Derivation of the HL7 RIM Ontology

1
Derivation of the HL7 RIM Ontology

• A Top-Down Methodology

2
Concept - a thing in the minds eye
Hmmm - Frank needs an ace of hearts
3
The Concept Challenge

• marine animal
• eats smaller things
• nice to eat

Concept (1)
Concept
Thing (1) Cant put the thing on this slide
since the instance exists only in physical
space
Symbols (Many)
Thing
Frank the Shark (in English)
Adapted from Charlie Mead the Semantic Triangle
4
Predicate Logic in RDF, RIM, and SNOMED
RDF
Subject
Predicate
Object
RIM
Observ-ation
has Participation Subject
Patient
SNOMED
Fracture of Femur
has Finding Site
Structure of Neck of Femur
5
SNOMED in the HL7 RIM
6
Propositions Assertions

• Propositions in RDF triples
• Subject Predicate Object
• Propositions may be true or false
• Assertions are believed by the author to be true

Subject
Predicate
Object
Observ-ation
has Participation Subject
Patient
HL7 RIM
Fracture of Femur
has Finding Site
Structure of Neck of Femur
has Associated Morphology
Compression Fracture
SNOMED
7
Ontologies Mass Energy
Proposition emc2
8
Mass and Energy (emc2)
Energy
9
Analogy Mass to Entity/Energy to Act
Entity
id SETltIIgt
classCode CS
determinerCode CS
importanceStatusText ED
0
qty SETltPQgt
telecom SETltTELgt
description ED
statusCode CS
code CE
nm SETltENgt
riskCode CE
Act
id SETltIIgt
moodCode CS
classCode CS
txt ED
statusCode CS
activityTime GTS
effectiveTime GTS
confidentialityCode SETltCVgt
repeatNumber IVLltINTgt
0
interruptible_ind BL
priorityCode SETltCVgt
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
10
Ontologies Materials Labor
11
PropositionCost Materials Labor
Entity
id SETltIIgt
classCode CS
determinerCode CS
importanceStatusText ED
0
qty SETltPQgt
telecom SETltTELgt
description ED
statusCode CS
code CE
nm SETltENgt
riskCode CE
Act
id SETltIIgt
moodCode CS
classCode CS
txt ED
statusCode CS
activityTime GTS
effectiveTime GTS
confidentialityCode SETltCVgt
repeatNumber IVLltINTgt
0
interruptible_ind BL
priorityCode SETltCVgt
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
12
Association Class
Entity
id SETltIIgt
classCode CS
determinerCode CS
importanceStatusText ED
0
qty SETltPQgt
telecom SETltTELgt
description ED
statusCode CS
code CE
nm SETltENgt
riskCode CE
Act
id SETltIIgt
moodCode CS
classCode CS
txt ED
statusCode CS
activityTime GTS
effectiveTime GTS
confidentialityCode SETltCVgt
repeatNumber IVLltINTgt
0
Associations Class
interruptible_ind BL
priorityCode SETltCVgt
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
13
RIM - Backbone

• Entity
• People, Places, Physical Things
• Associations
• Roles Relationships
• Act
• Collections of Events

