HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S....

HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

V3 Software Implementation

Slide contents published under the Creative Commons / Attribute-Share Alike licenseSource: www.ringholm.com/download/implementation_mechanics.ppt

Full source: www.ringholm.com/download/ implementation_mechanics.ppt

HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. 2

René Spronk M.Sc. FHL7

HL7/IHE roles:•Co-chair of the international HL7 RIMBAA Working Group•Co-chair of various Committees, HL7 Germany, HL7 Netherlands•Contributor to the IHE Laboratory Technical Framework•HL7 Fellow, 2011

Trainer / Senior Consultant Ringholm bvHaarlem, the Netherlands

Tel. +31 (0)318 589 789Fax: +31 (0)318 548 090

eMail: [email protected]: http://www.Ringholm.com


Key Objectives

Understand some architectural approaches and techniques for v3 Implementation

Discuss some technologies and tools available to implement v3 specifications

Show some of the ‘best practices’ collected by the HL7 RIMBAA Workgroup


Overall Agenda

Introduction XML Serialization In memory object processing Persistence Mapping v2 to v3 (optional) Implementation Tools User Interfaces (optional)

01/01/20114


HL7 v3 Implementation –

an introduction


An Introduction


Agenda – Introduction section

HL7 v3 modeling/HDF – bottom up MIF and the origins of schema

Conformance/validation principles RIMBAA Technology Matrix

6


An introduction

HL7 v3 modeling / HDF

-bottom up-



XM

L exam

ple

8

XML ITS

DT R1


HL7 v3: Model Refinement

9

ITS(serialization format

of instances)

R-MIM / SIMSerializable Model

PharmacyClinical

Documents

D-MIM / DIMDomain Model

RIMRIM

Stable model,Domain agnostic

Refinement of

Refinement of


RIM – Abstract Data Model


Notes

Core of all information models: Data Type specification

Behavioral (dynamic) model: Interactions, initial/response exchanges between 2

applications

Service layer, contractual issues, -work in progress in HL7 v3-

11


An introduction

MIF – Model Interchange Format



MIF

The Model Interchange Format (MIF) a set of XML formats used to support the storage

and exchange of HL7 version 3 artefacts the pre-publication format of HL7 v3 artefacts

used by tooling. the formal definition of the HL7 metamodel.

MIF can be transformed into derived forms such as UML/XMI, OWL, or XML schema.

13


MIF documents:

Requirements-analysis related structures. Static model related structures. Dynamic model related structures. Infrastructure related structures:

including data types, and vocabulary

Structures related to testing Conformance-related HL7 structures Publication related structures

14


Derived forms

15

HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.16

MIF: How Is It Defined? (1)

mif-core-base

mif-model-static-serializedmif-model-static-flat

mif-model-staticBase

mif-core-staticBase

mif-model-datatype

mif-core-enumerations

Core

Vocabulary

Data type

xhtml1-strict

xml

mif-model-requirements mif-model-publication

mif-model-crossReference

mif-model-package

mif-model-interface

mif-model-dynamic mif-model-documentation

mif-COMPLETE

mif-model-static-derived

mif-core-patterns

mif-model-testing

mif-model-vocabulary

mif-model-conformance

mif-core-changes

Mark-up

xhtml-special.ent xhtml-symbol.ent

xhtml-lat1.ent

MIF 2.1 - June 13, 2008

mif-model-annotationLibrary

Static

Dynamic

Interface

Stable Beta Draft

Other

A set of XML schemas (+ Schematron):


MIF: How Is It Defined? (2)

The XML schemas define the MIF language constructs as types, with the meaning of the types explained informally in annotations:


Why MIF instead of UML?

MIF is a single unified metamodel that spans all HL7 artifacts. The metamodel is maintained and under the sole control of HL7. The metamodel represents all HL7 artifacts in a consistent fashion.

There will always be a "newer" and "better" technology out there, but there is currently no alternative metamodel representation that covers all of HL7's metamodel.

