HL7 Reference Information Model
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1 2 3.2 Classes in subject area Entities 3 3.2.1 Class: Entity (in Entities)
4Attributes of Entity:
5 Attributes of Entity:
classCode:: CS quantity:: SET
6 Associations of Entity: 7 communicationFunction::(0..*)CommunicationFunction::entity::(1..*) 8 languageCommunication::(0..*)LanguageCommunication::entity::(1..1) 9 playedRole::(0..*)Role::player::(0..1) 10 scopedRole::(0..*)Role::scoper::(0..1)
11 Specializations of Entity generalizes:
EntityHeir Material Place LivingSubject Organization
12 Generalization of Entity: Entity is a specializesation of: InfrastructureRoot
13Definition of Entity:
14A physical thing, group of physical things or an organization capable of participating in 15Acts, while in a role.
16Discussion: An entity is a physical object that has, has had or will have existence. The 17only exception to this is Organization, which, while not having a physical presence, 18fulfills the other characteristics of an Entity. The Entity hierarchy encompasses living 19subjects (including human beings), organizations, material, and places and their 20specializations. It does not indicate the roles played, e.g. Patient, but the role must always 21be played by an entity—e.g. a person, in the case of a patientor acts that these entities 22participate in. [This paragraph may not be necessary.]
23Constraints: It does not include events/acts/actions, or the roles that things can play (e.g. 24patient, provider). [this is not a constraint and should be removed]
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2Attributes of Entity:
3 3.2.1.1 Entity.classCode:: CS (1..1) Mandatory 4Vocabulary domain: EntityClass (CNE) 5Definition:An HL7- defined value representing the class or category that the Entity 6instance represents.
7Examples: Person, Animal, Chemical Substance, Group, Organization
8Rationale: Due to the extremely large number of potential values for a code set 9representing all physical things in the universe, the class code indicates both the subtype 10branch of the Entity hierarchy used as well as a high level classifier to represent the 11instance of Entity. [If this is a mood distinction, it is not needed; otherwise clarify] This 12can be used to constrain the eligible value domains for the Entity.code attribute.
13Version 2.x reference: 14| GT1^10^00414^Guarantor Type | 15| LOC^3^00945^Location Type-LOC | 16 17 3.2.1.2 Entity.determinerCode:: CS (1..1) Mandatory 18Vocabulary domain: EntityDeterminer (CNE) 19Definition:An HL7 defined value representing whether the Entity represents a kind-of or 20a specific instance.
21Examples: 1 human being (an instance), 3 syringes (quantified kind) or the population of 22Indianapolis (kind of group) [that's still a specific population, not clearly a kind. replace]
23Rationale: An Entity may at times represent information concerning a specific instance 24(the most common), a quantifiable group with common characteristics or a general type 25of Entity. This code distinguishes these different representations. [in def; remove]
26 3.2.1.3 Entity.id:: SET
28Rationale: Successful communication only requires that an entity have a single identifier 29assigned to it. However, it is recognized that as different systems maintain different 30databases, there may be different instance identifiers assigned by different systems. Note 31that an instance identifier is a pure identifier and not a classifier. For Material, serial 32numbers assigned by specific manufacturers, catalog numbers of specific distributors, or 33inventory numbers issued by owners, may also be represented by the Role.id, which 34allows a more clear expression of the fact that such a code is assigned by a specific party 35associated with that material.
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1 3.2.1.4 Entity.code:: CE (0..1) 2Vocabulary domain: EntityCode (CWE) 3Definition:A value representing the specific kind of Entity the instance represents.
4Examples: A medical building, a Doberman Pinscher, a blood collection tube, a tissue 5biopsy.
6Rationale: For each Entity, the value for this attribute is drawn from one of several 7coding systems depending on the Entity.classCode, such as systems for living subjects 8(animal and plant taxonomies), chemical substances (e.g., IUPAC code), organizations, 9insurance companiesy, government agenciesy, hospitals, parks, lakes, syringes, etc. It is 10possible that Entity.code may be so fine grained that it represents a single instance. An 11example is the CDC vaccine manufacturer code, modeled as a concept vocabulary, when 12in fact each concept refers to a single instance. [Does this conflict with the entity ID?]