14
AssociativeClasses
Entity
Role
id SETltIIgt
classCode CS
classCode CS
playedRole
player
effectiveTime IVLltTSgt
determinerCode CS
1
0..
id SETltIIgt
importanceStatusText ED
statusCode CS
qty SETltPQgt
positionNumber LISTltINTgt
telecom SETltTELgt
qty PQ
description ED
certificateText ED
statusCode CS
addr SETltADgt
scopedRole
scoper
code CE
0..1
telecom SETltTELgt
0..
nm SETltENgt
code CE
riskCode CE
1
0..
Act
id SETltIIgt
Participation
moodCode CS
typeCode CS
classCode CS
tmr IVLltTSgt
txt ED
note_text ED
statusCode CS
signatureCode CV
activityTime GTS
functionCode CD
effectiveTime GTS
awarenessCode CV
confidentialityCode SETltCVgt
1
0..
0..
signatureText ED
repeatNumber IVLltINTgt
encounter_accommodationCode CV
interruptible_ind BL
statusCode CS
priorityCode SETltCVgt
modeCode CV
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
15
Review of UML Terms
Entity
Classes
id SETltIIgt
classCode CS
determinerCode CS
importanceStatusText ED
0
Attribute value pair
qty SETltPQgt
telecom SETltTELgt
description ED
statusCode CS
code CE
nm SETltENgt
Datatype
riskCode CE
Act
id SETltIIgt
moodCode CS
classCode CS
txt ED
hierarchy or IsA association symbol
statusCode CS
Simple or hasA association symbol
activityTime GTS
effectiveTime GTS
confidentialityCode SETltCVgt
repeatNumber IVLltINTgt
0
interruptible_ind BL
priorityCode SETltCVgt
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
cardinality or multiplicity symbol
16
RecursiveAssociativeClasses
Entity
Role
id SETltIIgt
classCode CS
classCode CS
playedRole
player
effectiveTime IVLltTSgt
determinerCode CS
1
0..
id SETltIIgt
importanceStatusText ED
statusCode CS
qty SETltPQgt
positionNumber LISTltINTgt
telecom SETltTELgt
qty PQ
description ED
certificateText ED
statusCode CS
addr SETltADgt
scopedRole
scoper
code CE
0..1
telecom SETltTELgt
0..
nm SETltENgt
code CE
riskCode CE
1
0..
Act
ActRelationship
outboundLink
is_source_for
id SETltIIgt
typeCode CS
Participation
moodCode CS
inversion_ind BL
0..
1
typeCode CS
classCode CS
sequenceNumber INT
tmr IVLltTSgt
txt ED
priorityNumber INT
note_text ED
statusCode CS
pauseQty PQ
has_target
target
signatureCode CV
activityTime GTS
checkpointCode CS
functionCode CD
effectiveTime GTS
splitCode CS
1
0..
awarenessCode CV
confidentialityCode SETltCVgt
joinCode CS
1
0..
0..
signatureText ED
repeatNumber IVLltINTgt
negation_ind BL
encounter_accommodationCode CV
interruptible_ind BL
conjunctionCode CS
statusCode CS
priorityCode SETltCVgt
modeCode CV
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
17
Act-Relationship Recursion
Entity
Role
id SETltIIgt
classCode CS
classCode CS
playedRole
player
effectiveTime IVLltTSgt
determinerCode CS
1
0..
id SETltIIgt
importanceStatusText ED
statusCode CS
qty SETltPQgt
positionNumber LISTltINTgt
telecom SETltTELgt
qty PQ
description ED
certificateText ED
statusCode CS
addr SETltADgt
scopedRole
scoper
code CE
0..1
telecom SETltTELgt
0..
nm SETltENgt
code CE
riskCode CE
1
0..
Act
id SETltIIgt
Participation
moodCode CS
