
0..1 pertains_to
Preauthorization
authorized_encounters_qty
authorized_period_begin_dt
authorized_period_end_dt
id
issued_dttm
requested_dttm
restriction_desc
status_cd
status_change_dttm
Administrative_birth_event
baby_detained_ind
birth_certificate_id
birth_method_cd
0..* is_part_of
birth_recorded_county_cd
birth_recorded_dttm
newborn_days_nbr
stillborn_ind
authorizes 0..1
is_booked_in 0..*
Appointment
reserves 0..* appointment_disposition_cd
appointment_duration_tmr
appointment_timing_qt
is_entered_by 0..* cancellation_dttm
event_reason_cd
expected_end_dttm
has_as_a_contact 0..*
expected_service_desc
is_parent_of
expected_start_dttm
id
0..1
overbook_ind
scheduling_begin_dttm
status_cd
0..*
schedules 0..* urgency_cd
visit_type_cd
is_child_of
wait_list_priority_amt
scheduling_completed_dttm
has_as_primary_facility 0..*
1
is_involved_in
1
has
0..* is_reason_for
0..* +has_as_target
is_authorized_by 1..*
1 has
Disability
0..* effective_dttm
pertains_to return_to_work_auth_dttm
termination_dttm
unable_to_work_effective_dttm
Diagnostic_related_group
base_rate_amt
capital_reimbursement_amt
cost_weight_amt
id
major_diagnostic_category_cd
operating_reimbursement_amt
reimbursement_amt
1 is_assigned_as
standard_day_qty
standard_total_charge_amt
trim_high_day_qty
trim_low_day_qty
1..* is_scheduled_by
Patient_encounter
pertains_to 0..*
has_parts 1 administrative_outcome_txt
cancellation_reason_cd
Administrative_patient_accident
desc
accident_death_ind
involves 0..* encounter_classification_cd
1..* accident_desc
end_dttm
is_obtained_from accident_dttm
Episode_of_condition
Episode_of_care
accident_location_desc
has 1..* expected_insurance_plan_qty
first_similar_illness_dttm
accident_state_cd
0..* is_present_in
0..*
follow_up_type_cd
accident_type_cd
is_part_of 1
links_condition 0..1
id
is_identified by job_related_accident_ind
patient_classification_cd
1..* has_parts
assessment_dttm
purpose_cd
0..1 has_assigned_to_it
record_signing_dttm
1 has
special_courtesies_cd
start_dttm
Patient_admission
1
status_cd
admission_dttm
1 is_preceded_by
transport_requirement_cd
admission_reason_cd
has_as_participant
urgency_cd
admission_referral_cd
Patient_departure
triage_classification_cd
0..* pertains_to
admission_source_cd
actual_discharge_disposition_cd
medical_service_cd
admission_type_cd
0..1
Risk_management_incident
discharge_dttm
confidentiality_constraint_cd
patient_valuables_desc
follows
discharge_location_id
incident_cd
pre_admit_test_ind
expected_discharge_disp_cd
incident_dttm
readmission_ind
0..*
1
incident_severity_cd
valuables_location_desc
has precedes
incident_type_cd
terminates 0..1
preceded 1
is_assigned_by 0..*
0..* is_an_assignment_of
Encounter_drg
approval_ind
assigned_dttm
confidential_ind
cost_outlier_amt
desc
0..* is_assigned_to
grouper_review_cd
grouper_version_id
outlier_days_nbr
outlier_reimbursement_amt
outlier_type_cd
is_terminated_by 1
is_preceded_by 1
precedes 0..1
Inpatient_encounter
actual_days_qty
estimated_days_qty
Patient_arrival
acuity_level_cd
arrival_dttm
medical_service_id
source_of_arrival_cd
mode_cd
is_assigned 1
has_as_target 0..* Target_participation
is_target_of
has_as_target 0..* tmr
has_as_target 0..* participation_type_cd 1..*
Encounter_practitioner
1..* participation_type_cd
Service_reason
determination_dttm
documentation_dttm
