1. © Copyright Mayo Foundation for Medical Education and Research 2004 The Relationship between ebXML, Archetypes, Templates, Terminology and the HL7 RIM By Peter L. Elkin, MD Associate Professor of Medicine and Medical Informatics Mayo Clinic, School of Medicine

2. © Copyright Mayo Foundation for Medical Education and Research 2004 Unambiguous Concept Representation Interoperable exchange of Healthcare Data Enabling distributed Semantic Interoperability Semantically empowering the ebXML Standard

3. © Copyright Mayo Foundation for Medical Education and Research 2004 Object Oriented View of Knowledge Representation Many concepts are composite concepts with a defined structure –Blood Pressure (BP) Systolic BP Diastolic BP –Orthostatic Blood Pressures Lying BP Sitting BP Standing BP

4. © Copyright Mayo Foundation for Medical Education and Research 2004 Health Expression Archetype Language (HEAL)

5. © Copyright Mayo Foundation for Medical Education and Research 2004 Suggested Schema CDA Level 1 –Document Structure and Metadata ADL Archetypes –Constraints on a Model Templates –Formal Definitions Comparable Data OWL Language

6. © Copyright Mayo Foundation for Medical Education and Research 2004 Clinical Document Architecture CDA Level One DTD shown in “XML Authority” from Extensibility CDA Level One document shown in “Internet Explorer” from Microsoft

7. © Copyright Mayo Foundation for Medical Education and Research 2004 Clinical Document Architecture

8. © Copyright Mayo Foundation for Medical Education and Research 2004 Clinical Document Architecture

9. © Copyright Mayo Foundation for Medical Education and Research 2004 Clinical Document Architecture

10. © Copyright Mayo Foundation for Medical Education and Research 2004 archetype openehr-ehr-observation.bp_measurement.draft concept [at0000] -- blood pressure measurement description author = "> submission = < organisation = date = > version = status = revision = description("en") = < purpose = use = misuse = > adl_version = rights =

11. © Copyright Mayo Foundation for Medical Education and Research 2004 HL7 - CDA - XML

12. © Copyright Mayo Foundation for Medical Education and Research 2004

14. HL7 Templates R-MIM Fragment The R-MIM fragment (graphically represented here) can be converted to OWL Abstract Syntax (next slide), and used as a definition model for template development and validation.

15. © Copyright Mayo Foundation for Medical Education and Research 2004 R-MIM Fragment OWL Syntax ::= Class(ex:R-MIM Individual (ex:ID "12345"))  Defines the entire Restricted MessageInformation Model ::= Class(ex:R-MIM_Fragment Individual (ex:Frag_ID "67890") unionOf(ex:Observation ex:hasComponent) )  Defines the R-MIM Fragment as being the union of the Observation Class with the hasComponent Class (previous slide, and below) ::= SubClassOf(sub=ex:R-MIM_Fragment super=ex:R-MIM)  Specifies that the R-MIM fragment is a subclass of the entire R-MIM ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0) ) )  Defines the Class Observation as a complete Act with defined restrictions (previous slide for reference) ::= Class(ex:hasComponent (ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) )  Defines the Class hasComponent as being a complete Observation within the COMP domain (previous slide for reference) ::= ObjectProperty(ex:typeCode (Individual(ex:codeValue) ) ) ::= ObjectProperty(ex:class_cd (Individual(ex:codeValue) ) ) ::= ObjectProperty(ex:moodCode (Individual(ex:codeValue) ) )  Defines the Object Properties used in the above Class definitions ::= DatatypeProperty(ex:codeValue xsd:integer)  Defines the Data Type Properties for the Object Properties

16. © Copyright Mayo Foundation for Medical Education and Research 2004 R-MIM Fragment mapping to XML The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. Can be used to validate. LOINC 0 0 0 ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Combined with

17. © Copyright Mayo Foundation for Medical Education and Research 2004 R-MIM Fragment mapping to XML The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. Can be used to validate. LOINC 0 0 0 ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Combined with

18. © Copyright Mayo Foundation for Medical Education and Research 2004 R-MIM Fragment mapping to XML The OWL R-MMIM Fragment can validate an existing OWL Template, I.e. LabTest is a SubClass of Observation. Can be used to validate. LOINC 0 0 0 ::= Class(ex:Observation complete ex:Act restriction(ex:classCode minCardinality( 0 ) ex:moodCode minCardinality( 0 ) ex:hasComponent minCardinality(0))) ::= Class(ex: hasComponent(ex:typeCode complete ex:Observation restriction(ex: domain(ex:COMP) minCardinality(0) ) ) ) Combined with

19. © Copyright Mayo Foundation for Medical Education and Research 2004 LOINC 0 0 0 Can be used to validate. 1 0 1 …… continued on next slide ….. CBC is a subClassOf LabTest

20. © Copyright Mayo Foundation for Medical Education and Research 2004 LOINC 0 0 0 Can be used to validate. CBC is a subClassOf LabTest …… continued from previous slide ….. 1 1

21. © Copyright Mayo Foundation for Medical Education and Research 2004 Show Blood Pressure Archetype

22. © Copyright Mayo Foundation for Medical Education and Research 2004 Show Blood Pressure Archetype / XML Output

23. © Copyright Mayo Foundation for Medical Education and Research 2004 Show Blood Pressure OWL:Archetype Formal Definition

24. © Copyright Mayo Foundation for Medical Education and Research 2004 ebXML Registry Both the R-MIM Fragment and the full OWL_CBC.xml Template can be stored, with meta-data in ebXML. This will allow automated Template validation, and ease of retrieval and submission of Templates and Fragments. The following slides are snapshots of the ebXML Registry browser showing the XML R-MIM_ Fragment.xml Object, and it’s associations with the OWL_CBC.xml Template

25. © Copyright Mayo Foundation for Medical Education and Research 2004 ebXML Registry Object Browser

26. © Copyright Mayo Foundation for Medical Education and Research 2004 Extrinsic Object Meta-Data Model

27. © Copyright Mayo Foundation for Medical Education and Research 2004 Next Steps Select groups can submit valid R-MIM Fragments in OWL:Archetypes syntax to the ebXML Registry. Develop software for HL7 Template Validation in ebXML. Allow groups to submit HL7 Templates composed in OWL:Archetypes/XML to be validated against registered R-MIM Fragments. Develop software to validate instances of an HL7 Template against the registered HL7 Template in OWL:Archetypes/XML syntax. Allow groups to validate their HL7 messages against registered instances of HL7 Templates in OWL:Archetypes/XML.

28. © Copyright Mayo Foundation for Medical Education and Research 2004 Conclusion: Join the ongoing development of the ebXML Registry Standard and the HL7 Templates SIG –Where the Action is… –Where the Rubber Meets the Road… –Looking for hard working creative individuals to dedicate themselves to making interoperability a reality –Discussion: ……… Thank You for Your Kind Attention!