13Version 2.x reference: 14| IN2^14^00485^Champus Service | 15 3.2.1.5 Entity.quantity:: SET
18Examples: With undetermined kinds, the quantity is but a reference quantity for the 19specification of the proportion of ingredients or components (e.g. through a has-part, has- 20ingredient, or has-content Role). For example, a kind of group with 60% females is 21Person(quantity = 100) has-part Person(quantity = 60; sex = female). Amoxicillin 500 mg 22per tablet is Material(Tablet, quantity = 1) has-ingredient Material(Amoxicillin, quantity 23= 500 mg). Glucose 5% (D5W) is Material(D5W, quantity = 1 kg) has-ingredient 24Material(Glucose, quantity = 50 g).
25[the population example raises the mereological question of whether the 60 is determinate 26or not—whether the other 40 are known to be male.]
27[The other two examples imply that when the determiner = kind, proportions are the 28appropriate inference, but that the syntax is to be scalar; that rather than 5%, the sender 29must postulate an arbitrary mass of solution and the corresponding mass of glucose, and 30that the receiver must then infer the correct ratio from this scalar data. Is this correct?]
31Material-specific quantity relations are expressed using the fact that the data type of this 32attribute is a set of physical quantitiesy (SET
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1[the explanation may be clearer from the perspective of the sender: “If the sender needs 2to stipulate more than one dimension for the quantity, multiple quantity values may be 3sent in the SET
6Discussion: When the Entity instance is a portion of a substance, the quantity specifies 7the amount of that substance comprised by that portion. [example needed in example 8section] For an undetermined substance (kind) the quantity serves two purposes at the 9same time: (a) it provides a means of relations between quantities specific for that 10substance, and (b) it is a reference quantity for the specification of ingredients or 11components. [distinction not clear—if these are ratios in different moods, then the terms 12should be congruent] In all cases, the quantity is an extensive "amount" kind of quantity 13(e.g., number, length, volume, mass, surface area, energy, etc.). Note that most relative or 14fractional quantities are not amounts, in particular, mass fraction, substance 15concentration, mass ratios, percentages, etc. are not extensive quantities and are 16prohibited values for this attribute.
17[all discussion topics are example-specific and should be moved to the example section.]
18Constraints: For Entities with determinerCode = INSTANCE, the quantity is 1. [Is this 19categorical? Might not a lab specimen require a mass measurement, and would this not 20be an appropriate place for it?] For an Entity with determinerCode = 21QUANTIFIED_KIND, the quantity is the number of individual members in the group; 22for an Entity with a determinerCode = KIND, the value is undetermined. 23[“undetermined” suggests “indeterminate”--but it may be intended to mean “not 24constrained by the above consideration”]
25 3.2.1.6 Entity.name:: BAG
27Examples: Proper names, nicknames, legal names of persons, places or things.
28Rationale: Most entities have a commonly used name that can be used to differentiate 29them from other Entities, but does not provide a unique identifier. [remove]
30 3.2.1.7 Entity.desc:: ED (0..1) 31Definition:A textual or multimedia depiction of the Entity.
32Discussion: The content of the description is not considered part of the functional 33information communicated between systems. Descriptions are meant to be shown to 34interested human individuals. All information relevant for automated functions must be 35communicated using the proper attributes and associated objects.
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1[Might this discussion be a 'Design advisory'?]
2Rationale: Names and descriptions of entities are typically more meaningful to human 3viewers than numeric, mnemonic or abbreviated code values. The description allows for 4additional context about the entity to be conveyed to human viewers without 5impactaffecting the functional components of the message. [is this necessary?]
6Version 2.x reference: 7| PV2^5^00185^Patient Valuables | 8| PV2^6^00186^Patient Valuables Location | 9 3.2.1.8 Entity.statusCode:: CS (0..1) 10Vocabulary domain: EntityStatus (CNE) 11Definition:A value representing whether the information associated with the Entity is 12currently active or inactive for the purpose of participation in acts.
