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RIMBAA 201001 Minutes

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Minutes of the RIMBAA WG for the January 2010 WGM

Monday (January 18) Q3 Business-Icon.jpg Technical med.gif

Meeting Attendance - :

At Name Affiliation Email Address
x Alejandro Pica EMA, UK alejandro.pica@ema.europa.eu
x Amnon Shabo IBM, IL shabo@il.ibm.com
x Andrew McIntyre Medical Objects, AU andrew@medical-objects.com.au
x Andy Stechislin GordonPoint, CA andy.stechishin@gmail.com
x Ann Wrightson NHS Wales, UK ann.wrightson@wales.nhs.uk
x Brian Pech KP, US brian.pech@kp.org
  Chris Winters Vocollect Healthcare Systems, Inc., US cwinters@healthcare.vocollect.com
x Duana Bender Mohawk College, CA duane.bender@mohawkcollege.ca
x Ed Larsen Larsen Inc., US e.laresen@ix.netcom.com
x Ernst de Bel UMCN, NL e.debel@ic.umcn.nl
x Ewout Kramer Furore, NL e.kramer@furore.com
x Gordon Raup Carefacts, US graup@carefacts.com
x John Finbraaten Marshfield Clinic, US finbraaten.john@marshfieldclinic.org
x John Harvey Iatric, US john.harvey@iatric.com
x John Timm IBM, US johntimm@us.ibm.com
x Kenneth Weng CareFx, US kweng@carefx.com
x Lorraine Constable CA lorraine@constable.ca
  Marilyn Maguire Fuji Med, US marilyn.maguire@fujimed.com
x Mario Roy Iatric, US mario.roy@iatric.com
x Mark Bevivino Iatric, US markb@iatric.com
x Mark Tucker Regenstrief, US mtucker@regenstrief.org
x Michael van der Zel Groningen University Hospital,
and Results4Care, NL
m.van.der.zel@ict.umcg.nl
x Peter Hendler KP, US peter@hendler.net
x Rene Spronk Ringholm, NL rene.spronk@ringholm.com
x Scan Muir VA, US scan.muir@va.gov
x Scott Parkey Axolotl, US sparkey@axolotl.com
x Stacy Berger COH sberger@coh.org
x Steve Fine Cerner, US sfine@cerner.com
x Tod Ryal Cerner, US tryal@cerner.com
  • Rene chairs the meeting and calls to order at 13:45
  • Approval of agenda for the week
    • MOTION: Approved by consensus
  • Administrative agenda items
    • Announcements
      1. Reminder that there is a RIMBAA co-chair election (today only)
    • Approval of the minutes of the RIMBAA meeting in Amsterdam
      • MOTION by Ewout/Michael van der Zel, 19-0-6
    • Motion to organize two RIMBAA meetings in Europe in 2010 and to designate those as out-of-cycle meetings; the European meetings are to be held inbetween regular WGM meetings (e.g. June and November).
      • (Note that a March 11 out-of-cycle RIMBAA meeting has already been approved during the 20091027 out-of-cycle meeting.)
      • MOTION by Ann W/Ewout 25-0-0.
      • Ann suggests that one of them be held in the UK. Rene welcomes the suggestion.
    • Draft agenda for the Rio WGM
      • 50% of attendees (by show of hands) state that it's likely they'll be in Rio. We'll meet in Rio, the number of quarters has yet to be determined. The agenda will consist of product presentations and discussion of workitems.
    • Accept/reject work item to describe best practices / approaches for GTS implementation (as suggested by Ewout)
      • Accepted in principle, although (by show of hands) the number of interested parties is low (4)
    • Accept/reject work item to ensure that the RIM covers software-user, account, user groups, things one needs in RIMBAA applications, but not in HL7 v3 interactions
      • Accepted in principle, although (by show of hands) the number of interested parties is low (3)
  • RIMBAA Product presentation: Scott Parkey (Axolotl) presents an architectural/RIMBAA overview of the the Axolotl Elysium suite using examples from Axolotl's next generation MPI component. See http://www.ringholm.de/persist/20100118_RIMBAA_Axolotl_Elysium_MPI.ppt for the presentation.
    • Objective is to maintain full RIM-fidelity. Currently fully implement v3 patient/person classes.
    • Design decision: use DB2 pure XML database. Directly store XML files, indexes them based on a tree based representation. Query using XPath, no joins as in relation structure. Works pretty well with RIM, store XML. maintaining fidelity then easy, helps performance aspect.
    • Main reason for DB2: fidelity of data. Rene: probably makes sense esp. given that we're talking about CDA.
    • Custom HL7 v3 java Library (generated from MIF) Construct CDA fragments from Java objects. CO-cell in the matrix. CP-CO-CS cells, all based on the CDA R2 R-MIM.
    • (the following comments were recveived after the meeting was held, as such they're not part of the minutes of the meeting, but provided as background information):