typeCode CS
classCode CS
tmr IVLltTSgt
txt ED
note_text ED
statusCode CS
signatureCode CV
activityTime GTS
functionCode CD
effectiveTime GTS
awarenessCode CV
confidentialityCode SETltCVgt
1
0..
0..
signatureText ED
repeatNumber IVLltINTgt
encounter_accommodationCode CV
interruptible_ind BL
statusCode CS
priorityCode SETltCVgt
modeCode CV
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
18
ActRelationship RecursionsClasses, Instances of
Classes, Instance Diagrams
Act
ActRelationship
Act
outboundLink
is_source_for
id SETltIIgt
typeCode
has_target
target
moodCode Event
has component
id SETltIIgt
code Chem 4
moodCode Event
code Glucose
ActRelationship
Act
outboundLink
is_source_for
typeCode
has_target
target
id SETltIIgt
has component
moodCode Event
code Total Cholesterol
ActRelationship
Act
outboundLink
is_source_for
typeCode
has_target
target
id SETltIIgt
has component
moodCode Event
code Sodium
ActRelationship
Act
outboundLink
is_source_for
typeCode
has_target
target
id SETltIIgt
has component
moodCode Event
code Potassium
19
InfiniteNesting
Entity
Role
id SETltIIgt
classCode CS
classCode CS
playedRole
player
effectiveTime IVLltTSgt
determinerCode CS
1
0..
id SETltIIgt
importanceStatusText ED
statusCode CS
qty SETltPQgt
positionNumber LISTltINTgt
telecom SETltTELgt
qty PQ
description ED
certificateText ED
statusCode CS
addr SETltADgt
scopedRole
scoper
code CE
0..1
telecom SETltTELgt
0..
nm SETltENgt
code CE
riskCode CE
1
0..
Act
ActRelationship
outboundLink
is_source_for
id SETltIIgt
typeCode CS
Participation
moodCode CS
inversion_ind BL
0..
1
typeCode CS
classCode CS
sequenceNumber INT
tmr IVLltTSgt
txt ED
priorityNumber INT
note_text ED
statusCode CS
pauseQty PQ
has_target
target
signatureCode CV
activityTime GTS
checkpointCode CS
functionCode CD
effectiveTime GTS
splitCode CS
1
0..
awarenessCode CV
confidentialityCode SETltCVgt
joinCode CS
1
0..
0..
signatureText ED
repeatNumber IVLltINTgt
negation_ind BL
encounter_accommodationCode CV
interruptible_ind BL
conjunctionCode CS
statusCode CS
priorityCode SETltCVgt
modeCode CV
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
20
HL7 RIM Act Hierarchy
0..
1
1
PatientEncounter
acuityLevelCode CE
admissionSourceCode CE
birthEncounterInd BL
WorkingList
dischargeDispositionCode CE
ownershipLevelCode CE
lengthOfStayQuantity PQ
preAdmitTestInd BL
referralSourceCode CE
specialAccommodationCode SETltCEgt
SubstanceAdministration
specialCourtesiesCode SETltCEgt
routeCode CE
urgencyCode CE
approachSiteCode SETltCDgt
doseQuantity IVLltPQgt
rateQuantity IVLltPQgt
doseCheckQuantity SETltRTOgt
ControlAct
maxDoseQuantity SETltRTOgt
structureTypeId II
potencyQuantity PQ
responseCode CS
substitutionCode CE
DeviceTask
Procedure
parameterValue LISTltANYgt
methodCode SETltCEgt
Supply
FinancialAct
approachSiteCode SETltCDgt
quantity PQ
netAmt MO
targetSiteCode SETltCDgt
expectedUseTime IVLltTSgt
FinancialContract
paymentTermsCode CE
Observation
value ANY
interpretationCode SETltCEgt
methodCode SETltCEgt
