© copyright mayo foundation for medical education and research 2004 the relationship between ebxml,...

© Copyright Mayo Foundation for Medical Education and Research 2004

The Relationship between ebXML, Archetypes, Templates,

Terminology and the HL7 RIM

By

Peter L. Elkin, MD

Associate Professor of Medicine and Medical Informatics

Mayo Clinic, School of Medicine


Unambiguous Concept Representation

• Interoperable exchange of Healthcare Data

• Enabling distributed Semantic

Interoperability

• Semantically empowering the ebXML

Standard


Object Oriented View of Knowledge Representation

• Many concepts are composite concepts with a defined structure– Blood Pressure (BP)

• Systolic BP

• Diastolic BP

– Orthostatic Blood Pressures• Lying BP

• Sitting BP

• Standing BP


Health Expression Archetype Language (HEAL)


Suggested Schema

• CDA Level 1– Document Structure

and Metadata

• ADL Archetypes– Constraints on a

Model

• Templates– Formal Definitions

Comparable Data

OWL

Language


Clinical Document Architecture

CDA Level One DTD shown in “XML Authority” from Extensibility

CDA Level One document shown in “Internet Explorer” from Microsoft


Clinical Document Architecture


archetype

openehr-ehr-observation.bp_measurement.draft

concept

[at0000] -- blood pressure measurement

description

author = <"Sam Heard <[email protected]>">

submission = <

organisation = <"openEHR Foundation">

date = <2003-06-10> >

version = <"version">

status = <"draft">

revision = <"1.0">

description("en") = <

purpose = <"Describe systemic blood pressure measurement result and protocol">

use = <"">

misuse = <""> >

adl_version = <"0.9">

rights = <"">


HL7 - CDA - XML<?xml version="1.0" encoding="UTF-8"?> <!DOCTYPE levelone SYSTEM "NotesIIST_RTF.DTD" [ <!ENTITY deg '°'> <!ENTITY sup2 '²'> <!ENTITY micro 'µ'> ]> <levelone> <clinical_document_header> <id EX="" RT=""/> <set_id EX="" RT=""/> <version_nbr V="1.0"/> <document_type_cd V="openehr-ehr-observation.bp_measurement.draft" S="" DN="blood pressure measurement"/> <origination_dttm V="20030610T120000"/> <confidentiality_cd V="" S=""/> <patient_encounter> <practice_setting_cd V="" S="" DN=""/> <encounter_tmr V=""/> <service_location> <id EX="" RT=""/> </service_location> </patient_encounter> <legal_authenticator> <legal_authenticator.type_cd V=""/> <participation_tmr V=""/> <signature_cd V="S"/> <person> <id EX="" RT=""/> <person_name> <nm> <GIV V=""/> <MID V=""/> <FAM V=""/> <PFX V=""/> <SFX V=""/> </nm> <person_name.type_cd V=""/> </person_name> <telecom V="" USE=""/> </person>


HL7 Templates R-MIM Fragment

• The R-MIM fragment (graphically represented here) can be converted to OWL Abstract Syntax (next slide), and used as a definition model for template development and validation.

Observation

class_cd* <= OBSmoodCode *: CS <= EVN + INTid*: II [0..1] (f iller order number)code*: CE CWE <= ObservationType (e.g. LOINC code)negationInd: BL [0..1]text*: ED [0..1] (f ree text describing the ev ent)statusCode*: CS [0..1]ef f ectiv eTime*: IVL<TS> [0..1] ("phy siologically relev ant time")activ ity Time: IVL<TS> [0..1] (time of perf ormance)priority Code: CE CWE [0..1] "R"conf identiality Code*:SET<CE> CWE [0..*] "N"v alue: ANYinterpretationCode: SET<CS> [0..*] ("abnormal f lags")methodCode: CE CWE [0..1]targetSiteCode: CD CWE [0..1]

Note:This f ragment is taken f rom an imaginary O/O Results R-MIM.

The abstract constraint is:

When reporting the results of a CBC, the f ollowing observ ations shall be present:

o Hemoglobin (required, cannot repeat)o Hematocrit (optional, cannot repeat)o Platelet count (required, cannot repeat)

hasComponent

0..*

typeCode* <= COMPcontextControlCode: CS <= N+C "C"sequenceNumber*: INTpriority Number: INTpauseQuantity : PQ


R-MIM Fragment OWL Syntax• <axiom> ::= Class(ex:R-MIM Individual (ex:ID "12345"))

Defines the entire Restricted MessageInformation Model

• <axiom> ::= Class(ex:R-MIM_Fragment Individual (ex:Frag_ID "67890")

