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Patient Care

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Welcome to the HL7 Patient Care WG Wiki!

Welcome to the Patient Care Work Group Wiki Site.The Patient Care WG is chartered to define messages to support the needs for communicating information regarding the creation, management, execution and the quality of diagnostic and therapeutic care. This wiki page is for facilitation of ongoing discussions. Please see the hl7 website for more information about the patient care TC

NOTE: the wiki page of Patient Care is under construction. Not all links to following wiki pages are working. These are shown in red. We are working on these pages. You can help if you like!

Current Elections and Ballots: We Need Your Input and Help!

Preparation of the January 2012 Normative Ballot

Steps: Sept 2011 PSS preparation in San Diego Okt 2011 modeling, walk-through and publishing Nov submission Workplan Patient Care Normative Ballot Content

Next WGM, Klaus is running for his next term as co-chair. Please be sure to vote during the elections!

Last meeting PC decided to have a fifth co-chair to assist in all the work we have to do. That was agreed.

We would like to appoint Kevin Coonan (our past co-chair) to be an interim co-chair. We have established a Doodle poll for this. Please vote at:

This is a vote for the interim position. Kevin will stand up for election in January to confirm this.

Doodle poll for vote for 5th interim co-chair

The co-chair meeting of August 9, discussed the situation around the DCM ballot (project 320). The polls have closed, with some line items with a 4 for and 3 against vote. Co-chairs decided that this is meeting the current decision making practices. Hence the co-chairs decided that the reconciliation package can be uploaded and all voters are kindly requested to withdraw their negatives if they agree to how PC will start to address the comments and approved solutions.

In the Sept WGM we want to continue the discussions on the DCM, in particular with the UML style guide applied to the 5 balloted examples (to discuss methodology) and a document on how to handle DCM in HL7 space, to be provided.

I hope that work within ISO and JIC is progressing such that we also can have a formal vote on the ISO 13972 in the HL7 community. You will be informed on this progress.

William August 10, 2011.


Co-Chair Co-chair Co-chair Co-chair
William Goossen
Results 4 Care The Netherlands
Phone: +31654614458
(Term ends in May 2013)
Stephen Chu
National eHealth Transition Authority (NEHTA) Australia
Phone: ??
(Term ends May 2013)
Ian Townend
NHS Connecting for Health United Kingdom
Phone: ??
(Term ends in May 2013)
Klaus Veil
Phone: ??
(Term ends in ??)
Responsible for V2

Model Facilitator Publishing Facilitator Vocabulary Facilitator Project lead Project lead
Jean Duteau
Phone: ??
Email: ??
Michael Tan
Phone: ??
Susan Matney
Phone: ??
Email: ??
Andre Boudreau
Care Plan
Phone: ??
Email: ??
Laura Heermann
Care Plan
Phone: ??
Email: ??

The role of a project lead is to take responsibility for one of the Patient Care Projects and engage PC membership to achieve the project goals. Hence, they relieve the work of the co-chairs. Once a project could go to ballot, co-chairs will arrange for appropriate voting procedures and ballot formalities.

26 May 2011: Missing information can be added.


This section contains the management issues for the PC committee. This is for work group health, to track and trace our work and to stay current.

Change Requests

Patient Care has now a formal request for change (RFC) page which can be used to request changes in the ballot materials.

Patient Care Change Requests

Please use this for RFC you have pertaining to Topics, D-MIM, R-MIM, use cases, interactions, walkthrough etc. Those that have been handled by either a motion accepted, and /or models or descriptions being changed are listed under Dispositioned Requests.

Meeting Information

Draft agenda for next WGM minutes from the HL7 website

Please also look both in the general document section and minutes section.

Conference Calls / Meetings

Project Priorities

Patient Care has several active projects and some waiting for volunteers to step up and carry on.

  • Our main goals are to bring the Domain Message Information Model (D-MIM) to normative ballot in the January 2012 cycle, and following this the 4 core Topics Referral, Acceptance, Record Query and Care Record in the May 2012 cycle (unless we can speed up the work for January).
  • In addition two Active Topics include Allergy and Intolerance and Care Plan. For both information analysis

is ongoing, leading to Domain Analysis Models (DAM) and updating the dynamic models R-MIMs for both Topics. Allergy and Intolerance Topic is currently planned to go to Normative in September 2012 ballot.

