CIMI/IHTSDO DCM tooling ecosystem thoughts

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Arron Nicholson
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1 / DCM tooling ecosystem thoughts Thomas Beale openehr Foundation Stan Huff, MD Intermountain Healthcare

2 Introduction These slides describe a possible semantic health modelling environment for /, featuring: Next generation archetype / template tools Integrated terminology subset authoring Model management tool - AML-enabled UML tooling With underlying terminologies, including SNOMED CT and LOINC

3 Introduction They also describe the possible technical relationships between central artefacts and downstream environments. Getting to this or a similar tooling environment will require investment and commitment of multiple organisations. These slides try to provide a basis for thinking about the work tasks and scale.

4 Introduction The core formalism for and templates is the Archetype formalism. Specifications: Archetype Definition Language 2 Archetype Object Model 2 Artefact Identification

5 Introduction are based on the reference model Currently available here on Github

6 Tooling ecosystem (summary) Modelling Transformation Development / modelling environment Modellers Service SNOMED, LOINC etc extension Value sets ADL Work bench (AWB) Editors, Reviewers Clinical Modellers Workbench (CMW) AML Bridge (XMI) (future) -based XSDs FHIR proprietary UML/AML-tool based environment Other sites / users Other Concrete sites formatbased / users sites releases Import Export CEML CEMs IHC CEMs openehr / openehr /13606 Intermountain Legacy environment (current tools) openehr/13606 sites / vendors (current tools) CDA tpls / v3 msgs Other DCMs e.g. FHIM (VHA)

7 POTENTIAL PROJECT PHASES

8 Notes The following slides mention broad possible phases, each 3-6 months in duration Could be broken down differently / more finely Order is not significant here, i.e. some development can occur in parallel

9 Notes represents Clinical Knowledge Manager, a tool in use by openehr.org, and various e-health programmes: openehr Nehta (Australia) Norway MoH Brazil National Health Centre Slovenia MoH Scottish NHS and UK clinical groups It supports team-based online development and lifecycle management of, templates and terminology subsets

10 AWB++,, some exports / modelling environment Ref-set building Modellers Ref-set builder Basic bridge ADL Workbench (AWB) Service SNOMED, LOINC etc releases extension Value sets Querying, Subsets, etc Editors, Reviewers Review RM Manager Publication Import arche type CEM Governance Technical Transform Export XSDs, FHIR, other IHC CEML CEMs openehr / openehr /13606 Concrete formatbased sites Intermountain Legacy environment (current tools) openehr/13606 sites / vendors (current tools)

11 CMW core tool platform / modelling environment Modellers Ref-set building Ref-set builder A W B Archetype Editor CMW Clinical Modeller UI Template Editor Binding Query-builder ADL/AOM tool platform CTS2 Editors, Reviewers Service SNOMED, LOINC etc releases extension Value sets Querying, Subsets, etc Review other RM Manager Publication Import arche type CEM Governance Technical Transform Export XSDs FHIR proprietary CEML CEMs IHC CEMs openehr / openehr /13606 Other sites / users Other Concrete sites formatbased / users sites Intermountain Legacy environment (current tools) openehr/13606 sites / vendors (current tools) CDA tpls / v3 msgs Other DCMs e.g. FHIM (VHA)

12 CMW Clinical Modeller UI & ref-set builder / modelling environment Modellers tools Integration? A W B Archetype Editor CMW Clinical Modeller UI Template Editor Binding Query-builder ADL/AOM tool platform CTS2 Editors, Reviewers Service SNOMED, LOINC etc releases extension Value sets Querying, Subsets, etc Review other RM Manager Publication Import arche type CEM Governance Technical Transform Export XSDs FHIR proprietary CEML CEMs IHC CEMs openehr / openehr /13606 Other sites / users Other Concrete sites formatbased / users sites Intermountain Legacy environment (current tools) openehr/13606 sites / vendors (current tools) CDA tpls / V3 msgs Other DCMs e.g. FHIM (VHA)

13 Notes AML = Archetype Modelling Language, a new OMG RfP which will become a standard in ~18 months. AML is a UML profile based on the openehr Archetype Object Model (AOM 2) specification. Note that it is reference model independent and has no technical relationship or specificity to any openehr information model. AML, implemented in a UML tool will enable archetype modelling i.e. it will bring archetype modelling to the IT mainstream

14 AML bridge / modelling environment Modellers tools Integration? A W B Archetype Editor CMW Clinical Modeller UI Template Editor Binding Query-builder ADL/AOM tool platform AML Bridge (XMI) UML/AML-tool based environment AML-enabled UML tool Generation tools S/W devs Software components CTS2 Editors, Reviewers Service SNOMED, LOINC etc releases extension Value sets Querying, Subsets, etc Review other RM Manager Publication Import arche type CEM Governance Technical Transform Export XSDs FHIR proprietary CEML CEMs IHC CEMs openehr / openehr /13606 Other sites / users Other Concrete sites formatbased / users sites Intermountain Legacy environment (current tools) openehr/13606 sites / vendors (current tools) CDA tpls / V3 msgs Other DCMs e.g. FHIM (VHA)

15 REPRESENTATIVE DOWNSTREAM ENVIRONMENTS

16 Notes Here we try to show some details of how, templates and subsets could be used by downstream environments, each of which have their own reference model(s), and potentially content modelling formalisms.

17 Intermountain Legacy environment / modelling environment CTS2 Service SNOMED, LOINC etc releases extension Value sets A W B other arche type CMW CEM Local customisation CEML CEMs Intermountain legacy environment Dev t artefacts cetype Technical Transforms XSD???? S/W devs Development tools Deploy Model-based system app HIS app FHIR WS

18 Archetype-based sites / vendors / modelling environment CTS2 Service SNOMED, LOINC etc releases extension Value sets A W B other arche type CMW CEM openehr/13606 product / project environment Local & templating Specialised & templates openehr community Review openehr / openehr.org Dev t artefacts API FHIR Technical Transforms XSD UI Runtime OPTS Norway Nehta Moscow S/W devs Development tools Deploy Model-based system app app openehr EHR/HIS Brasil Slovenia FHIR & IHE WS

19 Other environment e.g. FHIM/MDHT/CDA / modelling environment A W B CMW CTS2 Service SNOMED, LOINC etc extension Value sets CDA template MDHT/FHIM/CDA S/W devs MDHT Dev tools Deploy releases other arche type CEM app app HIS app

20 Other environment HL7v3 messages / modelling environment A W B CMW CTS2 Service SNOMED, LOINC etc extension Value sets HL7 v3 RMIM MDHT/FHIM/CDA S/W devs Model ler Dev tools Deploy releases other arche type CEM app app HIS app

21 FHIR environment / modelling environment A W B CMW CTS2 FHIR artefact dev environment Service SNOMED, LOINC etc extension Value sets FHIR FHIR profiles S/W devs Dev tools Deploy releases FHIR WS HIS

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