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X Paradigm Status and Summary

Last Updated: July 28, 2016
Current activities:

We are ready to publish and are following up with negative ballot comments.

Final Pakage:



Final documents proposed for publication as of 7/28/2016 for publication:





Amalgamated ballot comments:


Individual comments from January ballot:



January 2015 ballot documents:




Common Information Model

proposed revisions:

green highlights represent additions

FHIR Mapping

HL7 V2 to FHIR Mapping


Reconciled Ballot Materials

Text:


Field mappings:

Ballot comments:





Archived

Drafts going into Jan 2015 ballot:


New




SAIF Architecture Program questions for 1/8/14 and 1/15/14 conference calls and January WGM:


Detailed news article - final draft as submitted

X Paradigm in HL7 News:
X Paradigm in HL7 May Newsletter

Cambridge Fall 2013 WGM Relevant Quarters

Tue Q3 SOA: X Paradigm update and feedback session
Tue Q4 PHER: Review data elements and use of FHIR
Wed Q3 SOA: Work session
Wed Q4 SAIF Architecture Program (2nd half - the group is spending 1st half with OO): Update

Spring 2013 Working Notes


We are concentrating on two project sections, the Common Information Model and the Common Behaviour Model.

Information Model

Coming out of Phoenix (see WGM notes), we determined that MDMI was the best bet as an approach, and that what is needed is to finish the reference index and maps. PHER is undertaking to finish the immunization resource started by Grahame Grieve using the materials supplied by this project. The schedule will be accelerated as it is driven by the May ballot cycle.

Ken Lord of Firestar and others participating in MDMI and MDHT projects are currently preparing a first draft MDMI-based referent index and maps for both V2 and C-CDA paradigms. This effort is scheduled to be complete for the May WGM.

Behavioural (Computational) Model

This discovery led to the search for a similar approach to behaviour model. This was also discussed As discussed in Phoenix in SOA, one approach seems to be to define service behaviour as a series of state transitions based upon operation inputs and expected results, as was done in the IXS tech spec. This leads naturally to the development of a test harness.

We have reviewed three approaches:

one based upon soaML supplied by Stefano Lotti:
http://www.cybersyn.net/XParadigm02HTML/
In SAIF, this is thought to fit at the logical level - it provides a representation of a base service

A second based upon Executable UML supplied by Cory Casanave:


In SAIF, this is thought to fit at the implementable level - it provides a mechanism for mapping behaviour between services.

A third uses materials submitted for HL7 ballot this cycle supplied by Zoran Milosevic:
http://hssp-infrastructure.wikispaces.com/HSSP+SOA+Service+Ontology
This is thought to cover the enterprise viewpoint, and also the conceptual level of the behavioural model

There is a feeling that it is not necessary to choose between these but that they work together at different levels. There is some overlap. For instance there is a decision between an ontology-based or UML-based framework (for the enterprise viewpoint), the former involving perhaps more work. You could support both but again there is work involved.

Suggested approach:
Start with UML (or soaML) and work outwards to ontology and implementable level. Executable UML would used to create your mapping between services. Executable UML combined with MDMI will provide the specification and implementation of the adapters between two paradigms.

How to go about applying this in X Paradigm (ideas):
  • reverse engineer existing identified HSSP specs to make sure they are in proper UML format
  • Storyboard (high level use case) can be represented in BPMN - then translate into (existing HSSP) service interfaces
  • To get down to the implementable level, you have to specify the paradigms - in other words, which PSMs, for example V2 and XDS, then Executable UML can be used to create the maps on the behavioural viewpoint (MDMI is used in the informational viewpoint)
  • Map both PSMs to the UML representation of the PIM
Vet at WGM
NIEM - consider adding. Used by CMS.

Open issues

  1. fleshing out the TBD columns. These include the new "Source System" section, some misc. data elements throughout, and the entire Immunization Recommendations section, in particular, as relates to contraindications and precautions. Existing standardized sections, for example, CDA non-immunization sections such as Allergies, Medications, etc., contain information which could relate to contraindications and precautions. Yet to expand the scope of X Paradigm to include all possible values from these sections would be too broad.
  2. Integration of FHIR into field mappings.
  3. what to make prescriptive vs. suggested. For example, suggestions for resolving differences between IHE Immunization Content and HL7 Consolidated CDA have evolved from X Paradigm, but it is out of scope to actually resolve them. However a resolution may be suggested to both HL7 and IHE. Likewise, some data elements may be mapped by certain paradigms more than one way, for example, by vMR. Suggested mappings that are included in X Paradigm may be suggested but not prescribed.
  4. How to refer "standards gaps" discovered during X Paradigm analysis to responsible group. Integration of Immunization Content with C-CDA was proposed to IHE in the planning cycle just passed and was added to a task to harmonize IHE profiles with C-CDA.
  5. Process issue raised by Keith Boone in ballot comments - that the following section (taken from ballot document) be raised with ArB. The process for coordination across SDOs is still ad hoc and still a challenge for X Paradigm."There is also no clear precedent for working across Standards Development Organizations (SDOs). Issues of membership, intellectual property, process, meeting schedules, and access to artefactts all must be addressed. Thus far, it has been the effort of individuals such as Richard Soley, Ken Rubin, Laura Bright, Michael Flynn, Noam Arzt and others who have helped us reach out to SDOs and profiling organizations outside of HL7: the Object Management Group (OMG), Integrating the Healthcare Enterprise (IHE), and the American Immunization Registry Association (AIRA)."