reason_txt
0..*
has_as_evidence
is_target_of 0..*
0..*
is_reason_for
collects 0..1
Procedure
anesthesia_cd
anesthesia_tmr
delay_reason_txt
incision_open_tmr
priority_nbr
procedure_tmr
functional_type_cd
modifier_cd
Treatment_service_event
prescription_id
refills_remaining_nbr
PTrout
PTcomp
indication_id
substance_expiration_dttm
substance_lot_number_txt
substance_manufacturer_cd
dosage_form_cd
strength_qty
amount_qty
route_cd
body_site_cd
substitution_cd
<<Data_type>>
Annotated : ANT
<<Data_type>>
History_item : HXIT
0..1 is_ordered_on
is_an_instance_of 0..*
Goal
expected_achievement_dttm
goal_list_priority_nbr
management_discipline_cd
review_interval_cd
goal_value_cd
is_measured_by 1..*
_item_CV
Condition_node
life_cycle_start_dttm
lifecycle_status_cd
management_discipline_cd
ranking_nbr
employment_related_ind
1 defines_episode
is_associated_with0..* is_participant_for
Treatment_service_dispense
Treatment_service_give Treatment_service_administration
administered_rate_qty
dispense_package_method_cd
give_per_timeunit_cd
completion_status_cd
dispense_package_size_qty
qt
substance_refusal_reason_cd
needs_human_review_ind
give_rate_qty
suppliers_special_dispensing_instruction_cd needs_human_review_ind system_entry_dttm
administration_nbr
total_daily_dose_qty
administered_per_timeunit_cd
administrators_notes_cd
Reference Information Model
ambulatory _status_cd
13
8
att
newborn_baby _ind
14
9
att
multip le_birth_ind
Class
15
10 or
att
organ_donor_ind
Property
of aso
Class
16 11
is_a_role_of
(Attribute
Association)
Rim Source Class
17or12
att
birth_dttm
8
9
3
4
cla
att
Patient
id
10
5
att
status_cd
6
itm
7
att
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
8
9
10
11
12
13
14
15
16
17
18
19
20
21
att
att
att
aso
att
att
att
att
att
att
att
att
att
itm
27
22
aso
28
23
itm
29
30
31
32
33
34
35
24
25
26
27
28
29
30
att
att
att
att
stc
att
att
36
31
aso
47
26
49
51
52
53
54
37
32
33
34
35
36
37
38
39
attr
itm
aso
attr
attr
attr
attr
aso
38
40
att
39
41
att
40
42
itm
41
43
att
42
44
att
43
45
att
44
46
aso
18 13
att
19 14
att
20 15
att
21 16
att
22 17
att
23 18
att
24 19
att
ambulatory _status_cd
25 20
att
26 21
itm
newborn_baby
_ind
multip le_birth_ind
27 22 aso
organ_donor_ind
is_a_role_of
28 23
itm
birth_dttm
29 24
att
birthp lace_addr
30 25
att
deceased_dttm
31 26
att
education_level_cd
att
gender_cd32 27
33 28 stc
marital_status_cd
34 29
att
race_cd
35 30
att
religious_affiliation_cd
p hon
36 31 aso
47 32
26 33
49 34
51 35
52 36
nm
53 37
effective_dt
54 38
cd
37 39
p urp ose_cd
value
38 40
termination_dt
has
attr
itm
aso
attr
attr
attr
attr
aso
birthp lace_addr
Patient
deceased_dttm
Patient
education_level_cd
Patient
gender_cd
marital_status_cd
Patient
race_cd
religious_affiliation_cd
Patient
p hon
Patient
Patient
has
Patient
Patient
Person
nm
Person
effective_dt
Person
cd
Person
p urp ose_cd
Person
value Person
termination_dt
Person
ty p e_cd
Person
Stakeholder
has_a_primary_provider
Stakeholder
p hon
Person
Person_as_IHCP
Person
nm
cd
Person_name
p urp ose_cd
Person_name
ty p e_cd
Person_name
has
Person_name
Person_name
att
id
Person_name
ty p e_cd
Person_name
39 41
att
status_cd
has_a_primary_provider
Patient
40 42 itm
p hon
Stakeholder
Stakeholder
41 43
att
billing_status_cd
Person_as_IHCP
nm
42
cd
p urp ose_cd
43
ty p e_cd
Patient
Pt
II
Pt