13Design Advisory: This attribute was defined in the original RIM as repeating, owing to 14the presence of nested states in the state machines. In actual practice, however, there is 15never a need to communicate more than a single status value. therefore, committees are 16advised to constrain this attribute to a maximum cardinality of 1 in all message 17designs.
18[there is a question here regarding when an attribute describes the record rather than the 19referent]
20 3.2.1.9 Entity.existenceTime:: IVL
23Examples: ManufactureDate/DisposalDate
24Constraints: This period may represent past, present or future time periods.
25Rationale: Physical entities have specified periods in which they exist. Equipment is 26manufactured, placed in service, retired and salvaged. The relevance of this attribute is in 27planning, availability and retrospective analysis.
28[Is product management the only or primary use of this attribute? The immediate 29assumption is that this might refer to a living subject's lifespan.]
30 3.2.1.10 Entity.telecom:: BAG
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1| GT1^18^00422^Guarantor Employer Phone Number | 2| IN1^7^00432^Insurance Co Phone Number | 3| IN3^16^00517^Certification Contact Phone Number | 4| IN3^19^00520^Certification Agency Phone Number | 5| OM1^17^00602^Telephone Number of Section | 6| OM1^29^00614^Phone Number of Outside Site | 7| GT1^46^00749^Contact Person's Telephone Number | 8| NK1^31^00749^Contact Person's Telephone Number | 9| IN2^50^00790^Employer Contact Person Phone Number | 10| IN2^53^00793^Insured's Contact Person Telephone Number | 11| IN2^58^00798^Insurance Co Contact Phone Number | 12| IN2^63^00803^Insured's Telephone Number - Home | 13| IN2^64^00804^Insured's Employer Telephone Number | 14 15 3.2.1.11 Entity.riskCode:: CE (0..1) 16Vocabulary domain: EntityRisk (CWE) 17Definition:A value representing the type of hazard or threat associated with the Entity.
18Examples: Petrochemical or organic chemicals are highly flammable agents that pose an 19increased risk of fire under certain conditions. Entities with either natural or introduced 20radioactive character pose a risk to those handling them. Entities comprising specimens 21from diseased individuals pose an increased risk of infection to those handling them. 22Persons or animals of irascible temperament may prove to be a risk to healthcare 23personnel.
24Rationale: Some entities have characteristics that pose potential increased risk of injury 25or damage to other Entities. This attribute identifies the type of risk without specifying 26the level of risk. [remove]
27 3.2.1.12 Entity.handlingCode:: CE (0..1) 28Vocabulary domain: EntityHandling (CWE) 29Definition:A value representing special handling requirements for the Entity.
30Examples: Keep at room temperature; Keep frozen below 0 C; Keep in a dry 31environment; Keep upright, do not turn upside down.
32Rationale: This attribute is used to describe special handling required by the Entity to 33avoid damage to it or other entities. [remove]
34 3.2.1.13 State machine for Entity 35Link to state diagram for this class.
36States of Entity:
37 active (sub-state of normal): The state representing the fact that the Entity is 38 currently active.
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1 inactive (sub-state of normal): The state representing the fact that an entity can no 2 longer be an active participant in events. 3 normal: The "typical" state. Excludes "nullified",,” which represents the 4 termination state of an Entity instance that was created in error 5 nullified: The state representing the termination of an Entity instance that was 6 created in error.
7
8State transitions of Entity:
9 revise (from active to active) 10 inactivate (from active to inactive) 11 reactivate (from inactive to active) 12 revise (from inactive to inactive) 13 nullify (from normal to nullified) 14 create (from null to active)
15 16 3.3 Classes in subject area Roles 17 3.3.1 Class: Role (in Roles)
18Attributes of Role:
19 Attributes of Role:
classCode:: CS addr:: BAG
20 Associations of Role: 21 player::(0..1)Entity::playedRole::(0..*) 22 scoper::(0..1)Entity::scopedRole::(0..*) 23 participation::(0..*)Participation::role::(1..1) 24 outboundLink::(0..*)RoleLink::source::(1..1) 25 inboundLink::(0..*)RoleLink::target::(1..1)
26 Specializations of Role generalizes:
Access LicensedEntity RoleHeir Employee Patient
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1 Generalization of Role: Role is a specializatesion of: InfrastructureRoot
2Definition of Role:
3A competency of the Entity playing the Role as identified, defined, guaranteed, or 4acknowledged by the Entity that scopes the Role.