DoD RFI Response

HL7's Issue and Policy Statements
HL7 Response - RFI iEHR Joint Immunization Capability (pdf)

Project Organization

The initial project outline in both short and detailed form are given here. We wish to thank Ann Wrightson and Steve Hufnagel for invaluable assistance in conceiving the approach to this project initially.



Next, immunization-related standards, or artefacts, within the project scope were identified. Artefacts were cross-referenced with the project sections they most closely apply to. Links to source documents for each artifact were added. In the table below, where particular artefacts have been treated in a particular project section, a capital "X" appears in the corresponding cell. Small "x" indicates an artefact that has been identifed by not yet been considered by the project.

Refer to the above Artefacts.xlsx document under Project Organization.

At this point, work started in various sections more or less simultaneously. The current ballot materials bring together the various parts into the evolving methodology and conclusions of X Paradigm.

The project was developed both top down and bottom up, for a "meet in the middle" conclusion.

Related Projects

Semantic Health Net

Project Sections

Layered Service Arch.
Use Cases
Case Studies -- US
Affiliate Case Studies
Platform Independent Model -- Common Behavioral Model
Platform Independent Model -- Common Information Model
Solution Architecture
Relating to SAIF


WGM Notes

Atlanta May WGM

Slides from Atlanta:

SOA Tue Q3 notes:

Schedule:
Tue Q2 PHER
Tue Q3 SOA
Wed Q4 SAIF Architecture Program (scheduled) - last 1/2 hour will be about X Paradigm and alignment with other SAIF Architecture Program projects

Atlanta notes:


Phoenix HL7 WGM Meeting Notes for X Paradigm


X Paradigm Status after Phoenix

Last Updated: April 3, 2013

Theory and approach

We are concentrating on two project sections, the Common Information Model and the Common Behaviour Model.

Coming out of Phoenix (see WGM notes), we determined that MDMI was the best bet as an approach, and that what is needed is to finish the reference index and maps. PHER is undertaking to finish the immunization resource started by Grahame Grieve using the materials supplied by this project. The schedule will be accelerated as it is driven by the May ballot cycle. The suggestion came up in the CDS quarter that FHIR may be suitable as the index rather than the initially proposed C154-based index.

This discovery led to the search for a similar approach to behaviour model. This was also discussed in Phoenix in SOA. The best approach seems to be to define service behaviour as a series of state transitions based upon operation inputs and expected results, as was done in the IXS tech spec. This leads naturally to the development of a test harness. The work ahead is to explore this approach further.
As we have realized for awhile, the outcome of this may be some or all of:
  • a new set of PSMs for existing HSSP service specifications,
  • a revised set of service specifications,
  • a set of specifications for composed or orchestrated services to achieve immunization use cases.

With the MDMI work and the addition of new mappings (vMR, MDMI), we are just developing a better concept of what these might look like. Additionally ,the wrap-around back to SAIF has begun, with both the crosswalk between MDMI and SAIF, and other activities as suggested by the HL7 SAIF Architecture Program.

Summary of MDMI/SAIF crosswalk by Ken Lord:

Slides presented to PHER in Phoenix by Ken Lord:

LInks to MDMI materials on OMG site:
http://www.omg.org/spec/MDMI/ is the standard
http://www.omg.org/technology/finance/mdmi.htm contains additional information, however it has a finance focus
Link to initial soaML modeling draft for X Paradigm by Stefano Lotti: http://www.cybersyn.net/XParadigm01HTML/