Set <CV>
_CV
Pt
CV
ambltry Status
Pt
CV
att
Patient_billing_accoun
nm
t
cd
45
att
Patient_billing_accoun
p urp ose_cd
t
ty p e_cd
is_involved_in
Patient
nwbrnInd
Pt
multbrthInd
Pt
in
of
orgnDonrInd
Pt
Message
Message
PtPrsn
Pt
Element
Type
Element
Type
brthDttm
PtPrsn
nm
p atient_financial_class_cd
cd
p urp os
p rice_schedule_id
ty p
has_Patient_billing_account
PtBillAcnt
Patient
is_involved_in_Patient_encounter
id
id
Patient_encounter
id
Patient_encounter
status_cd
status_cd
PN_IHCP
p tFnanclClass
PN_IHCP
PN_IHCP
p riceSchedId
PN_IHCP
0..1
0..1
0..1
0..1
1
0..1
0..1
Pt
PtEnctr
PtBillAcnt
id
PN
PtBillAcnt
CV
CV
PtBillAcnt
CV
PtBillAcnt
Pt
II
PtEnctr*
SetPtEnctr
<CV>
1..*
1
0..1
0..1
0..1
0..1
1
0..1
0..1
IHCP
Set <TIL>
TIL
PN_IHCP
PN
CV
CV
CV
PtBillAcnt
<p urp sCd>
1
0..1
0..*
1
1
1
0..1
0..1
0..1
0..1
1
CV
0..1
0..1
ST
0..1
PtEnctr &
IptEnctr
II
<@state,
CV
EXT:CNE>
status
PtBillAcnt
PtBillAcnt
CV
1
<@state,
EXT:CNE>
billngStatus
PtBillAcnt
CV
0..1
<bilngStatus>
p tFnanclClass
PtBillAcnt
CV
0..1
<p tFincl
Class>
p riceSchedId
PtBillAcnt
Pt
45
47
att
id
Patient_encounter
id
id
PtEnctr*
46
48
att
status_cd
Patient_encounter
status_cd
status
PtEnctr
ST
PtEnctr &
IptEnctr
II
CV
1..*
1
CV
CV
0..1
M
1
1
M
M
V
R
R
R
No
2
R
R
R
R
R
R
R
R
R
N
R
R
<@state,
EXT:CNE>
<@state,
EXT:CNE> R
N
<bilngStatus>
R
R
R
N
R
R
R
R
R
R
R
R
R
N
N
R
R
R
R
R
R
R
R
R
R
R
R
R
R
<p urp sCd> R
R
R
R
R
N
R
R
R
R
R
R
R
2
0..*
1
1
1
0..1
0..1
0..1
0..1
1..*
status
PtEnctr
0..1
II
_CV
p rice_schedule_id
<relgsAfltn>
R
1
No
No
M
14
<martlStatus>
No
R
<race>
0..1
0..*
1
1..*
M
M
No
V
<edctnLevl>
No
R
0..1
M
0..1
Set <CV>
p atient_financial_class_cd
is_involved_in_Patient_encounter
1
PN
TS
CV
<edctnLevl>
14
CV
ST
<martlStatus>
TS
<race>
CV
<relgsAfltn>
0..1
0..1
0..1
0..1
0..1
0..1
0..1
0..*
1
C00XMM011
<@state,
EXT:CNE>
<@state,
EXT:CNE>
<ambltr
Status>
<clasfcn>
1
0..1
0..1
0..1
1
0..1
0..1
0..1
M
0..1
M
0..1
billing_status_cd
_item_CV
Constraints
1
1
0..1
BL
BL
BL
PtPrsn
TS
PtPrsn
ST
Pt
1
PtPrsn
TS
II
1
PtPrsn
CV
<@state,
Set <CV>
1
PtPrsn
CV
EXT:CNE>
PtPrsn
CV
<@state,
CV
1
PtPrsn
CV
EXT:CNE>
PtPrsn
CV
<ambltr
CV
0..1
PtPrsn
Set Status>
<TIL>
Set
TIL
BL <TIL>
0..1
<clasfcn>
S et
BL
0..1
PtPrsn
BL
0..1 <PtPrsnName>
Set
PtPrsn
1
PtPrsnName
<PtPrsnName>
TS
0..1
brthp lcAddr
decesdDttm
Pt
educnLevl
Pt
gendr
maritlStatus
Pt
race
Person
religious_affiliation_cd
relgsAfiltn
ambulatory _status_cd
ambltry Status
Pt
Stakeholder
p hon
p hon
Stakeholder
_item_TIL
_TIL
newborn_baby _ind
nwbrnInd
Pt
multip le_birth_ind
multbrthInd
Pt
Person
has_S et_Person_name_for_Patient
PtName
organ_donor_ind
orgnDonrInd
Pt
is_a_role_of_Person_as_patient
PtPrsn
Pt
Person
_item_Person_name_for_Patient
_PtPrsnName
birth_dttm
brthDttm
PtPrsn
Person_name
nm
nm
PtPrsnName
birthp lace_addr
brthp lcAddr
PtPrsn
ST
Person_name
effective_dt
efectvDt
PtPrsnName
deceased_dttm
decesdDttm
PtPrsn
TS
Person_name
cd
cd
PtPrsnName
education_level_cd
educnLevl
PtPrsn
CV
Person_name
p urp ose_cd
p urp os
PtPrsnName
gender_cd
gendr
PtPrsn
CV
Person_name
value
valu
PtPrsnName
marital_status_cd
maritlStatus
PtPrsn
CV
Person_name
termination_dt
termntnDt
PtPrsnName
race_cd
race
PtPrsn
CV
Person_name
ty p e_cd
ty p
PtPrsnName
religious_affiliation_cd
relgsAfiltn
PtPrsn
CV
has_a_primary_provider_Individual_healthca
p hon
p hon
PtPrsn
Set <TIL>