5Discussion: An Entity participates in an Act as in a particular Role. Note that a particular 6entity in a particular role can participate in an act in many ways. Thus, a Person in the 7role of a practitioner can participate in a patient encounter as a rounding physician or as 8an attending physician. The Role defines the competency of the Entity irrespective of any 9Act, as opposed to Participation, which areis limited to activity performed within the 10scope of an Act.
11Each role is "played" by one Entity, called the "player" and is "scoped" by another Entity, 12called the "scoper"..” Thus the Role of "patient" may be played by a person and scoped 13by the provider organization from which the patient will receive services. Similarly, the 14employer scopes anthe "employee" role.
15The identifier of the Role identifies the Entity playing the role in that role. This identifier 16is assigned by the scoping Entity to the player. The scoping Entity need not have issued 17the identifier, but it may have re-used an existing identifier for the Entity to also identify 18the Entity in the Role with the scoper.
19Most attributes of Role are attributes of the playing entity while in the particular role.
20
21Attributes of Role:
22 3.3.1.1 Role.classCode:: CS (1..1) Mandatory 23Vocabulary domain: RoleClass (CNE) 24Definition:A code specifying the major category of a Role as defined by HL7 vocabulary. 25 3.3.1.2 Role.id:: SET
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1Discussion: The Role.code must conceptually be a proper specialization of 2Role.classCode. Role.code does not modify Role.classCode. Rather, each is a complete 3concept or a Role-like relationship between two Entities, but Role.code may be more 4specific than Role.classCode.
5The Role.code may not be coded if only an un-coded name for the type of role is 6commonly used. [does this mean that the data type can be used with a null code value, or 7that the text value can be written into the code field?]
8 3.3.1.4 Role.negationInd:: BL (0..1) 9Definition:An indicator specifying that the Role is a competency that is specifically not 10attributed to the Entity playing the Role.
11Examples: 1.) This Person is not our Employee
122.) This Mouthwash does not have Alcohol as an ingredient.
13Constraint [not in italic format: is this tagged correctly?]
14Normally all Unless otherwise specified, Roles are considered to be affirmative. (This 15attribute defaults to FALSE).
16 3.3.1.5 Role.name:: BAG
19Examples: Names used as an employee, as a licensed professional, etc.
20Usage: In general, names are specified using Entity.name. Role.name is only used when 21the standard wishes to distinguish names that are appropriate for use when referring to the 22Entity in one Role as opposed to other Roles.. [Discussion, not Usage]
23 3.3.1.6 Role.addr:: BAG
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1| PID^13^00116^Phone Number - Home | 2| NK1^6^00195^Business Phone Number | 3| GT1^6^00410^Guarantor Ph Num- Home | 4| GT1^7^00411^Guarantor Ph Num-Business | 5| GT1^18^00422^Guarantor Employer Phone Number | 6| IN1^7^00432^Insurance Co Phone Number | 7| IN3^16^00517^Certification Contact Phone Number | 8| IN3^19^00520^Certification Agency Phone Number | 9| OM1^17^00602^Telephone Number of Section | 10| OM1^29^00614^Phone Number of Outside Site | 11| GT1^46^00749^Contact Person's Telephone Number | 12| NK1^31^00749^Contact Person's Telephone Number | 13| IN2^50^00790^Employer Contact Person Phone Number | 14| IN2^53^00793^Insured's Contact Person Telephone Number | 15| IN2^58^00798^Insurance Co Contact Phone Number | 16| IN2^63^00803^Insured's Telephone Number - Home | 17| IN2^64^00804^Insured's Employer Telephone Number | 18 3.3.1.8 Role.statusCode:: CS (0..1) 19Vocabulary domain: RoleStatus (CNE) 20Definition:A code specifying the state of this Role as defined in the state-transition 21model.
22Design Advisory: This attribute was defined in the original RIM as repeating, owing to 23the presence of nested states in the state machines. In actual practice, however, there is 24never a need to communicate more than a single status value. Ttherefore, committees are 25advised to constrain this attribute to a maximum cardinality of 1 in all message 26designs.