18


An introduction

ITSs and

the origins of HL7 Schema



ITS – Implementable Technology Specification

An ITS specifies how instances of HL7 SIMs should be ‘transmitted’ Serialization, deserialization, encoding syntax

The most commonly used ITS is the “XML ITS” Alternatives: RIM serialization ITS (“RIM ITS”),

Green CDA

20


RepositoryRepository

MIFMIF

MIF transform toXML based ITS schemas

XML SchemasXML SchemasR-MIMR-MIM

XSLTXSLT

MIFMIFMIFMIF

PubsPubs

XSLTXSLT


MIF Example: E_NonPersonLivingSubject

22

Other attributes


MIF Header

23


MIF classes/associations (snippet)

24


MIF v. XML-based ITS

XML provides a syntax only An XML based ITS defines the set of

valid XML instances for a given message type no schema can do this

Download informative schemas with the v3 Ballot Package Normative Edition schemas as a reference


Generated XML-Schema for BirthPlace (snippet, XML ITS 1.1)

26

XML ITS


An introduction

Conformance and Validation



A “Valid” v3 instance..

Complies with the requirements as defined by the HL7 v3 information model Conformance indicator, cardinality, vocabulary

Complies with additional (“contractual”) requirements Template definitions, business rules

28


Attribute/AssociationConformance Levels

Conformance indicator: Optional: MAY be present, MAY be

processed, allows for nullFlavors Required*: SHOULD be present, SHALL be supported by

sender/receiver, SHALL be sent if known, allows nullFlavors Mandatory yes/no:

Mandatory*: SHALL be present, SHALL be processed/supported by sender/receiver, no nullFlavors

29


Vocabulary: Value Sets Attribute is linked to

Concept Domain The concept domain is

(UV Realm) represented by a value set.

The value set is based on a coding system.

AdministrativeGender

(Concept Domain)

The gender of a person used for administrative purposes (as opposed to clinical gender)

Personname: EN [0..*]

administrativeGenderCode: CE CWE <= AdministrativeGender

…

(Value Set – Universal Realm)OID 2.16.840.1.113883.19.11.1

M, F, UN

IAGC Release 2

(Coding System)OID 2.16.840.1.113883.19.1

M, F, UN, X, B


R-MIM (SIM).. and a Template (LIM)

Notes: • Template model must be a valid constraint on the R-MIM

-- An instance would not be able to conform to both if the above doesn’t hold true

• Reminder: Clone names of classes carry no semantics (they are irrelevant)


Constraint Language

To express additional constraints OCL, ADL, Gello No solution has been formally adopted

Typical (OCL) example: The Person object should have either an id or a

name context Person

inv: id.hasContent or name.hasContent

32


Example: „Valid“ CDA Document

1. Validates against the published XML Schema XML Schema based validation tool

2. Validates against the abstract CDA model specification

Use a MIF (specification of the abstract model) based validation tool, includes conformance and vocabulary validation

3. Validates against requirements / templates as specified in implementation guides

Mostly: a XML Schematron based validation tool; could be MIF/OCL based


An introduction

RIMBAA Technology Matrix



RIM - Abstract Data Model


The RIM is “abstract”

The same “instance” of information can be shared via different information interoperability paradigms

E.g. lab results can be shared via (electronic) documents (v3 Clinical Document

Architecture) via V3 lab messages via Web Services with v3 payloads

..or they can be imported In a RIM Based Application (RIMBAA)


RIMBAA

Use of V3 artefacts


PersistentRepresentation


ObjectRepresentation


SerializedRepresentation


RIM

Con

stra

ined

In

form

atio

n M

odel

RIM

Con

stra

ined

In

form

atio

n M

odel

RIM

(gen

eric

)M

odel

RIM

(gen

eric

)M

odel

App

licat

ion

spec

ific

Mod

el

App

licat

ion

spec

ific

Mod

el

RIMBAA Technology Matrix


Overall Agenda


01/01/201139


XML Serialization

About the HL7 v3 XML Schema



Two XML-based ITSs

XML ITS 1.1 Has been in use since the

beginnings of HL7 v3 Based on serialization of

an R-MIM (SIM) XML elements names

based on clone/business names for classes as used in the R-MIM

Separate schema for each and every R-MIM (SIM)

RIM ITS New (2010) Based on serialization of

the RIM XML element names

based on the RIM core class names.

One single schema for all RIM-based models; 50 classes.


