CIMI Reference Model Requirements

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On this page, we list the known requirements of the CIMI reference model. Please note that:

  • These requirements are WORK IN PROGRESS and have NOT been finalised by the taskforce; and
  • Some of these requirements may, at a future point in time, be identified as requirements of the clinical modelling formalism, the reference terminology, or the clinical models themselves, and may as a result be moved to a separate document. The requirements that may fall into this category have been marked with an asterisk, but have been retained below (for the moment) for completeness.

General Technical Requirements

The general technical requirements of the CIMI reference model include:

ID Name Description
RM-REQ-GT-01 Support for the Architectural Framework The CIMI reference model will support an architectural framework (as shown above) in which CIMI clinical models are constraints on the CIMI reference model, and CIMI model examples are instances of the CIMI reference model.
RM-REQ-GT-02 Multiple Purposes The CIMI reference model must support the creation of clinical models for use in multiple purposes, including (but not limited to):
  • Exchanging clinical content;
  • Querying, analytics and research over clinical content;
  • Decision support over clinical content;
  • Storing clinical content in EHR systems;
  • Entering clinical content (e.g. using a form-based user interface); and
  • Displaying clinical content.
RM-REQ-GT-03 Multiple Outputs The CIMI reference model (together with the associated clinical models, terminology semantics, model mappings and metadata) should enable the automated generation of multiple different artefacts, with no change to the meaning (wherever possible), including:
  • Computable exchange format specifications (e.g. CDA, HL7 v3, XML Schema);
  • Clinical models defined in other formalisms (e.g. UML 2.0);
  • Human-readable visualisations of the models (e.g. HTML and default user interfaces)
RM-REQ-GT-05 (*) Realm-Specific Specialisations and Extensions The CIMI reference model (and associated artefacts) must support the ability for CIMI clinical models to be specialised for realm-specific requirements, and extended with realm-specific information that does not need to be interoperable between realms.
RM-REQ-GT-06 No Clinically Relevant Attributes or Specialisations The CIMI reference model will express the non-clinical structural patterns which underpin all clinical models. As such, the CIMI reference model will not include any clinically relevant attributes or specialisations (e.g. ‘Observation’). This will provide a clear separation of the structural patterns from the clinical patterns, to simplify the clinical verification process, and ensure that the specialisation of clinical information can be performed in a consistent way. This implies that there will be a layer of reusable clinical patterns (e.g. Finding observations, Property observations, Procedures, Investigations, Instructions, Orders, Material activities), expressed using the archetype formalism, which can be composed together and specialised as appropriate to form the leaf-level clinical information models.
RM-REQ-GT-07 (*) Model Mapping The CIMI reference model (and associated artefacts) must allow mappings to be defined to/from other model formalisms (including, but not limited to openEHR, ISO13606 and HL7 CDA), with no loss of meaning (where possible).
RM-REQ-GT-08 Model Query Support The CIMI reference model must support the ability to query its instances (i.e. the CIMI model examples) in terms of the CIMI clinical models.
RM-REQ-GT-09 Versioning The CIMI reference model must be able to identify its own version.
RM-REQ-GT-10 Approval Status The CIMI reference model must be able to identify its approval status.
RM-REQ-GT-11 Stability The CIMI reference model (including the CIMI datatypes) must be as stable as possible over time.
RM-REQ-GT-12 Inter-Organisation Semantic Interoperability The CIMI reference model must support clinical models that aim to achieve semantic interoperability across a federation of enterprises. CIMI models should not be limited to supporting semantic interoperability within an enterprise and should not be limited to syntactic or structural interoperability across enterprises.

General Governance Requirements

The general governance requirements of the CIMI reference model include:

ID Name Description
RM-REQ-GG-01 Governance, Cost and Licensing The CIMI reference model must have no intellectual property restrictions, legal conditions or costs associated with the community’s ability to:
  • create, use or share clinical models which are created based on it;
  • build tools to support the creation, storage, rendering or transformation of these artefacts.

The CIMI reference model must be governed by an organisation that is sustainable going forward, and has appropriate mechanisms in place by which it can be extended and maintained to fully support the requirements of the member community.

RM-REQ-GG-02 (*) Clinician Verification The CIMI reference model must enable the associated clinical models to be verified by non-technical clinicians and other data users, and/or transformed into one or more formats that can be effectively verified by these users (e.g. tree based hierarchy, user interface design, clinical report)

Structural Requirements

The structural requirements of the CIMI reference model include:

ID Name Description
RM-REQ-ST-01 Data Elements The CIMI reference model must support the explicit representation of data elements. Each data element can be constrained in the clinical models by the set of available datatypes.
RM-REQ-ST-03 Relationships The CIMI reference model must represent structural and/or semantic relationships (or links) between different information components within one or more clinical information models.
RM-REQ-ST-04 Multiple Relationships The CIMI reference model must allow multiple relationships (or links) to exist between each pair of information components.
RM-REQ-ST-05 Data Groups The CIMI reference model must allow information components to be grouped together via relationships to a data group. Data groups must support the grouping of both data elements and other data groups.
RM-REQ-ST-06 Tree Structure The CIMI reference model must allow data groups to be organised into a tree structure, based on a selected root component, to support tree-based visualisations and serialisations.
RM-REQ-ST-07 Entry / Clinical Statement The CIMI reference model must allow certain data groups to be identified as representing a single ‘Clinical Statement’ (or Entry).
RM-REQ-ST-08 Composition The CIMI reference model must allow certain data groups to be identified as a composition – that is, a logical grouping of information to be recorded at a given time for a given subject of care
RM-REQ-ST-09 Data Absent The CIMI reference model must allow data groups and data elements to include a reason that there is no value. This may to be used by the model examples. Please note that this feature should not be supported within the datatypes (as per ‘nullFlavour’).