targetSiteCode SETltCDgt
derivationExpr ST
FinancialTransaction
InvoiceElement
Account
creditExchangeRateQuantity REAL
modifierCode SETltCEgt
name ST
debitExchangeRateQuantity REAL
unitQuantity RTOltPQ,PQgt
currencyCode CE
interestRateQuantity RTO
unitPriceAmt RTOltMO,PQgt
interestRateQuantity RTOltMO,PQgt
factorNumber REAL
allowedBalanceQuantity IVLltMOgt
DiagnosticImage
PublicHealthCase
pointsNumber REAL
detectionMethodCode CE
subjectOrientationCode CE
coverageSourceCode CE
transmissionModeCode CE
notifySubjectInd BL
diseaseImportedCode CE
21
Bottom-Up Modeling Artifacts
Entity
Classes
id SETltIIgt
classCode CS
determinerCode CS
importanceStatusText ED
0
Attribute value pair
qty SETltPQgt
telecom SETltTELgt
description ED
statusCode CS
code CE
nm SETltENgt
Datatype
riskCode CE
Act
id SETltIIgt
moodCode CS
classCode CS
txt ED
hierarchy or IsA association symbol
statusCode CS
Simple or hasA association symbol
activityTime GTS
effectiveTime GTS
confidentialityCode SETltCVgt
repeatNumber IVLltINTgt
0
interruptible_ind BL
priorityCode SETltCVgt
independent_ind BL
availability_dttm GTS
code CD
transfer_reasonCode CV
cardinality or multiplicity symbol
22
The Meaning of Hierarchy
0..
1
1
PatientEncounter
acuityLevelCode CE
admissionSourceCode CE
birthEncounterInd BL
WorkingList
dischargeDispositionCode CE
ownershipLevelCode CE
lengthOfStayQuantity PQ
preAdmitTestInd BL
referralSourceCode CE
specialAccommodationCode SETltCEgt
SubstanceAdministration
specialCourtesiesCode SETltCEgt
routeCode CE
urgencyCode CE
approachSiteCode SETltCDgt
doseQuantity IVLltPQgt
rateQuantity IVLltPQgt
doseCheckQuantity SETltRTOgt
ControlAct
maxDoseQuantity SETltRTOgt
structureTypeId II
potencyQuantity PQ
responseCode CS
substitutionCode CE
DeviceTask
Procedure
parameterValue LISTltANYgt
methodCode SETltCEgt
Supply
FinancialAct
approachSiteCode SETltCDgt
quantity PQ
netAmt MO
targetSiteCode SETltCDgt
expectedUseTime IVLltTSgt
FinancialContract
paymentTermsCode CE
Observation
value ANY
interpretationCode SETltCEgt
methodCode SETltCEgt
targetSiteCode SETltCDgt
derivationExpr ST
FinancialTransaction
InvoiceElement
Account
creditExchangeRateQuantity REAL
modifierCode SETltCEgt
name ST
debitExchangeRateQuantity REAL
unitQuantity RTOltPQ,PQgt
currencyCode CE
interestRateQuantity RTO
unitPriceAmt RTOltMO,PQgt
interestRateQuantity RTOltMO,PQgt
factorNumber REAL
allowedBalanceQuantity IVLltMOgt
DiagnosticImage
PublicHealthCase
pointsNumber REAL
detectionMethodCode CE
subjectOrientationCode CE
coverageSourceCode CE
transmissionModeCode CE
notifySubjectInd BL
diseaseImportedCode CE
23
Act-Supply-Diet Hierarchy
0..
1
1
Supply
quantity PQ
expectedUseTime IVLltTSgt
24
Diet Act Combines Attributes in Hierarchy
0..
1
1
Diet Act
id SETltIIgt
moodCode CS
classCode CS
code CD
text ED
statusCode CS
confidentialityCode SETltCEgt
1
1
effectiveTime GTS
activityTime GTS
interruptibleInd BL
availabilityTime TS
contextLockInd BL
independentInd BL
interruptibleInd BL
negationInd BL
priorityCode SETltCEgt