      • Nick Radov (Axolotl): On Monday 01/18/2010 Scott Parkey, one of our software engineers, gave a presentation to the RIMBAA work group in Phoenix regarding Axolotl's new Enterprise Master Patient Index (EMPI) and the supporting HL7 V3 Java library. He mentioned that there were a couple follow-up questions so I am posting answers here in case anyone is interested
      • 1. To what extent is our HL7 V3 library "truly" RIM based, as opposed to being a CDA based "clone implementation"? It's both. We have a set of core Java interfaces (and matching set of implementation classes) for all of the RIM classes. And then we have another set of Java interfaces (and matching implementation classes) for CDA R2 which extend the RIM class interfaces. We had to overcome several design problems because the RIM interfaces are based on the latest RIM MIF file (currently version 2.29) whereas the CDA R2 interfaces are based on the POCD_MT000040.xsd XML Schema file distributed with CDA R2 (based on RIM version 2.20). There are several discrepancies between the two versions. Going forward we will also implement another set of Java interfaces and classes for the POCD patient administration domain, as used by the IHE PDQV3 integration profiles.
      • 2. How, more specifically, did we use MIF to generate the library? I wrote custom Java code to parse the RIM and vocabulary MIF files and generate additional Java code. We considered using XSLT for this but decided to do it all in Java just for simplicity. For each RIM class interface the code generator creates getter and setter methods for each attribute. For vocabulary we create a Java class for each concept domain, and in that class we create Java constants for all of the predefined concept codes.
      • 3. How were the datatypes implemented? So far we have only implemented data types R1 (abstract types plus the extensions defined in the XML ITS). Since those standards are already finalized and we won't have to track periodic changes I just wrote custom code instead of writing a code generator. In a few places we had to diverge from the abstract data types specification in order to handle discrepancies introduced by the XML ITS so that would have also made it impractical to write a code generator.
  • RIMBAA Product presentation: Duane Bender (Mohawk College) presents an overview of the EVEREST Toolkit which is based on collapsed MIF models. The overview focuses on RIMBAA aspects of the toolkit: the architecture of the tool, MIF collapsing, code generation, and the manipulation of collapsed RIM objects in-memory. See http://vimeo.com/8831424 for a video which contains a presentation by Duane of the core architecture of the toolset. See http://www.ringholm.de/persist/20100118_RIMBAA_MARC-HI_Everest_Framework.ppt for his presentation.
    • Framework for building a higher level API. also used directly by application programmers. Provides a rich class experience, no need to deal with XML.
    • The current version is .net based, working on a (port to) an Eclipse (Java) version. Open source released late 2009 as part of OHT.
    • CO-CS cells (no persistence), RMIM oriented product. MIF v2 generated code.
    • Build-in message conformance testing: Classes are conformance aware, when serialization is done it is an conformant instance.
    • Didn't tie to one specific ITS or Datatypes release. Supports both R1 as well as R2.
    • Build-in message conformance testing: Classes are conformance aware, when serialization is done it is an conformant instance.
      • No support for Templates yet. Nor of OCL.
    • Datatypes MIF not really sufficient, need to add custom code. hand written. Called helper functions in the Framework.
    • Working with HTB as a persistence platform. Persistence (in general) not within current shipped product.
    • Lesson learned: Preserve all information in MIF into the framework, including documentation.
    • Lesson learned: tried to only use business names, but had to switch back to pure RIM semantics. People couldn't understand the business names, no consistent use. Mixture of RIM terms and business names doesn't work. have to do either/or. Ann confirms that UK had similar experience.
    • Raised productivity 10-100x, by just having the Framework available
  • MOTION to adjourn (Ewout/Peter H) at 15:00

