The document provides an overview of a tutorial presentation on designing a relational database structure based on the HL7 Reference Information Model (RIM). It discusses key concepts such as RIM-based models, RIM conformance, and constrained views of the RIM. It also outlines the database design modeling steps and introduces some of the core RIM classes like Act, Entity, Role, and Participation.

1. Reference Information Model-Based Relational Database Design Abdul-Malik Shakir Principal Consultant, Shakir Consulting HL7 Working Group Meeting, Vancouver, BC September 2008

6. Structural Variance and Semantic Consistency Person - lastName: char - firstName: char - birthDate: dateTime - homePhone: char - workPhone: char Model One Person - name: PersonName - birthDate: dateTime - phone: PersonPhone [0..2] (list) constraints {PersonPhone(1) is Home Phone} {PersonPhone(2) is Work Phone} «datatype» PersonName - lastName: char - firstName: char «datatype» PersonPhone - phoneKind: PhoneKind - phoneText: char «enumeration» PhoneKind «enum» Home Work Model Two Person - birthDate: dateTime PersonName - personNameKind: PersonNameKind - personNameText: char constraints {PersonNameKind is Unique} PersonPhone - phoneKind: PersonPhoneKind - phoneText: char constraints {PersonPhoneKind is Unique} «enumeration» PersonPhoneKind «enum» Home Work «enumeration» PersonNameKind «enum» lastName firstName 0..2 0..2 Model Three

9. HL7 v3.0 Reference Models Reference Information Model Datatype Specification Vocabulary Specification Reference Models The HL7 Reference Information Model is the information model from which all other information models and message specifications are derived. The HL7 Vocabulary Specification defines the set of all concepts that can be taken as valid values in an instance of a coded attribute or message element. The HL7 Datatype Specification defines the structural format of the data carried in an attribute and influences the set of allowable values an attribute may assume.

10. HL7 RIM Class Diagram

12. RIM Core Classes Entity class_cd : CS cd: CE determiner_cd : CS status_cd : CS id : II Role class_cd : CS cd: CE effective_time : IVL<TS> status_cd : CS id : II Act class_cd : CS cd: CD mood_cd : CS status_cd : CS effective_time : GTS id : II 0..* 0..* 1 0..* plays

18. HL7 RIM Normative Specification

22. Datatype Class Diagram

24. Basic Datatype Descriptions Coded data, is like a CE with the extension of modifiers. Modifiers for codes have an optional role name and a value. Modifiers allow one to express, e.g., &quot;FOOT, LEFT&quot; as a postcoordinated term built from the primary code &quot;FOOT&quot; and the modifier &quot;LEFT&quot;. CD Concept Descriptor Coded data, consists of a coded value (CV) and, optionally, coded value(s) from other coding systems that identify the same concept. Used when alternative codes may exist. CE Coded With Equivalents Coded data, consists of a code, display name, code system, and original text. Used when a single code value must be sent. CV Coded Value Coded data, consists of a code and display name. The code system and code system version is fixed by the context in which the CS value occurs. CS is used for coded attributes that have a single HL7-defined value set. CS Coded Simple Value Text data, primarily intended for machine processing (e.g., sorting, querying, indexing, etc.) Used for names, symbols, and formal expressions.) Note that the ST data type is a specialization of the ED data type when the ED media type is text/plain. ST Character String Data that is primarily intended for human interpretation or for further machine processing outside the scope of this specification. This includes unformatted or formatted written language, multimedia data, or structured information in as defined by a different standard (e.g., XML-signatures.) Instead of the data itself, an ED may contain only a reference (see TEL.) Note that the ST data type is a specialization of the ED data type when the ED media type is text/plain. ED Encapsulated Data The Boolean type stands for the values of two-valued logic. A Boolean value can be either true or false. BL Boolean Description Symbol Name

