Towards International Alignment

Introduction to the Canadian Health Data Model

and potential contribution to HL7 Harmonization processes

•RIM Basics

•RIM Privileges

•Harmonization Process

•Facilitator Responsibilities

•International Committee Responsibilities

•RIM Influence Strategies

•Model Alignment

•Common Concept Model

•Canadian Health Data Model

Reference InformationModel (RIM)

Technical CommitteeA

Technical CommitteeB

DomainInformationModel

2.

PinkSteward

BlueSteward

RIM Basics

RIM Privileges

•Stewardship

•Submit Changes

•Attend Harmonization

•Vote on Changes

International CommitteeRIM Privileges

•Stewardship

•Submit Changes

•Attend Harmonization

•Vote on Changes

(see M&M Minutes Sept. ‘98)

Harmonization Process

1. Document Proposed Changes

2. Discuss with Steward(s)

3. Post Changes on Website

4. Present Changes in Meeting

5. Vote on Changes

6. Refresh RIM with HL7 tooling

7. Technical Corrections

8 Post new RIM Version on Website

Facilitator Responsibilities

•Coordinate Documentation and Justification

•Facilitate Discussions with Stewards

•Format RIM Change Proposals

•Submit for Posting

•Facilitate Pre-Meeting Discussions

•Represent Proposal during Harmonization

•Assist Stewards with Technical QA

International Committee Responsibilities for RIM

•Determine Information Needs

•Prioritize Information Needs

•Determine Influence Strategy

•Provide Domain Expertise for Content &

Justification

•Recommend Specific RIM Changes

•Follow Version 3 Methodology for New

Messages

RIM Influence Strategies

•Join a HL7 TC and influence changes by persuading the collective members of the TC and being present for all decisions

•Propose specific RIM changes to the harmonization process

•Align external models to the RIM for general information and raising awareness of different perspectives

Model Alignment

•Models can be aligned in 3 dimensions: Vertically - From less detail to more detail

Horizontally - Across Jurisdictions (Perspectives)

Over Time - Multiple Versions

•Each model represents a congruent whole - i.e. is internally consistent

•Different organizations or jurisdictions have different perspectives and can have different models to represent their interests

Level of Detail

Conceptual

Contextual

Logical

Physical

Figure 1: Each Data Model Covers the Same Scope

ScopingShared UnderstandingSpecification

Solution

ImplementationConstruction

Contextual

Conceptual

LogicalDesign

PhysicalDesign

PhysicalObjects

DeployedObjects

Wh

at

Wh

y

Wh

o

How

Wh

ere

Wh

en

Common Concept Model•Represents the key concepts that must be commonly understood to share meaning

•Has insufficient detail to construct messages orbuild information systems

•Provides a foundation structure for more detailed models or models representingdifferent perspectives

•Provides an aid to aligning models via cross-references

Canadian Health Data Model

•Background

•Objectives

•Development Process

•What does it look like

•Significant Patterns

•Proposal

Background

•Canada has another “standards process “ -CIHI Partnership for Informatics and Telematics

•Partnership WG1 developed a Health Information Framework (1997) to describe the scope of information of interest to the entire health system (with an emphasis on population health)

•Data Model Project struck to identify primary data needed to meet Health Information Framework requirements

Objectives

•ComprehensiveTo reflect current knowledge and practice across jurisdictions.

•FlexibleTo provide a basis for integration of data across jurisdictions.

•DurableTo be resilient to change.

•UniversalRelevant to all jurisdictions in Canada and beyond

Development Process•Working Group Representing multiple perspectives and jurisdictions•Examined various models available•Chose HL7 RIM as staring point•Examined fit to Health Information Framework

requirements•Synthesized extensions from various models•Tested against Scenarios•Used Scenarios to develop extensions where

information requirements weren’t met•Abstracted/refined until reached congruence•Tested against Scenarios and other perspectives

Resource

RequiresAffects

MonitoringSurveillanc

eResearch

GovernanceEvent

ParticipantRole

Environment

Event Linkage

People

Person

Group

ResourceEvent

Place

EnvironmentEvent

Governance

Isexecute

dby

peoplein

Defines

Affectedby

Occursat

Is locatedat

Constrains

Is takenby

Is locatedat

Isaffected

by

AreLocated

at

Characteristicof

MonitoringSurveillanc

eResearch

People Event

MonitoringSurveillanc

eResearch

IsAffected

By

Involves peoplein

Constrains

Is executedby

ServiceRecipient

Event

CIHI Canadian Health DataModel Project

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Occursat

Affects

Defines

Is executedby

MonitoringSurveillanc

eResearch

Constrains

Skills

Possess

Significant Patterns

1) events affect the state of their respective classes

2) event linkage

3) governance constrains events and

4) governance events monitor the state of everything

People

CIHI Canadian Health DataModel Project

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Governance

Mission / Purpose

Core Activity Policy

Strategy & Tactics

Accountability

Goals & Objs

Program Service

Jurisdiction

Org Structure

MonitoringSurveillanc

eResearch

GovernanceEvent

ParticipantRole

Environment

ResourceEvent

EnvironmentEvent

Isexecute

dby

Defines

Constrains

Is takenby

Isaffected

by

MonitoringSurveillanc

eResearch

People Event

MonitoringSurveillanc

eResearch

Involves peoplein

Constrains

ServiceRecipient

Event

Defines

Is executed by

Characteristicof

MonitoringSurveillance

Research

Constrains

Resource

Requires

Person

Group

Skills

Possess

Proposal Accepted

•Accepted the concept of a

common conceptual model•International Committee to work to

synthesize common conceptual

model (CCM)•Canadian Health Data Model work

in progress considered along with

other jurisdiction’s models•Map the RIM to the CCM•Participate in a process to cross-

reference to other models