Monday (January 18) Q4 Technical med.gif

Meeting Attendance - :

At Name Affiliation Email Address
  Alejandro Pica EMA, UK alejandro.pica@ema.europa.eu
x Amnon Shabo IBM, IL shabo@il.ibm.com
x Andrew McIntyre Medical Objects, AU andrew@medical-objects.com.au
x Andy Stechislin GordonPoint, CA andy.stechishin@gmail.com
x Ann Wrightson NHS Wales, UK ann.wrightson@wales.nhs.uk
x Brian Pech KP, US brian.pech@kp.org
x Chris Winters Vocollect Healthcare Systems, Inc., US cwinters@healthcare.vocollect.com
  Duana Bender Mohawk College, CA duane.bender@mohawkcollege.ca
  Ed Larsen Larsen Inc., US e.laresen@ix.netcom.com
x Ernst de Bel UMCN, NL e.debel@ic.umcn.nl
x Ewout Kramer Furore, NL e.kramer@furore.com
x Gordon Raup Carefacts, US graup@carefacts.com
x John Finbraaten Marshfield Clinic, US finbraaten.john@marshfieldclinic.org
x John Harvey Iatric, US john.harvey@iatric.com
x John Timm IBM, US johntimm@us.ibm.com
x Kenneth Weng CareFx, US kweng@carefx.com
x Lorraine Constable CA lorraine@constable.ca
x Marilyn Maguire Fuji Med, US marilyn.maguire@fujimed.com
x Mario Roy Iatric, US mario.roy@iatric.com
  Mark Bevivino Iatric, US markb@iatric.com
x Mark Tucker Regenstrief, US mtucker@regenstrief.org
x Michael van der Zel Groningen University Hospital,
and Results4Care, NL
m.van.der.zel@ict.umcg.nl
x Peter Hendler KP, US peter@hendler.net
x Rene Spronk Ringholm, NL rene.spronk@ringholm.com
x Scan Muir VA, US scan.muir@va.gov
x Scott Parkey Axolotl, US sparkey@axolotl.com
x Stacy Berger COH sberger@coh.org
  Steve Fine Cerner, US sfine@cerner.com
x Tod Ryal Cerner, US tryal@cerner.com
  • Product/Tooling demonstrations
  • Virtual Medical Record WG (vMR) Presentation: (Andrew McIntyre)
    • Keywords: vMR overview (see Virtual Medical Record (vMR)), use of GELLO, MIF-gelloclass-UML transforms, RIMBAA aspects of the ongoing vMR effort. See http://www.ringholm.de/persist/20100118_RIMBAA_vMR_GELLO.ppt for his presentation.
    • Andrew: I aim to demonstrate how GELLO can operate over a VMR (The one we have is a basic one, but RIM like, as in the one in the GELLO standard)
    • vMR is created by Clinical decision support. The model GELLO talks to. GELLO is a OCL variant, specialized for querying. To extract data out of an EHR.
    • vMR model based on various inputs in term of models. vMR could be the basis for services, is GELLO inspired as well. Interested in methods of classes next to their structure.
    • use a facade models (not real RIM) in GELLO to shorten path to access classes/attributes. No moodCode attribute, semantics in context. vMR expressed as a UML class diagram model. Model is (should be) mappable to pure RIM.
    • Attempt is to express vMR as a level-2 CCD R-MIM. Not going for 100%.
    • Ann: OCL is designed to query an object model. Need to ensure that vMR is developed according to HL7 processes, and ensure mappability to RIM. Andy: group would probably benefit from having a Modeling facilitator.
  • RIMBAA Product presentation: RIMBAA Aspects of the DB2 PureXML database. Amnon Shabo (IBM) presents: "research effort developing a data warehouse (RIMon) that is based on the RIM". See http://www.ringholm.de/persist/20100118_RIMBAA_IBM_Hypergenes_BII.PDF for the presentation.
    • Core aspect: BII - Biomedical Information Infrastructure, contains general purpose data warehouse. Called RIMon (RIM based XML storage); querying supported by XQuery. Created datamarts 9exports out of DB2 in ER tables) using RDF definitions.
    • Received v3 instances are RIMified (mapped to generic RIM classes); allows for creation of Rimified queries for decision support. Archived instances are "RIM ITS" (an in-company own version thereof) based, with preserved clone names.
    • Lesson learned: XQuery too complex for most researchers. Lead to the creation of datamarts.
  • RIMBAA in the (SA)EAF Matrix (Michael van der Zel) see RIMBAA: SAEAF vs RIMBAA
    • Michael: SEAF is based on ODP/RM. Views on a system, each view has a different focus. Will need more work to determine how RIMBAA deliverables (best practices, reference implementation) fit with the SAEAF matrix.
  • MOTION to adjourn by Ewout/Peter H at 16:50