25. Basic Datatype Descriptions Positive and negative whole numbers typically the results of counting and enumerating. The standard imposes no bounds on the size of integer numbers. INT Integer Number A restriction of EN that is equivalent with a plain character string (ST). Typically used for the names of things, where name parts are not distinguished. TN Trivial Name A name of an organization. ON name parts are typically not distinguished, but may distinguish the suffix for the legal standing of an organization (e.g. &quot;Inc.&quot;, &quot;Co.&quot;, &quot;B.V.&quot;, &quot;GmbH&quot;, etc.) from the name itself. ON is a restriction of EN. ON Organization Name A name of a person. Person names usually consist of several name parts that can be classified as given, family, nickname etc. PN is a restriction of EN. PN Person Name A name of a person, organization, place, or thing. Can be a simple character string or may consist of several name parts that can be classified as given name, family name, nickname, suffix, etc. EN Entity Name For example, a mailing address. Typically includes street or post office Box, city, postal code, country, etc. AD Postal Address A telephone number or e-mail address specified as a URL. In addition, this type contains a time specification when that address is to be used, plus a code describing the kind of situations and requirements that would suggest that address to be used (e.g., work, home, pager, answering machine, etc.) TEL Telecommunication Address An identifier to uniquely identify an individual instance. Examples are medical record number, order number, service catalog item number, etc. Based on the ISO Object Identifier (OID) II Instance Identifier Description Symbol Name

26. Basic Datatype Descriptions One or more time intervals used to specify the timing of events. Every event spans one time interval (occurrence interval). A repeating event is timed through a sequence of such occurrence intervals. Such timings are often specified not directly as a sequence of intervals but as a rule, e.g., &quot;every other day (Mon - Fri) between 08:00 and 17:00 for 10 minutes.&quot; GTS General Timing Specification A time stamp. TS Point in Time A quantity explicitly including both a numerator and a denominator (e.g. 1:128.) Only in the rare cases when the numerator and denominator must stand separate should the Ratio data type should be used. Normally, the REAL, PQ, or MO data types are more appropriate. RTO Ratio The amount of money in some currency. Consists of a value and a currency denomination (e.g., U.S.$, Pound sterling, Euro, Indian Rupee.) MO Monetary Amount A dimensioned quantity expressing the result of measurement. It consists of a real number value and a physical unit. Physical quantities are often constrained to a certain dimension by specifying a unit representing the dimension (e.g. m, kg, s, kcal/d, etc.) However, physical quantities should not be constrained to any particular unit (e.g., should not be constrained to centimeter instead of meter or inch.) PQ Physical Quantity Fractional numbers. Typically used whenever quantities are measured, estimated, or computed from other real numbers. The typical representation is decimal, where the number of significant decimal digits is known as the precision. REAL Decimal number Description Symbol Name

27. HL7 Data Type Packages

28. Demographic Datatypes

30. Thing Datatypes

32. Reductionist View of Concept Descriptor ConceptDescriptor : CD - dataType: CodedSimpleValue - nullFlavor: CodedSimpleValue - code: CharacterString - displayName: CharacterString - codeSystem: ISOObjectIdentifier - codeSystemName: CharacterString - codeSystemVersion: CharacterString - originalText: CharacterString -/ translation: CodedValue [0..*] (SET) -/ modifier: ConceptRole [0..*] (LIST) CodedValue : CV - dataType: CodedSimpleValue - nullFlavor: CodedSimpleValue - code: CharacterString - displayName: CharacterString - codeSystem: ISOObjectIdentifier - codeSystemName: CharacterString - codeSystemVersion: CharacterString - originalText: CharacterString ConceptRole : CR - dataType: CodedSimpleValue - nullFlavor: CodedSimpleValue - name: CodedSimpleValue - value: ConceptDescriptor - inverted: Boolean +translation 0..* «SET» +modifier 0..* «LIST»

35. HL7 V3 Vocabulary Specification Schematic ParentConcept VocabularyDomain name : String description : String CodedConcept conceptCode : String conceptDesignation : String 0..* 0..* 0..* 0..* ValueSet name : String description : String definingExpression : String 0..* 0..* 0..* 0..* 0..* 0..* includes CodeSystem identifier : OID name : String description : String 0..* 0..* 0..* 0..1 0..* 0..1 based on ValueSetContext contextExpression : String

37. HL7 Vocabulary Table

38. HL7 Reference to External Code Systems

39. Vocabulary Binding Vocabulary Terms Vocabulary Binding Information Model Class Attribute Vocabulary Domain Value Set Coded Concept Code System 1 0..* 0..* 0..1 0..1 0..* 0..* 0..* 0..* 0..* 0..* 1 0..* 0..1

