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Use of Clinical Statements in Care Provision

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Patient Care Normative Ballot Content

Use of Clinical Statements in Care Provision

The Care Provision Domain D-MIMs and R-MIMs for specific message topics depend on the RIM, vocabulary and modeling approaches like any message domain.

However, two HL7 base materials are fundamental for all the Care Provision messages. These are the Clinical Statement Pattern (CSP), specifically the CMET COCT_MT530000 (A_SupportingClinicalStatement universal), which in this normative materials replaces the earlier Care_Statement CMET, and a templating approach. The Care Provision D-MIM has the A_SupportingClinicalStatement as core specification mechanism for the numerous date elements for clinical content in Care Records and Care Record based messages.

Care Provision D-MIM uses the CSP as whole, which can also be used as the source for an HL7 template.

Patient Care is specifying several clinical contents materials into Detailed Clinical Models (DCM). These normally allow multiple terminology and code bindings. Once the DCMs are specified to function in Care Provision R-MIMs, they are transformed into Clinical Statements / clinical statement based HL7 templates. In this process, one action is to choose one code only for implementation. So creating an implementation specification from a DCM means that the specified clinical content will adhere to the CSP in general, and has to confirm to the instance template specification for codes among other constraints.

A whole series of different CSP derived templates can be used on top of a compatible model (such as CDA in general and CCD in particular) to describe the various clinical data sets, codes and value sets, and other constraints that are needed.

Each Clinical Statement use in Patient Care is organized as follows:

  • Each topic has a narrative description defining the scope and use case.
  • Each topic has an associated Figure, showing a subset of the Care Provision model and/or Clinical Statement model being constrained. It should be noted that the entire Care Provision D-MIM and Clinical Statement models are available for use, and that the topics are only focusing on specific use cases and required constraints.
  • Each topic has a set of constraints, expressed using conformance verbs (e.g. "shall", "should", "may").
  • Each topic has a template identifier, which can be used to populate the InfrastructureRoot.templateId attribute of an instance. An instance that thus populates the templateId attribute is claiming conformance to the corresponding topic.