Executive Summary



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New ITS – Proposals Summary September 2006




Executive Summary


The NHS National Programme for IT experience to date has identified a number of business issues related to HL7 V3 usability, mostly concerned with learnability, efficiency and satisfaction.

We have considered a number of proposals for improvements to HL7 V3 that may address some of these issues. Key proposals are summarized here:



  • Introduce an implementation model called a XUM (XML-UML-Model)

  • Build the XUMs automatically, based on new annotations to RIM-based Models (RBMs) that support implementation usability

  • Define a formalism for data type constraints

  • Make XUMs easy to use with commercial tools

  • Enable the capability of automatically creating XUMs from any RBM (including profiles), but declare only one XUM as normative. This XUM will define the ‘global’ V3 wire format.

  • Encourage the use of ‘business names’ annotations to RBMs to provide a graphical view that links RBMs with terms used in requirements analysis models

Issues related to the inclusion or exclusion of fixed and default values in the instance are still under debate.


Further investigation is still required to complete the analysis of the best set of detailed proposals to ‘package’. One of the reasons for this is that benefits to implementers vary depending on the approach they take for message processing.
During this investigation, two main ways to process V3 instances were identified (by active V3 implementers), which may be categorized as “specific message processing” and “reference model processing”. From the various proposals described at this intermediate stage, various sets have been assembled that serve either one of these better, and these sets have been compared against the original project goals. From these, a single proposal seems to provide an opportunity for moving forwards in terms of testing activities.
In addition, a number of developments within this project have raised the opportunity for some technical convergence between CEN 13606 and HL7 V3. This is an important outcome for the NHS and will be pursued further.
Further testing will include the use of a RIM-based serialisation with allowance for a very specific model serialisation where appropriate. We would like to have preliminary discussions at the Boca Raton HL7 meetings to help prepare a suitable HL7 project proposal in order to foster wider collaboration with the HL7 community in this work.

Table of Contents


Executive Summary i

New ITS – Proposals Summary September 2006 i

Table of Contents 2

New ITS – Proposals Summary September 2006 2

1 Background 1

New ITS – Proposals Summary September 2006 1

1.1 Objectives 1

1.2 Design Principles 2

2 XML UML Models (XUMs) 2

1.1 XUMs in concept 3

1.1.1 Proposal 3

1.1.2 Benefit 4

1.1.3 Cost / Risk 5

1.1.4 Usability 5

1.1.5 Performance 5

1.1.6 Example XUMs 5

1.1.7 Further discussion 6

1.2 Multiple XUMs and a normative XUM 7

1.2.1 Proposal 7

1.2.2 Discussion 7

1.2.3 Benefit 8

1.2.4 Cost / Risk 8

1.2.5 Performance 8

1.2.6 Usability 8

1.3 Mixing XUM level by model 8

1.3.1 Proposal 8

1.3.2 Discussion 8

1.3.3 Benefits 9

1.3.4 Cost / Risk 9

1.3.5 Performance & Usability 9

1.4 A RIM level XUM only 9

1.4.1 Proposal 9

1.4.2 Discussion 9

1.4.3 Benefits 10

1.4.4 Cost / Risk 10

1.4.5 Performance 10

1.4.6 Usability 10

1.5 Secondary UML presentations 11

1.5.1 Proposal 11

1.5.2 Discussion 11

1.5.3 Benefits 11

1.5.4 Cost / Risk 11

1.5.5 Performance 11

1.5.6 Usability 11

1.6 Relationship to the current XML ITS 11

1.6.1 Proposal 11

1.6.2 Discussion 11

1.6.3 Benefits 11

1.6.4 Cost / Risk 11

1.6.5 Performance 11

1.6.6 Usability 12

1.7 XUMs are built automatically 12

1.7.1 Proposal 12

1.7.2 Discussion 12

1.7.3 Benefits 12

1.8 Annotating RIM-based Models (RBMs) 13

1.8.1 Managing References 13

1.8.2 Infrastructure Root Attributes 13

1.8.3 “Flattening” Models 14

1.8.4 Annotating RBMs with business names 15

1.8.5 Using Business Names in the instance 17

1.8.6 Specifying which fixed and default values to send 18

1.9 Other changes 19

1.9.1 Data Type property constraints 19

2 Groups of Proposals 19

2.1 A package for Specific Model Processing 20

2.2 A package for Generic Model Processing 21

2.3 Having your Cake and Eating it too? 23

2.4 Generally Recommended Package 24

3 CEN 13606 25

4 Conclusion 25

4.1 Testing Activity 25

A Usability in detail 1

New ITS – Proposals Summary September 2006 1

A.1 Learnability 1

A.1.1 Requirements Traceability 1

A.1.2 Message Structures 1

A.1.3 Level of Abstraction 2

A.1.4 Wire formats that are easily understandable to implementers 2

A.1.5 Semantic reusability 2

A.2 Efficiency 2

A.3 Satisfaction 3

A.3.1 Industry tool support 3

A.3.2 Wire format stability 3

A.3.3 Semantic interoperability 5

B Current processing approaches 1

New ITS – Proposals Summary September 2006 1

B.1 GP2GP (1 message) in 2002 - R. Smithies 1

B.1.1 Semantic processing 1

B.1.2 Comment 1

B.2 NHS CFH design support tool: Clinical Statement Renderer - R. Smithies 1

B.2.1 Semantic processing 1

B.2.2 Comment 2

B.3 NHS National Programme for IT Local Service Provider - I. Singh 3

B.4 British Telecom (BT) Approach to NHS NPfIT Semantic Processing 3

B.4.1 Transaction Messaging Service (TMS) 3

B.4.2 e-Transmission of Prescriptions (ETP) 4

B.4.3 Personal Demographic Service (PDS) / ACF 4

B.4.4 Personal Spine Information Service (PSIS) & Clinical Service Application (CSA) 4

B.5 CSW Record aggregation using existing clinical data – A. Wrightson 5

C Notes on RMIM Reshaping – R. Worden 1

New ITS – Proposals Summary September 2006 1

C.1 Overview of the RMIM Shaper Tool 1

C.2 Reshaping Data Types 3

C.3 Semantic Effects of Reshaping 4

C.4 Message Translation from the Reshaping Mappings 5

C.5 Node Counts 5

C.6 Examples 6

C.7 Possible Future Work 7

New ITS – Proposals Summary September 2006 3

D Using Fixed and Default Values in Instances 1





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