Template Exchange ITS Preliminary Report Project # 885

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Template Exchange ITS

Preliminary Report Project #885

Dr Kai U. HeitmannHeitmann Consulting and Services, Germany

Past Board Member, HL7 InternationalChair, HL7 Germany

HL7 Working Group Meeting Baltimore, US, September 2012

Andy Stechishin , Mark Shafarman, Kai Heitmann


Agenda History and driving force Objectives Requirement analysis DECOR Chapter I: C-CDA and Trifolia Coming up next


History and driving force Multiple (national/international) groups

creating HL7 CDA templates independently

• Creation of a (canonical) format for template specifications

• Exchange of templates between groups / tools

• Template Repository • Artefact Registry


Objectives Knowledge sharing Creating new templates or new versions of

templates Version management support Support implementations using templates Persistent storage Consistent documentation of templates


Step 1: Requirements analysis Existing template tools

Model-Driven Health Tools (MDHT) Trifolia Workbench DECOR Templates Registry Business Process

Requirements Model Interchange Format (MIF) Several other approaches, e.g. UK, NZ How fits FHIR into the game?


Project #885 HL7 Templates ITS Pilot

sub-project of #272 (Templates DSTU) Creating an ITS that supports an interchange

format in a canonical form for HL7 CDA templates

DECOR methodology as a candidate for that format


DECOR: Skills +development cycle


DECOR’s “separation of concerns” DECOR

=> Data-Elements,Codes, OID‘s and Rules

Goal: consistent artefact documentation, generation ofsupporting materials for

Implementation Validation Testing, Qualification, Certification Change Management

Terminologists

Architects

HL7 Experts

Certificators

Software-Vendors


DECOR projects “worldwide” ELGA (AT), national infrastructure – CDA RIVM (NL), national screening programme on

bowel cancer – CDA QiN /KfH (DE), dialysis treatment data exchange –

Care Provision Nictiz (NL), multiple projects, e.g.

Perinatology – CDA and Care Provision Laboratory results for pharmacists – Orders Care Transfer Data – CDA GP Acute Care – Care Provision Youth Health Care – Care Provision, Immunization



Chapter I: C-CDA and Trifolia Trifolia templates “data” DECOR template 2 step conversion (by xslt’s)

Keith Boone: extract from sql database Kai: transform to DECOR


Overview templates(in ART, the interface to DECOR)


Value Sets Integrated terminology services


Chapter I: C-CDA and Trifolia Material

~ 140 templates of various types ~ 40 value sets

Results Conversion succeeded DECOR Value set and templates documentation Generation of schematron


Tabular viewOne of many ways to present DECOR templates

Distraction from “fixed” items

Focus on instance construction

Validation as a “side-effect”Your actual work starts

here!!!


Chapter I: C-CDA and Trifolia Further findings

Need of an extended version management (which is required by DECOR)

Id and Name Version date Status code Template life cycle support

Templates Meta Data (see Templates Registry Business Process Requirements)

Artefact Registry (HingX)



DECOR would use less embedded schematron assertions

e.g. for choices, data type assertionscount(cda:assignedPerson | cda:representedOrganization)=1SHALL contain exactly one [1..1] assignedPerson exactly one [1..1]representedOrganization

C-CDA: mean # of schematron per template: 1.1 ELGA: 133 templates, 17 inline asserts (mean 0.13)

General problem: expression of co-constraints



Reuse „This reference/@value SHALL begin with a '#' and SHALL point to its

corresponding narrative (using the approach defined in...“ Repeated 14 times with different conf-x

Consistency


Chapter I: C-CDA and Trifolia

• C-CDA (from Trifolia) can be expressed in DÉCOR

• “Manual” enhancements possible

• Conceptual enhancements


Coming up next Model-Driven Health Tools (MDHT)

Completely different approach Model Interchange Format (MIF) FHIR

Profiles ~ Templates Not really in the focus of the group yet XML based profiles, small group of volunteers to

proceed on expressing FHIR profiles in DECOR Results will be available on the HL7 wiki


Thank you!More questions?

Templates Exchange ITS

Dr Kai U. HeitmannLater? mailto:[email protected]

Documents

Template Exchange ITS Preliminary Report Project # 885