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Proposed CIMI Reference Model

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Core Requirements for the CIMI Reference Model

  • The CIMI Reference Model shall provide the core expressivity required to author CIMI archetypes. In this aspect, the CIMI Reference Model functions as a metamodel, asserting the building blocks that are then constrained in archetypes. At its core, the CIMI Reference Model:
    • shall support the representation of 'classes' which may contain 'simple attributes' and 'nested classes'.
    • shall support the layered application of constraints in archetypes through specialization
    • may support the enforcement of model constraints in tooling based on metadata explicitly captured in the model
  • The CIMI Reference Model shall support the expressivity needs of domain archetypes aimed at modeling a patient EHR as well as CDS and CQI knowledge artifacts.
  • The CIMI Reference Model shall limit its expressivity to those metamodel constructs required for archetype development and delegate domain-level expressivity to those archetypes constructed from the reference model.

Introduction to Reference Model Components

The proposed Core CIMI Reference Model consists of the following components:

Core CIMI Reference Model Components
Component Name Description Notes Examples

UML Representation of the CIMI Reference Model

Version as of July 27, 2016 1:47 pm ET

Proposed changes

  • Addition of new complext data type CODED_NAME_VALUE to support name value types where the name is a CODED_TEXT and the value is a DATA_VALUE
  • Addition of a new metadata attribute to ITEM with cardinality 0..* of type CODED_NAME_VALUE


  • Provides an extensible mechanism for adding meta model attributes beyond those currently provided by the OpenEHR Basic Meta Model Specification (BMM). These metadata attributes are primarily intended for tooling.
  • Allows the definition of additional meta model metadata attributes without changing and re-versioning the reference model.
  • Supports the requirement for additional CLUSTER types in the reference model in order to allow validation, translation, and compilation without needing to introduce them explicitly in the reference model.
  • Ultimately supports the definition of a small and compact core reference model, thus enabling greater expressivity at the CIMI core archetype level.

Disadvantage of Proposed Approach

  • Metamodel attributes are specified at the archetype level alongside clinical attributes but are contained within the metadata container.
  • Constraints and validation rules need to be defined outside the OpenEHR specification (i.e., cannot leverage ADL to enforce constraints). No formalism has been proposed to do so at this time.

BMM Model

BMM File

UML Representation of Reference Model

CIMI core reference model v2.gif

Proposed Metadata Attributes

CIMI Archetype Metadata Attributes
Attribute Name Allowed Values Scope Description
container_kind cluster, composition, section, statement, statement_group, knowlege_definition, knowledge_definition_group ITEM_GROUP Specifies the kind of ITEM_GROUP container for tooling and validation purposes.
is_abstract true, false ITEM_GROUP Specifies whether an archetype is abstract and must be further constrained or whether the archetype can be used as a fully constrained schema for clinical instance data generation.

Tentative Value Sets

Container Kind
Code Preferred Name Code System Description Parent
1 cluster A grouping for a dependent structure or complex data type N/A
2 composition A grouping that holds the content of a document N/A
3 section A grouping representing a section in a document N/A
4 statement_group A grouping representing a collection of clinical statements N/A
5 statement A single clinical statement N/A
6 knowledge_definition_group A grouping representing a collection of clinical statements N/A
7 knowledge_definition An atomic knowledge definition N/A