Wednesday Q2 (January 20) Technical med.gif

Meeting Attendance - :

At Name Affiliation Email Address
  Alejandro Pica EMA, UK alejandro.pica@ema.europa.eu
  Amnon Shabo IBM, IL shabo@il.ibm.com
x Alan Nicol Informatics, UK alan.nicol@informatics.co.uk
  Andrew McIntyre Medical Objects, AU andrew@medical-objects.com.au
x Andy Stechislin GordonPoint, CA andy.stechishin@gmail.com
  Ann Wrightson NHS Wales, UK ann.wrightson@wales.nhs.uk
  Brian Pech KP, US brian.pech@kp.org
x Charlie McCay Ramsey, UK charlie@ramseysystems.com
  Chris Winters Vocollect Healthcare Systems, Inc., US cwinters@healthcare.vocollect.com
x Dave Barnet NHS, UK david.barnet@nhs.net
x Diane Gutiw SAIC, US gutiwd@saic.com
  Duana Bender Mohawk College, CA duane.bender@mohawkcollege.ca
  Ed Larsen Larsen Inc., US e.laresen@ix.netcom.com
x Ernst de Bel UMCN, NL e.debel@ic.umcn.nl
x Ewout Kramer Furore, NL e.kramer@furore.com
  Gordon Raup Carefacts, US graup@carefacts.com
x John Finbraaten Marshfield Clinic, US finbraaten.john@marshfieldclinic.org
  John Harvey Iatric, US john.harvey@iatric.com
  John Timm IBM, US johntimm@us.ibm.com
x John Ulmer ??, US johnu@clemson.edu
  Kenneth Weng CareFx, US kweng@carefx.com
x Lorraine Constable CA lorraine@constable.ca
  Marilyn Maguire Fuji Med, US marilyn.maguire@fujimed.com
  Mario Roy Iatric, US mario.roy@iatric.com
  Mark Bevivino Iatric, US markb@iatric.com
x Mark Shafarman Shafarman Consulting, US mark.shafarman@earthlink.net
  Mark Tucker Regenstrief, US mtucker@regenstrief.org
x Michael van der Zel Groningen University Hospital,
and Results4Care, NL
m.van.der.zel@ict.umcg.nl
x Peter Hendler KP, US peter@hendler.net
x Rene Spronk Ringholm, NL rene.spronk@ringholm.com
x Rik Smithies NHS, UK rik@nprogram.co.uk
x Robert Worden Charteris, US robert.worden@charteris.com
  Scan Muir VA, US scan.muir@va.gov
x Scott Parkey Axolotl, US sparkey@axolotl.com
  Stacy Berger COH sberger@coh.org
x Steve Fine Cerner, US sfine@cerner.com
x Tim Dodd CA tim.dodd@health.gov.sk.ca
  Tod Ryal Cerner, US tryal@cerner.com
  • Topic: Model Driven Software Development (MDD). MDD could be regarded as a best practice when it comes to RIMBAA application.
  • Rene calls the meeting to order at 11:03
  • MOTION: agenda is approved by consensus.
  • Intro in MDD concepts (Rene Spronk)
    • Rene briefly introduces the basics of MDD and the acronyms used in that context, e.g. DSL, PIM, PSM.
  • Project presentation: DSL and MDD (Charlie McCay)
    • Charlie has been working on Domain Specific Language work and states that he'll present the relationship between HL7 and horizontal software industry methodologies (including MDD) as well.
    • Has experiences with MDD, initally generation of stylehseet (for viewing) based on HMDs. Generate user interface (a simplified tabular view) based on HMD of clinical statement flavors (bit like DCM, or CCD level 3 templates)
    • Wrote mapping v3 RMIM to XML format with a format close to a spreadsheet as it was used by domain experts. (in MDD terms: model to model transformation, with the spreadsheet as the preferred DSL).
    • Mostly we talk about 'tables' , not models. We need to look at 'what works' for requirements gathering. Mapping to underlying R-MIM transparent to domain experts - recognizing that we need the mapping to semantically define the information items. We need to define DSL (a scripting language) to express data structures as well as operations.
    • Used a language workbench application (in Eclipse), define a language that exposes the structure of the spreadsheet. One can then define requirements in the context of an IDE (supports help features, syntax highlighting and language validation). (DSL expressed in Ecore using a mapping to MIF, elements in DSL bound to elements in a MIF) The language gives you a view into the models, its more usable and consumable.
    • Robert Worden: if model is a tree, textual languages work well. If model has loops you need a graphical language.
    • Charlie: from RIMBAA perspectives, domain experts find models confusing. Specifiers, implementers and semantic propellorheads have a different view on the model.
    • Charlie: interested in 'language driven software development' (based on the implemention view of the model)
    • Charlie: Could do this in any layer of the Technology Matrix boxes.
    • Andy: suggest to document this on the wiki (Page: Textual DSL driven application generation).
    • Example of the DSL (some highlights just to get an idea):
 obsCoded ; one particular flavor of a clinical statement
   valueset="Diagnosis"
 obsCodedDate ; a different flavor
   Fixedvalue="DateOfReport"
  • MDD in the MDHT toolsuite (John Timm)
    • Agenda item was dropped; intended speakers were not present.
  • Discussion
    • Michael: to me productivity gain of MDD isn't that important, it's Traceability (between models and code)
  • MOTION to adjourn at 12:28 by Peter H/Ewout K

