EHRs FM Profiling Tool

EHR-S FM Profiling Tool Project

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Project Overview

This project, sponsored by the HL7 Tooling Workgroup and co-sponsored by the EHR Workgroup, produces a desktop tool to create EHR-S FM profiles (starting with the EHR-S FM R2), with enforced profiling rules, and exports as documents, support for and XML interchange format for reuse across profile tool instances or for use in other tools. Additionally, the tool will:

• shall support multiple platforms, Windows, Linux, MacOS, the project starts with Enterprise Architect, which is a windows based tool.
• be available via OHT.
• There is a defined XML exchange format that is used by at least one other tool (via import and export of the FM in Enterprise Architect).

This tool will become a tool in the HL7 suite of tools.
This project is targeted for the EHR-S FM R2. However if it is determined that there is enough harmonization with R1.1, there may be support for references to R1.1 to aid in the updating of manually created R1.1 profiles.

The project consists of two phases. Phase 1 delivers the design and inclusion of the EHR-S FM into Enterprise Architect. It also includes the validation, and export of the EHR-S FM and documentation. Phase 2 will consist of creating profiles by using the developed tool in phase 1.

Project Need

The current method of creating EHR-S FM profiles, using unstructured tools (spreadsheet, text processor), do not enforce moderately complex rules for creating EHR-S FM profiles leading to a very laborious manual effort that is prone to errors. Furthermore the current methods do not easily provide methods for building on top of, merging, or updating existing profiles. These challenges prove to be significant barriers in the use and adoption of the EHR-S Functional Model.

Project Success Criteria

• Supports Functional Models that support the EHR WG specifications (e.g. Personal Health Record System (PHR-S FM) with the same model schema.
• Tooling is supported by the HL7 tooling workgroup as part of the HL7 suite of tools.
• Capable of producing fully conformant EHR-S FM profiles, which may be ballotted.
• Supports exportation of profiles as a document, a computable interchange format (XML), a spreadsheet and a hyperlinked html document.
• Supports importation of profiles via the defined interchange format.
• The tool is used in the EHR-S FM Tutorial.

Currently Out of Scope

Other related tooling
- Model balloting, balloting, reconciliation, and publishing
- MIF
- MAX
- Desc ???
- Links ???

Project Leaders

Corey Spears

John Ritter

Michael van der Zel

Project Team

William Goossen, internal projectleader

Michael van der Zel, modeller

Andy Stechishin, tester

Anneke Goossen, documenter

Meeting Information

Conference Calls
The project team has a weekly conference call on Monday evening.

Members of the project team will join the regular conference calls of the WG EHR and the WG Tooling.

Project Documents

HL7 Project Scope Statement - EHR-S FM Profiling Tool.doc

• The project scope statement was approved by the EHR and Tooling Workgroups in November 2011.

Project Status

Project Plan Draft

This project is slated to follow an iterative development pattern. Below is an initial draft for the first iteration.

1. Functional requirement definition
   • EHR-S FM Chapter 2 (Conformance rules - Tool business rules)
   • Define user experience requirements
   • Functional Brainstorm and Survey (define initial release functional requirements
2. Existing tool analysis
3. Functional Specification
4. Technical Specification
5. Development
6. Testing
7. Release

Dependencies

The project depends on the availability of the following materials:

• Full XML export from the EHR-S FM spreadsheet
This material has been made available Dec 31, 2012.
• Validation rules for the EHR-S FM
The validation rules where provided in September 2012 and used as input to the validation function.

Current Activities

Exporting XML from the EHR-S FM spreadsheet.
EHR-S FM design pattern development.
EHR-S FM XML to UML mapping.
Completing the set of validation rules for EHR-S FM.
Inclusion of the EHR-S FM in Enterprise Architect.
Exporting EHR-S FM documentation from Enterprise Architect.
User documentation for EHR-S FM import/installation in Enterprise Architect.
Documentation to use EHR-S FM in Enterprise Architect.
Documentation to export EHR-S FM from Enterprise Architect.