repeatNumber IVLltINTgt
reasonCode SETltCEgt
substitutionConditionCode CE
From Supply
levelCode CE
From Diet
uncertaintyCode CE
quantity PQ
expectedUseTime IVLltTSgt
energyQuantity PQ
carbohydrateQuantity PQ
25
The Meaning of Hierarchy
0..
1
1
PatientEncounter
acuityLevelCode CE
admissionSourceCode CE
birthEncounterInd BL
WorkingList
dischargeDispositionCode CE
ownershipLevelCode CE
lengthOfStayQuantity PQ
preAdmitTestInd BL
referralSourceCode CE
specialAccommodationCode SETltCEgt
SubstanceAdministration
specialCourtesiesCode SETltCEgt
routeCode CE
urgencyCode CE
approachSiteCode SETltCDgt
doseQuantity IVLltPQgt
rateQuantity IVLltPQgt
doseCheckQuantity SETltRTOgt
ControlAct
maxDoseQuantity SETltRTOgt
structureTypeId II
potencyQuantity PQ
responseCode CS
substitutionCode CE
DeviceTask
Procedure
parameterValue LISTltANYgt
methodCode SETltCEgt
Supply
FinancialAct
approachSiteCode SETltCDgt
quantity PQ
netAmt MO
targetSiteCode SETltCDgt
expectedUseTime IVLltTSgt
FinancialContract
paymentTermsCode CE
Observation
value ANY
interpretationCode SETltCEgt
methodCode SETltCEgt
targetSiteCode SETltCDgt
derivationExpr ST
FinancialTransaction
InvoiceElement
Account
creditExchangeRateQuantity REAL
modifierCode SETltCEgt
name ST
debitExchangeRateQuantity REAL
unitQuantity RTOltPQ,PQgt
currencyCode CE
interestRateQuantity RTO
unitPriceAmt RTOltMO,PQgt
interestRateQuantity RTOltMO,PQgt
factorNumber REAL
allowedBalanceQuantity IVLltMOgt
DiagnosticImage
PublicHealthCase
pointsNumber REAL
detectionMethodCode CE
subjectOrientationCode CE
coverageSourceCode CE
transmissionModeCode CE
notifySubjectInd BL
diseaseImportedCode CE
26
Observation Act Act Attributes Observation
Attributes
0..
1
1
Observation Act
id SETltIIgt
moodCode CS
classCode CS
code CD
text ED
statusCode CS
confidentialityCode SETltCEgt
1
1
effectiveTime GTS
activityTime GTS
interruptibleInd BL
availabilityTime TS
contextLockInd BL
independentInd BL
interruptibleInd BL
negationInd BL
priorityCode SETltCEgt
repeatNumber IVLltINTgt
reasonCode SETltCEgt
substitutionConditionCode CE
levelCode CE
uncertaintyCode CE
value ANY
From Observation
interpretationCode SETltCEgt
methodCode SETltCEgt
targetSiteCode SETltCDgt
derivationExpr ST
27
Observation.code / Observation.valueWhat is the
Question? / What is the Answer?
0..
1
1
Observation Act
id SETltIIgt
moodCode CS
classCode CS
White Blood Count CTP code xyz 10,000
Established Diagnosis SNOMED code 14657009
Malig Tumor of Breast SNOMED code 254837009
code CD
text ED
statusCode CS
confidentialityCode SETltCEgt
1
1
effectiveTime GTS
activityTime GTS
interruptibleInd BL
availabilityTime TS
contextLockInd BL
independentInd BL
interruptibleInd BL
negationInd BL
priorityCode SETltCEgt
repeatNumber IVLltINTgt
reasonCode SETltCEgt
substitutionConditionCode CE
levelCode CE
uncertaintyCode CE
value ANY
From Observation
interpretationCode SETltCEgt
methodCode SETltCEgt
targetSiteCode SETltCDgt
derivationExpr ST
28
Sample Glossary
29
What is an Information Model?

