HL7 v3 教育訓練系列教材

HL7 Taiwan 協會秘書長 范士展

sjvann@gmail.com

HL7 Taiwan Google 論壇 :http://groups.google.com/group/hl7-taiwan

教育訓練委員會Education Technical Committees

版權所有：台灣健康資訊交換第七層協定協會

Refine Message Information Model

(2 小時 )

1. R-MIM 模型介紹2. R-MIM 術語說明3. 實作概念4. 上機操作

RMIM 模型介紹

RIM 於應用之缺憾

使用 V3 方法論重新定義 RIM ，使其能夠產生

特定功能目的之物件。

1. RIM 為一般化抽象類別模型 (Class) 。2. 類別模型無法表達特定物件 (Object) 。

擴展 RIM 資訊** 限制循環

**

D-MIM Domain Message Information Model 延伸自 RIM 。 由特定領域 (domain) 負責建構。

例如“ Patient Administration” 。 會有多個“ entry points”(XML Root Element) 。 類別的部分屬性開始賦予內容值。

R-MIM Refined Message Information Model 衍生自 RIM ，是 D-MIM 之子集合。 類別的部分屬性會再多一些給定內容值。 只會有一個“ Entry Point” 連接到特定焦點

或主題類別。Patient Administration DMIM

Active Emergency Encounter RMIM

New PersonRMIM

R-MIM 範例Active Emergency Encounter

Entry PointFocal Class

R-MIM 術語說明

讀懂 R-MIM類別是複製與顏色編碼

Acts:EncounterEvent

A_EncounterValuablesLocation

A_ConsentA_ObservationDx

A_AccountAccomodationEvent

PatientTransportation

Entities:E_Organization

E_Place

Roles:R_NotificationPartyR_AssignedPersonR_AssignedEntity

R_PatientServiceDeliveryLocationR_AssignedOrganization

Participations:notificationContact

attenderconsultant

referrersubjectlocation

responsiblePartyadmitter

ActRelationships:componentOf

pertinentInformation2Authorization

pertinentInformation1ReferencesequelTo

arrivedBy

如何閱讀 R-MIM RMIMs are in an HL7 “proprietary” modeling format, not UML. Classes cloned and renamed to improve readability Color matters ActRelationship and Participation represented as block arrows: makes

models more compact. Source points to target

Roles Solid line = played Dashed line = scoped

Special Choice Box Representation Constraint boxes

重要術語 EntryPoint

Act & Entity Class

重要術語 Role Class

Relationship Classes

重要術語 Recursive Relationships

Non-Core Classes

重要術語 Non-Core Associations

Choice

重要術語 CMETs(Common Message Element Type)

Constraint

Note

Vocabulary Domain

屬性內容

Bold means Mandatory

Data TypeCoding

Strength

Default Value

Cardinality

實作概念

方法論步驟 HL7 工具的應用可分成三種步驟：

Scope 範疇Dynamic Model 動態模型Static Model 靜態模型

範疇 本步驟要回答下列三個問題：

What is communicated?What happens?Who is involved?

假設情境 A clinician, using a local medical office support

system, orders a lab test for one of her patients. The test will be performed on a specimen collected at her office. She will send the specimen by courier, and expects to receive a confirmation that the test will be performed, and a result of the test.

有位臨床醫師，使用辦公室支援系統為其病患開立一個檢驗醫令。此檢驗所需的檢體是在他的辦公室收集的。他利用派送者將檢體送出，並期望能收到對方的回覆，確認要執行此檢驗以及最後結果。

動態模型 動態模型包含兩個步驟：

(a) Blocking out the Interactions

(b) Documenting the Interactions

Blocking out the Interactions 從情境故事中擷取出交互作用，應先回答

下列問題：Who sends and receives?When to communicate?What is sent?Response obligations?

The right information to the right person at the right time

Blocking out the Interactions 情境故事

Initial order from MdOffice to LabMgmt; when the order is ready;

Content: patient, orderer, specimen, performer (lab), test; expect confirmation

Confirmation from LabMgmt to MdOffice; upon receipt and acceptance;

Content: order reference; performer; expected completion

Result from LabMgmt to MdOffice; when test done; Content: order reference; patient reference; findings; specimen

status

Documenting the Interactions 要完成事項包含：

A. 定義或找出發送端與接收端的應用角色B. 規範 “ trigger event” 作為溝通啟始C. 給予交互作用特性化D. 訊息類型之需求文件化

Documenting the Interactions 情境故事範例

A. MdOffice -> 1) Lab Order Placer; 2) Lab Confirmation Receiver; 3) Lab Observation Event Tracker; LabMgmt -> 1) Lab order fulfiller; 2) Lab Promise confirmer; 3) Lab Observation Event Informer

B. 1) Order activate; 2) Promise activate; 3) Event complete

C. 1) Request for action; 2) Request response; 3) Event notification

D. 1) Lab observation order; 2) Lab observation promise; 3) Lab observation event

情境假設

靜態模型 靜態模型包含三個步驟：

(a) Defining Subject-specific Information Model,

(b) Defining Message Design in an HMD

(c) Documenting the Message Design

Defining Subject-specific Information Model 應完成：

確認是屬於哪一個領域或則是使用哪一個 R-MIM 。

建立副本，設定其屬性與關連。從 D-MIM 中組合或收集。參照 “ Common” 型態 ( 共用模組）R-MIM 文件化存入儲存庫

Defining Message Design in an HMD 此步驟應包含：

Walking the graph to serialize the R-MIMDefining message types based on (within) the

HMDDefining R-MIM constraintsSaving to repositoryExpressing HMD as XML, and/or CSV files

Documenting the Message Design 最後步驟：

Publish designs in ExcelCreate schemasPublish in HTML

上機操作

詳細流程，請參考HL7Tools_TheComprehensiveGuide.doc 第六章

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OrderOrder

PhysicianPhysician

PerformerPerformer LaboratoryLaboratory

SubjectSubjectSpecimenSpecimen

Record targetRecord target PatientPatient

DefinitionDefinition

Ordered TestOrdered Test

AuthorAuthor

Order

Definition

Performer

Author

Record target

Patient

Laboratory

Physician

Ordered test

Subject

Specimen

最後結果

哪些物件是需要的 Act (order) – Order

Participation – Author Role - Physician

Entity - Dr. Smith in the MD office Participation – Performer

Role – LaboratoryEntity - The lab that will perform the test

Participation – Subject Role – Specimen

Participation – Record target Role – Patient in whose record the result goes

Act relationship – Definition Act (definition) – Ordered Test

This order …

…was authored by …

…a physician role played by…

Suzy Smith.

… of this order.

… was the author …

… in her role as a physician …

Suzy Smith …

1. 注意儲存庫的位置2. 注意版本

感謝聆聽 Refine Message Information Model

下一場：使用 LOINC 、 SNOMED 與 OID介紹