Wes Rishel

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Wes Rishel
VP Distinguished Analyst
12 years at Gartner
45 years IT industry

Wes Rishel is a vice president and distinguished analyst in Gartner's healthcare provider research practice. He covers electronic medical records, interoperability, health information exchanges and the underlying technologies of healthcare IT, including application integration and standards. Read Full Bio

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At Last, Data Molecules! CIMI

by Wes Rishel  |  December 13, 2011  |  3 Comments

Last February, I blogged on “data molecules,” low-level models for clinical concept that are not buried in the obscurity by conformance to a grand and abstract uber-model. These models are often called Detailed Clinical Models or Clinical Element Models.

I am delighted to report that the Clinical Information Modeling Initiative (CIMI) is a small group of volunteers led by Stan Huff that is working to consolidate the detailed clinical models of various groups in a way that could be adapted to meet the needs of standards groups in all those areas. Bless their hearts, they have decided an approach that is short on hoopla and focused on actually developing a sizable set of models ASAP. They are working with a minimum set of governance without worrying about the specific requirements of any specific system, technology or standards organization. They are convinced that if they produce valuable, open intellectual property and make it easy to adopt that usage will follow. I personally believe that the ultimate value of their work will extend beyond information interchange to include describing data for clinical decision support rules, sharing metadata used to create data entry templates or reports for specific clinical concepts.

These guys are so focused on results that they don’t even have a Web site yet. They did take some time away from modeling to develop a joint description of their principles and approach. Here is that statement in its entirety.

Public Release

The Clinical Information Modeling Initiative is an international collaboration that is dedicated to providing a common format for detailed specifications for the representation of health information content so that semantically interoperable information may be created and shared in health records, messages and documents. CIMI has been holding meetings in various locations around the world since July, 2011. All funding and resources for these meetings have been provided by the participants. At its most recent meeting in London, 29 November – 1 December 2011, the group agreed on the following principles and approach.

Principles

  1. CIMI specifications will be freely available to all. The initial use cases will focus on the requirements of organisations involved in providing, funding, monitoring or governing healthcare and to providers of healthcare IT and healthcare IT standards as well as to national eHealth programs, professional organisations, health providers and clinical system developers.
  2. CIMI is committed to making these specifications available in a number of formats, beginning with the Archetype Definition Language (ADL) from the openEHR Foundation (ISO 13606.2) and the Unified Modeling Language (UML) from the Object Management Group (OMG) with the intent that the users of these specifications can convert them into their local formats.
  3. CIMI is committed to transparency in its work product and process.

Approach

  • ADL 1.5 will be the initial formalism for representing clinical models in the repository.
    • CIMI will use the openEHR constraint model (Archetype Object Model:AOM).
    • Modifications will be required and will be delivered by CIMI members on a frequent basis.
  • A set of UML stereotypes, XMI specifications and transformations will be concurrently developed using UML 2.0 and OCL as the constraint language.
  • A Work Plan for how the AOM and target reference models will be maintained and updated will be developed and approved by the end of January 2012.
    • Lessons learned from the development and implementation of the HL7 Clinical Statement Pattern and HL7 RIM as well as from the Entry models of 13606, openEHR and the SMART (Substitutable Medical Apps, Reusable Technologies) initiative will inform baseline inputs into this process.
  • A plan for establishing a repository to maintain these models will continue to be developed by the group at its meeting in January.

Representatives from the following organizations participated in the construction of this statement of principles and plan:

B2i Healthcare www.B2international.com
Cambio Healthcare Systems www.cambio.se
Canada Health Infoway/Inforoute Santé Canada www.infoway-inforoute.ca
CDISC www.cdisc.org
Electronic Record Services www.e-recordservices.eu
EN 13606 Association www.en13606.org
GE Healthcare www.gehealthcare.com
HL7 www.hl7.org IHTSDO www.ihtsdo.org
Intermountain Healthcare www.ihc.com
JP Systems www.jpsys.com
Kaiser Permanente www.kp.org
Mayo Clinic www.mayoclinic.com
MOH Holdings Singapore http://www.mohh.com.sg/
National Institutes of Health (USA) www.nih.gov
NHS Connecting for Health www.connectingforhealth.nhs.uk
Ocean Informatics www.oceaninformatics.com
OpenEHR www.openehr.rog
Results4Care www.results4care.nl
SMART www.smartplatforms.org
South Korea Yonsei University www.yonsei.ac.kr/eng
Tolven www.tolven.org
Veterans Health Administration (USA) www.va.gov/health

Further Information

In the future CIMI will provide information publicly on the Internet. For immediate further information, contact Stan Huff (stan.huff@imail.org)

3 Comments »

Category: Healthcare Providers Interoperability Uncategorized Vertical Industries     Tags: , , ,

3 responses so far ↓

  • 1 Mark Frisse   December 13, 2011 at 10:59 pm

    Wes,

    Great idea. As a great fan of Stan and Intermountain, I want to thank you for bringing this up on your blog.

    Best to you in California

    Mark Frisse

  • 2 Gary Dickinson   December 15, 2011 at 4:56 pm

    Wes,

    A fact check might have better served your endorsement of CIMI.

    First Stan makes the statement that “the group agreed on [CIMI] principles and approach” and later lists a group of organizations. While these organizations may have participated in formative discussions at one point or another, they did not in fact all agree to CIMI principles and approaches.

    Regards,

    Gary Dickinson

  • 3 Wes Rishel   December 16, 2011 at 3:05 am

    See response to Gary in subsequent post, HL7′s Position on CIMI