XML ITS example<component typeCode="COMP">

<commonObservationEvent classCode="OBS" moodCode="EVN”

<templateId root='2.16.840.1.113883.10.20.1.24'/>

<code code="8302-2" codeSystem="2.16.840.1.113883.6.1" displayName="Lichaamslengte“>

<statusCode code="completed"/>

<effectiveTime value="200907011346" />

<value xsi:type="PQ" value="90" unit="cm" />

<subject typeCode="SBJ" contextControlCode="OP">

<patient classCode="PAT">

<patientPerson classCode="PSN“

determinerCode="INSTANCE">

<name>ROELOFSEN, TOM</name>


RIM ITS example<rim-graph xmlns="urn:hl7-org:v3-rim"

xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" version="0226"

xmlns:sbad=“urn:oid:2.16.840.1.113883.10.20.1.24” >

<outboundRelationship xsi:type="ActRelationship" assocName="subject" cloneName="Subject2" contextControlCode="AN" typeCode="SUBJ" contextConductionInd="false"> <target xsi:type="SubstanceAdministration"

classCode="SBADM" moodCode="RQO“

templates=“sbad:root” > <id root=""/> <code code="DRUG" codeSystem=""/> <participation xsi:type="Participation"

contextControlCode="OP" typeCode="DIR"> <role xsi:type="Role" assocName="medication"

cloneName="Medication" classCode="ADMM"> <player xsi:type="ManufacturedMaterial“

assocName="administerableMedicine" classCode="MMAT" determinerCode="KIND">

<code code="" codeSystem="?"/>








RIM

Con

stra

ined

In

form

atio

n M

odel

RIM

Con

stra

ined

In

form

atio

n M

odel

RIM

(gen

eric

)M

odel

RIM

(gen

eric

)M

odel

App

licat

ion

spec

ific

Mod

el

App

licat

ion

spec

ific

Mod

el

ITSs - RIMBAA Technology Matrix

Note:RIM ITS

Note:XML ITS


Using HL7 v3 Schemas

HL7 produces informative XML Schema Definitions (XSD) for all v3 messages

There are no normative XML schema (current workitem) normative schema are being

discussed Things to understand

An XML document that satisfies Schema validation is not necessarily a valid HL7 v3 Message/Document


XML ITS Schema - Abstract Models

In v3, Element Names are derived from the permitted structural codes No meaning is lost if you strip all element names

from HL7v3 XML <Foo classCode=“PSN”>..</Foo> is the semantic

equivalent of <Person classCode=“PSN”>..</Person>

However, most XML tools are useless if you strip all element names from a document. First generation implementations will use XML element

names, later systems will be driven off the structural vocabulary (classCode, moodCode, typeCode.. )

Model Driven Architectures / Code Generation

XML ITS


XML Schema what are schemas bad at

No ambiguous content models allowed Problem for model-XML mapping (requires use of

clone class names in XML instances) No conditional constraints

cannot have an element that may either have a nullFlavour, or a set of attributes

Date+Time types are a mess HL7 uses short ISO dates (without validation)

Code list validation Only for small (enumerated) code lists

Friendly messages when validation fails


XML Serialization

Serialization/Deserialization

(using XML techniques)



Parsing and ValidationUsing XML Techniques

Serialized Message to Application Object Streaming API

SAX, XmlReader for efficient parsing of XML instances

Stripping out of those parts one needs only, skipping all other content

DOM, XPath Total control on XML processing In memory object which represents all of

the XML contents




Normalization

HL7 v3Message

SchemaValidation

HL7Rules

HL7

HL7 v3Schema

ImplementationSpecific

MessageParsing

ExtendedValidation

InformationModel

ApplicationRules

ClinicalRepository


TransformationUsing XML Techniques

Serialized Message to/from other serialized model: XSLT 1.1, XSLT 2.0, EXSLT

Every platform has multiple implementations of XSLT for XML transformations• Saxon, .NET Framework, JAXP…

Cascade XSLT transformations to simplify and flatten the instances

XQuery XML Query Language for procedural XML

processing Several XQuery implementations are avaliable,

refer to W3C XQuery home page (over 50 listed)


SerializationUsing a template

Simply fill in the blanks to create message Use XPATH for inbound models Ignorant of V3 data model and XML

set message ={<patientPerson> <id root="2.16.578.1.34.1000.1" extension=“$PAT_ID"/> <name use="L">

