Selected CIMI Policies and Decisions

Modeling formalism

  • ADL 1.5 (Archetype Definition Language) as the initial formalism, including the AOM (Archetype Object Model)
  • A CIMI UML profile AML (Archetype Modelling Language) is being developed concurrently as a set of UML stereotypes, XMI specifications, and transformations


One or more Examples of instance data will be created for each model with examples showing both proper and improper use.


  • SNOMED CT is the primary reference terminology
    • CIMI has obtained a SNOMED CT extension identifier
    • CIMI will adhere to IHTSDO Affiliate’s Agreement for referencing SNOMED CT codes in models
      • Copyright notice in models, SNOMED CT license for all production implementations
    • CIMI will create a Terminology Authority to review and submit concepts to IHTSDO as appropriate
  • LOINC is also approved as a reference terminology
    • In the event of overlap, SNOMED CT will be the preferred source
  • CIMI will propose extensions to the reference terminologies when needed concepts do not exist
    • CIMI will have a place to keep needed concepts that are not a part of any standard terminology

Semantic Interoperability

  • CIMI models must be capable of supporting semantic interoperability across a federation of enterprises
  • We will define the relationship between each parent and child node in the hierarchy
  • SNOMED relationship concepts will be used to define the parent-child relationships in the models
  • Goal: Enable use of the SNOMED CT concept model to support translation of data from pre coordinated to post coordinated representations

Isosemantic Models

CIMI supports isosemantic clinical models:

  • We will keep isosemantic models in the CIMI repository that use a different split between pre-coordination versus post coordination (different split between terminology and information model)
  • One model in an isosemantic family will be selected as the preferred model for interoperability (as opposed to everyone supporting every model)
  • Profiles of models for specific use cases will be created by authoritative bodies: professional societies, regulatory agencies, public health, quality measures, etc.)

Implementation Strategy

CIMI DOES care about implementation. There must be at least one way to implement the models in a popular technology stack that is in use today. The models should be as easy to implement as possible.

  • Only use will determine if we are producing anything of value
  • Approve “Good Enough” Reference Model and Data Types
  • Get practical use ASAP
  • Change Reference Model and Data Types based on use

As needed, we will make official mappings from the CIMI logical models to particular implementations (logical data types -> physical data types)

  • FHIR - Resources & Pprofiles
  • C-CDA - Templates
  • HL7 V3 - Messages
  • Etc.

Content Ownership and Intellectual Property

CIMI is committed to making specifications available

  • without hindrance to access or use
  • without financial or other payment

License assessment

CIMI will assess proposed licenses against the criteria below.  Only licenses which meet all the criteria are acceptable.  The details of all the licenses used in a CIMI shall be referenced within the specification.  The reference shall be in the form of a persistent resolvable HTTP URL.

Register of assessed licenses

CIMI will maintain a register of assessed license agreements including

  • a persistent resolvable HTTP URL linking to the license and
  • a persistent resolvable HTTP URL to an assessment

License acceptance criteria

CIMI specifications will be made available using licenses that meet the following criteria:



Licensees may copy, publish, distribute and transmit the intellectual property


Licensees may adapt the intellectual property


Licensees may exploit the intellectual property commercially


The license is worldwide, perpetual and non-exclusive


The license indicates the jurisdiction it is governed in.  This will normally be the principle jurisdiction of the intellectual property owner.


The license includes the provider and extent of any warranty


The intellectual property rights are royalty free



The use of SNOMED CT™ is an agreed exception.

CIMI models shall, by design, include SNOMED CT™ content. See ihtsdo.org/licensing for details.