Patient
primryIHCP
Pt
re_practitioner
_item_TIL
_TIL
Set <TIL>
TIL
Stakeholder
p hon
p hon
IHCP
S et
has_S et_Person_name_for_Patient
PtName
PtPrsn
Stakeholder
_item_TIL
_TIL
Set <TIL>
<PtPrsnName>
has_Person_name_for_IHCP
PN_IHCP
IHCP
Set
_item_Person_name_for_Patient
_PtPrsnName
PtPrsnName
Person_name
nm
nm
PN_IHCP
<PtPrsnName>
Person_name
cd
cd
PN_IHCP
nm
nm
PtPrsnName
PN
Person_name
p urp ose_cd
p urp os
PN_IHCP
effective_dt
efectvDt
PtPrsnName
TS
Person_name
ty p e_cd
ty p
PN_IHCP
cd
cd
PtPrsnName
CV
Patientp urp ose_cd
has_Patient_billing_account
PtBillAcnt
Pt
p urp os
PtPrsnName
CV
Patient_billing_accoun
value
valu
PtPrsnName
ST
id
id
PtBillAcnt
t
termination_dt
termntnDt
PtPrsnName
TS
Patient_billing_accoun
ty p e_cd
ty p
PtPrsnName
CV
status_cd
status
PtBillAcnt
t has_a_primary_provider_Individual_healthca
primryIHCP
Pt
IHCP
Patient_billing_accoun
re_practitioner
_item_CV
_CV
PtBillAcnt
t
p hon
p hon
IHCP
Set <TIL>
Patient_billing_accoun
_item_TIL
_TIL
Set <TIL>
TIL
billing_status_cd
billngStatus
PtBillAcnt
t
has_Person_name_for_IHCP
PN_IHCP
IHCP
PN_IHCP
44
Person_name
p atient_financial_class_cd
Person_name
Person_name
p rice_schedule_id
Person_name
has
Patient
44 46 aso
is_involved_in
Patient_billing_accoun
id
45 47
att
id
t
Patient_billing_accoun
att
status_cd
status_cd 46 48
t
Patient_billing_accoun
t
Patient_billing_accoun
billing_status_cd
t
Patient_billing_accoun
p atient_financial_class_cd
t
Patient_billing_accoun
p rice_schedule_id
t
ambulatory _status_cd
Patient
newborn_baby _ind
Patient
multip le_birth_ind
Message
Patient
organ_donor_ind
Element Short
Patient
is_a_role_of_Person_as_patient
Message Element
Name
Name
Person
birth_dttm
Person
birthp lace_addr
Patient
Pt
Person
deceased_dttm
id
id
Person
education_level_cd
status_cd
status
Person
gender_cd
Person
marital_status_cd
_item_CV
_CV
Person
race_cd
of
Common
Message
Element Type
Pt
status
Domain Specification (#)
in
Message
Element Type
Pt
id
Conformance Flag
att
status_cd
Update mode set
7
Message Element Name
Patient
id
Default Update Mode
12
Message
Element Short
Name
Message Elements
Rim Source Class
Patient
Default Value (#)
Patient
Class or
Constraint/Note #
Patient
Patient
status_cd
itm
Mandatory
Patient
id
att
6
T
<<Data_type>>
Non-parametric_probability_Distribution : NPPD
Service_intent_or_order
charge_type_cd
clarification_phon
entering_device_cd
escort_required_ind
expected_performance_time_qty
filler_order_id
status_cd
has_as_participant 0..1
status_reason_cd
is_referred_to_in 0..1 order_effective_dttm
order_id
expects_patient_located_at 0..*
order_placed_dttm
has_as_target 0..1 qt
placer_order_id
is_fulfilled_by 0..1 echo_back_txt
has_as_reason 0..1 planned_patient_transport_cd
report_results_to_phon
is_source_for 1
response_requested_cd
service_body_site_cd
has_as_source 0..*
service_body_site_modifier_cd
transport_arranged_ind
Service_intent_or_order_relationship
transport_arrangement_responsibility_cd
relationship_type_cd
0..* is_billed_to
transport_mode_cd
reflex_testing_trigger_rules_desc
when_to_charge_dttm
constraint_txt
when_to_charge_cd
qt
intent_or_order_cd
join_cd
0..* has_as_target
status_dttm
secondary_identification_txt
is_target_for 1 reporting_priority_cd
Clinical_observation
abnormal_result_cd
last_observed_normal_values_dttm
