Leeds / Rockville 2013

CIMI Meeting Leeds, England and Rockville, Maryland, USA.
Meeting date: 
Thursday, April 11, 2013 - 09:00 to Saturday, April 13, 2013 - 17:00


Thursday April 11, 2013
Topic Lead
Welcome and Overview Stan Huff

Modelling Task Force Update

  • Laboratory Results
  • Demographics Model
  • Reference Model - Overview
Linda Bird
Reference Model – Gap Analysis & Implementation Michael van der Zel
Rheumatology OWL/Protege Model Peter Hendler
Michael Rossman
Overview of Oxford Work Jim Davies
Steve Harris
Update on OMG and UML Models Dave Carlson
Further Review of CIMI Work and Plans Stan Huff
Friday April 12, 2013
Topic Lead
Mindmap ADL Creation Joey Coyle
Patrick Langford
Tooling Harold Solbrig
CIMI Repository Requirements Stan Huff
Model Governance Stan Huff
Saturday April 13, 2013
Topic Lead
Terminology Binding Linda Bird
MTF Work Plan Stan Huff
CIMI Enterprise Architecture Bo Dagnall
Immunization Model

IEC Update

  • HL7 support contract
  • IHTSDO Agreement
  • CIMI funding requirements
  • CIMI organization structure
  • CIMI membership
  • CIMI organizational governance
Mike Lincoln
Review of Action Items and Next Steps Stan Huff

Leeds/Rockville 2013 Meeting Highlights

There were 50 participants in the meeting (Leeds, Rockville, and remote).

Voting Members present at the meeting:

  1. CDISC – Julie Evans (alt)
  2. Canada Health Infoway –Ron Parker (alt, remote)
  3. en13606 Association – Gerard Freriks (remote)
  4. HL7 – John Quinn (alt)
  5. Intermountain Health – Stan Huff
  6. Kaiser – Jamie Ferguson
  7. Mayo Clinic – Harold Solbrig
  8. MOHHoldings Singapore – Linda Bird (alt, remote)
  9. NHS England – Nicholas Oughtibridge
  10. Results4Care - William Goossen
  11. South Korea – Sun-Ju Ahn
  12. Tolven – Tom Jones

By formal vote

1. A motion was made, seconded and passed to freeze the CIMI RM DSTU 1.0.11 (Draft Standard for Trial Use). Because of concerns about whether a quorum of voting members was present, this resolution was confirmed on conference calls with the voting members.

2. A motion made, seconded, and passed to accept an offer from the VHA to utilize their version of the IHTSDO workbench for terminology navigation and reference set selection/management and for authoring CIMI extensions to be submitted to SNOMED CT (or another suitable reference terminology). Because of concerns about whether a quorum of voting members was present, this resolution was confirmed on conference calls with the voting members.

Sense of the meeting agreement

Stan led a discussion about requirements for a repository, outlining requirements for supporting model development and publication. Following his suggestions for an approach to the Editorial Board and Model Governance, the sense of the meeting supported the approach for the editorial board.

The group discussed the need to identify opportunities to implement CIMI models. This could include lab profiles for FHIR, ONC’s structured data capture initiative, VA/DoD lab and immunization models, and work at Oxford and Kaiser. Other topics addressed in the meeting (slides form each section will be in the CIMI Wiki.

Modeling activity

Linda Bird reviewed progress with:

  • Reference model
  • Demographics Model
  • Laboratory report model
  • Terminology binding
  • Specialisation
  • Data Type

The group identified the following priorities for MTF work:

  1. Diabetes – lab, physical findings, scales
  2. FHIR connectathon – lab data

The group requested that a web tutorial be arranged to explain how to complete the modeling templates.

Michael van der Zel reviewed gap analysis indicating the work that needs to be done before models are ready for use. Comments from community were noted.

Jamie Ferguson raised the topic of ADL being the preferred formalism and questioned the lack of progress with ADL in the creation of models for use. There was agreement that the CIMI Community would have the opportunity to re-visit this approach in the coming months. The group confirmed CIMI’s commitment to developing models in both ADL and UML.

Work on the OMG ADL ballot was discussed. There was agreement that there on the need to identify a formal sponsor and to have CIMI volunteers to move the work forward.

Dave Carlson discussed progress in UML modeling with a focus on terminology binding

Patrick Langford and Joey Coyle discussed progress in MindMap to ADL creation at Intermountain Health.

Vocabulary tooling and binding

Michael Rossman and Peter Hendler presented the current Kaiser approach to vocabulary binding, including the employment of a “reasoner” that makes extensive use of “triplets” to drive the process.

Harold Solbrig reviewed the current status of terminology tooling. Harold expressed concerns about the lack of complete models in a CIMI repository. Harold discussed the principles of Agile development in relation to the tasks at hand.

Linda Bird led discussion of terminology binding. It was agreed that the modeling group (with Harold and Linda leading) will meet for 2 hours this coming week to clean up areas if ambiguity.

