CIMI Modelling Taskforce Workshop (Groningen)

Dr Linda Bird

2nd – 4th December 2012

Meeting Goals

• Finalise draft CIMI Laboratory Results Report mindmaps• Update CIMI Laboratory Results Report ADL 1.5

o Drafts prepared by Tom & Ian

• Progress CIMI Implementation worko FHIR profile, UML profile, others

• Confirm terminology binding methodology & progress Lab bindings.• Review reference model updates• Discuss approach for representation of model example instances• Planning for future work / Brainstorm, reflection and scaling

3-day Agenda

Q1: 8:30 – 10:15; Q2: 10:30 – 12:00; Q3: 1:00 – 3:00; Q4: 3:15 – 5:00

• Sunday 2nd December– Q1: Introduction & Reference Model– Q2,: Lab Results modelling– Q3: Lab Results modelling– Q4: Lab Results modelling

• Monday 3rd December– Q1: Lab Results modelling– Q2: Lab Results modelling– Q3: Implementation– Q4: Implementation

• Tuesday 4th December– Q1: Terminology binding– Q2: Terminology binding– Q3: Miscellaneous (e.g. Example instances, Style guide)– Q4: Planning future work

Sunday 2nd December

Q1: Introduction and Reference Model• Brief scene setting and review of goals• CIMI model objectives (e.g. Use-case agnostic models versus goal-

state interoperability ... Or both?)• Reference model updates• Recap of Laboratory Test Result analysis, mindmaps & ADL

completed so far

Q2, Q3 & Q4: Modelling • Comparative Analysis & Mindmap:

– Laboratory Test Result When, Who, Where & How– Reference Range, Specimen, Anatomical Location, Test Procedure– Lab Report Composition, Lab Request

Monday 3rd December

Q1 & Q2: Modelling (continued)• Comparative Analysis & Mindmap:

– Lab Report Header, Patient Event– Lab Report Template (tying it all together)– Other models or outstanding issues identified during modelling

Q3 & Q4: Implementation • Review of ADL updates required• Mapping CIMI Models to FHIR profile and extensions• FHIR Connect-a-thon• Tooling and repositories• UML Profile• Other implementation planning

Tuesday 4th December

Q1 & Q2: Terminology Binding• Use cases, Requirements, Options and Proposals (using Heart Rate

example)• Terminology Binding for the Laboratory Results Models

Q3 & Q4: Other Topics • Representing example data• Documentation of Style Guide• Planning future work• Other topics, as required

CIMI Architectural Overview

CIMI Modelling Layers

Reference Model

Modelling PatternsSchedule,Address,Material

Observation,Action Clinical List

Event Summary,Assessment

Clinical Models Medication Item Blood Pressure Medication List Discharge Summary

Add Specialty Context

Paediatric Medication Item

Neonatal Blood Pressure

Nephrologist Medication List

Cardiology Discharge Summary

CLUSTER ENTRY SECTION COMPOSITION

Add Care Setting Context

G.P. Dispensed Medication Item

Home Blood Pressure

Outpatient Clinic Current Medication

List

Inpatient Discharge Summary

Add Implementation Purpose Context

Dispensed Medications GUI

Neonatal Blood Pressure in EHR

Current Medication List in EHR

Discharge Summary Doc or Message

Add Use Case Context

Dispensed Medication Item

Standing Blood Pressure

Current Medication List

Medication Reconciliation Report

Modelling Layers

Reference Model

Modelling Patterns

Mater-ial Order Report Item

Document

Clinical Models

Specimen Laboratory Report Item

Laboratory Report

Specialty Context

Microbiolgy Report Item

Microbiology Report

CLUSTER(not standalone)

ENTRY (Clinical statement – standalone - with context)

SECTION (navigtn)

COMPOS-ITION

Care Setting Context

Implemnt.Purpose Context

EHR Message

Use Case Context

Order Observ-ation

Clinical Entry

Event SummaryAdmin Entry

Laboratory

Order

Laboratory

Result

Spec-imen

Test Result

Reference

Range

Document Informaton

Patient Event

Observation Item

Hematocrit

Result

Hemat ocrit

Ref RgHematlgyTest Result

Hematology Ref Rg

Decisin Supprt

Hematocrit

Order

Complte Blood Count

Admissin

Hematology Order

Hemat-ology Result

Inpatient Admissin

GUI

Laboratory Results Report

Lab Report (Composition)

Test Result Group/Item (Cluster)

Lab Report Header (Entry)

Patient Event (Entry)

Lab Request (Entry)

Lab Test Result (Entry)

Reference Range (Cluster)

0..*

0..*

0..*

1..*

1

0..1

Specimen (Cluster)

was requested in

ADMIN

ADMIN

ORDER

OBS

0..*

Specimen (Cluster)

0..*

• Foundations1. CIMI Reference Model2. Archetype Object Model3. CIMI Modelling Patterns4. CIMI Style Guide

• Modelling Approach1. Analyse clinical models submitted (with value sets)2. Identify maximal set of data elements3. Remove ‘out of scope’ data elements (Style Guide)4. Select appropriate CIMI Modelling Patterns(Style Guide)5. Define CIMI model (Mindmap, ADL, UML)6. Add Terminology bindings

o Meaning (nodes, node relationships)o Value sets (maximal set from submitted models)

7. Add Example Model Data Instances8. Technical Validation

o ADL, UML

9. Clinical Validation / Review10. Confirm mappings from submitted models

Overview