EHR System Function and Information Model (EHR-S FIM) Release 2 EHR System Function and Information Model (EHR-S FIM) Release 2.1 Executive Summary for Immunization Capability and its EHR-S FIM Stephen.Hufnage.ctrl@tma.osd.mil , EHR WG facilitator Nancy.Orvis@tma.osd.mil DoD Point-of-Contact February 9, 2012 – Original February 13, 2012 – Last Update Call for Participation This work is being done by the HL7 EHR Interoperability Work-group, meeting every Tuesday at 4PM ET, dial-in: 1-770-657-9270, Passcode: 510269#  The most current artifacts are at: http://wiki.hl7.org/index.php?title=EHR_Interoperability_WG 5/6/2019 DRAFT WORKING DOCUMENT

DRAFT WORKING DOCUMENT Executive Summary For EHR-S FIM Release 2.1, this project has the purpose to add core information models for each EHR-S FM function make the EHR-S FM easier to use for analysts and engineers verify and validate EHR-S FM Release 2.0 Service Aware Interoperability Framework (SAIF) DSTU demonstration Support specific profiles (e.g., WG project DAMS, DIMS, DCMS). The plan is to use an architecture modeling tool to represent the EHR-S FIM and then generate appropriate views, reports, XML and HTML renderings of each EHR-S function’s scenarios, requirements, actors, actions/activities, dependencies, business rules, information & data The DoD-VA Joint Immunization Capability (JIC), HL7 EHR Diabetes project, ISO 13940 Continuity-of-Care harmonization are proposed as a set of demonstration prototypes of increasing complexity. 5/6/2019 DRAFT WORKING DOCUMENT

Immunization Management Prototype Scope We started with CP6.2 and included its dependencies: CP.6.2 Manage Immunization Administration CP.1.6 Manage Immunization List CP.1.2 Manage Allergy, Intolerance and Adverse Reaction List CP.1.3 Manage Medication List CP.3.3 Manage Clinical Documents and Notes CPS.1.7.2 Manage Patient Advance Directives CPS.3.9 Clinical Decision Support System Guidelines Updates CPS.9.4 Standard Report Generation AS.4.1 Manage Registry Communication 5/6/2019 DRAFT WORKING DOCUMENT

CP.6.2 Immunization Management “See Also” Dependencies DRAFT WORKING DOCUMENT RED: delete, Blue: insert 5/6/2019

EHR-S FIM Immunization Management Prototype Status EHR-S Function L A S t CC Notional Scenario Act CIM CDM RT See Also CP.6.2 Manage Immunization Administration 2/11 X CP.1.6 Manage Immunization List √ CP.1.2 Manage Allergy, Intolerance and Adverse Reaction List CP.1.3 Manage Medication List CP.3.3 Manage Clinical Documents and Notes CPS.1.7.2 Manage Patient Advance Directives CPS.3.9 Clinical Decision Support System Guidelines Updates CPS.9.4 Standard Report Generation AS.4.1 Manage Registry Communication √ = first draft done, X = Peer reviewed by WG CC=Conformance Criteria, Act=Activity Diagram, CIM=Conceptual Information Model, CDM=Conceptual Data Model, RT-A=Requirements Trace to Activities, RT-D=Requirements trace to Data 5/6/2019

Immunization Capability Conceptual Information Model (CIM) DRAFT WORKING DOCUMENT RED: delete, Blue: insert 5/6/2019

DRAFT WORKING DOCUMENT Methodology Sparx Enterprise Architect was used to create a separate slide set for each of the applicable EHR System Functions, based on “See Also” Dependencies.. Create Data Traceability View Start with applicable reusable components Add necessary function-specific components Add required/new data elements Create Conceptual Information Model Create Conceptual Data Model Create EHR-S Function Dependency Model Create Activity Model for the function. Map Activities to EHR-S Components Map EHR-S Components to EHR-S Functions (“See Also” Dependencies) This Executive Summary of Data Models was created from the resultant model as a set of EHR-S Immunization-Management-Capability’s Components, showing their traceability to EHR-S Conformance Criteria. 5/6/2019 DRAFT WORKING DOCUMENT

Immunization Management EHR-S Component Data Models The EHR system was modeled as a set of event, clinical information, documents, notes and list managers/components resulting in the following EHR-S Component Data Entitiies and associated operations): Advanced directive event and document Allergy, Intolerance and Adverse Reaction event and list Clinical Decision Support information and rules Clinical Document or Note Event (generic) Immunization event, list, report List (generic) Medication event and list 5/6/2019 DRAFT WORKING DOCUMENT

Advanced Directive Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

DRAFT WORKING DOCUMENT Allergy, Intolerance and Adverse Reaction Event Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

CDS-Clinical Decision Support Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

Clinical Document or Note Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

Event Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

Immunization Event Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

Immunization History Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

List Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

Medication Event Component Data Model Traceability 5/6/2019 DRAFT WORKING DOCUMENT

DRAFT WORKING DOCUMENT Conclusion EHR-S FIM can populate portions of SAIF for HL7 WGs Information and Computational Dimensions Conceptual Perspective EHR-S FIM can be composed into higher level capabilities by functional analysts and system engineers Encourage reuse Avoid duplication EHR-S FIM can be the basis for Interoperability Specifications Messages Documents Services An Enterprise Architecture tool is essential to maintain consistency across models 5/6/2019 DRAFT WORKING DOCUMENT

Reference Information EHR-S FIM Legend EHR-S FIM Verb Hierarchy 5/6/2019 DRAFT WORKING DOCUMENT

DRAFT WORKING DOCUMENT EHR-FIM Legend 5/6/2019 DRAFT WORKING DOCUMENT

EHR-S FIM Action Verb Hierarches Manage (Data) Capture Maintain Render Exchange Determine Manage- Data- Visibility Auto-Populate Enter Import Receive Store Update Remove Extract Present Transmit Export Analyze Decide De-Identify Hide Mask Re-Identify Unhide Unmask Archive Backup Decrypt Encrypt Recover Restore Save Annotate Attest Edit Harmonize Integrate Link Tag Delete Purge 5/6/2019 DRAFT WORKING DOCUMENT