nature_of_abnormal_testing_cd
clinically_relevant_tmr
method_cd
status_cd
status_dttm
observation_sub_id
val
references_range_val
universal_service_identifier_suffix_txt
user_defined_access_check_cd
value_datatype_cd
confirmation_status_cd
cla
att
5
b
<<Data_type>>
Person_name_part : PNXP
<<Data_type>>
Person_name_type : PN
is_entered_at 0..*
Advance_directive
competence_ind
directive_cd
disclosure_level_cd
life_quality_desc
mortuary_preference_nm
notarization_dttm
assessment_dttm
employment_related_ind
3
4
11
Information Model
Mapping
Property of Class
<<Data_type>>
Person_name_variant : PNXV
T
<<Data_type>>
Parametric_probability_distribution : PPD
Treatment_intent_or_order
Dietary_intent_or_order Observation_intent_or_order
Referral
has_as_target 0..1
fulfills 0..*
indication_id
diet_type_cd
authorized_visits_qty
patient_hazard_cd
Service_event
0..1 is_evidence_for
has_as_active_participant 0..1
ordering_providers_instruction_txt instruction_desc
relevant_clinical_information_txt desc
attestation_dttm
0..1 has_as_reason
requested_give_strength_qty
tray_type_cd
reason_txt
specimen_action_cd
tmr
orders
substitution_allowed_ind
service_period_cd
charge_to_practice_qty
0..*
is_source_for
delivers 0..* charge_to_practice_cd
Treatment_intent_or_order_revision
patient_sensitivity_cd
1
0..* has_as_source
1 has_parts
is_assigned_to 0..* consent_cd
dispense_package_method_cd
dispense_package_size_qty
Service_event_relationship
service_desc
filler_id
relationship_type_cd
is_part_of give_indication_id
give_per_timeunit_cd
filler_order_status_dttm
scheduled_start_dttm
1..* give_rate_qty
has_as_target 0..*
last_refilled_dttm
specimen_received_dttm 1
max_give_qty
family_awareness_txt
is_target_for
is_documented_by 0..*
min_give_qty
individual_awareness_cd
needs_human_review_ind
confidential_ind
PTcomp
status_cd
is_performed_at 0..*
PTrout
billing_priority_nbr
Judgement_link
Rule_link
Conditional_link
is_charged_to 0..* status_reason_cd
qt
type_cd
priority_nbr
is_associated_with 1
prescription_id
refills_allowed_nbr
refills_doses_dispensed_nbr
refills_remaining_nbr
substitution_status_cd
treatment_suppliers_instruction_cd
Assessment
Care_event
total_daily_dose_qty
Consent
pertains_to 1..*
Location_encounter_role
is_primary_facility_for Master_patient_service_location 1 is_scheduled_by
accommodation_cd
0..1 addr
effective_tmr
open_tmr
location_role_cd
desc
pertains_to 0..* status_cd
1 has
email_address
transfer_reason_cd
houses 1 id
usage_approved_ind
Patient_service_location_group
provides_services_on_behalf_of 0..* licensed_bed_nbr
1..* belongs_to
contains 0..*
nm
id
phon
is_requested_by 0..1
service_specialty_cd
1 is_requested_by
is_included_in 0..* slot_size_increment_qty
0..1 expected_patient_location_for
status_cd
type_cd
0..1 is_target_for
equipment_type_cd
1 is_entry_location_for
0..1 is_location_for
includes 0..1
<<Data_type>>
Address_part : ADXP
T
<<Data_type>>
Uncertain_discrete_value_using_probability : UDVP
T
1 measures
Master_qualitative_observation
abnormal_result_cd
critical_result_cd
normal_result_cd
preferred_coding_system_cd
valid_answer_cd
(Attribute or Association)
8
9
10
<<Data_type>>
Postal_and_residential_address : AD
<<Data_type>>
Uncertain_value-narrative : UVN
T
<<Data_type>>
History : HIST
0..*
is_target_of
Episode
desc
episode_type_cd
id