• unionOf(ex:Observation ex:hasComponent) ) Defines the R-MIM Fragment as being the union of the Observation Class with the hasComponent Class (previous slide, and below)

• <axiom> ::= SubClassOf(sub=ex:R-MIM_Fragment super=ex:R-MIM) Specifies that the R-MIM fragment is a subclass of the entire R-MIM

• <axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 )

ex:hasComponent minCardinality(0) ) ) Defines the Class Observation as a complete Act with defined restrictions (previous slide for reference)

• <axiom> ::= Class(ex:hasComponent (ex:typeCode complete ex:Observationrestriction(ex: domain(ex:COMP) minCardinality(0) ) ) )

Defines the Class hasComponent as being a complete Observation within the COMP domain (previous slide for reference)

• <axiom> ::= ObjectProperty(ex:typeCode (Individual(ex:codeValue) ) )

• <axiom> ::= ObjectProperty(ex:class_cd (Individual(ex:codeValue) ) )

• <axiom> ::= ObjectProperty(ex:moodCode (Individual(ex:codeValue) ) ) Defines the Object Properties used in the above Class definitions

• <axiom> ::= DatatypeProperty(ex:codeValue xsd:integer) Defines the Data Type Properties for the Object Properties


R-MIM Fragment mapping to XML• The OWL R-MMIM Fragment can validate an existing OWL

Template, I.e. LabTest is a SubClass of Observation.

Can be used to validate.

<owl:Class rdf:ID="LabTest"> <rdfs:subClassOf rdf:resource="http://www.example.org/Observation"/> <owl:Restriction> <owl:onProperty rdf:resource="#LabTest"/> <owl:allValuesFrom>LOINC</owl:allValuesFrom> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:allValuesFrom rdf:resource="# Observation"/> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#hasComponent"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction></owl:Class>

<axiom> ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0)))

<axiom> ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) )

Combined with




<owl:Class rdf:ID="CBC"> <owl:subClassOf rdf:resource="#LabTest"/> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:hasValue rdf:resource="#CBC_class_cd"/> <owl:Restriction> <owl:onProperty rdf:resource="#class_cd"/> <owl:minCardinality>1</owl:minCardinality> </owl:Restriction> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:hasValue rdf:resource="#CBC_moodCode"/> <owl:Restriction> <owl:onProperty rdf:resource="#moodCode"/> <owl:minCardinality>0</owl:minCardinality> </owl:Restriction> </owl:Restriction> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent"/> <owl:hasValue rdf:resource="#Hemoglobin"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:cardinality>1</owl:cardinality> </owl:Restriction> </owl:Restriction>

…… continued on next slide …..

CBC is a subClassOf LabTest




CBC is a subClassOf LabTest

…… continued from previous slide …..

<owl:Restriction><owl:onProperty rdf:resource="# hasComponent"/> <owl:hasValue rdf:resource="#Hematocrit"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:maxCardinality>1</owl:maxCardinality> </owl:Restriction></owl:Restriction><owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:hasValue rdf:resource="#PlatletCount"/> <owl:Restriction> <owl:onProperty rdf:resource="# hasComponent "/> <owl:cardinality>1</owl:cardinality> </owl:Restriction></owl:Restriction>

</owl:Class>


Show Blood Pressure Archetype


Show Blood Pressure Archetype / XML

Output


Show Blood Pressure OWL:Archetype

Formal Definition


ebXML Registry

• Both the R-MIM Fragment and the full OWL_CBC.xml Template can be stored, with meta-data in ebXML. This will allow automated Template validation, and ease of retrieval and submission of Templates and Fragments.

• The following slides are snapshots of the ebXML Registry browser showing the XML R-MIM_ Fragment.xml Object, and it’s associations with the OWL_CBC.xml Template


ebXML Registry Object Browser


Extrinsic Object Meta-Data Model


Next Steps• Select groups can submit valid R-MIM Fragments in OWL:Archetypes syntax

to the ebXML Registry.

• Develop software for HL7 Template Validation in ebXML.

• Allow groups to submit HL7 Templates composed in OWL:Archetypes/XML to be validated against registered R-MIM Fragments.

• Develop software to validate instances of an HL7 Template against the registered HL7 Template in OWL:Archetypes/XML syntax.

• Allow groups to validate their HL7 messages against registered instances of HL7 Templates in OWL:Archetypes/XML.


Conclusion:

• Join the ongoing development of the ebXML Registry Standard and the HL7 Templates SIG – Where the Action is…– Where the Rubber Meets the Road…– Looking for hard working creative individuals to

dedicate themselves to making interoperability a reality

– Discussion: ………

• Thank You for Your Kind Attention!

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