41. Entity.classCode

45. SIIS SIP Logical Data Model

47. SIIS SIP Information Needs RMIM

49. SIIS SIP RIM Class Subset Model (Level 0)

50. SIIS SIP RIM Attribute Subset Model (Level 1)

53. Generalization Relationships Indicate Inheritance =

57. RIM Subset Model (Inheritance Exposed)

59. RIM Subset Model (Inheritance Anomalies Resolved)

62. RIM Subset Model (Level 2)

66. RIM Subset Model (Level 2.1)

68. RIM Subset Model (Level 2.2) class RIM Subset Entity # classCode: CS # determinerCode: CS + id: SET<II> + code: CE Person + addr: BAG<AD> + administrativeGenderCode: CE + birthTime: TS + deceasedInd: BL + raceCode: CE + multipleBirthInd: BL + name: BAG<PN> + ethnicGroupCode: CE + telecom: BAG<TEL> LanguageCommunication + languageCode: CE Organization + id: II + code: CE + name: ON Place + addr: AD + id: SET<II> + code: CE ManufacturedMaterial + formCode: CE + lotNumberText: ST + code: CE Role # classCode: CS + id: SET<II> + code: CE + effectiveTime: IVL<TS> Participation # typeCode: CS Act # classCode: CS # moodCode: CS + id: II + code: CD SubstanceAdministration + routeCode: CE + approachSiteCode: CD + doseQuantity: IVL<PQ> + availabilityTime: TS + activityTime: IVL<TS> + id: II + code: CD ActRelationship # typeCode: CS Observation + value: ANY + code: CD Consent + code: CD + negationInd: BL + reasonCode: CE +target 1 +inboundRelationship 0..* +outboundRelationship 0..* +source 1 1 0..* 0..* 1 +scoper 0..1 +scopedRole 0..* +player 0..1 +playedRole 0..* 0..1 isA 1 0..1 isA 1 0..1 isA 1 0..1 isA 1 1 0..1 1 isA 0..1 0..1 isA 1 0..1 isA 1

70. RIM Subset Model (Level 3)

73. RIM Subset Model (Level 3)

75. RIM Subset Model (Level 4)

78. RIM Subset Model (Level 4)

80. II: Instance Identifier If applicable, specifies during what time the identifier is valid. By default, the identifier is valid indefinitely. Any specific interval may be undefined on either side indicating unknown effective or expiry time. Note: identifiers for information objects in computer systems should not have restricted valid times, but should be globally unique at all times. The identifier valid time is provided mainly for real-world identifiers, whose maintenance policy may include expiry (e.g., credit card numbers.) optional IVL<TS> validTime A human readable name or mnemonic for the assigning authority. This name is provided solely for the convenience of unaided humans interpreting an II value. Note: no automated processing must depend on the assigning authority name to be present in any form. optional ST assigningAuthorityName A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier, an extension value is not needed. mandatory OID root The value of the identifier, unique within its assigning authority's namespace. optional ST extension Definition Status Type Name

81. Instance Identifier

82. AD: Postal Address ADXP: Postal Address Part Identifies the periods of time during which the address can be used. Typically used to refer to different addresses for different times of the year or to refer to historical addresses. optional GTS validTime A code advising a system or user which address in a set of like addresses to select for a given purpose optional SET < CS > use The address data mandatory LIST < ADXP > Definition Status Type Name Indicates whether an address part is the street, city, country, postal code, post box, etc. optional CS type The address part data mandatory ST ST Definition Status Type Name

83. Postal Address

84. EN: Entity Name ENXP: Entity Name Part Entity Name Specializations: TN: Trivial Name PN: Person Name ON: Organization Name A set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type EntityNameQualifier NULL optional SET < CS > qualifier Indicates whether the name part is a given name, family name, prefix, suffix, etc. EntityNamePartType NULL optional CS type The entity name part data NULL mandatory ST Definition Constraint Default Status Type Name Identifies the interval of time during which the name was used. Typically used to record historical names. NULL optional IVL<TS> validTime A code advising a system or user which name in a set of names to select for a given purpose NamePurpose NULL optional SET < CS > use The name data NULL mandatory LIST < ENXP > Definition Constraint Default Status Type Name

85. Entity Name

86. Tel: Telecommunication Address Identifies the periods of time during which the telecommunication address can be used. For a telephone number, this can indicate the time of day in which the party can be reached on that telephone. For a web address, it may specify a time range in which the web content is promised to be available under the given address. optional GTS validTime A code advising a system or user which telecommunication address in a set of like addresses to select for a given telecommunication need. optional SET < CS > use The essence of a telecommunication address is a Universal Resource Locator. mandatory URL URL Definition Status Type Name

