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HL7 Version 3.0 Mini-Tutorial
Helen Stevens
Senior Project Manager –Web Solutions Office
McKessonHBOC - Information Technology Business
1. What is the Message Development
Framework?
2. What is the Reference Information
Model?
3. Why is HL7 3.x different?
HL7 Modeling
Abstractions:
Dispense
Medications
Manage
Care
Perform Lab
Tests
Review
Utilization
Activities
(Use Case
Model)
Objects
Account
Patient
Provider
Encounter
Order
(Information
Model)
Communication
(Interaction and
Message Models)
HL7 message
Finance
HL7 message
ADT
Pharmacy
HL7 Modeling
Abstractions:
Dispense
Medications
Manage
Care
Perform Lab
Tests
Review
Utilization
Version 2.x focused its
Activities
energies at the communication
By the
demanding
(Use Case
level and covered
other
Model)
analysis
abstractions only
looselyofinthe
the
requirements
and
specifications.
Account
Encounter
Provider
Order
Patient
Objects
information content,
(Information
Version 3 assures
Model)
consistency in and
enhances the value
HL7 message
HL7 message
Communication
of the resulting
(Interaction and
messages.
Message Models)
Finance
ADT
Pharmacy
Models developed in Phases
Develop Scope
Create
Use Cases
Identify
Actors &
Events
Information Model
Use Case Model
Spec
Spec
DIM Spec
Class Diagram State Diagram
Define
Interactions
Create
Conformance
Claims
Model new
concepts
UCM Spec
Use Case Diagram
Harmonize with
RIM
Define Trigger
Events
Define Application
Roles
Draw initial
contents from
RIM
Interaction Model
Spec
Inter Spec
Interaction Diagram
Message Design
2-nd Order
1 choice of
0-n Drug
0-1 Nursing
h//mt:50”d”
…
…
…
Develop Message
Information Model
Develop
Message Object
Diagram
Specify HMD
Sample Use Case Model
Health Care Enterprise
Manage Health
Plans
Provide Services
Provide Services
Manage Health Plans
Perform Triage
Manage
Network
Manage
Membership
Order
Service
Treat Patient
Schedule
Service
Treat Patient
Order Service
Administer
Procedure
Manage Membership
Enroll Member
Create Order
Evaluate
Outcomes
Discharge
Member
Status Order
Record Results
Approve Services
Manage Network
Evaluate Provider
Schedule Service
Create
Appointment
Market
Services
Monitor
Appointment
Sign
Order
Reference Information Model (RIM)
Legend
Stakeholders Patient Encounters
Stakeholder
Scheduling
Organizations
Affiliations
Data types
Appointments
Insurance
Person
Patient
USAM
Encounter
Service Provider
Service
Episode
Accounting
Finance
Doc.
Document
Roles
Location
Material
Material
Message
control
Sample State Transition Diagram
Figure State diagram for Patient class.
S c h e d u le d
d e l e te _ s c h e d u l e d _ e n c o u n te r ^C 0 0 X M T 0 0 6
D e l e te d
s c h e d u l e _ e n c o u n te r ^C 0 0 X M T 0 0 3
d e l e te _ a c ti ve _ e n c o u n te r ^ C 0 0 X M T 0 0 7
n u ll
s ta r t_ e n c o u n te r ^C 0 0 X M T 0 0 5
d e l e te _ d i s c h a r g e d _ e n c o u n te r
s ta r t_ e n c o u n te r ^C 0 0 X M T 0 0 4
A c ti ve
d i s c h a r g e _ p a ti e n t ^C 0 0 X M T 0 0 8
D is c h a rg e d
c a n c e l _ d is c h a r g e ^ C 0 0 X M T 0 0 9
State diagram for Patient_encounter class
Transitions include reference
to the trigger event.
Sample Interaction Model Diagram
Figure Interactions for Patient subject class.b
A R _ P a ti e n t_ m a n a g e r :
A R _ P a ti e n t_ tr a c ke r :
A R _ P a ti e n t_ m a n a g e r
A R _ P a ti e n t_ tr a c k e r
1 : a d d _ p a t i e n t( ti d )
2 : a d d _ p a ti e n t( ti d x)
3 : d e l e te _ p a ti e n t
Application Role Role subscribed to by an
application that is used to
verify compliance.
4 : d e l e te _ p a ti e n t (t id x)
Interaction Trigger Event causes a Message
to be sent by a Sending role to a
Receiving role for which there may
be a Receiver responsibility
Compliant!
Message
Object
Diagram
(MOD)
Patient_encounter
none
C
Inpatient_encoun ter
is_preceded_by 1..1
involves 1..1
Patient_admission
Patient
is_a_role_of 1..1
Person[Pt]
Stakeholder[Pt]
Sample
with three
Person
Objects
has a primary provider 0..1
is_assigned 1..1 Stakeholder_identifier
[Pt]
Individual_HC_practioner
[Prim care phys]
Person
[Prim care phys]
is_a_role_of 1..1
Stakeholder
[Prim care phys]
has 0..*
is_assigned 1..1 Stakeholder_identifier
[Prim care phys]
Patient_billing_account
Encounter_practitioner
includes 1..*
is_participant_for 1..1
Individual_healthcare_practitioner
[Participant HCP]
is_a_role_of 1..1
Person
[Participant HCP]
Stakeholder
[Participant HCP]
is_assigned 1..1 Stakeholder_identifier
[Participant HCP]
Common Message Elements
 Reusable Elements
• Patient
• Provider
• Order
• Observation
 Defined by one group and applied to all
messages
Models are used to build the HMD
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Hierarchical
Message
Description
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical Message Definition
The HMD & ITS then give messages
Implementation
Technology
Specifications
"Send as ASCII
string in XML
format"
Hierarchical
Message
Definition
"Discontinue
pharmacy order"
ITS
Data
HL7
Message
Creation
HL7-Conformant
Application
Message
Instance
HL7
Message
Parsing
Data
HL7-Conformant
Application
HL7 3.x Schedule
 Fall 2000
• Interaction design complete (triggers list)
• Preliminary message design (CMET list)
 Winter 2001
• Committee ballot on Messages ready
• Committee ballot on Data Types & XML ITS complete
 Spring 2001
• Committee ballot on Messages complete
• Member ballot on Messages ready
• Member ballot on Data Types & XML ITS complete
 Fall 2001
• Member ballot on Messages complete
• Support documentation
• Education prepared
 2002
• Publish HL7 3.0
HL7 3.x Status Report
 80% of workgroup meeting time dedicated to
3.x development
 George (Woody) Beeler hired as project
leader
NOT expected to meet schedule outlined!
• Lack of resources
• Lack of structure/organization/process to
complete required ballots
Reality Check
 Solicit committed resources from key organizations.
 Cut scope:
•
•
•
•
•
Postpone full use case analysis
Postpone full interaction analysis
Postpone application role definitions
Postpone compliance verification
Minimize trigger events supported in 3.0
 Risk:
• Duplicate ‘hack’ mentality from 2.x
• Introduce errors perpetuated through ‘backward
compatibility’ requirements
What is in HL7 3.0?
 Ballot is for Hierarchical Message Definitions (HMD)
only – not RIM or vocabularies.
• RIM/Vocabulary are only locked once class / attribute
is used in a message.





Data Types
Vocabulary
XML Implementation Technology Specification (ITS)
2.x messages (80/20 rule)
Limited new interactions
Questions / Discussion / Feedback