DoF Semantic Content Mapping
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A key element to the DoF work is to ensure consistent and coherent mapping of device semantics from the ISO/IEEE 11073 domain information model (DIM) and related terminology to HL7 constructs, both V2 - which is in wide production system use today for device information reporting - and FHIR. The referenced materials and discussion topics below capture the details and challenges around achieving high quality mappings and conversions where the integrity of the abstract semantics are properly managed and maintained.
The ISO/IEEE 11073 standards for medical and personal health devices form the foundation for device information exchange. They include:
- ISO/IEEE 11073-10101 Nomenclature / terminology specialized for device semantics
- ISO/IEEE 11073-1010x Additional terminology support for specialized areas, such as Annotated ECG (aECG)
- ISO/IEEE 11073-10201 Domain Information Model (DIM) which provides an object model specialized for device-sourced information
- ISO/IEEE 11073-20601 Personal Health Device (PHD) optimized specifications, including a "simplified" version of the DIM specifically for the typicallly less complex PHDs
- ISO/IEEE 11073-104xx PHD specializations that include models based on -20601 (which is based on -10201)
There is a distinction made between two broad classes of devices:
- PoCD = Point-of-Care Devices which are primarily used in acute care settings and tend to have more complex capabilities (e.g., physiological monitors, infusion pumps, ventilators, anesthesia machines, etc.)
- PHD = Personal Health Devices which are primarily used in home / non-acute care settings and tend to be simpler (e.g., insulin pumps, weighing scale, 3-lead ECG, etc.)
Both classes of devices, though, derive from the same foundational semantic standards, namely IEEE 11073 DIM and terminology. This greatly simplifies the "mapping" effort.
Depending on the use context, though, and infrastructure architecture, device data may be exchanged using pure 11073 protocols and content or the 11073 content expressed in HL7 Version 2 messages or FHIR components.
For example, most acute care device data today is initially communicated from the device using company proprietary protocols - and semantics. IHE Patient Care Device (PCD) profile specifications, though map this 11073 semantic content onto HL7 Version 2 messages (primarily ORU message variations). The Continua PHD guidelines also adopt this IHE PCD messaging to send semantically consistent PHD data from a Personal Health Gateway (PHG) across a WAN to some other enterprise system.
Thus, the DoF mapping challenge is to leverage the 11073 semantic foundation, factor in the mappings to HL7 v2, and apply that to FHIR constructs.
It should be recognized that whereas PHD devices are primarily concerned with directly mapping from 11073 to FHIR, both and especially PoCD data streams may need an interim V2 mapping. Thus the materials provided below tend to have DIM to V2 to FHIR mapping sections. Keeping this match-up will help ensure consistency between the three.
Note: The deliverables of this DoF mapping initiative include ...
- Resource mapping sections in the FHIR specification
- Implementation Guide content
- White paper content - especially where there are unresolved topics, due to a lack of consensus or lack of time / resources to complete
- [NOTE: Consider adding a DIM overview section here ...that has content w/ graphics or at least links to where additional information can be found on-line; this may best be handled in the DEV WG wiki home page though.]
Mapping Discussion Materials
PoCD Mapping Documents
PHD Mapping Documents
Mapping Challenges / Topics
The "devil is in the details" definitely applies to any detailed mapping and conversions between these systems, and that is definitely the case with device informatics and achieving semantic consistency and coherence between the various implementation architectures and technologies. The following issues were of particular interest during the DoF's discussions:
- 1. <list topics here with subordinate bullets OR link to wiki pages>
NOTE: Much of the content in this section and related wiki pages may be captured in the DoF Implementation Guide (IG) or white paper(s) for broader distribution to the community.