<given> $PAT_FIRSTNAME</given><given> $PAT_MIDDLE</given><family> $PAT_FAMILY</family>

</name> <administrativeGenderCode code=“$PAT_GENDER"

codeSystem="2.16.840.1.113883.5.1"/> <birthTime value=“$PAT_BIRTHDATE"/></patientPerson>}


SerializationUsing a template

Use only when variability is low, when a few messages/documents need to be supported

Beware of exceptions: nullFlavor instead of code Variable has no value:

<name></name> is valid XML, but it isn’t valid in a V3 XML instance (1)

<Act code=“” codeSystem=“1.2.3”/> isn’t valid in a V3 XML instance


XML Serialization

XML Based conformance/validation




XML Schema Validation HL7 provides informative schemas for first-pass

message validation Not sufficient for full validation

Schematron, RELAX NG Better than XSD as validating messages, but still

not widely used no HL7-provided schematron (although could be

generated from MIF) May be provided by the author of an

implementation guide Validating Stylesheet

Produces “human readable” errors


Schematron is a …

Rules-based validation language A way to test XML documents A way to specify and test assertions about

patterns in XML documents A cool report generator


Reasons to Use Schematron

Business/operating rules that other constraint languages can’t enforce

Different requirements for different stages of the document lifecycle

Local or temporary constraints (not in base schema)

Unusual (but not illegal) variation No schema Ad hoc querying and discovery


A Short Example Schematron ...in a CDA instance

Schematron

<rule context="hl7:typeId"> <assert role="error“ test="@extension='POCD_HD000040'"> ClinicalDocument.typeId (2.16.840.1.113883.2.4.6.10.35.3) @extension SHALL have value POCD_HD000040 static </assert>

<assert role="error" test="@root='2.16.840.1.113883.1.3'"> ClinicalDocument.typeId (2.16.840.1.113883.2.4.6.10.35.3) @root SHALL have value 2.16.840.1.113883.1.3 static </assert></rule>

<typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>


Schematron – Example (v3 Messages)

60


Overall Agenda


01/01/201161


In-memory object processing

Class Generators



Model Driven Software Development (MDD)

Image credits: Johan den Haan, Mendix.nl

Model Generate


MDD - Application Generation

Software application

Software application

Generic Software Components-Terminology-Data types

Generic Software Components-Terminology-Data types

PersistenceDatabase

RIM RIM


Class-based Parsing

Class generators – XML Schema driven Every major development platform provides tools

to generate classes from XML Schemas E.g. JAXB, .NET Framework/Mono (XSD.EXE), XML

Beans…

Class Generators – Model driven Model Driven Software development

environments allow classes to be generated from (UML-) models

E.g. MARC Everest API Generator (XML ITS/RIM ITS)


Class-Based ParsingUsing Coding Techniques


Model based code generation

Full (abstract) model specification is stored in a model repository (RoseTree) Abstract model is expressed as a MIF (Model

Interchange Format) file MIF can be transformed to less expressive XML

Schema

Code generation MIF (to alternate model representation, e.g. UML) to

code (e.g. MDHT) XML Schema to code (e.g. JAXB xjc)


Code Generation

MIF Based Code Generation

68


MIF Based Code Generator

Full (abstract) model specification is stored in a model repository (RoseTree) Abstract model is expressed as a MIF file – including

GELLO/OCL expressions and (DCM derived) Template definitions

Code (class) generation MIF - the code generator has to be aware of the

structure of the MIF UML/EMF (derived from the MIF) - the code generator

has to know UML/EMF, including the v3 specific extensions


MIF v. Derived model

MIF Normative (full) specification

of a v3 model, inclusive of documentation

Full validation support No cross-industry tools for

class generation MIF based class generators

are being created: MRC-HI Everest, OHT

Derived (e.g. UML, Schema) Derived (lossy)

specification of v3 model

Cross-industry tools for code generation

70


Programming Components

71

CMETMIF

WrapperMIFs

Reusable components

DatatypesCustom code

codeTargetModelMIF

TargetModelDSL

Terminology server API + data

Code generationModel transform

VocabMIF

Ser

ializ

atio

n

XM

L e

nco

din

g/d

eco

din

g


Data Types – custom code Custom library with support for v3 data

types Mostly: ISO data types, patched to support data types

R1 as well Relationship with Terminology Server (C* data types) Needs custom coding: data types MIF is abstract.

