Detailed Clinical Model instance construction

Patient Care

The HL7 steering committee, domain experts TSC, and the HL7 board approved the Patient Care Proposal

HL7 Project Scope Statement_PatientCare2008DCM-ID320.doc

Work has started in preparation of the Vancouver meeting where on Tuesday Sept 16, examples of the format, the Glasgow Coma Scale and Blood Pressure where presented, consisting of a word document describing the clinical details, a xls spreadsheet holding all data elements, meaning, data type and code from code system / terminology and a UML model.

Generic comment from attendees:

continue the work

we must look at meta information we must look at consistency in UML modelling and harmonising with existing examples. we must look at appropriate coding etc.

ergo: work started and needs to continue, but discussions on all elements will evolve discussing more examples.

William Goossen 17 sept 08

DCM examples

Open for Comment

Currently we have the following DCM examples:

• Apgar Score
• Barthel Index
• Blood Pressure
• Body Height
• Body Temperature
• Body Weight
• Braden Scale
• Glasgow Coma Scale
• Heart Rate
• Respiration

In-Progress DCM (examples)

• Chief complaint, presenting problem, and/or reason for visit
• History of present illness
• Review of systems / symptoms
• Prior/past medical history of disease / disorder
  • History of specific infectious disease
  • History of coronary artery disease
  • History of reactive airway or other obstructive lung disease (asthma, COPD)
  • History of cancer
  • Obstetric and current pregnancy history
  • History of psychiatric disorder
  • History of stroke
  • History of diabetes
  • History of drug allergy or intolerance
  • Birth and gestation history (primarily of interest in pediatrics)
  • Clinical sex
• History of specific procedure
• Physical exam finding
• Current medication use
• Entries in a health concern tracker / problem list / diagnostic impression / differential diagnosis
• Evaluation or treatment plan

In-Progress DCM for e-Diabetes

Nictiz developed about 25 DCM for diabetes care. These are developed around the e-Diabetes dataset distributed in HL7. However, the DCM are only available in Dutch at this time. This is available in English upon request, with time permitted.

• list to be completed

External Links / Internal Links

Back to:

• [Patient Care WG page]