The Four Pillars of Computable Semantic Interoperability Necessary

The Four Pillars of Computable Semantic Interoperability Necessary but not Sufficient • Common model across all domains-of-interest – Information model vs Data model – The semantics of common structures • Model grounded on robust data type specification • Methodology for binding terms from concept-based terminologies – Domain-specific semantics • A formally defined process for defining specific structures to be exchanged between machines, i. e. a “data exchange standard” The Version 3 Tool Kit

The Semiotic Triangle: ‘How We Exchange Meaning’ (Concept) Symbol “Shark” Thing Concept 1 Concept 2 “A guy who hustled me. ” “Delicious with cabernet. ” Concept Thing 2 Symbol “Shark” Thing 1

Information vs Terminology Models Intersecting and interleaving semantic structures Terminology Model Information Model Common Structures for Shared Semantics Binding/Interface Domain-Specific Terms specifying Domain-Specific Semantics Information Model Common Structures bound to Domain-Specific Structures specifying Domain-Specific Semantics Terminology Model Domain-Specific Terms specifying Domain-Specific Semantics

HL 7 V 3 Reference Information Model (RIM) “An instance of an Entity may play zero or more Roles. Each instance of a Role may, in turn, play zero or more instances of a Participation in the context of an instance of an Act. Each instance of a Participation participates in a one and only one Act for the ‘duration’ of that Acts may be related to each other through instances of Act Relationship. ” • Has component • Is supported by Act Relationship 0. . * 1 Entity • Organization • Place • Person • Living Subject • Material 0. . * 1 Role 0. . * 1 • Patient • Member • Healthcare facility • Practitioner assignment • Specimen • Location Participation • Author • Reviewer • Verifier • Subject • Target • Tracker 1 1. . * 1 Act • Referral • Transportation • Supply • Procedure • Consent • Observation • Medication • Administrative act • Financial act

Collection, Context, and Attribution Building Complex RIM-based structures • A diagnosis of pneumonia (observation Act) related to three other observations Acts. Each Act is fully attributed with its own context of Entity-Role-Participation values. is OBS: Dx Pneumonia s AR: r fo “is supported ce r by” ou AR: “is supported by” is source for has target OBS: Temp 101 F Attribution has target OBS: Abnormal CXR Attribution has target OBS: Elevated WBC Attribution is s ou rc ef PARTICIPAT: Subject ROLE: Clinician PARTICIPAT: Author ROLE: Patient or AR: “is supported by” ENTITY: Person Attribution