list_closed_ind
outcome_txt
recurring_service_ind
<<Data_type>>
Integer : INT
T
T
<<Data_type>>
Interval : IVL
T
is_basis_for
Master_quantitative_observation
corresponding_SI_unit_of_measure_cd
unit_of_measure_cd
conforms_to 1 delta_check_change_computation_method_cd
delta_check_change_threshold_qty
delta_check_value_range_qty
0..* has_as_participant
delta_check_numeric_low_value_amt
Active_participation
delta_check_retention_period_qty
tmr
display_length_and_decimal_precision_cd
participation_type_cd
minimum_meaningful_increment_nbr
si_conversion_factor_expr
0..*
0..*
participates_in
participates_in
1 is_requested_by
0..1 is_target_of
is_source_for 0..1
has_a_primary_provider 0..*
Master_treatment_service
dea_level_cd
drug_category_cd
formulary_status_cd
medication_form_cd
pharmaceutical_class_cd
route_cd
therapeutic_class_cd
Master_observation_service
instrument_cd
permitted_data_type_cd
has_as_basis processing_time_qty
specimen_required_ind
0..* typical_turnaround_time_qty
derivation_rule_desc
applies_to 0..*
is_contact_for 0..*
<<Data_type>>
Monetary_amount : MO
<<Data_type>>
Technical_instance_locator : TIL
b
has 1
Individual_healthcare_practitioner_slot
0..*
is_scheduleable_unit_for
is_specified_for 0..*
Master_numeric_range
type_cd
condition_desc
age_qty
gestation_age_qty
value_qty
race_subspecies_txt
gender_cd
species_txt
manages 1
Patient_slot
0..*
is_a_scheduleable_unit_for
0..* is_a_subdivision_of
<<Data_type>>
Technical_instance_identifier : TII
Domain Specification (#)
Resource_request
allowable_substitutions_cd
duration_qty
start_dttm
start_offset_qty
status_cd
Domain Specification (#)
Transcriptionist 0..1 is_role_of
is_requested_by
Durable_medical_equipment_request
quantity_amt
type_cd
requests 0..*
Conformance Flag
requests 0..*
Update mode set
practitioner_type_cd
0..* is_entered_by
Cardinality
0..* requests
Appointment_request
Service_scheduling_request
appointment_rqst_reason_cd
allowable_substitutions_cd
appointment_rqst_type_cd
duration_qty
1 requests
equip_selection_criteria_expr
start_dttm
is_requested_by 0..*
id
start_offset_qty
location_selection_criteria_expr
status_cd
priority_cd
repeating_interval_duration_tmr 1 requests
repeat_pattern_expr
rqst_event_reason_cd
rqsted_duration_tmr
start_tmr
time_selection_criteria_expr
explicit_time_interval_expr
Individual_healthcare_practitioner_request
Default Update Mode
0..*
Constraint/Note #
0..* has_as_contact
pertains_to
is_the_recipient_of 1
Quantity/ Time
Generalizations
Mandatory
has_as_a_parent_document
0..1 transcribes
<<Data_type>>
Binary_data : BIN
<<Data_type>>
No_information : NULL
Domain Specification (#)
0..1 is_role_of
<<Data_type>>
Floating_point : FPN
Cardinality
Document_recipient 0..1 of
<<Data_type>>
Physical_quantity : PQ
Row Number
Originator 0..1 of
0..1 is_role_of
Stakeholder_affiliation
affiliation_type_cd
desc
effective_dt
termination_dt
Generic
<<Data_type>>
Point_in_time : TS
Demographic
<<Data_type>>
Number : N
Row Type
created_by 1
Healthcare_document_authenticator
0..1 is_a
has_as_secondary_participant 0..*
<<Data_type>>
Ratio : RTO
<<Data_type>>
Boolean : BL
<<Data_type>>
Code_value : CV
<<Data_type>>
Concept_descriptor : CD
Former Row
Patient_encounters
Healthcare_finances
Master_service
<<Data_type>>
allowable_processing_priority_cd
Code_translation : CDXL
