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Proposed CIMI Reference Model

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Notes to reviewers

This page has been put up to facilitate review but is a work in progress and is still highly preliminary. The goal of this page is to eventually display the full reference model in both UML and BMM format with an explanation of the model's component structures for broader consumption. Please note that not all parts of the model are currently displayed but they will soon be. Note that when I was developing this model, I had the following goals in mind:

  • Extend the RM beyond its current state but minimize breaking changes
  • Address the shortcomings identified during our last few CIMI calls
  • Stay as faithful as possible to OpenEHR and ISO 13606 - It will make downstream harmonization easier and provide a solid rational for our modeling choices.
  • Attempt to make the RM extensible for other needs such as CDS and CQI's desire to develop a logical model (RM + Archetypes) to support declarative and sharable CDS knowledge artifacts on top of the core foundation CIMI is putting in place. This may require loosening the semantics of ISO13606.

This is a first attempt to do so. In order to meet the above requirements, there is a departure on some of the naming conventions of OpenEHR and ISO 13606 as both of these models are centered around the clinical patient record. The goal of the renaming is to support a more general model but it was done in such a way as to not take away from what was already defined for CIMI. The flip side though is that some of the fleshing out will need to be done at the archetype level. However, despite this potential shortcoming, I feel this model offers the closest compromise and provides a solid foundation on which to build our archetypes. Please let me know your thoughts.

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