Transcript documentcenter/public/wg/inm/V3_9809

Version 3:
Is it Real, or is it Memorex?
Wes Rishel
Vice-chair, Technical Steering Committee
[email protected]
www.Rishel.com
Version 3 Message Definition Process
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
4
Use Case Model
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
5
Information Models
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
7
Interaction Model
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
12
Message Object Diagram
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
15
Hierarchical Message Description
Reference
Information Model
Domain
Information
Model
Use Case Model
Interaction
Model
Message
Information
Model
Message
Object
Diagram
Common
Message
Element
Definition
Hierarchical
Message
Description
9/14/98
©1998 by HL7 & Wes Rishel
30
HMD Has Three Parts
Information
Model
Mapping
Person Object
Name attrib
Message
Elements
PSN Segment
Name data field
Message
Structures
Message
Format 1
Yes
Yes
Message
Format 2
No
--
Object from Message Object Diagram
9/14/98
©1998 by HL7 & Wes Rishel
31
Rows in HMD Match Fields in Message
ENC|A|TE|ENC703421||2|19970301|I|1998011110815|A
BC|IPChoice|I
IPE||4
PADM|1998011110815|{3^OBSERVATION^99ARE}|{1^PHYS REFERRAL^99ARF}|ED|I|N|N
EC
PTP|||||Y|U|19670329|Dallas,TX||HS|M|D|{Jones^Sam^Houston}|W|BAPT||X454337
PCP|{Anderson^Sara^^Dr^MD}|[{WPN^^206^2721234}^{ASN^^206^5551212}]|15892
BL|AccountList
PTBA|X1256243|U^UNBILLED^99BAS|P|A27
PTBA|X1256997|U^UNBILLED^99BAS|C|F13
EL|AccountList
BL|EncPractList
BG|EncPrac
ENP|ATT
HCP|{Winters^Hubert^S^Dr^MD}|[{WPN^^206^3914871}^{HPN^^206^5551234]|77032
EG|EncPrac
BG|EncPrac
ENP|CONS
HCP|{Scully^Dana^^Dr^MD}|[{WPN^^206^3934871}^{HPN^^206^5556667}]|25122
EG|EncPrac
EL|EncPractList
Not so fast !
What about XML?
9/14/98
©1998 by HL7 & Wes Rishel
33
Conformance Claim
list of HL7written
statements...
Offered by a
Sponsor...
...Relied on
by a User
...Describes the sponsor’s
Information System
...Leads to an agreement
9/14/98
©1998 by HL7 & Wes Rishel
35
Trigger Events, Interactions, App Roles
Applic.
Role
Trigger
Event
InterAction
Pharmacy_
order_
Creator
Pharmacy_
order_
Manager
Pharmacy_
order_
Tracker
Med_order
_admin_
Manager
Med_order
_admin_
Historian
Create Unencoded Pharmacy Order
Create Unencoded Pharmacy Order
Provide Filler ID
Create Unencoded Pharmacy OrderX
Convert Unencoded Pharmacy
Order to Fully Encoded Order
Convert Unencoded Pharmacy Order
to Fully Encoded OrderX
Create Med Administration Order
Create Med Administration Order
Create Med Administration OrderX
Report Administered Medications
Report Administered Medications
Report Administered MedicationsY
9/14/98
©1998 by HL7 & Wes Rishel
36
Certification
• HL7 “Seal of Approval”
• Certification = Testing
• What do we certify?
– That a system passed a test …
– … that individually tested one or
more conformance claims.
• In other words … there is no logo
that says “100% HL7 Compliant”
9/14/98
©1998 by HL7 & Wes Rishel
37
The Change Paradox
It is change, continuing change, inevitable
change, that is the dominant factor in society
today. No sensible decision can be made any
longer without taking into account not only the
world as it is, but the world as it will be. . . .
Isaac Asimov (1920–92)
Most of us are about as eager to be changed as we
were to be born, and go through our changes in a
similar state of shock.
James Baldwin (1924–87)
9/14/98
©1998 by HL7 & Wes Rishel
38
The Gain (V3 Benefits)
• Interfaces installed much more quickly
– reduce sight-specific negotiations
– greatly reduce custom programming
– asymptote is “plug and play”
• Conformance claims; support for
conformance testing
• Functional adaptation to the changing
healthcare system
9/14/98
©1998 by HL7 & Wes Rishel
39
Other Benefits
• Improved clarity and correctness of
specification
• Appropriate to newer
communications paradigms
9/14/98
©1998 by HL7 & Wes Rishel
40
The Pain?
• Changes to the interface software
– subtle, but substantial
– segment groups
– subsubsubcomponents
– recursive types
• Functional changes to systems
– more precise specifications
– requirement to use data that is received
• Retraining
9/14/98
©1998 by HL7 & Wes Rishel
41
Is the Pain worth the Gain?
