Section 3: Clinical and Administrative Domains
HL7 Version 3 Detailed Clinical Models, Release 1 - Body Weight and Body Height
These first two Detailed Clinical Models (DCM) follow a generic UML format for the data element, datatype and code binding specifications, together with meta information (author, version, etc.) and medical knowledge. Of the original group of 5, length and weight are now finalized. They are published separately to follow up on multiple ballot comments and not combined into one large document.
HL7 Version 3 Detailed Clinical Models, Release 1 - Body Weight and Body Height may also go by the following names or acronyms:
- Clinical and Public Health Laboratories
- Quality Reporting Agencies
- Healthcare Institutions (hospitals, long term care, home care, mental health)
- Health Care IT Vendors
- Emergency Services
- Provides single specification for DCM content, including SNOMED CT / LOINC binding for overall consistency in the family of HL7 standards
- Health Base in the Netherlands
- Perinatal Registration Netherlands
- Onze Lieve Vrouwe Gasthuis Amsterdam
- Parelsnoer initiative
Although there is still discussion on what the best clinical models would be, the current DCM are created using medical knowledge and with technical implementation as HL7 clinical statements in mind. They are consistent and work.
RESPONSIBLE WORK GROUP
The overall goals of the DCM initiative are: - to develop methods, tools for requirements gathering with clinicians, requirements for modelling tools, - to enforce quality control, authorisation and governance of DCM rules - to identify clinical items, binding of clinical content to terminology, - to model generically and make transforms to different formalisms, - and to maintain in a repository a set of DCM that are useable in different standards, formats and different technical implementations using the same generic model. The purpose is to enhance the semantic interoperability between different systems and developments. Based on discussions in ISO Joint Working Group 9, the JWG leadership requested two projects to be started: 1. A set of examples, useful in a standard 2. A set of criteria for good quality of DCM that are indeed clinically sound and implementable in different technical environments. We have created a Top 10 list of DCMs and discussed its use in HL7 project 320 on DCM. Establishing DCM criteria and methodologies is currently done under ISO NIWP 13972, which was approved on July 2009.
A DCM includes the purpose of one or small set of clinical data elements, the evidence base, data element specification, proper procedure, interpretation of values, and literature references. A guideline for this has been created on behalf of Nictiz in the Netherlands. A DCM specification must be - usable within the HL7 Clinical Statement and HL7 template specification - meet HL7 TermInfo requirements - adjustable to the CEN/IOS 13606 and OpenEHR archetype environment, and the Clinical template specification, among others. Technical implementations that would be able to deploy DCM include GUI design, database design, HL7 message design, algorithm design, rule-based Decision Support System design, among others. In particular a DCM is to form a bridge between different technical representation formats, in particular HL7 v3 templates / clinical statements and OpenEHR archetypes. That is the harmonization aspect of DCM. In order to actually use a DCM, the transformation to HL7 must be made. This is done via mapping the DCM content to a Clinical Statement R-MIM, in any HL7 domain that uses Clinical Statement. The formalism to use a DCM in HL7 space would be that of an HL7 v3 template.