27Version 2.x reference: 28| PID^27^00130^Veterans Military Status | 29 3.3.1.9 Role.effectiveTime:: IVL
35Examples: The certificate can be represented in many different ways, either inline or by 36reference, according to the ED data type. Typical cases followare:
371.) Paper-based certificate: the ED data type may refer to some document or file that can 38be retrieved through an electronic interface to a hardcopy archive.
392.) Electronic certificate: this attribute can represent virtually any electronic certification 40scheme, such as, an electronically (including digitally) signed electronic text document.
413.) Digital certificate (public key certificate): in particular, this attribute can represent 42digital certificates, as an inline data block or by reference to such data. The certificate
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1data block would be constructed in accordance to a digital certificate standard, such as 2X509, SPKI, PGP, etc.
34. The 'security' code provided with a credit card [this is not intended to be recorded or 4transmitted]
55. The 'version number' associated with a particular copy of an insurance or health card
6The certificate subject is the Entity that plays the Role. The certificate issuer is the Entity 7that scopes the Role.
8 3.3.1.11 Role.confidentialityCode:: SET
12Discussion: It is important to note that the necessary confidentiality of the medical record 13cannot be achieved solely through confidentiality codes to mask individual record items 14from certain types of users. There are two important problems with per-item 15confidentiality: one is inference and the other is the danger of holding back information 16that may be critical in a certain care situation. Inference means that filtered sensitive 17information can still be assumed given the other information that was not filtered. The 18simplest form of inference is that even the existence of a test order for an HIV Western 19Blot test or a T4/T8 lymphocyte count is a strong indication for an existing HIV 20infection, even if the results are not known. Very often, diagnoses can be inferred from 21medication, such as Zidovudin for treatment of HIV infections. The problem of hiding 22individual items holding back information that may be critical in a certain care situation 23becomes especially difficult with current medications, since the continuing administration 24of the medication must be assured.
25To mitigate some of the inference-risk, aggregations of data should assume the 26confidentiality level of the most confidential action in the aggregation.
27Version 2.x reference: 28| GT1^38^00743^Publicity Indicator | 29| IN2^36^00743^Publicity Indicator | 30| NK1^22^00743^Publicity Indicator | 31| PD1^11^00743^Publicity Indicator | 32| GT1^39^00744^Protection Indicator | 33| IN2^37^00744^Protection Indicator | 34| NK1^23^00744^Protection Indicator | 35| PD1^12^00744^Protection Indicator | 36 3.3.1.12 Role.quantity:: RTO (0..1) 37Definition:A ratio (numerator : denominator) specifying the relative quantities of the 38Entity playing the Role in the Entity scoping the Role, used for Roles that represent 39composition relationships between the scoping and playing Entities.
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1Examples: 1.) This syrup's (scoper) ingredients include 160 mg (numerator) 2Acetaminophen (player) per tablespoon (denominator).
32.) This herd (scoper) consists of 500 (numerator) cattle (player).
43.) A VAX 6630 computer (scoper) has 3 (numerator) CPUs (player) as parts.
54.) This package (scoper) contains 100 (numerator) pills (player).
6Discussion: In composition-relationships (e.g., has-parts, has-ingredient, has-content) the 7Role.quantity attribute specifies that a numerator amount of the target entity is comprised 8by a denominator amount of the source entity of such composition-relationship. For 9example, if a box (source) has-content 10 eggs (target), the relationship quantity is 10:1; 10if 0.6 mL [of fluid?] contain 75 mg of FeSO4 the ingredient relationship quantity is 75 11mg : 0.6 mL. Both numerator and denominator must be amount quantities (extensive 12quantities, i.e., a count number, mass, volume, amount of substance, amount of energy, 13etc.).
14[Clarify that RTO is a generic data type: the appropriate units must be specified for the 15numerator and denominator]
16 3.3.1.13 Role.positionNumber:: LIST
19Discussion: This attribute is primarily used with respect to containment roles. For 20example, some containers have discrete positions in which content may be located. 21Depending on the geometry of the container, the position may be referenced as a scalar 22ordinal number, or as a vector of ordinal numbers (coordinates). Coordinates always 23begin counting at 1.
