HL7 RIM June 2010

Entity

class_cd : CScd: CEdeterminer_cd : CSstatus_cd : CSid : II

Role

class_cd : CScd: CEeffective_time : IVL<TS>status_cd : CSid : II

Participation

type_cd : CStime : IVL<TS>status_cd : CS

Act

class_cd : CScd: CDmood_cd : CSstatus_cd : CSeffective_time : GTSid : II

0..1

0..*1

0..*

1

0..*

Role Link

type_cd : CSeffective_time : IVL<TS>

Act Relationship

type_cd : CS

0..1

0..*

plays

scopes

1 1

0..* 0..*

1 1

0..* 0..*

OrganizationclassCode* <=ORGdeterminerCode* <= INSTANCEId*: II[1..1]

ObservationEventclassCode* <=OBSmoodCode* <= EVNId*: II[1..1]code*: CV CNE[1..1] < ObservationTypeeffective Time*: TS[1..1]

PersonclassCode* <=PSNdeterminerCode* <= INSTANCEname: PN[0..1]

PatientclassCode* <=PATId*: II[1..1]

AgentclassCode* <=AGNTId*: II[1..1]

subjecttypeCode* <=SBJ

authortypeCode* <=AUTTime*: TS [1..1]

componenttypeCode* <=COMP

componenttypeCode* <=COMP

ObservationEventclassCode* <=OBSmoodCode* <= EVNId*: SET II[1..1]code*: CV CNE[1..1] < CPT4value*: ST[1..1]

ObservationEventclassCode* <=OBSmoodCode* <= EVNId*: SET II[1..1]code*: CV CNE[1..1] < CPT4value*: ST[1..1]

1..1

provid

erOrg

aniza

tion

0..1 patientPerson

HL7 RIM: Sample Observation

ObservationclassCode* <=OBSmoodCode* <= EVNId*: II[1..1]code*: CV CNE[1..1] < ObservationTypeeffective Time*: TS[1..1]Value*:

PersonclassCode* <=PSNdeterminerCode* <= INSTANCE

PatientclassCode* <=PATId*: II[1..1]

subjecttypeCode* <=SBJ

0..1 patientPerson

HL7 RIM: Simple Observation

Mapping 11179 CDE to RIM: Ex 1

Data Element

Data Element Concept

Value Domain

Object Class

Property

Conceptual domainRepresentation classData type (added)Unit of measure (added)Value meanings (added)

12345

ASSESS_RESULTSN/ANumbermmHgC25509:C69319:C25209

6 First Dinamap Oscillometric Measurement

Assessment: C25367

7

8

Diastolic Blood Pressure: C25299

9

Diastolic Blood Pressure10

Diastolic Blood Pressure First Dinamap Oscillometric Measurement

Measurement: Oscillometric Blood Pressure Monitor : First

Mapping to RIM11179 Construct 11179 Value RIM

ConstructRIMValue

Object Class Diastolic Blood Pressure

OBS:classCodeOBS:code

OBSObservationType(CD)

Property Assessment ?? ??

Conceptual Domain ASSESS_RESULTS

Representation Class N/A

Data Type Number

Unit of Measure mmHg

Value Meaning C25509:C69319:C25209 (Measurement: Oscillometric Blood Pressure Monitor : First)

Problems with Ex 1• The property Assessment does not really have any

useful semantics – dangling concept• No context information – cannot infer entity, role and

participation• “Measurement: Oscillometric Blood Pressure Monitor :

First” – has to be parsed• Not easy to convert into a terminology expression• Hard to derive from the concept derivation rule that

oscillometric blood pressure monitor is the methodCode

• Leveling and context of information changes from CDE to CDE

Data Element

Data Element Concept

Value Domain

Object Class

Property

Conceptual domainRepresentation classData type (added)Unit of measure (added)Value meanings (added)

12345

AE_RESULTSN/ANumbermmHgN/A

6

Assessment: C25367

7

8

Person Blood Pressure: C25190:C54706

9

Person Blood Pressure10

??Person Blood Pressure

Mapping 11179 CDE to RIM: Ex 2

11179 Construct 11179 Value RIMConstruct

RIMValue

Object Class Person Blood Pressure

ENT:LIV:POSNOBS:classCodeOBS:code

OBSObservationType(CD)

Property Assessment ?? ??

Conceptual Domain ASSESS_RESULTS

Representation Class N/A

Data Type Number

Unit of Measure mmHg

Value Meaning N/A

Mapping to RIM

Problems with Ex 2

• The property Assessment is hard to map• Assessment is used to reference blood

pressure but the concept itself links to “assessment” semantics of assessment seam irrelevant

• Leveling and context of information changes from CDE to CDE

Data Element

Data Element Concept

Value Domain

Object Class

Property

Conceptual domainRepresentation classData type (added)Unit of measure (added)Value meanings (added)

12345

ASSESS_RESULTSN/ATimeN/AC25529:C48154:C25207

6 Hour Minute Time

Begin Measurement : C25431:C25209

7

8

Blood Pressure : C54706

9

Blood Pressure Start Measurement10

Blood Pressure Start Measurement Hour Minute Time

ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: CODE

ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: EFFECTIVETIME

ObservationEventclassCode* <=OBSmoodCode* <= EVNId*: II[1..1]code*: CV CNE[1..1] < ObservationTypeeffective Time*: TS[1..1]methodCode*:

Mapping 11179 CDE to RIM: Ex 3

Problems with Ex 3

• The property Assessment is hard to map• Assessment is used to reference blood

pressure but the concept itself links to “assessment” semantics of assessment seam irrelevant

• Mapping Time interval is challenging• Leveling and context of information changes

from CDE to CDE

Data Element

Data Element Concept

Value Domain

Object Class

Property

Conceptual domainRepresentation classData type (added)Unit of measure (added)Value meanings (added)

12345

ASSESS_RESULTSC38147 CHARACTERN/ACL307587, CL30586

6 Assessments Ind-2

Blood Pressure Assessment : C54706:C25217

7

8

Dental Professional Practice: C41136:C52673

9

10

Dental Professional Practice Blood Pressure Assessment Ind-2

ENT:LIV:POSN.ROL:PAT.DIR

ENT:LIV:POSN.ROL:PAT.DIR:SBJ.ACT:OBS: CODE

ObservationEventclassCode* <=OBSmoodCode* <= EVNId*: II[1..1]code*: CV CNE[1..1] < ObservationTypeeffective Time*: TS[1..1]methodCode*:

Dental Professional Practice Blood Pressure Assessment

Mapping 11179 CDE to RIM: Ex 4

Mapping Challenges and Risks• Every mapping is a custom problem• Inferencing using concepts doesn’t work as same concepts

are used differently• Context has to be provided manually in many cases• Post migration verification will take a lot of time and effort

- as losing information will not be acceptable• All the CDE administrative constructs for lifecycle

management have to be migrated – no placeholder in RIM• Creating forward and reverse transforms is not feasible – as

the view will change from element to element• Identifying simple, medium and hard CDEs will require

manual work as tooling cannot infer from the information