a rim based model for clinical decision support andrew mcintyre medical-objects
Post on 05-Jan-2016
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A RIM based model for clinical decision support
Andrew McIntyreMedical-Objects
vMR – RIM based ModelsUses ISO 21090 Data types
Need to add methods to classes for GELLOUses GELLO (extended OCL) base types (iso21090
uses ocl)Aiming for low hanging fruit eg:
Problem List (Past History)Procedures (Surgical History)Family HistoryAllergiesCurrent MedicationMedication HistoryLab ObservationsSocial History (Alcohol/Tobacco)
vMR – Base ModelCCD being used as source model
Transformable to and from CCRDocumentedSpecified in US realmPotential to develop v2 version (Australia)
IssuesFamily History Model not as rich as desired
Allow extensions for Genomics data items (optional)Currently using v1 datatypes
As is “Virtual” medical record can be mapped
vMR - UsesDesigned for Decision Support
Little interest in display dataDemands terminology for safe usage
SNOMED-CT/ICD-9/ICD-10
Several Use casesLocal decision supportDecision support servicesQuality assessmentsGello uses it as its Model
vMR - Example GELLO usage
vMR – GELLO Examples
vMR – UML Overview
vMR – Why use “Simplified Model”GELLO usability
Navigating to eg: patient would take complex statementIdentifying specific clinical data easilyGELLO should be written by clinical peopleSimplify GELLO
Interfacing with “Legacy” systemsAllow CDS to occur with legacy data
Avoid overly complex transformations – “sweet spot hard to find”
Allow Clinicians to understand ModelMany attributes of RIM are not needed for a snapshot
view
vMR – Simplication ExamplesDirect ACT<->Patient Link
vs Person playing role of patientAlso link Provider/OrganisationCCD has single patient
Excludes use on conjoined twins!Current Medications Medication HistoryCCD ACT relationships exposed as typed PropertiesFamily History exposed as object model with direct
links to sub-observationsCCD could be reconstructed from vMR (except for
text)
vMR – Data sources GELLO v1 described a simple vMR as example
Implemented against HL7 v2 data as trial In real use in
GLIF ISO 13606-2 Archetypes Calculated results in editors
RIMBA relationshipRIMBA is ultimate vMR
Only likely to need thin Facade to complyDatatypes alignYour experience and input is welcome
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