Highlights of Baltimore HL7 meeting Sept 2012

Ballot recon in SOA and PHER
  • Standards “gaps” revealed by the X Paradigm analysis stimulated much discussion
  • Ballot comments to be posted, some ballot recon remaining
Progress on Common Information Model
  • FHIR – GIf we add cardinality and null flavors to field mappings, Grahame Grieve will provide FHIR resources
  • FHIM, CIMI – possible alternative approaches to FHIR
  • vMR – CDS is interested in mapping in vMR
Structured Documents
  • Alternate ways forward to resolve IHE Immunization Content, Consolidated CDA
    • Work with IHE to repoint IC to C-CDA and add the few additional constraints
    • Work in next C-CDA ballot cycle to add additional constraints
wrap back in to S&I framework for public health reporting CDA
Possible approach to modeling the solution identified
  • MDMI
Strong interest is “lessons learned”
  • Feedback from this project to approaching similar projects in the future
Suggestion that generalization to the next use case will be an incremental effort

Notes:



Informational ballot materials for the September cycle:



Accompanying documents:



Immunization Standards Harmonization




Past meeting schedules


WGMs:

Relevant sessions at HL7 Phoenix

Mon Q4 SOA - brief project update
Tue Q2 PHER - Common Information Model
Tue Q3 SOA - Behaviour Model/Work Session
Wed Q3 CDS - CDS aspects of X Paradigm
Wed Q4 HL7 SAIF Archtecture Program - project update

Summary of activities in the cycle preceding Phoenix:

  • Developed a new theory of how the Common Information Model can be modeled taking advantage of MDMI
  • Proposed a similar approach for Behavioural Model
  • Added vMR and MDMI to field mappings
  • Review with HL7 SAIF Architecture Program. Recommendations to:
    • review OO ballot document Domain Analysis Model for Lab Orders to see how behavioural aspect is handled
    • review SAIF Governance Framework
    • note referral of discovered "standards gaps" back to responsible orgs and track representatives
  • Reconciled ballot comments from September ballot

Relevant sessions at HL7 Baltimore:

Mon Q4: Structured Documents Topic: Immunization CDA
Tue Q3: SOA Topic: X Paradigm ballot recon
Tue Q4: SOA Topic: X Paradigm ballot recon
Wed Q3: CDS and PHER, hosted by CDS.
Wed Q4: SAIF Architecture Program

Working notes from week of September 2012 Baltimore WGM


Relevant sessions at HL7 Vancouver (all tentative):

Mon Q4: Structured Documents Topic: Immunization CDA
Tue Q2: Arden Syntax. Topic: Arden and Immunization Decision Support
Wed Q3: CDS and PHER, hosted by CDS.
Wed Q4: SAIF Architecture Program
Thurs Q3: SOA - X Paradigm
Fri Q1: SOA - X Paradigm work session

Working notes from week of May 2012 Vancouver WGM


Relevant sessions at HL7 San Antonio:

Tue Q2: Arden Syntax (unconfirmed). Topic: Arden and Immunization Decision Support
Wed Q3: CDS and PHER, hosted by CDS.
Wed Q4: SAIF Architecture Program http://wiki.hl7.org/index.php?title=20120118_SAIF_AP_Meeting
Thurs Q3: SOA with ArB http://hssp.wikispaces.com/event-2012-01-HL7-SanAntonio
Friday Q1 and Q2: Work sessions hosted by SOA (confirmed)

Working notes from week of Jan 2012 San Antonio WGM

Call minutes

Wednesday, October 22, 2014: worked on the following revisions (Lotti, Kirnak, Lord)

Wednesday, August 20, 2014:

Wednesday, July 30, 2014:

Wednesday June 18, 2014:

Wednesday, June 4, 2014

Wednesday, March 26, 2014

Wednesday, February 19, 2014

Wednesday, February 5, 2014

Wednesday, January 15, 2014

Wednesday, January 8, 2014

Wednesday, December 11, 2013

Powerpoint Presentation on MDMI from December 11 meeting

Wednesday, December 4, 2013

Wednesday, October 16, 2013

Wednesday, September 11, 2013

Wednesday, September 4, 2013

Wednesday, July 10, 2013

Wednesday, May 22, 2013

Wednesday, May 1, 2013

Slides from May 1 Meeting (view in presentation mode):

Wednesday, April 24, 2013

Slides from April 24 Meeting (view in presentation mode):

Wednesday April 3, 2013

Wednesday Feb 20, 2013

Wednesday Jan 30, 2013

Attachment to Jan 30 call minutes:

Wednesday Jan 23, 2013

Wednesday Jan 09, 2013

Wednesday Dec 26, 2012

Wednesday Dec 19, 2012

Wednesday Dec 12, 2012

Wednesday Dec 5, 2012

Wednesday Nov 21, 2012

Wednesday Oct 24, 2012

Wednesday Oct 9, 2012

Wednesday Oct 3, 2012 - possible use of MDMI for solution architecture. Ken Lord presenting.

Healthcare Technical Overview