VMR%20Progress

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VMR Progress

• HL7 Baltimore October 2002

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Points from May HL7

• Need to distinguish Orders from Events
• Coping with Aggregate terms
• VMR as part of an API
• Alerts/triggers

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With subclasses
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R-MIM Changes Order vs. Event

• All Interventions now have three possible mood
  codes
• INT intent (for use in a plan)
• ORD order not yet happened
• EVN event record of it having happened

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Changes Aggregates

• Aggregate terms
• E.g. Blood Pressure
• Systolic
• Diastolic
• Observations can now be components of other
  observations.
• Uses an act_relationship, type_cd COMP
• OR we can do with Aggregate object
• Discuss

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Changes Plans

• Added
• Relationship to Interventions
• Relationship to Goals

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Changes Intervention

• Health Care intervention
• Base class of all actions in UML diagram
• Needed to specify services carried out for
  patients e.g. Annual Diabetic Review
• This was in UML diagrams, but omitted from R-MIM
  in May

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Changes Reasons

• Reason for encounter
• Reason for appointment
• Reason for referral
• -all of these are act_relationship to one of the
  choices

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API expression

• VMR describes
• classes used in an API
• Attributes of the classes
• Not the methods
• API needs
• Queries on real clinical system
• Writes/updates on clinical system
• Action requests to clinical system
• Registration for trigger notification
• Notification of events/triggers from clinical
  system

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DSS KB Has expressions using VMR terms
CDSS module
Queries
Writes/updates
Action requests
Trigger events
Trigger requests
API - uses VMR objects/attributes/terms
Terminology Mediation KB VMR ltgt host
Clinical system adaptor
Clinical System
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API parts

• Queries, writes, updates
• e.g. haemoglobin values in past month
• Return set of observations
• Can be done as XML messages from R-MIM use for
  loosely coupled systems
• Can be done in OO IDL - useful for close coupled
  systems

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IDL definition of API
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Host System Services

• Carrying out action requests
• create a new action on host system
• record it as side effect

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Host System Services Triggers