87. Telecommunication Address

88. PQ: Physical Quantity The original unit of measure. optional CV original unit The magnitude of the quantity measured in terms of the original unit. optional REAL original value The unit of measure mandatory CS unit The magnitude of the quantity measured in terms of the unit mandatory REAL value Definition Status Type Name

89. Physical Quantity

90. CD: Concept Descriptor Quite often in an interfaced environment, codes need to be translated into one or more other coding systems. In our example, the California DMV may have their own code translation Some code systems permit modifiers, additional codes that refine the meaning represented by the primary code. HL7 Version 3 accommodates a list of modifiers. Continuing with our truck example, the list of modifiers &quot;Body-ECAB, Eng-V8, EM-CE&quot; modify &quot;F150&quot; to designate that the truck has an extended cab, V8 engine, and California Emissions package. &quot;Body-,&quot; &quot;Eng-,&quot; and &quot;EM&quot; designate the roles (body, engine, emissions) represented by the codes &quot;ECAB,&quot; &quot;V8,&quot; and &quot;CE.&quot; modifier This is the text, phrase, etc., that is the basis for the coding. (e.g., &quot;The new truck purchased for hospital facility maintenance was a Ford model F150 ...&quot;). originalText A string qualifying the version of the code system (e.g., &quot;Model Year 2001&quot;). codeSystemVersion A string containing a short, human-readable description of the code system (e.g., &quot;Ford Car and Truck Models &quot;). codeSystemName An Object Identifier ( OID ) that uniquely identifies the code system to which the code belongs (e.g., &quot;106.75.314.67.89.24,&quot; where this uniquely identifies Ford Motor Company's set of model numbers). codeSystem A string containing a short, human-readable description of the code. (&quot;Ford F150 Full-size Pickup Truck&quot;) displayName A string containing the value of the code (e.g., &quot;F150&quot;) code Description Name

91. Concept Descriptor Datatypes CS: Coded Simple CV: Coded Value CE: Coded With Equivalents optional ST displayName mandatory ST code Status Type Name optional ST originalText optional ST codeSystemVersion optional ST codeSystemName mandatory OID codeSystem optional ST displayName mandatory ST code Status Type Name optional SET < CV > translation optional ST originalText optional ST codeSystemVersion optional ST codeSystemName mandatory OID codeSystem optional ST displayName mandatory ST code Status Type Name

