Structure & planning Care Provision Domain
[Patient Care Normative Ballot Content]
The Care Provision materials consist of four levels of message constructs. All adhere to the Care Provision D-MIM specifications. This means that all constructs are directly derivable via constraining from the D-MIM.
The first layer are the R-MIMs for messages. The messages include those for referral and acceptance (Referral Topic), Care Record (Care Record Topic) and Care Record Query (Query Topic).
The second layer consists of R-MIMs that are constraints on the Clinical Statement Pattern. These specify additional structures in the different messages. Examples of such level 2 structures include the Statement Collector, the Concern Tracker, the Care Plan structure, and others. All of these have, or will get a separate Topic under Care Provision. These structures are reusable in other HL7 domains that deploy the Clinical Statement.
The third layer consists of R-MIMs that are also constraints to the Clinical Statement, but are concrete clinical data elements. These structures can be general, such as the Assessment Scale Pattern Topic and the Vital Signs Pattern Topic.
At level four, there can be concrete implementation specifications for clinical contents, usually consisting of one to many data elements, each data element representing one clinical statement. This fourth level will normally not be specified in R-MIM format, but as specific Detailed Clinical Models and the clinical statement template representation for each DCM.
Care Provision and Clinical Statement in particular can hold millions of variations of clinical data elements. If all this would be specified as R-MIMs, such as the examples presented to HL7 in 2005 / 2006, the implementation variations would be enormous. Hence the Detailed Clinical Model (DCM) format was developed.