Mohawk (.net) and OHT (Java) contain such libraries Or use datatypes.xsd as the basis for development

72


Serialization – XML En/DeCoding

Serialization engine Serialize RIM structures according to HL7 rules

XML En/DeCoding Encoding of a serialized graph Rules as specified by the ITS (e.g. XML ITS, RIM

ITS)

73


Code Generation

Schema Based Code Generation

74


Schema based code generation

Advantage: wide availability of tools Serious disadvantage: XMl schema

language isn’t powerful enough to express all model requirements

Disadvantage when validating templates (in-memory, not on serialized format): Templates are expressed in MIF, there is no Schema version.

75


Schema's serve multiple masters

Schema’s serve more than one purpose design validation contract code generation

those purposes often need different Schema’s For code generation:

+ simplicity, readability

- reuseability, composability

Slide courtesy of: Marc de Graauw


The HL7v3 Schema’s

XML ITS Example:QUPA_IN101102UV01 Get Person Demographics Query

MCCI_MT000300UV01 COCT_MT040203UV01

COCT_MT150003UV03 COCT_MT030203UV02

MFMI_MT700711 COCT_MT090300UV01

COCT_MT150000UV02• COCT_MT070000UV01

COCT_MT710000UV01 COCT_MT150003UV03 COCT_MT070000UV01

• COCT_MT710000UV01 COCT_MT090100

COCT_MT150000UV02• COCT_MT070000UV01

COCT_MT710000UV01 COCT_MT150003UV03 COCT_MT070000UV01

• COCT_MT710000UV01 COCT_MT090003

COCT_MT150003UV03 MCAI_MT900001

QUPA_MT101102_V01 QUPA_MT101101_V01


..and: voc, datatypes, infrastructureRoot

XML ITS


Remove ‘includes’ from v3 Schema’s

Schema’s should be readable tools can solve this but they make you dependent on the tool

Therefore: flatten the Schema’s remove all includes put included schema’s where they belong

For readability: make the Schema resemble the instance

Readable Schema’s generate readable code!Slide courtesy of: Marc de Graauw

XML ITS


SOAP

Transmission Wrapper

Control Wrapper

Payload Data

ANY

ANY

ANY


XML ITS


The XML ITS HL7v3 Schema’s

Not very readable without Schema editor not practically feasible

Generated from database Fix them with XSLT or other:

Flatten the Schema’s Remove unneeded datatype hierarchies Layer the Schema’s Replace all CMET flavors by a generic CMET flavor

Makes the Schema’s much more readable Generates simpler code

Slide (modified) courtesy of: Marc de Graauw

XML ITS


RIM ITS Schema

Essentially 1 core schema with 50 classes Generated classes will process any RIM ITS

instance Content validation to be done within application, not

at the XML level

Additional MIF based code generation probably required Processing of RIM-based object trees almost

always requires knowledge of the structure of templates (SIM, LIM)

81

RIM ITS


Example use-case: E-Novation

1. Serialized messages mapped to in-memory message objects (JAXB, code generation)

2. Application (business-) objects mapped to relational database (Hibernate ORM)

3. Custom code: mapping of message objects to application objects


Example use-case: JAXB

There is no direct link between Payload ControlAct Message

From Object(s) to DOM in 3 separate steps

From DOM to Object in 3 steps (in reverse order)

<<POJO>>

Payload

<<POJO>>

ControlAct

<<POJO>>

Message

Any

Any

<<DOM>>

Payload

Marshaller.marshal(payload)

<<DOM>>

ControlAct

Marshaller.marshal(controlAct)

<<DOM>>

Message

Marshaller.marshal(message)


Example use-case: JAXB


E-Novation example: message object


Overall Agenda


01/01/201186


Persistence

Overview



Database models (Relational)

88

RIM

LDM

PDM

RIM or RIM-based model:Conceptual Data Model

Logical Data Model•Not DBMS specific, no tables, no keys

Physical Data Model•DBMS specific, tables, keys

ORM – Object Relational Mapping


Conceptual Data model - RIM

Enormous flexibility, at the cost of a very abstract structure. makes enforcement of data integrity rules very difficult making it

necessary to rely on stored procedures and application logic to enforce rules.

