RIMBAA 201103 Minutes Washington DC

On March 30 and 31 an international RIMBAA meeting will be held in Washington DC. This meeting has been designated as an out-of-cycle meeting of the international HL7 RIMBAA working group.

• Date: March 30 (10:00-17:00) and March 31 (09:00-14:00)
• Location: EPN Room H, 6130 Executive Blvd, Rockville, MD 20852, USA
• Registration: There is no registration fee - the size of the room is limited to 25 attendees. Please register by either adding your name to the list at the end of this wiki page or e-mal Rene.
• Travel/accomodation: 35-40 minutes from IAD, during rush hour (6-9AM or 4-7PM), travel time could be as long as 60-75 minutes.
• Co-chairs: Rene Spronk, Peter Hendler
• Short URL: http://bit.ly/9j4ong

March 30 Agenda (10:00-17:00)

1. Administrative (max 30 minutes)
   • Agenda Review/Additions/Changes (max 5 minutes)
   • Approval of the Minutes of the previous meeting in Sydney (max 5 minutes)
   • Announcements (max 10 minutes)
   • Report from the HL7 Sydney WGM, and the meeting in London (Rene, max 15 minutes)
   • Planning of the next meeting in Lake Buena Vista FL, USA
   • MOTION: To approve an out of cycle RIMBAA meeting to be held in Amsterdam in November 2011.
2. Validation aspects of the caCIS project at NCI (Todd Parnell, Dan Kokotov, 5AMSolutions)
   • Schematron validation. Schematron has been extensively used to validate R2 datatypes in the XML ITS using an open source tech stack. Local modifications have been made to the MIF tooling to do validation of local datatype flavors. Todd will show how the use of schematron fits into the overall validation picture,which includes schema, vocab, and other layers.
3. Experiences with using the RIM to enable agile architecture - start developing and capturing data while use cases are forming (George de la Torre, max 45 minutes).
   • George has been developing clinical based applications based on RIM Java objects for the past 6 years. Examples include: Proteomics experiments/robotics, Public Health immunization registries, Genomics EDC application, Clinical Repository and recently a Clinical Trials Scheduling system for the Harvard Medical School (HMS).
   • He will focus on how the RIM enables agile architecture, that is, how one can start developing and capturing data while use cases are forming. The HMS case study is a great example..
4. So it's a RIMBAA - so what? (Ann Wrightson ,NHS Wales Informatics Service - UK, max 45 minutes)
   • The fact that the internal model of an application is RIM-based has a "good feeling" in the context of communication using messages, documents or services based on the same RIM. What lies behind this good feeling?
   • An architectural and philosophical exploration of the role of a RIM-based application alongside RIM-based interoperability standards in meaningful human-to-human communication such as a transfer of care using a patient summary expressed as a CDA document.
5. An approach to WSDL generation, and how to associate them with RMIMs. (Lorraine/Jean/John K.)
   • This approach is also used at NCI.
   • Services have a 'payload' R-MIMs; with context (e.g. author, patient) removed; the context shows up as a service parameter. The service 'payload' may consist of a simple II data type instance.
6. The KIS (Keep It Simple) EHR Architecture (Gordon Raup, max 45 minutes)
   • We are pursuing the development of a different architecture for EHRs:
     • The basic idea is to split both the logic and the data into small chunks so that they can be handled in a uniform fashion, allowing many different vendors and independent developers to work on the parts they know best and have everything work together as a whole. For example we use small separate electronic documents as the unit of permanent storage (almost certainly in the cloud), instead of databases
   • The current focus on interoperability and Health Information Exchanges (HIEs) only really supports serial collaboration (I'll take care of this patient and then refer them to you). To support true simultaneous collaboration, each provider caring for the patient needs to be able to access the patients entire chart at any time, all the time. This is not possible with the current architecture of storing the data for each provider in separate databases in separate locations. It is with the new architecture we are proposing.
7. Solving data analytics for CDM using a RIM based approach (Diane Gutiw, Senior Technology Director, SAIC Canada, max. 45 minutes)
   • Chronic Disease Management (CDM) is an area where collaborative teams of clinicians share data on patient demographics, encounters, disease events, treatment protocols and outcomes to determine the most effective treatment protocols and regimes. CDM data and documents are stored in numerous clinician point of service systems such as EMRs, hospital ADTs and clinical information systems. Canada Health Infoway funded the development of an HL7 v3 CDM message to help avoid manual re-entry of relevant data. The objective of this message is to facilitate the collection, transformation and normalization of CDM data and clinical document attachments.
   • The next step in this process is to implement the HL7 v3 message into a RIM-based Shared Health Record and point of service clinical applications. Various approaches to the development and implementation of this RIM based solution will be discussed.
8. Issues related to the querying of a RIM based persistence layer (Rene Spronk)
   • In the past the RIMBAA WG has seen various approaches to retrieving subsets of clinical data from a RIM based persistence layer (notably for data mining purposes / OLAP). Rene will provide an overview of the various issues, including how one determines the scope of the data which should be returned, versioning, use of metamodel repositories, data 'safety'.
9. Persistence Models versus Interoperability Models
   • See wiki page linked to above for details

March 31 Agenda (09:00-14:00)

1. agenda continued from March 30

Registrations

(max 25 attendees)

• Ann Wrightson (NHS Wales Informatics Service, UK), Peter Hendler (co-chair, KP), Rene Spronk (co-chair, Ringholm), Chirag Bhatt (FEI Systems), Jamie Ferguson (KP), Michael Rossman (KP), Pascal Mattiocco (KP), Jean Duteau (GP Informatics), Lorraine Constable, John Koisch (Guidewire Architecture), George de la Torre, Gordon Raup, Diane Gutiw (SAIC, CA) , Clement Chen (SAIC, US), Todd Parnell, Dan Kokotov (5AM Solutions), Geoffry Roberts (Blue Thread LLC), Kenneth Salyards (SAMSHA), Richard Thoreson (SAMSHA-CSAT)