CIMI Quality Modeling Collaboration

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Welcome to the CIMI Quality Modeling Collaboration

The Clinical Quality Information (CQI) Working Group, in conjunction with the Clinical Decision Support (CDS) Working Group and the Federal Health Information Model (FHIM) Team have joined forces with the Clinical Information Model Initiative (CIMI) to develop a common clinical logical model from which Quality Information Core FHIR Profiles ((QI Core FHIR Profiles) and CIMI Detailed Clinical Models (DCM) will be derived.

As part of this effort, the joint team will focus on:

• Enhancing the CIMI Reference Model to support CQI, CDS, and FHIM requirements
• Developing and/or enhancing CIMI Core Reference Archetypes
• Providing a formal semantic foundation to the CIMI logical model based on SNOMED, LOINC, and RxNORM (SOLOR)

An Important Note about this Effort

This effort aims to develop a number of experimental archetypes in both the CIMI and CQI space in order to further understanding on how to develop CIMI Reference Archetypes and leverage CIMI as part of the CQI ecosystem. In return, we intend to contribute our archetypes, experiences and lessons-learned back to the CIMI initiative as it works to develop a set of CIMI canonical or 'preferred' archetypes. While the archetypes proposed here may not ultimately become preferred CIMI archetypes, it is hoped that our work will influence the development of preferred archetypes or become a starting point for that work. The CDS and CQI Work Groups ultimately aim to adopt the CIMI preferred archetype set once it has been formally defined and approved by the CIMI Working Group.

An Introduction to the CIMI Architecture

The proposed CIMI architecture is a layered architecture, each layer adding increasing domain specialization. The CIMI model has four layers. Click on the links below to learn more about each one:

• Proposed CIMI Reference Model - The core metamodel from which all archetypes are derived.
• Foundational CIMI Reference Archetypes - The set of foundational archetypes that serve as the top level hierarchies for all downstream archetypes. These archetypes are closely aligned to ISO 13606 and OpenEHR.
• CIMI Reference Archetypes - The set of foundational clinical archetypes upon which all detailed clinical models are built. They are sometimes referred to as the schematic anchors of the model or patterns- archetypes that provide the structure and general semantic constraints to be refined by downstream archetypes.
• CIMI Detailed Clinical Models - The set of most constrained 'leaf-level' archetypes specifying formal and unambiguous constraints on parent archetypes to support the interoperable exchange of clinical information and knowledge.

Note that the Foundational CIMI Reference Archetypes and the CIMI Reference Archetypes are often referred to as CIMI Core Reference Archetypes.

Design Principles and Modeling Approaches

To be fleshed out. In particular need to add blurb on:

* Compositional design of clinical statement to support reuse
* Condition vs Observation concerns
* Negation such as 'Absence of' or 'Not done'
* Virtual clusters and what they mean
* Integration with terminology - especially a note about alignment with terminology models
* How Clinical Statement and Modality represent the context for the topic of a clinical statement

Additional Resources

• Susan Matney's procedure spreadsheet can be found here.
• Claude Nanjo's procedure spreadsheet can be found here.
• Use case spreadsheet can be found here.