• Transition costs
– retooling of character-stream based
interface software
– or, adaptation of object-based approaches,
with corresponding benefits
– Analyst time to interpret 2.3 transactions
and configure interface engines for 3.0
• The good news
– You have a two-year+ head start
9/14/98
©1998 by HL7 & Wes Rishel
42
Other Observations on Change
Change is inevitable ...
… inevitably slower than anticipated
Change for marginal benefit gets overrun by
newer change
Change begets change
9/14/98
©1998 by HL7 & Wes Rishel
43
The Revolution, um, Evolution of XML
• eXtended Markup Language
• Fundamental economic driver is an
evolutionary change to the World Wide
Web
–
–
–
–
content-based searching and presentation
management of documents in pieces
indirect links
etc.
• Compatible upgrade to HTML
9/14/98
©1998 by HL7 & Wes Rishel
44
XML Benefits Will Beget Other Changes
• Document markup: SGML changes its
costume and gets “discovered”
• Self-documenting data files
– almost self-parsing
• The begetting happens through
– tools,
– people,
– and hoopla (i.e. the attention of the marketing
department)
9/14/98
©1998 by HL7 & Wes Rishel
45
XML and Version 3
•
•
•
•
The syntax handles recursion
Parsers are “free”
Self-documenting data files
XML-related tools
– viewing
– testing
– conversion
• Availability of trained personnel
• LOTS and LOTS of HOOPLA!
9/14/98
©1998 by HL7 & Wes Rishel
46
Dr. Asimov Revisited
“No sensible decision can be made any
longer without taking into account not
only the world as it is, but the world as it
will be. . . .”
• Design decisions require cautious
optimism about change.
• Five years from now, if V3 does not
use XML, people will, at best, be
amused by our quaint eccentric ways.
9/14/98
©1998 by HL7 & Wes Rishel
47
Describing an HL7 Message Format
Implementation
Technology
Specifications
"Send as ASCII
string in XML
format"
Hierarchical
Message
Definition
"Discontinue
pharmacy order"
ITS
Data
HL7
Message
Creation
Message
Instance
HL7-Conformant
Application
9/14/98
©1998 by HL7 & Wes Rishel
HL7
Message
Parsing
Data
HL7-Conformant
Application
48
Technology Layering in V3 Messaging
HL7-Conformant Application
Msg Element
Instance
ITS-Specific
Software
Agent
Msg Element
Instance
Msg Element
Instance
HL7 Message
Processing
Hierarchical
Message
Definition
HL7 Version
3.X
Data
Message
Element
Type
Msg Element
Instance
Msg Element
Instance
Message
Element
Type
Message
Element
Type
Msg Element
Instance
HL7
Instance Object Model
Message
Element
Type
Message
Element
Type
Message
Element
Type
HL7 Type Object Model, v3.X
ITS-Specific
Transfer
Mechanism
Message
Element
Type
Msg Element
Instance
Msg Element
Instance
ITS-Specific
Software
Agent
Msg Element
Instance
Message
Element
Type
Msg Element
Instance
Msg Element
Instance
Message
Element
Type
Message
Element
Type
HL7 Type Object Model, v3.Y
HL7 Message
Processing
Msg Element
Instance
Data
HL7
Instance Object Model
HL7-Conformant Application
9/14/98
Message
Element
Type
Message
Element
Type
©1998 by HL7 & Wes Rishel
Hierarchical
Message
Definition
HL7 Version
3.Y
49
The Gotchas
• Not a patch to an existing parser
• Access to “free” parsers on legacy
operating systems
• Message sizes substantially larger
9/14/98
©1998 by HL7 & Wes Rishel
50
The Plan
• Prototype
– demo at HIMSS in HL7 booth
– multiple systems
– mixed version 2 and v3/XML
– interface engine
• Prototype goals:
– evaluate methodology
– evaluate parsing difficulty/message size
– HOOPLA
9/14/98
©1998 by HL7 & Wes Rishel
51
Is it Real?
• The V3 Effort has already profoundly
improved HL7
• RIM provides coordinating point for
broad array of standards efforts
• Organizational awareness of enabling
technologies
• Technology-independence seemingly
proven by our current work
9/14/98
©1998 by HL7 & Wes Rishel
52
HL7--Not Just
Messaging
Anymore
Common User Envt
Envt
UserLink,
Common
(CCOW User
Patient Link, etc.)
Information
Model
(Version
3 RIM)
User
Interface
Models
(Arden
Syntax)
System
Mgt
Data
Management
Enterprise Communications
(Traditional HL7)
9/14/98
©1998 by HL7 & Wes Rishel
53
Implementing Version 3 as Change
• End user benefits need to be proven
• Some will derive from RIM
improvements currently underway
• Some will derive from being enabled by
new enabling technologies
• We are now entering the fray!
9/14/98
©1998 by HL7 & Wes Rishel
54