24Some containers may have customary ways of referring to the positions or no way at all. 25In the absence of any specific regulation for a specific container type, the rule of thumb is 26that the coordinate that is changed earlier first is positioned first. For an automated blood 27chemistry analyzer with a square shaped tray, this means that the first coordinate 28represents the directionis the one in which direction the tray moves at each step, and the 29second coordinate represents the direction is the one in which the tray moves only every 3010 (or so) steps periodically.
31 3.3.1.14 State machine for Role 32Link to state diagram for this class.
33States of Role:
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1 active (sub-state of normal): The state representing the fact that the Entity is 2 currently active in the Role. 3 cancelled (sub-state of normal): The terminal state resulting from cancellation of 4 the role prior to activation. 5 normal: The "typical" state. Excludes "nullified",,” which represents the 6 termination of a Role instance that was created in error. 7 nullified: The state representing the termination of a Role instance that was 8 created in error 9 pending (sub-state of normal): The state representing that fact that the role has 10 not yet become active. 11 suspended (sub-state of normal): The state that represents the suspension of the 12 Entity playing the Role. This state is arrived at from the "active" state. 13 terminated (sub-state of normal): The state representing the successful 14 termination of the Role.
15
16State transitions of Role:
17 revise (from active to active) 18 suspend (from active to suspended) 19 terminate (from active to terminated) 20 nullify (from normal to nullified) 21 create (from null to active) 22 create (from null to pending) 23 activate (from pending to active) 24 cancel (from pending to cancelled) 25 revise (from pending to pending) 26 resume (from suspended to active) 27 revise (from suspended to suspended) 28 terminate (from suspended to terminated) 29 reactivate (from terminated to active) 30 revise (from terminated to terminated)
31 3.3.2 Class: RoleLink (in Roles)
32Attributes of RoleLink:
33 Attributes of RoleLink:
typeCode:: CS priorityNumber:: INT effectiveTime:: IVL
34 Associations of RoleLink:
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1 target::(1..1)Role::inboundLink::(0..*) 2 source::(1..1)Role::outboundLink::(0..*)
3 RoleLink is a specialization of:specialization of InfrastructureRoot
4Definition of RoleLink:
5A connection between two roles expressing a dependency between those roles and 6permitting the authorization or nullification of a dependent role based on status changes 7in its causal or directing role.
8Examples: 1.) A role of assignment or agency depends on another role of employment, 9such that when the employment role is terminated, the assignments would be are 10terminated as well. This is the dependency of the assignment role with on the 11employment role, or in other words, the assignment is "part of" the employment.
122.) One role has authority over another (in organizational relationships). For example, an 13employee of type "manager" may have authority over employees of type "analyst" which 14would be indicated by a role link for "direct authority"..”
15Discussion: RoleLink specifies the relationships between roles, not between people (or 16other entities). People (or other Entities) are primarily related by their direct the 17player/scoper relationships in around the player's Role, and more generally through their 18interactions (i.e. their participations in acts).
19[The emphasis on authority fails to represent the possibility of composition or 20replacement indicated by the vocabulary values. This class needs more examples.]
21Attributes of RoleLink:
22 3.3.2.1 RoleLink.typeCode:: CS (1..1) Mandatory 23Vocabulary domain: RoleLinkType (CNE) 24Definition:A code specifying the kind of connection represented by this RoleLink, e.g., 25has-part, has-authority. 26 3.3.2.2 RoleLink.priorityNumber:: INT (0..1) 27Definition:An integer specifying the relative preference for considering this relationship 28before other like-typed relationships having the same source. RoleRelationships with 29lower priorityNumber values are considered before and above take priority over those 30with higher values.
31Examples: For multiple backups, specifies which backup is considered before others.
32Specifies What is the preferred ServiceDeliveryLocation for a Physician working on 33behalf of a particular Health Authority.?
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1Discussion: The ordering may be a total ordering in which all priority numbers are 2unique or a partial ordering, which assigns the same priority to more than one 3relationship.
4 3.3.2.3 RoleLink.effectiveTime:: IVL
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