allowable_reporting_priority_cd
challenge_information_txt
confidentiality_cd
<<Data_type>>
effective_tmr
Code_phrase : CDPH
factors_that_may_affect_observation_desc
is_requested_by 1 fixed_canned_message_cd
<<Data_type>>
imaging_measurement_modality_cd
ISO_object_identifier : OID
is_target 1 incompatible_change_dttm
interpretation_considerations_desc
kind_of_quantity_observed_cd
has_target 0..*
<<Data_type>>
last_update_dttm
Real_world_instance_identifier : RWII
Master_service_relationship
method_cd
relationship_type_cd
nature_of_service_cd
T, S, R
reflex_testing_trigger_rules_desc
observation_id_suffix_txt
constraint_txt
orderable_service_ind
<<Data_type>>
qt
patient_preparation_desc
Collection : COLL
point_versus_interval_cd
portable_device_ind
T, R
has_source 0..*
report_display_order_txt
<<Data_type>>
is_source 1 alternate_id
Bag : BAG
alternate_name_use_cd
alternate_nm
T, R
is_delivered_during 1
contraindication_desc
desc
<<Data_type>>
Master_specimen_requirement
performance_schedule_cd
List : LIST
primary_nm
additive_cd
T, R
standard_time_to_perform_qty
container_desc
target_anatomic_site_cd
container_preparation_desc
<<Data_type>>
universal_service_id
container_volume_qty
Set : SET
qt
derived_specimen_cd
join_cd
minimum_collection_volume_qty
when_to_charge_cd
normal_collection_volume_qty
consent_required_cd
special_handling_desc
priority_cd
1 is_instantiated_as
retention_time_qty
type_cd
is_produced_by 1..1
0..* produces
Row Type
Master_tables
Healthcare_finances
Healthcare_stakeholders
Healthcare_finances
1
0..* is_related_to
Clinical_document_header
0..* documents
availability_status_cd
change_reason_cd
completion_status_cd
confidentiality_status_cd
content_presentation_cd
Patient_information_disclosure
document_header_creation_dttm
disclosure_dttm
file_nm
info_disclosed_desc
id
info_requested_desc
last_edit_dttm
reason_cd
has_been_originated_by 0..* origination_dttm
requested_dttm
reporting_priority_cd
urgency_cd
results_report_dttm
storage_status_cd
is_provided_to 0..*
has_been_received_by 0..* transcription_dttm
type_cd
0..1
is_transcribed_by 0..* document_change_cd
is_parent_document_for
contained_in 0..*
0..*
Row Number
is_source_of 0..*
Healthcare_finances
Healthcare_finances
Producer_of_master_service
service_producing_department_type_cd
is_related_to
Former Row
has_as_participant 0..*
Authentication
authentication_dttm 0..* is_related_to
type_cd
Default Value (#)
<<Data_type>>
Character_string : ST
<<Data_type>>
Free_text : FTX
is_covered_by 1..*
HEALTH LEVEL 7
REFERENCE INFORMATION MODEL
RIM_0092
released September, 1999
reflects agreements made through harmonization in June, 1999
R
M
No
V
R
M
No
V
R
No
V
R
No
R
R
No
R
R
M
R
<p tFincl
Class>
No
V
<@state,
No
V
EXT:CNE>
No
V
M
M
R
R
R
0..1
0..1
1
1
<@state,
EXT:CNE>
M
No
R
R
M
No
R
R
Hierarchical Message
Descriptions
Union: C00XXM M
Putting the pieces together
Implementation
Technology
Specification
"Send as ASCII
string in XML
format"
Hierarchical
Message
Definition
"Discontinue
pharmacy order"
ITS
for
XML
Data
HL7
Message
Creation
HL7-Conformant
Application
Message
Instance
HL7
Message
Parsing
HL7-Conformant
Application
Data
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/methodologymodeling/Rose tooling/
*this includes a text file to describe what each downloadable file is