  • Beside these more infrastructural parts we are working on the domain content. In principle: a HL7 sound specification of what goes into the Care Record, what can be in the Query, or what goes in the Care Plan.

Two current examples include the DAM for Skin Care and Detailed Clinical Models (DCM) for five frequently used clinical materials.

  • We are cleaning up the Assessment Scale R2 DSTU ballot to be included into the NE 2012.

All other Topics in the table below are still on our to do list, but will follow our above priorities.

Project Information

Project Status
Care Provision D-MIM

The Care Provision D-MIM is the fundamental piece of work of the Patient Care Working Group. All HL7 messages under Care Provision are dependend on this Domain Message Information Model. All R-MIMs representing specific messages for specific tasks for continuity of care are derived from this basic model. The derivation is done via removing from D-MIM what we do not need, replacing full classes with CMETs, constraining attributes, cardinalities or relationships, or - very important - roll out specific structures that are derived from the clinical statement.
Activity ongoing is to move this as a single Topic in the ballot to normative ballot, and to split all underlying R-MIMs to separate topics. In particular obsolete material such as the assessment scale part in care structures with RM_***120 needs to be removed, in favor of the new DSTU version R2, with number RM_**125. The latter has been submitted for publication.
Project ID: 284

Project contact: William Goossen,|

Allergy & Intolerance

This topic covers all interactions related to clinically recorded adverse reactions.
Finish the work from the ballot resolution on the Allergy/Intolerance topic and have it published as DSTU.
Project ID: 174
Project contact: Stephen Chu;

Pressure Ulcer Prevention

This topic covers pressure ulcer risk assessment and interventions.
The project will develop a Domain Analysis Model based on work performed by the Kaiser-Permanente US Department of Veterans Affairs collaboration.
Project ID:
Project contact: Jay Lyle;

Health Concern

Concern Tracking and Care statements provide a framework for tracking and managing health concerns.
Ballot resolutions for Health Concern are completed. Currently work is in DSTU status, but all work from the reconciliation needs to be carried out.
after the work is done, and material is remodelled and publishable a publication request needs to go to HL7 HQ.
Project ID: 666.
Project contact: Jean Duteau, Canada

Care Plan Topic & Ordersets

The Care Plan structure is used to define the management action plans for the various concerns identified for the target of care. It is the structure in which the care planning for all individual professions or for groups of professionals can be organized, planned and checked for completion.
Care Plan is Draft.
Project ID: No separate project ID, but part of ongoing work joint with CDS and O&O WG
Project Contact: William Goossen;

Care Plan Initiative project 2011

Care Plan has been balloted some years ago as DSTU. However, it was felt at that time that more work needed to be done in defining care plan, the components of the care plan, identifying use cases and use. The plan for 2011 is to first develop a Domain Analysis Model (DAM) for the Care Plan, and then decide on follow on activities. The HDF 1.5 (HL7 development framework) approach will be followed.
HL7 PC will build on the material and knowledge of various groups to develop the DAM.
Project ID: No project id assigned yet, once PSS gets in, the ID will be assigned.
Project contact: André Boudreau, or Laura Heermann Langford,

New PSS and Project ID needed before moving any material to ballot
Care Plan Topic project

Care Plan has been balloted some years ago as DSTU. However, it was felt at that time that more work needed to be done in defining care plan, the components of the care plan, identifying use cases and use. The plan for 2010 is to complete the contents of Care Plan.
HL7 PC will work together with: HL7 Structured Documents WG IMIA-NI IHE For the content of this DSTU material.
Project ID: 651
Project contact: Rosemary Kennedy, or Laura Heermann Langford,

Care Composition

It is part of the ballot since 2010 as DSTU.

Project ID: 106
Project contact: Does need a PC member to be responsible for this project for future work (early 2012 to be decided to move to normative).