What has been done till end of September 2012

The project team has held weekly Skype conference calls to discuss the goals, plan, deliverables, work and progress.
A Github repository for the source code was established for the project team, which at the end of the project will be handed over to HL7
A MS Groove folder was established for all other files, meeting agenda’s and reports, links etc, for internal use.
The HL7 Sept 2012 WGM was prepared for, through a PowerPoint presentation, delivered to Tooling WG, EHR WG and tooling planning meeting.
Dependency was discussed, and consequences expressed. In case that would become a blockade, report to HL7 before December 1.
The EHR workgroup members have been asked for validation rules. These where provided, and discussed in the conference call Sept 25. A draft document with validation rules was created.
Initial efforts to create the wiki page for the project have been undertaken and we will follow up with the EHR WG how to arrange that.
XML to UML import meta model was available for R1.1. This existing material is changed to EHR-S FM R2. Our current version of the UML meta model of R2 is v 3.2. This will definitely change when the import, meta model and UML representation and mapping are 100%.

What has been done till end of January 2013

1. Continued weekly Skype conference calls, with some interruptions for holiday and Jan WGM.
2. A Github repository for the source code and all deliverables are made available for EHR WG.http://gforge.hl7.org/gf/project/ehrsfm_profile/frs/
3. MS Groove folder for internal use and meetings.
4. PowerPoint presentations at HL7 Sept 2012 and January 2013 WGMs.
5. Dependency discussed at WGM and in conference and individual calls.
6. Mr. Corey Spears consulted in Dec 2012 and Jan 2013 with results in XML/ schema suggestions.
7. EHR workgroup provided validation rules and reviewed the validation rules document.
8. XML to UML import meta-model for EHR-S FM R2 draft was created (v 3.2).
9. May 2012 XML was used as baseline file for the draft work.
10. Corey Spears’ XML materials and Helen Stevens’ master Excel table where used to check and update the approach.
11. 90% ready UML representation of the EHR-S FM delivered, waiting for update to 100% once validation is approved.
12. Tool design sheet delivered, describing the whole process (see figure 1 on the bottom of this report).
13. Excel to XML exports developed and delivered.
14. Decisions made to include the informative parts of the EHR-S FM as add on’s to the XML.
15. Export from EA EHR-S FM in UML to XML using MAX format confirmed, using xpath 1.
16. Initial testing approach discussed and first draft test approach developed and delivered Jan 2013.
17. Additional export XML from Excel tool developed and reviewed.
18. Import of EHR-S FM from new XML into EA now 99% ready.
19. User guide discussed with EHR WG, will be updated when new materials are approved.
20. Errors in XML document has been discussed and solutions for most issues determined.
21. Internal Testing the XML generation from XLS.
22. Internal Testing Import of the full XML into EAP, using the XML R2 Schema.
23. Organize feedback from WGs to UML representation of the EHR-S FM based on full XML export from Excel.
24. Discuss the validation rules with WG and create first validator as stand alone version.

Summary of the January 2013 deliverables

1. EHRSFM_EA_AddIn (2013-jan-27) v2.zap (http://gforge.hl7.org/gf/project/ehrsfm_profile/frs/). This file must be renamed to *.zip to open. It contains the EHR-S FM extension to EA tool.
2. FM-validation file.It contains the EHR-S FM validation tool in a version external to EA for stand alone testing.
3. Unchanged EHR-S FM export from EA: EHRS_FM_R2 (import v2.2) generated-ehrs-fm-20121115-full2.max (http://gforge.hl7.org/gf/project/ehrsfm_profile/frs/).
4. Edit Forms in EA (2013-jan-27) which illustrates first drafts of the user interface for EHR S #FM (colored sections) and the validator output (black / white on left bottom). See figure below.
5. EHR-S-FM-Testdesign. First draft for comment of the test of the tool by the EHR and tooling WG. the final document will be published.
6. We have uploaded the release package to the GForge EHR-S FM Tool project here: http://gforge.hl7.org/gf/project/ehrsfm_profile/frs/?action=index. This release is labeled 2013-Jan.

