1. EHR System Function and Information Model (EHR-S FIM) Release 2
EHR System Function and Information Model (EHR-S FIM) Release Executive Summary for Immunization Capability and its EHR-S FIM
, EHR WG facilitator
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: , Passcode: #
 The most current artifacts are at:
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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 Continuity-of-Care harmonization are proposed as a set of demonstration prototypes of increasing complexity.
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3. 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 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
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4. CP.6.2 Immunization Management “See Also” Dependencies
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5. 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 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
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6. Immunization Capability Conceptual Information Model (CIM)
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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.
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8. 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
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9. Advanced Directive Component Data Model Traceability
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Allergy, Intolerance and Adverse Reaction Event Component Data Model Traceability
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11. CDS-Clinical Decision Support Component Data Model Traceability
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12. Clinical Document or Note Component Data Model Traceability
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13. Event Component Data Model Traceability
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14. Immunization Event Component Data Model Traceability
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15. Immunization History Component Data Model Traceability
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16. List Component Data Model Traceability
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17. Medication Event Component Data Model Traceability
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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
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19. Reference Information
EHR-S FIM Legend
EHR-S FIM Verb Hierarchy
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EHR-FIM Legend
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21. 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
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