niem healthcare domain fhim/s&i framework strategy 4/7/2011
TRANSCRIPT
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NIEM Healthcare Domain FHIM/S&I Framework Strategy
4/7/2011
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Background• Focus of Study – NIEM Healthcare Domain• Strategy to Integrate Healthcare Standards and Technologies with the National Information
Exchange Model (NIEM).– From Modeling perspective– From IEPD perspective – Tool Requirements
• FHIM and S&I Framework– How they potentially fit in
• Audience• ONC Decision Makers, Information Modelers, and Architects• Anyone Interested in NIEM and Healthcare
• Recommendations for way forward• Authors: John McKim, Monica Morris• Lead by Steve Wagner and Anand Basu• Output
– Whitepaper – details of what is contained in this presentation– This Presentation
• Interactions and Resources– Discussions with PMO – Justin Stekervetz ([email protected]>)– Discussions with John Quinn and others at HL7– Discussion with NIEM Modelers (USCIS)
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Dimensions of the Study• Business Case – what are objectives, payback, and costs for ONC to integrate
with NIEM from a business perspective?• Model Integration – Is it technically feasible and if so, what are the
classes/types that would make up the NIEM Healthcare Domain, including their structure within the domain, and how would they be integrated with the current NIEM model?
• IEPD Integration – Is there value in using the IEPD approach and if so, what is the best approach to integrate FHIM/S&I Framework models and processes with the NIEM IEPD Repository and IEPD Life Cycle?
• Conformance – what does it mean for models and schemas to be either NIEM conformant or support NIEM conformance with respect to the IEPD process and the schemas themselves?
• Tool Integration – defines how ONC tooling would need to integrated with the model and IEPD process through conformance to the NIEM Tooling Architecture.
• FHIM and the S&I Framework Utilization to support the creation and maintenance of a Healthcare Domain within NIEM.
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The Business Case for NIEM Integration
• Benefits to the Healthcare Community– Expanding the Use and Reach of Healthcare Data– Potential Use of IEPD Process– Potential to Address PCAST Report Issues and Suggested Way Forward
• Universal Exchange Language, Finer Granularity, Metadata
• Benefits to the NIEM Community– Healthcare Types and Schemas– MDHT
• Disadvantages– Potentially Expensive– Expansion of MDHT– Model Mismatch– Significant Effort Needed
• Recommendations and Findings– Benefits Far Outweigh Disadvantages– Potential Additional Analysis, especially in Model Integration Area.
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Healthcare/NIEM Model Integration(Model Mismatch)
• Healthcare Models (FHIM/S&I Framework)– Based on UML and MDA– MDHT/CDA Consolidation/Constraining RIM Classes– Separated into Healthcare Domains
• Labs, Pharmacy, Security and Privacy, Problems, Allergies, Orders, etc.
– HL7 RIM: Only Representation of Foundation Classes– Messaging and Documentation: HL7 V2, V3, CDA
• NIEM– Conceptual Model is in RDF– NIEM Core: Foundation Classes (Represented in XML Schema)– IEPD Process
• Not Model Driven• NIEM Compliant Tools
– Messaging and Documentation• Document defined by nc:Document• Messaging Behavior – defined in IEPD
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NIEMCore
Health Care
NIEM Healthcare Domain
Managed IndependentlyOf NIEM Core by ONC
Composed of - NIEM Healthcare Core
Subdomain- NIEM Health
Subdomains- Extends NIEM Core
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Proposed Approach for NIEM Healthcare Domain
NIEM Healthcare
Core Subdomain
NIEM Core
3 Potential Approaches
NIEM Healthcare
Lab Subdomain
NIEM Healthcare Pharmacy
Subdomain
NIEM Healthcare
Problem Subdomain
.
.
.
FHIM Domains
FHIM Developed
Potentially 100 or More
Subdomains
Extends/Augments
Extends/Augments
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Healthcare/NIEM Model Integration (continued)
• Development of NIEM Healthcare Domain– Managed by ONC– Contains NIEM Healthcare Core Subdomain
• Basic Healthcare Types• Extends NIEM Core Types
– Contains NIEM Healthcare Subdomains• Labs, Pharmacy, Security and Privacy, Problems, Allergies, Orders, etc.