Low number of tables less programming work, easier to learn, easier to add new

functionality. More data in each table, need to tune queries.

Main use-case: If you're creating a data store for ad-hoc queries, mining

and exploration of all sorts of data from all sorts of different sources

89


Persistence

Persisting Data Types



Data Types

At a lower level, the data types are complex to support. Complex data types

Helper classes, or UDTs Abstract data types

Specialize; or use helper classes Collection data types

Helper classes

91


Normalization – Helper Classes

92


Data Type expansion – Helper Classes

93


Watch for “Table Explosion”..

94


CV with R1/R2 relations

95


Example: RIM persistence -OntoReason / MD Anderson

96


Overall Agenda


01/01/201197


HL7 version 3

Mapping v2 to v3 (optional)



Representation of „Reality“ in a standard

Dynamic: a subset of all „business cycle trigger events“

Static: a subset of the objects and attributes which play a role


Migration scenario

Extensively document the HL7 v2 messages Identify the corresponding HL7 v3

interactions Create a mapping

Syntax Semantic: Granularity, Vocabulary Dynamic model (trigger events)


Key Step: Version 2 Message Profiles

Registration OID

Use Case Model

Dynamic Definition

Static Definition

Application Role

Vendor Scenario

Interaction Model

Messagev2.x

Message Structure

Site Interface Info

Vendor Interface Info

Version 2 Implementation

Version 2 Message Profile („Version 3 Ready“)

Version 3 Implementation

Message Profiling (Analysis)

prop

rieta

ry,

ad-h

oc

docu

men

tatio

n


„Granularity“ of v3

The dynamic model in v3 is different than in v2: Trigger Events occur at different points in the business process. v3 v2.x: Multiple v3 trigger events map to a v2

event The static v3 models are „more granular“

than v2.x v3 v2.x: details get lost v2.x v3: missing information – if filled by

defaults: significant risk of faulty interpretation


Concepts

Does v3 contain the same concepts as v2 ? The RIM supports all administrative, financial and

clinical concepts as present in v2. Therefore v3 is from a functional perspective fully backwards compatible with v2.

There is however not a guaranteed 1-to-1 mapping between fields or datatypes in v2 and classes/attributes in v3.


Migration scenario - revisited

Avoid using mapping as a migration scenario If you have to rely on a translation:

Best practice recommendation1. Extensively document the HL7 v2 messages

2. Identify the corresponding HL7 v3 interactions

3. Create a mapping (syntax, semantic) Kludge: (as a vendor) extend HL7 v2 messages

with Z-segments [missing data & additional granularity] to allow for a translation to v3.


Overall Agenda


01/01/2011105


HL7 version 3

Implementation Tools



Implementation Tools (Nov.2011)

Tools that directly suport the software development process: MIF based class/code generators (e.g. MDHT. Everest, JavaSIG) MIF based database schema generator (e.g. MGRID)) MIF based UI generators ISO Datatypes library CTS products (e.g. Mayo Clinic's LexEVS , Apelon DTS) Mapping tools (e.g. Open Mapping Software)

Tools that support software developers: Testing tools (e.g. Instance Editor, MDHT) Code Documentation Generators

Tools that are used by analysts/providers: Model (static/dynamic/UIs/..) Driven application development tools (e.g.

PHI Technology) Model Driven Documentation generators (e.g. PHI Technology)

107


OHT (Open Health Tools)

To assemble and/or develop a comprehensive harmonized tool suite to enable the definition, development and deployment of interoperable Electronic Health Records.

http://www.openhealthtools.org/

108


HL7 version 3

Tools: MDHT


www.cdatools.org


MDHT (part of OHT)

Management/definition of templates Generating Java code from CDA (CDA only)

model inclusive of templates Generation of documentation

.net version – seeking cooperation

110


MDHT Inputs & Outputs

DomainModel MDHTMDHT

Add Custom Validations & Constraints

Add Custom Validations & Constraints

Java API(Source Code)