Assessment Scales

The aim of this release is to provide a generic template based on the clinical statement pattern for use with almost all scores systems and assessment scales. Therefore, it provides a framework for use in messages and documents.
Finish the work from the ballot resolution on the Assessment Scales topic and have it published as DSTU. It has been completed and is submitted for DSTU publication in NE 2012.
Project ID: 664
Project contact: William Goossen;

Detailed Clinical Models

The underlying assumption for a standard on Detailed Clinical Models is that to use, exchange and reuse data, and to obtain meaningful information from it for each purpose, data need to be handled consistently. This consistent use is required on both the mono- and multidisciplinary health professional level.
Five examples where balloted in September 2010.
Patient care has finished the reconciliations and the ballot has received sufficient support. PC is now planning meetings on methodology and following that will re-ballot each DCM one by one.
Project ID: 320
Project contact: William Goossen;

Detailed Clinical Model guidelines for creation

The DCM guidelines will be entered as soon as the ISO standard is finished. Please mail to the patient care list if you think it takes too long :-)
Plan is to translate a Dutch document covering UML style guide for DCM
Project ID: No Project ID. PSS might be considered in future, but preferably to handle via ISO 13972
Project contact: William Goossen;

Detailed Clinical Models for Medical Devices

The intent of this project is to create and maintain one generic Domain Analysis Model and a set Detailed Clinical Model that defines the main concepts of using medical device-related data safely and traceably for patient care.
the work is carried out as joint project with HL WG Devices
Project ID:
Project contact for patient care:Anneke Goossen;
project contact for devices: John Rhoads


The relationship between a Domain Analysis Model (DAM) and a Detailed Clinical Model (DCM)and how this fits into the Services-Aware Inteoperability Framework (SAIF)
Project ID: no project ID required, ongoing harmonization work in HL7 international and with other groups
Project contact: Michael van der Zel;

Patient Care Glossary

The concepts that Patient Care is using are defined in the glossary. Project is just started with defining the concepts that are being used in the Care Plan Topic project. See Care Plan Glossary Patient Care Glossary
this work is done in conjunction with the SKTM glossary of the international SDO's
See ISO 13940 Continuity of Care standard for definitions
Project ID: 495
Project contact:

Patient Care V2

Patient Care has resumed some responsibility for HL7 version 2 chapters 11 and 12. Australia will take care of the work involved.
Project ID:
Project contact: Klaus Veil

Diabetes project

Patient Care sponsors the Diabetes Dataset project by CIC See ***
Project ID: 509
Project contact: CIC co-chairs

Safe Patient Handling

The safe lifting and movement of patients, known as Safe Patient Handling (SPH), is a major concern for hospitals, nursing homes, rehabilitative facilities, and home healthcare workers. In order to protect patients and keep nursing staff healthy, many facilities are implementing SPH programs.
Project ID: PSS needed first.
Project contact: William Goossen;

On Hold pending input of project scope statement from requester.

Other topics the Patient Care TC has defined:

These have their own project numbers, or project scope statements need to be developed and balloted.

Needs New PSS and Project ID: by August 2011.

Needs New PSS and Project ID: by August 2011.

Needs New PSS and Project ID: by August 2011.

No later than before the Sept 2011 PC needs to create PSS for Care Transfer, Care Record and Care Record Query to check consistency with D-MIM update 2011, check Topic status as separate material in order to better manage our ballot publications, make changes and so on. This is necessary to move to normative ballot for January 2012. Next action needed for below materials: Include Care Transfer, Care Record and Care Record Query in table above and create PSS for each. Current # 284 for D-MIM needs to be split into four #. 284 then remains for D-MIM and Care Transfer, Care Record and Care Record Query each need a new Project ID:

  • Care Statement -- the clinical statement version in the D-MIM for patient Care, currently DSTU.

Will in future versions of Care Provision be replaced by the Clinical Statement CMET A_SupportingClinicalStatement universal (COCT_RM530000UV)

Needs to be split up in a whole set of different topics to allow finding these in the ballot. Current clustering renders it not findable. Each separate Topic needs a new PSS and separate ID around January 2012 once the D-MIM and first Topics Care Record, Query, Transfer have been brought to ballot.

  • Concern Tracking -- currently DSTU as part of care structures, to be moved to separate topic level

Needs new PSS and ID by January 2012 to move to normative

Project ID: 103


External links