• Potential Approaches to NIEM Healthcare Core– Develop New Foundation Classes from Scratch
• More tightly integrated with NIEM
– Use HL7 RIM/Data types with NIEM ITS• Legacy Approach• Dependent on HL7 ITS
– Hybrid approach – Extend/Modify HL7 RIM• Keep same HL7 Types, Add New Types, Closer NIEM Integration than ITS.
• Approaches to Extending NIEM Types– Create New Types by extending NIEM Core
• hcc:HealthCarePerson would extend nc:Person
– Extend NIEM Classes with new data – Augmentation• Augment nc:Person with additional data
• NIEM and CDA Documents– Extend nc:DocumentType– Map CDA types to nc:DocumentType Properties
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Healthcare/NIEM Model Integration Recommendations
• NIEM Healthcare Core– 2 Concurrent Efforts
• New Foundation Classes Harmonized with HL7 RIM and NIEM– PCAST Aware
• HL7 RIM ITS (Legacy Core)
• Utilization of NIEM UML Profile• NIEM Model in UML• MDHT Modifications
– Automated Conformance Checking• Utilize NIEM RDF Models
– Extend for RDF/OWL – Express Healthcare Domain in RDF– Utilized by MDHT Tools– NIEM Will work with us on this effort
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Proposed Approach for IEPD Integration
S&I Framework IEP Workgroups
HealthCare Core
NIEM Core
Labs
Pharmacy
FHIM UML Modeling
Lab Result
Healthcare Types
MDHTTools
(enhanced)
ONCNIEM
Healthcare Domain
NIEMIEPD
Repository
ONC Governance
Board
Other IEP Workgroups
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IEPD Integration Strategy
• Preliminaries– FHIM Develops Healthcare Subdomains– ONC Creates Local IEPD Repository– ONC Creates NIEM Healthcare Governance Body– MDHT Implements NIEM Tool Architecture
• Scenario Planning – Use Cases, Business Context– S&I Framework IEP Groups, Facilitate Workgroups– MDHT Support, Repository Interfaces
• Analyze Requirements– Create UML Model with NIEM UML Profile– S&I Framework IEP Groups Works with FHIM Group– Work with FHIM to Extend/Modify Health Core Types– MDHT Extended to work with ONC IEPD Repository
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IEPD Integration Strategy (Cont)
• Map and Model – mapping to core types– S&I IEP Groups– Mapping Tables– MDHT Tools Automates Process
• Apply Constraints
• Building and Validating– MDHT Tools Automates Process
• Schema Development (Reference, Constraint, Extension)• MDHT Repository Interfaces
• Assembling and Documenting (prepares IEPD)– MDHT Tools Automates Process
• Publishing and Implementing– MDHT Repository Integration
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NIEM Conformance
• Conformance– NIEM XML Schemas conform to the NIEM Naming and
Design Rules (NDR). – NIEM XML Instances conform by validating to the Schemas– NIEM IEPDs conform to the IEPD Specification
• Strategy– Healthcare Core classes extended/integrated with NIEM
Core Types, Activities, Roles, Associations– MDHT Tools would generate NIEM compliant XML
Schemas.– MDHT Tools would Enforce NDR Conformance
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Tools Integration
• MDHT Tools – Implements NIEM Tooling Architecture Interfaces
• User, System, IEPD, Import/Export, etc.
– Integrates with NIEM Repositories– NIEM UML Profile– NIEM Core in UML– Utilize RDF/OWL
• Strategy– MDHT Tools implements NIEM Tooling Architecture
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FHIM, MDHT Tools, and S&I Framework
• FHIM– Creates Healthcare Domain
• S&I Framework– IEP Development
• MDHT Tools– Supports all Activities– Model Driven– Integrated with IEPD Repository and Processes
FHIM, MDHT Tools, and S&I Framework
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Whitepaper Recommendations
• Benefits Outweigh Costs of NIEM Integration• FHIM Develops Healthcare Domain– Work with HL7– Develop New Foundational Classes
• S&I Framework Develops IEPs• MDHT Enhancements– NIEM Aware– NIEM Tool Architecture Interfaces
• RDF/OWL/UML Modeling– Compatible with NIEM Conceptual Model