• Describes Relationships Between Concepts (in UML)
• Class concepts
• Attribute concepts
• Association concepts
• Data-type concepts
• Provides Data-type Links to Vocabulary Concepts
• SNOMED
• LOINC
• ICNP
• ..
• Not a Data Model!
• Not concerned with application performance in a
  relational database
• Not concerned with ease of application
  programming
• Is concerned with communicating knowledge of
  domain

30
What is an Information Model?

• Describes Relationships Between Concepts (in UML)
• Class concepts
• Attribute concepts
• Association concepts
• Data-type concepts
• Provides Data-type Links to Vocabulary Concepts
• SNOMED
• LOINC
• ICNP
• ..

Action
timing
-onBehalfOf
31
Building an Information Model--an iterative
process

• Identify Basic Concepts
• Define Basic Concepts in Glossary
• Identify Relationships Between Concepts
• Attributes
• Multiplicities
• Associations
• Abstract Basic Concepts into Hierarchies
• Identify attributes that can be shared
• Define Abstract Concepts in Glossary

32
Identify Basic Concepts

• Objects
• Patient
• Strategies
• Breast cancer
• Nausea
• Vomiting
• Intervention
• Video

• Subjects (actors)
• Patient
• Nurse
• Physician
• Patient care aide

• Verbs
• Asked
• Reviewed
• Decided
• Printed
• Moved
• Documented
• Spoke
• Verbalized
• Assess

33
Identify Abstract Concepts
Subjects Persons
Verbs Actions
Objects ?
Subjects Doers

• Objects
• Patient
• Strategies
• Breast cancer
• Nausea
• Vomiting
• Intervention
• Video

• Subjects (actors)
• Patient
• Nurse
• Physician
• Patient care aide

• Verbs
• Asked
• Reviewed
• Decided
• Printed
• Moved
• Documented
• Spoke
• Verbalized
• Assess

34
Define Abstract Concepts in Glossary

• Doer is someone who performs an action
• Action is a word that describes what a doer is
  doing to the object
• Object is a direct object or an indirect object
  of a sentence
• A direct object of a sentence is the thing being
  done to
• An indirect object of a sentence is the .

35
Data-Types
Action
timing

• What kinds of values can an attribute have?
• Timing (date-timestamps frequency text etc)
• Code (alphanumeric text strings from code field
  of published vocabulary)
• Vocabulary (string with official identifier for
  published vocabulary)
• Vtext (string with English text corresponding to
  code in published vocabulary)
• Stext (string with exact text from storyboard)

36
Identify Relationships Between Concepts
Object of Action
Doer
-actsOn
-name
-role
Action
timing
37
Identify Relationships Between Concepts
Object of Action
Doer
-actsOn
-name
-role
Action
timing
-onBehalfOf
38
Storyboard Information Model Instance Diagrams

• Test the combination of Information Model and
  vocabularies against the storyboard
• Use the Storyboard Glossary to provide the
  vocabulary for the instance diagrams

39
Nursing Domain Information Model
Object of Action
Provider Role
-code
-actsOn
-name
-vocabulary
Finding includes the
-vtext
-role
concepts of Goal and
-stext
Recipient of Care
-code
Outcome depending
Action
-hasRecipientOfCare
-vocabulary
-name
on relationship timing
timing
-vtext
-role
and other actions
-code
-code
-vocabulary
-vocabulary
-hasSupply
-vtext

-vtext
-stext
-hasSite
-has Means
Focus
OtherObjects
Finding
-hasRoute
-hasFocus
-timing
-Result
-focusType
Site
Route
Means
Supply
-code
-code
-code
-code
-vocabulary
-vocabulary
-vocabulary
-vocabulary
-has Judgement
-vtext
-vtext
-vtext
-vtext
Judgement
-stext
-stext
-stext
-stext
-degree
Diagnosis
-potentiality
-hasSite
-acuity
-timing
Subject of information
focusType Value Set
Subject is coded for
-code
individual, family,
-vocabulary

• Patient Functioning
• Environment

or other physical entity
-vtext
-hasSubjec tOfInformation
-stext

• ICF and other similar
• concepts in other
• vocabularies

40
Example Instance DiagramSusan , an RN , reviews
Christine's chart
Object of Action
Provider Role
-code
Susan
-actsOn
ICNP
-name
-vocabulary
Finding includes the
RN
Record chart
-vtext
-role
concepts of Goal and
224535009
chart
-stext
Recipient of Care
-code
Outcome depending
Action
S
-hasRecipientOfCare
-vocabulary
Christine
-name
on relationship timing
Registered Nurse
timing
-vtext
Patient
-role
and other actions
55210009
-code
2B.2.1.1.1.1.1.1.22
-code
S
-vocabulary
ICNP
-vocabulary
-hasSupply
Review of
-vtext