Thursday (January 21) Q1 Technical med.gif

  • This is a joint ITS/RIMBAA WG meeting, hosted by the ITS WG. The notes below are provided for information only, see the minutes of the ITS WG for the official record of the meeting.
  • RIM ITS - Rene/Grahame present the reasons for, and the details of, the proposed RIM ITS.
    • Grahame: sees three uses: straight RIMBAA, use in messaging apps that don't want to read MIF to import data, use in CDA R3.
    • Conversion from XML ITS to RIM ITS is easy; conversion from RIM ITS to XML ITS is difficult (if one doesn't include cloneNames as an informational attribute) is difficult.
    • Keith: useful, yes (CDA R3), possible: yes. Jean Duteau: requirement for a single schema; deep validation done within application anyway. Ann: agrees with goodness of this, but we shouldn't be carried away by this. We should not set up the two ITSs to be in competition. Define "what this is good for", instead of stating that this is the only way forward. Keith: we have different ITSs, used for different purposes. Rik: like that instance doesn't use clone names, also a learning tool that one shouldn't assign semantics to clone names. Grahame: this helps to move semantics away from the techies to where it belongs.
    • MOTION To ballot the RIM ITS (on normative track, status to be determined) in the May ballot cycle. (Grahame/Keith, 18-0-1)
    • Paul Knapp: ask Mohawk to create a reference implementation. Grahame: I already have one..