Transcript Developing Methods to Message Domain Knowledge Using NIC

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)
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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
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SNOMED
LOINC
ICNP
…..
Building an Information Model
--an iterative process
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Identify Basic Concepts
Define Basic Concepts in Glossary
Identify Relationships Between Concepts
Attributes
 Multiplicities
 Associations
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Abstract Basic Concepts into Hierarchies
Identify attributes that can be shared
 Define Abstract Concepts in Glossary
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Identify Basic Concepts
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Subjects (actors)
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Patient
Nurse
Physician
Patient care aide
…
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Verbs
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Asked
Reviewed
Decided
Printed
Moved
Documented
Spoke
Verbalized
Assess
…
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Objects
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Patient
Strategies
Breast cancer
Nausea
Vomiting
Intervention
Video
…
Identify Abstract Concepts
Subjects = “Persons”
Subjects = “Do’ers”
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Subjects (actors)
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Patient
Nurse
Physician
Patient care aide
…
Verbs = “Actions”
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Verbs
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Asked
Reviewed
Decided
Printed
Moved
Documented
Spoke
Verbalized
Assess
…
Objects = “?”
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Objects
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Patient
Strategies
Breast cancer
Nausea
Vomiting
Intervention
Video
…
Define Abstract Concepts in
Glossary
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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
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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)
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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
 …
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Indirect Object
Direct Object
-code
-vocabulary
-vtext
-stext
-code
-vocabulary
-vtext
-stext
Actions
 Asked
 Reviewed
 Decided
 Printed
 Moved
 Documented
 Spoke
 Verbalized
 Assess
 …
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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
 …
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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
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Test the combination of Information Model and
vocabularies against the storyboard
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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