-vtext
Reviews
-stext
-hasSite
-has Means
Focus
OtherObjects
Finding
-hasRoute
-hasFocus
-timing
-Result
-focusType
Site
Route
Means
Supply
-code
-code
-code
-code
-vocabulary
-vocabulary
-vocabulary
-vocabulary
-has Judgement
-vtext
-vtext
-vtext
-vtext
Judgement
-stext
-stext
-stext
-stext
-degree
Diagnosis
-potentiality
-hasSite
-acuity
-timing
Subject of information
focusType Value Set
Subject is coded for
-code
individual, family,
-vocabulary

• Patient Functioning
• Environment

or other physical entity
-vtext
-hasSubjec tOfInformation
-stext

• ICF and other similar
• concepts in other
• vocabularies

41
Mapping from Nursing to HL7
42
Example Instance DiagramSusan , an RN , reviews
Christine's chart
Object of Action
Provider Role
-code
Susan
-actsOn
ICNP
-name
-vocabulary
Finding includes the
RN
Record chart
-vtext
-role
concepts of Goal and
224535009
chart
-stext
Recipient of Care
-code
Outcome depending
Action
S
-hasRecipientOfCare
-vocabulary
Christine
-name
on relationship timing
Registered Nurse
timing
-vtext
Patient
-role
and other actions
55210009
-code
2B.2.1.1.1.1.1.1.22
-code
S
-vocabulary
ICNP
-vocabulary
-hasSupply
Review of
-vtext

-vtext
Reviews
-stext
-hasSite
-has Means
Focus
OtherObjects
Finding
-hasRoute
-hasFocus
-timing
-Result
-focusType
Site
Route
Means
Supply
-code
-code
-code
-code
-vocabulary
-vocabulary
-vocabulary
-vocabulary
-has Judgement
-vtext
-vtext
-vtext
-vtext
Judgement
-stext
-stext
-stext
-stext
-degree
Diagnosis
-potentiality
-hasSite
-acuity
-timing
Subject of information
focusType Value Set
Subject is coded for
-code
individual, family,
-vocabulary

• Patient Functioning
• Environment

or other physical entity
-vtext
-hasSubjec tOfInformation
-stext

• ICF and other similar
• concepts in other
• vocabularies

43
Mappingto theRIM
Entity
RoleLink
Role
id SETltIIgt
outboundLink
source
classCode CS
effectiveTime IVLltTSgt
classCode CS
1
0..
1
playedRole
player
typeCode CS
effectiveTime IVLltTSgt
determinerCode CS
1
0..
inboundLink
target
id SETltIIgt
importanceStatusText ED
1
0..
1
statusCode CS
qty SETltPQgt
positionNumber LISTltINTgt
telecom SETltTELgt
qty PQ
description ED
certificateText ED
statusCode CS
addr SETltADgt
scopedRole
scoper
code CE
Registered Nurse
Susan
0..1
telecom SETltTELgt
0..
nm SETltENgt
RN
224535009
S
code CE
riskCode CE
1
2B.2.1.1.1.1.1.1.22
Patient
ICNP
Christine
0..
Act
ActRelationship
outboundLink
is_source_for
id SETltIIgt
typeCode CS
Participation
moodCode CS
inversion_ind BL
0..
1
typeCode CS
classCode CS
sequenceNumber INT
Reviewed Chart
tmr IVLltTSgt
txt ED
priorityNumber INT
note_text ED
statusCode CS
pauseQty PQ
has_target
target
signatureCode CV
activityTime GTS
checkpointCode CS
functionCode CD
effectiveTime GTS
splitCode CS
1
0..
awarenessCode CV
confidentialityCode SETltCVgt
joinCode CS
1
0..
0..
signatureText ED
repeatNumber IVLltINTgt
negation_ind BL
encounter_accommodationCode CV
interruptible_ind BL
conjunctionCode CS
statusCode CS
priorityCode SETltCVgt
modeCode CV
independent_ind BL
availability_dttm GTS
312853008 Medical Record Review S
code CD
transfer_reasonCode CV
--adapted from RIM V1.18