Research data considerations

Steve Harris and Jim Davis from Oxford University made a presentation that focused on research-driven data standards. Several members noted the analogous activities being considered by ONC.

Steve Harris (Oxford) led a discussion of looking into caDSR (“nicely curated content”) with a tool that his team has developed.

Jennifer Sisto reviewed progress of ONC’s Structured Data Capture initiative


Henk Jan Meijer presented the approach that Portavita proposes for the “public view of CIMI”. Harold asked that the current URL be re-directed to the Portavita site once it has been populated with sufficient content. It was recommended that Sarah Ryan manage the style sheet for this new web site.

Enterprise architecture

Bo Dagnall made the case for adopting an Enterprise Architecture Proposal. The group agreed to move forward with development of the CIMI Enterprise Architecture. An working group was established comprised of:

Federal Health Information Model

Mike Lincoln discussed the Federal Health Information Model (FHIM) and Galen Mulrooney drilled down into Immunization Domain and also into “assessment”. Galen pointed out that the FHIM is at the RMIM level rather than at a Detailed Clinical Model (DCM) level.

Next Meeting

The group agreed to hold the next meeting in June. Dates and locations will be determined and announced to the group via email.

  • VA/DoD iEHR projects (Stephen to send prioritized list)
    1. Immunizations (live by Sept 2014)
    2. Lab (live by Sept 2014)
      1. Individual measurements
      2. Panels
      3. Microbiology culture results
      4. Anatomic pathology (later)
    3. Pharmacy
    4. Order management (lab, radiology, medication)
  • NHS projects
    1. CDA templates – temperature
    2. Care Data Dictionary - future
  • Structured Data Capture – ONC
  • Commodity12 – Ready before November
    • Bo Dagnall
    • Gerard Freiks
    • Sarah Ryan
    • Stan Huff
    • William Goosen
    • Steve Huffnagel
    • Niranjan Sharma
    • Michael van der Zel

Location meeting:

Presentations and documents

12 documents available. Click on title for a preview and details.

Author: Dave Carlson Document: File Archetype Modeling Language

UML for Archetypes
Status update April 11, 2013

AML Objectives
UML Style Guide and profile for archetype modeling - Representation of ADL structures, constraints, and ontology
Define UML stereotypes, as necessary, to extend UML language - Most archetype structure already supported by UML - Primary addition: Terminology bindings (meaning and value set constraints)

Author: Bo Dagnall Document: File Enterprise Architecture Proposal

What is Enterprise Architecture?

“The structure of components, their inter-relationships, and the principles and guidelines governing their design and evolution over time” (TOGAF)

Author: Sarah Ryan Document: File CIMI for Infoway SCSC

Improve the interoperability of healthcare systems through shared implementable clinical information models.


Meet the needs of the clinical modeling community – everyone contributing, benefiting, and actively involved

Author: Linda Bird Document: File CIMI Modelling Taskforce Report

CIMI Modelling Approach
CIMI Modelling Foundations
Laboratory Results models
Demographics Models
Future Work
Terminology Binding

Author: Michael van der Zel Document: PDF icon CIMI Reference Model

The current CIMI RM
GAP Analysis – Current CIMI RM vs our Agreed RM Requirements in the RM TF Report 1.0 dd May 2012
Timeline & Next steps

Author: Linda Bird Document: File CIMI Terminology Binding

Use Cases and Requirements
Proposed Approach
Example Lab Results Bindings
Terminology Reference Sets
Archetype Object Model Support
Future Work

Author: Harold Solbrig Document: PDF icon CIMI Tooling Group Summary


Brief introduction to  – IHTSDO Value Set Editor (John Gutai) – IHTSDO Workbench – SnowOwl
Vocabulary Tooling Group formed – Harold Solbrig volunteered to chair
Discussion and review of modeling tools
Formation of Modeling Tooling Group – Harold Solbrig drafted to chair

Author: Stephen Hufnagel Document: File Clinical Informatics-Modeling

Draft Working Document; Not for Official Use or Wide Distribution


*.DOCX is at: http://informatics.mayo.edu/CIMI/index.php/Main_Page
*.EAP is at: https://www.dropbox.com/s/69ca6zhjuxhrcdj/CIMI%20in%20iEHR-CIIF.eap

Author: Peter Hendler, Michael Rossman Document: PDF icon Clinical Ontology Models

Rheumatoid Arthritis Assessment Use Case
Rheumatoid Arthritis Assessment Modell (RAAM)
An OWL Model for the Input & Output of a Clinical Decision

Author: Joey Coyle, Patrick Langford Document: PDF icon MindModel Converter

Goals, Caveats, Requirements, Ruby, Future Development, Enforce Syntax

Author: Jim Davies, Steve Harris Document: File Research-driven data standards

Patient records

Clinician’s notes for self or colleagues, for communication or justification
Notifications and summary reports against standard data sets
Detailed record of diagnosis, treatment, outcomes, and follow-up for translational research and service improvement