92. Property Summary of Concept Descriptor

93. Data Value

94. Complex Datatypes

95. RIM Subset Model (Level 5)

99. RIM Logical Data Model (Level 1)

107. RIM Logical Data Model (Level 2)

113. RIM Logical Data Model (Level 3)

116. Eliminate Redundancy

117. Reduce ambiguity and abstraction

118. Optimal Performance and Future Proofing

119. Structural Simplification

120. Simplify RI Enforcement

121. Physical Data Model (Level 1) E_PlacePostalAddrPart *pfK addrID: bigint *PK addrPartSeq: int * addrPartTypeCD: varchar(10) * addrPartVal: varchar(50) «FK» + FK_E_PlacePostalAddrPart_E_PlacePostalAddr(addrID) «PK» + PK_E_PlacePostalAddrPart(addrID, addrPartSeq) E_PlacePostalAddr *PK addrID: bigint *FK entityID: bigint usageTypeCD: varchar(10) effectiveFromDT: datetime effectiveThurDT: datetime «FK» + FK_E_PlacePostalAddr_E_Place(entityID) «PK» + PK_E_PlacePostalAddr(addrID) E_Facility *pfK entityID: bigint * typeCD: varchar(10) addrLine1text: varchar(50) addrLine2Text: varchar(50) addrCityName: varchar(50) addrStateCD: varchar(10) addrPostalCode: varchar(50) addrCountyCD: varchar(10) «FK» + FK_E_Place_E_Entity(entityID) «PK» + PK_E_Place(entityID) E_Entity *PK entityID: bigint * classCD: varchar(10) * determinerCD: varchar(10) typeCD: varchar(10) «PK» + PK_E_Entity(entityID) E_EntityID *pfK entityID: bigint *PK identifierNameSpaceID: varchar(50) *PK identifierVal: varchar(50) «FK» + FK_E_EntityID_E_Entity(entityID) «PK» + PK_E_EntityID(entityID, identifierNameSpaceID, identifierVal) R_Role *PK roleID: bigint *FK playerEntityID: bigint *FK scoperEntityID: bigint * classCD: varchar(10) typeCD: varchar(10) effectiveDT: datetime «FK» + FK_R_Role_ScoperE_Entity(scoperEntityID) + FK_R_Role_PlayerE_Entity(playerEntityID) «PK» + PK_R_Role(roleID) R_RoleID *pfK roleID: bigint *PK identifierNameSpaceID: varchar(50) *PK identifierVAL: varchar(50) «FK» + FK_R_RoleID_R_Role(roleID) «PK» + PK_R_RoleID(roleID, identifierNameSpaceID, identifierVAL) E_Person *pfK entityID: bigint administrativeGenderCD: varchar(10) birthDT: datetime deceasedInd: bit raceCD: varchar(10) multiBirthInd: bit ethnicGroupCD: varchar(10) primaryLanguageCD: varchar(10) primarySurname: varchar(50) primaryGivenName: varchar(50) primaryMiddleName: varchar(50) primaryNameSuffix: varchar(50) «FK» + FK_E_Person_E_Entity(entityID) «PK» + PK_E_Person(entityID) E_PersonPostalAddr *PK addrID: bigint *FK entityID: bigint usageTypeCD: varchar(10) effectiveFromDT: datetime effectiveThruDT: datetime addrLine1Text: bigint addrLine2Text: varchar(50) addrCityName: varchar(50) addrStateCD: varchar(10) addrPostalCode: varchar(50) addrCountryCD: varchar(10) «FK» + FK_E_PersonPostalAddr_E_Person(entityID) «PK» + PK_E_PersonPostalAddr(addrID) E_PersonPostalAddrPart *pfK addrID: bigint *PK addrPartSeq: int * addrPartTypeCD: varchar(10) * addrPartVal: varchar(50) «FK» + FK_E_PersonPostalAddrPart_E_PersonPostalAddr(addrID) «PK» + PK_E_PersonPostalAddrPart(addrID, addrPartSeq) E_PersonName *PK nameID: bigint *FK entityID: bigint usageTypeCD: varchar(10) effectiveFromDT: datetime effectiveThruDT: datetime surname: varchar(50) givenName: varchar(50) middleName: varchar(50) nameSuffix: varchar(50) «FK» + FK_E_PersonName_E_Person(entityID) «PK» + PK_E_PersonName(nameID) E_PersonNamePart *pfK nameID: bigint *PK namePartSeq: int * namePartTypeCD: varchar(10) * namePartVal: varchar(50) «FK» + FK_E_PersonNamePart_E_PersonName(nameID) «PK» + PK_E_PersonNamePart(nameID, namePartSeq) E_PersonTelcomAddr *PK addrID: bigint *FK entityID: bigint * addrTypeCD: varchar(10) usagetypeCD: varchar(10) effectiveFromDT: datetime effectiveThruDT: datetime * addressVal: varchar(50) «FK» + FK_E_PersonTelcomAddr_E_Person(entityID) «PK» + PK_E_PersonTelcomAddr(addrID) E_LangCom *pfK entityID: bigint * langCD: varchar(10) «FK» + FK_E_LangCom_E_Person(entityID) «PK» + PK_E_LangCom(entityID) E_PlaceID *pfK entityID: bigint *PK identifierNameSpaceID: varchar(50) *PK identifierVal: varchar(50) «FK» + FK_E_PlaceID_E_Place(entityID) «PK» + PK_E_PlaceID(entityID, identifierNameSpaceID, identifierVal) R_Patient *pfK roleID: bigint *FK playerEntityID: bigint «FK» + FK_R_Patient_E_Person(playerEntityID) + FK_R_Patient_R_Role(roleID) «PK» + PK_R_Patient(roleID) «unique» + UQ_R_Patient_playerEntityID(playerEntityID) 0..* (addrID = addrID) 1 0..1 (entityID = entityID) 1 0..1 (entityID = entityID) 1 0..* (entityID = entityID) 1 0..* (roleID = roleID) 1 0..1 (entityID = entityID) 1 0..* (entityID = entityID) 1 0..* (addrID = addrID) 1 0..* (entityID = entityID) 1 0..* (nameID = nameID) 1 0..* (entityID = entityID) 1 0..1 (entityID = entityID) 1 0..* (playerEntityID = entityID) 1 0..* (scoperEntityID = entityID) 0..1 0..* (entityID = entityID) 1 0..* (roleID = roleID) 1 0..* (playerEntityID = entityID) 1

127. Questions / Discussion / Feedback

128. Closing Thought All models are wrong; some are useful. ~ George Box