Information Pattern Requirements

The information pattern requirements of the CIMI reference model include:

ID Name Description
RM-REQ-IN-01 Concept Model The CIMI reference model must allow some data groups to be modelled using an information pattern that defines:
  • Key concept; (e.g. Problem/Diagnosis concept)
  • Qualifier (e.g. finding site + laterality)
  • Content (e.g. Related notes)
  • Context (e.g. Subject Relationship, Temporal, Finding Context, Patient State)
  • Attribution
RM-REQ-IN-02 Participation The CIMI reference model must allow the connection between information and its related parties (e.g. people, organisations, devices) to be represented.
RM-REQ-IN-03 Parties and Roles The CIMI reference model must enable the description of demographic details of parties and the roles that they play, to be represented in the clinical models.

Terminology Binding Requirements

The terminology binding requirements of the CIMI reference model include:

ID Name Description
RM-REQ-GN-01 Semantic Binding The CIMI reference model must allow clinical models to determine the meaning of a data group or data element by binding it to a coded concept, or a coded concept expression.
RM-REQ-GN-02 Value Binding The CIMI reference model must allow clinical models to refer to the set of valid values for a given data element by binding it to a terminology reference set or a terminology constraint expression.
RM-REQ-GN-03 Name Binding The CIMI reference model must allow each data group or data element to be assigned a name. This name may either be a string of characters, or a terminology description (i.e. identified term).
RM-REQ-GN-04 Relationship Semantics The CIMI reference model must allow clinical models to define semantic, value and name binding for each structural relationship (or link) between information components.
RM-REQ-GN-05 Concept Model Terminology Definition The CIMI reference model must allow each concept model structure to be defined as a single terminology expression created by combining the values of each component data element.
RM-REQ-GN-06 Translations The CIMI reference model should allow each data element to have one or more translations recorded for each of its values (e.g. between international and realm-specific reference terms or between semantically equivalent terms in different coding systems).

Data Type Requirements

The data type requirements of the CIMI reference model include:

ID Name Description
RM-REQ-DT-01 Common Data Types The CIMI reference model must include a common set of data types, which can be used to constrain the values of each data element.
RM-REQ-DT-02 Data Type Constraints The datatypes in the CIMI reference model must be expressive enough to support the definition of all required clinical model constraints.
RM-REQ-DT-03 Data Type Mappings The datatypes in the CIMI reference model should be able to be mapped with no loss of meaning (where possible) to other implementation-specific datatypes that are required by the Healthcare community.
RM-REQ-DT-04 Data Type Inheritance All datatypes must be a specialisation of a single datatype class. This is to ensure that the value of a data element can be generically defined in the reference model (using the most generic datatype class), and then specialised into any of the available datatype specialisations.
RM-REQ-DT-05 Primitive Data Types The CIMI reference model will include a set of primitive data types including:
  • boolean
  • integer
  • decimal (i.e. real)
  • string
  • base64Binary
  • dateTime
  • uri
RM-REQ-DT-06 String-Based Data Types The datatypes in the CIMI reference model will include a number of commonly used string-based datatypes, including:
  • Code
  • Object Identifier (oid)
  • Universally Unique Identifier (uuid)
  • System Identifier (sid)
  • Identifier (id)
  • Human Date (allowing partial dates)
RM-REQ-DT-08 Complex Data Types The CIMI reference model will include complex data types to represent those groups of information, which are regularly repeated within the clinical models, but whose details tend to be hidden during clinician verification. Required complex data types include:
  • Attachment
  • Choice
  • CodeableConcept
  • Coding
  • Identifier
  • Interval
  • Quantity
  • Ratio
RM-REQ-DT-09 Attachment The Attachment datatype must include:
  • mimeType [1]
  • data [0..1]
  • url [0..1]
  • hash [0..1]
  • lang [0..1]
  • title [0..1]
RM-REQ-DT-10 Choice The Choice datatype must include:
  • code [0..1]
  • values [0..*]
  • isOrdered [0..1]

This datatype supports the selection of a code from a short list of possible values, such as may be required by pain scales, questionnaires, or assessment indexes.

RM-REQ-DT-11 Codeable Concept The Codeable Concept datatype must include:
  • coding [0..*]
  • text [0..1]
  • primaryCode [0..1]
RM-REQ-DT-12 Coding The Coding datatype must include:
  • code [0.1]
  • system [1]
  • version [0..1]
  • displayName [0..1]
  • displayNameCode [0..1]
RM-REQ-DT-13 Identifier The Identifier datatype must include:
  • id [0..1]
  • system [0..1]
RM-REQ-DT-14 Interval The Interval datatype must include:
  • low [0..1]
  • high [0..1]

An interval may be applied to Quantity, integer, decimal, dateTime and humanDate.

RM-REQ-DT-15 Quantity The Quantity datatype must include:
  • value [1]
  • unitCoding [0..1]
  • status [0..1]

Quantities may be used to define Durations (time), Distances (length), money, mass etc, using different constraints on the above structure.

RM-REQ-DT-16 Ratio The Ratio datatype must include:
  • numerator [1]
  • denominator [1]

The numerator and the denominator must both represent Quantities (with or without units).