This release contains an update for the Enterprise Architect plug-in, a Schematron file to validate Functional Model extracts in MAX format, a stand-alone version of the Schematron file (an XSLT 1.0 file that will run with any XSLT 1.0 processor such as xsltproc on the command line), a sample MAX format file that contains an export of the preliminary load of the EHR-S FM into EA, a MAX format file that contains intentional error used in testing the Schematron validations, the validations document from the EHR WG with additional notes to trace the validation errors (by ID) to the source (not complete), the detail design spreadsheet containing the full list of validations identified to date with progress/status (and where applicable questions or comments on the validation), and a PDF with a sample of color-coding the input forms for the functional models in EA.

Please note that the Schematron validations and the detail validation design are preliminary deliverables, not final. We are expecting that these will continue to evolve in the next release cycle prior to final acceptance.

During EHR WG Conference cals the organization of the test will be discussed.

Past Activities

Creation of an EHR Tooling list - Helen
Suggestions mechanism - Michael
Invite Profiling SMEs - John
EHR-S FM Chapter 2 -> Link ???

Current Functional List

The following list contains all thus far identified functionality in general order of priority (greatest to least)

Input (not specific to this project, but defined through from EHR-S FM development and publication)

• EHR-S FM R2 source in XML

Absolute Functionality (Top Priority)

1. Enforce profiling rules (per Conformance Chapter)
   1. Include/Exclude functions from profile
   2. Conformance Optionality
   3. Conditional Criteria
   4. Criteria Inheritance
   5. Add functions and criteria
   6. Modify functions and criteria
   7. ... (Other absolute profile rules)
2. output formats
   1. HTML
   2. PDF
   3. XML
3. Browse & Navigation of the funtional model
   1. search capabilities, filtering capabilities, keyword search, search & replace.
4. Tool is framework specific (e.g. coded to EHR WG FM framework specifications), but content in-specific (enables the import/export of different conformant models/versions (e.g. EHR-S FM 2, future PHR-S FM). (Tool is content agnostic)
5. Save profile

Needed Functionality (High priority)

1. Ability to revert to previous state (undo)
2. Simple text copy paste (text editor related)
3. Text formatting (highlight, bold, underline, font, italicize
4. Show dependencies between functions/criteria
   1. Show impact of changes
5. Undo changes
6. Capture comments regarding specific elements (i.e. comments regarding specific functions or criteria)
7. Initialize/revert to conformant base standard (clear old comments, reset to clean restart to new version activity)
8. Ability to link functional model/profile (intra/inter base standard and profile, linked to a conceptual model, bi-directionally)

Operative Functionality (Medium Priority)

1. Output format HL7 HTML publication format (i.e. to publish through HL7 Publishing)
   1. Generate publication ready documents.
2. Attach front-matter to publication. Chapter 1 (Additional material
3. Maintain original for comparison with modified function/criteria
4. Compare to other profiles
5. Merge Functions/Criteria from separate Profiles
6. Export Sections from Master or working copy
7. Function copy paste
8. Balloting & reconciliation traceability version control
   1. Managing voting and input from reviewers.
   2. Reporting out all comments against an element.
9. Capturing institutional memory "allow for comments/notes" attached to elements.
10. converting a profile from one version to the next.
    1. If you have a profile based on R2.0, have the tool update baseline profile to R2.1 as starting point.
11. Requirements regarding tooling access (online)
    1. Support multi user - multiple users working on same profile at same time?
    2. User Management, access control
12. Workflow management tool (assigning activities to users)

Additional Functionality (Low Priority)

1. mobile access

• Note - will not support R1.1. Is it necessary to convert R1/R1.1 to R2?

Listserv

The EHR-S FM Profiling Tool Project is currently being set up.
To subscribe to a list service, please go to the HL7 Listservices Welcome Page

Additional Work

Make the FM available in UML for incorporation in UML Modeling & Design. Used with the EHR FIM, see EHR Interoperability WG. The mapping is for R2 now as work in progress for the EHR-S FM tool part phase 1. See first picture below. An earlier version for R1.1. has informed the work for R2. See 2nd picture below.

R2 Meta model in UML work in progress

R1.1 UML meta model