Including FHIR, CIMI or other standard refs in archetypes

Clinical
1

I have noticed quite a few archetypes making mention of particular FHIR resources, ‘CIMI’, HL7v2, and other data / interop standards. Unless the standard referenced is absolutely immutable, i.e. it is a past release, this is not a good idea. It may not be a good idea anyway, because these standards come and go in time.

Particular issues:

  • CIMI is not something we follow, and as far as I know, is not publishing much within HL7. I would suggest these references be removed.
  • FHIR resources such as the AllergyIntolerance once were sort of close to the openEHR counterpart but have since been remodelled, and text in the CKM archetype is likely to be out of date. Much of FHIR that might relate to CKM (i.e. not infrastructure resources) is still changing, and cannot be reliably linked at a detail level to openEHR archetypes.

In the past, we used to publish the openEHR primary (abstract) specifications (Reference Model and so on) with CEN/ISO 13606 and also HL7v3 cross-references. The latter standard is now obsolete, and the former has been greatly altered by the 2018 version such that all previous analysis of its correspondence to openEHR was not just obsoleted, but actually wrong. When we upgraded the publishing system to the current web-based one, I had to take hundreds of these references out from 1000 pages of specification.

Referring to very specific and stable standards, such as an IHE HL7v2.5 lab profile is probably safe.

In general however, I would suggest these kinds of cross-references be maintained in separate documents, e.g. wiki pages or similar. Otherwise archetypes risk containing text that has to be changed / removed later on as the standards change, or their relevance changes.

2 Likes
2

Makes sense. But I really like to refer to other standards from an archetype. To indicate implementers what other relevant models there are. And to indicate that at (some) design time it was compared. These references do not need to be within the archetype itself. But I would like the archetype to contain a standard way (or at the very least the CKM) to directly link to the place (wiki) where the references are for the archetype. I would like a standard wiki page for ckm archetypes. I see value in a standard wiki page to record meta information other then references. E.g. modelling discussions background.

3

I think these things have been added at different times for different purposes:

  • Provenance overview - this is mostly (only?) the Adverse reaction risk archetype. This archetype was reviewed jointly with FHIR, and the “source” comment for a lot of elements were added to track the provenance of each element, IIRC.
  • The ‘Extension’ SLOT which is added to all ENTRY archetypes. We mention CIMI and FHIR in a lot of these, as examples. We’ve stopped mentioning CIMI during the last couple of years or so. As far as we know these are the only places we mention CIMI in archetypes?
  • References - we sometimes reference FHIR resources when we use them as design inspiration and alignment. We try to link the specific version used, not the latest.
3 Likes