Java API(Source Code)

Validation CodeGeneration

Validation CodeGeneration

Implementation Guide(s)

Implementation Guide(s)


Constraints – DSL for Templating

112


CDA Template Models

MDHT are currently working on implementations of the following CDA-based document types: Continuity of Care Document (CCD) IHE Content Profiles HITSP C32 Patient Summary Public Health Case Report (PHCR) IHE Lab Report Document HITSP C74 Personal Health Monitoring Report Essential Hypertension


MDHT Architecture

E M F

Eclipse Modeling Framewo

rk

Includes EMF Core, EMF.Edit,

EMF.Codegen &

Validation Framework

DITA Document generation

Includes generation of DITA

xml files

Document Publishing

Includes generating

documents using DITA-OT

Custom ToolsIncludes

• UML Table Editor• New Project Wizards• New CDA templates• Property Editors

JAVA Classes Includes generating Java source code for

models and the constraints

HL7 CoreIncludes V3 datatype support, MIF-> UML

support, HDF

CDAIncludes

• CDA Support• CDA Templates• HITSP & IHE models

Validation SuiteIncludes testing instances of CDA and non-

CDA models.

MDHT

Terminology Services

Includes support for terminology sets

Model to

Model

Transformation

IncludesDomain

Model to implemen

tation models.


HL7 version 3

Tools: Everest


http://everest.marc-hi.ca/


MARC-Hi Everest Framework

Mohawk College (a Canadian university) has created a .net API-generator based on MIF (supports all of v3).

Java port planned for Q2 2012.

116

D


Optimizer

Optimizer

From MIF to Code

MIF 2.1.xMIF 2.1.x

GPMR

GPMR

C#C#

Java

Java

HTMLHTML

XSL/

XSD

XSL/

XSD

CORRepo.CORRepo.

.DLL.DLL

.HTM.HTM

.JAR.JAR

.XSL / .XSD.XSL / .XSD

REST/

JSON

REST/

JSON

.js .js


MARC-Hi Everest – From MIF to Instance

ApplicationCode

ApplicationCode

MIF v2MIF v2

Use Structures

Use Structures No ITS?

Create

Create

<PRPA_IN1012..

<id root=“”

<PRPA_IN1012..

<id root=“”

XML ITS1.0 with DT R1D


UV Support

NE2008 (since GPMR 0.9.x) *_HD*.*mif files should be removed

NE2009 / NE2010 HTML renderer works on Patched MIF files in quirks

mode Missing Several CMET definitions in DEFN IFC file Templating issue with several Interactions

CDAr2 (NE2010) (since GPMR 1.1.x)


Milestones

Q4 2011 – jEverest CTP (Community Tech. Preview) Formatters RMIM Structures GPMR Patches

Q1 2012 – Release Candidate 3 Everest .NET:

CDA Support Datatypes R2 Support

jEverest : Connectors

Q2 2012 – Release of Everest 1.0 jEverest + Everest + GPMR Bundles Documentation for jEverest


HL7 version 3

Tools: Instance Editor


http://hl7book.net/index.php?title=Eclipse_Instance_Editor


Instance Editor

Instance Editor (mostly used for CDA) This tool provides context aware editing and

interactive validation for CDA documents. The tool includes the best available validation for the data types.

XML editor look-and-feel

122


Eclipse CDA Editor tool

123


Undetected error.


Overall Agenda


01/01/2011125


HL7 version 3

User Interfaces



User Interfaces There are two (extreme) options:

Run time: Dynamically (at run time) generate the UI based on a CIM/LIM-like definition

need to do some pre-formatting, otherwise the generated layout may be quite nonsensical for the human user

Development time: Define the UI first; bind elements in the UI to RO/CO/AO classes/attributes.

127


User Interface - Development

UI integration with templates (LIM): commonality is one of the key reasons for using RIM start with the generic controls, make them work,

bolt them together, less generic as you go up the data stack.

128


Each Observation pattern will have a UI● BL will have a label and a Yes, No answer● PQ will have a label and a number input field with a

unit behind it● CD with a valueset of <4 will have a label and list of

items as radio buttons● CD with a valueset of >=4 and <32 will have a list● CD with a valueset of >1000 will have a Google

Search● etc.


MS CUI Clinical Noting in Forms Guidance


Model Driven User Interfaces

Personname: EN [0..*]

administrativeGenderCode: CE

…

(Value Set – Universal Realm)

M, F, UN

IAGC Release 2

(Coding System)OID 2.16.840.1.113883.19.1

M, F, UN, X, B

CE data type: (code, codeSystem) OR (nullFlavor)

MaleFemaleUndifferentiatedUnknown

Sex:

Person Demographics

•HL7 version 3 has an elaborate terminology model. •Based on HL7 (and ISO) data types


Example: UMCG

132


Example: UMCG

133


Example: UMCG

134


HL7 version 3

Summary



Recommendations

Never rely solely on XML schema At the least, use Schematron

MIF based code generation should be used for any non-trivial projects Tools like MDHT and Everest

Don’t rely on a generic v2->v3 mapping Use RIM based persistence

For use-cases which require its flexibility and ‘future-proofness’

01/01/2011136


Recommended reading (1/3)

http://www.ringholm.com/docs/03060_en_HL7_MIF.htm (Whitepaper/video about MIF)

http://www.ringholm.com/docs/03100_en.htm (The RIMBAA technology matrix) (v3 standard publication) // Foundation / Core Principles / Special topics on

Implementation and Representation (v3 standard publication) // Foundation / Model Interchange Format http://wiki.hl7.org/index.php?title=XML_ITS , http://wiki.hl7.org/index.php?

title=RIM_ITS, http://wiki.hl7.org/index.php?title=ITS http://en.wikipedia.org/wiki/Schematron (Wikipedia on Schematron) http://www.schematron.com/overview.html (Schematron overview) http://wiki.hl7.org/index.php?title=Migration_from_HL7_v2_to_HL7_v3 http://openmapsw.com/ (Open Mapping software toolkit) http://wiki.hl7.org/index.php?title=Software_Implementation_of_CDA (best

Practices document: implementation of CDA) http://wiki.hl7.org/index.php?title=MIF_based_code_generation (MIF based code

generation)

01/01/2011137


Recommended reading (2/3)

http://wiki.hl7.org/index.php?title=Schema_based_code_generation (Schema based code generation)

http://www.healthintersections.com.au/?p=769 (Blog: everything you didn’t want to know about GTS)

http://www.healthintersections.com.au/?p=707 (Blogpost: intervals [IVL_T] and boundary imprecision)

http://www.healthintersections.com.au/?p=705 (Blogpost: what content can ED contain?)

http://www.healthintersections.com.au/?p=592 (Blogpost: how do you put tablets into PQ.units ?)

http://www.healthintersections.com.au/?p=257 (Blogpost: NullFlavor) http://www.hl7.tv/Data_Types.html (Video/presentation: Datatypes R2 - what’s

changed?) (v3 standard publication) // Foundation / Core Principles / Types / Data Type

Flavors (v3 standard publication) // Foundation / Refinement Constraint and Localization /

Localization / Data Types Specialization Constraints

01/01/2011138


Recommended Reading (3/3)

http://wiki.hl7.org/index.php?title=RIM_Based_Persistence (work in progress, contains links to other pages)

http://en.wikipedia.org/wiki/Object-relational_mapping (ORM resource) http://sourceforge.net/search/?q=object+AND+relational+AND+mapping (ORM

resource) http://sharptoolbox.com/Category74089b0a-1105-4389-b1db-eedf27e20cfb.aspx (ORM

resource) http://wiki.hl7.org/index.php?title=ORM_best_practices

http://tl7.intelliware.ca/validateMessage.faces (TL7 message validator) http://www.openhealthtools.org/ http://www.cdatools.org (MDHT) http://everest.marc-hi.ca/ (MARC-HI Everest toolkit) http://hl7book.net/index.php?title=Eclipse_Instance_Editor (Instance Editor) http://support.phitechnology.it/wiki (PHI application development tools) See http://wiki.hl7.org/index.php?title=User_Interface_for_RIMBAA_Applications for

discussion and references.

01/01/2011139


Any Questions ?

Or: post your question/suggestions via•HL7 Wiki: http://bit.ly/d7tSsL •E-mail [email protected]•Twitter: @Ringholm

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