Re: Wait a sec...What about the HL7 RIM An Universal Exchange Language

On the use of RIM. You're absolutely right - why reinvent the "base types"?
Why yet another ontology for basic things? Any perceived shortcomings in the
RIM are edge things, not core.

If the semantic technologies are to have play in the world of health-care
data exchange (as opposed to information interpretation), they need to offer
something that an "XML blob + health-care proprietary RPC" doesn't. And I
think they do.

Just two.
1) Query fat, query narrow: you want everything from a dataset? The whole
graph? Fine. A simple link to xxx/patientid gives you what you want. You
only want specific assertions, in a time line, made by a particular
individual? Fine too. You can express your nuance in SPARQL.
2) Means of exchange is the means for interpretation: where do XML blobs go
when they leave the NHIN? To some SQL store? Or ... In the world of linked
data, there is no disconnect. You ask and interpret in the same medium. You
don't SOAP-this, XML parse that, table it up, turn OIDs into what? ... You
query and you interpret in the same medium, in the same terms.

Put nuance aside and this isn't about content - let's assume the information
is about Actors and ..., that it's RIM-based, let's assume SNOMED is used -
it get's down to "XML blob + custom RPC" leading God knows where vs "linked
graph stores + generic query language" for both exchange and
interpretation.

Or in commercial terms: must we make room for middleware vendors or not? How
many mediums are needed? Must exchange and interpretation use different
technologies?

Conor

p.s. one small quibble: an RDF (XML) equivalent of a CCD (XML) is smaller,
not bigger - it defines information once and uses references (rdf:resource)
whereas the CCD restates details - doctor details every time you qualify who
did what. The RDF uses a url for a drug or allergy or ... while the CCD
markup, even at its smallest (OID, codeSystemName etc) is more verbose. And
it's a lot easier to process RDF of patient data - even XSLT on it as a form
of XML - than it is to process the CCD.

On Thu, Dec 16, 2010 at 4:36 PM, <Peter.Hendler@kp.org> wrote:

> Just want to be clear about when we use the word HL7.  In the USA when you
> just say HL7 it is assumed you mean Version 2 which is in very wide use and
> is not OO at all.  You almost have to say RIM based or V3 before people
> assume you mean the OO model (RIM).
>
> There is a specific XML serialization of the V3 RIM called the XML ITS.  It
> generates the XML elements, attributes and the order that they must be
> serialized in. When you are dealing with a CDA document, then in addition to
> these rules there are "templates" that are mostly just verbal human readable
> rules that you must follow for a given template.  Templates refer to each
> other, so the C32 document mentioned in the Meaningful Use rules of the
> HITECH part of the ARRA act is made from HL7 and IHE and HITSP templates all
> referring to each other.  These templates specify many things including
> which vocabularies must be used (SNOMED for example for coding the
> diagnosis).
>
> For a C32 templated CDA you have no wiggle room. The XML is defined.  You
> don't gain anything by decomposing it and recomposing it into RDF.
> There is nothing to say that you couldn't come up with different ITS's  For
> example you could come up with a JSON ITS and I suppose you could also come
> up with another RDF ITS. I'm just not convinced it would add anything to the
> understandability and I think it would add a heck of a lot of size to the
> representation.
>
>  Because the diagnosis and much of the clinical data contained in a CDA is
> in SNOMED, I do see the benefits of using subsumption on the SNOMED codes.
>  For example you could ask for all the patients that had any form a diabetes
> or heart disease and then use subsumption to get the lists of possible
> SNOMED codes that would be in the records of the target patients.  What I
> don't see is the advantage of using RDF instead of the standard RIM XML
> syntax.
>
> You could come up with an entirely new model for healthcare not based on
> the RIM and based on RDF, but much of the world (outside the USA) is already
> using the RIM.
>
>
>
>
>
>
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>
>
>
>  *"M. Scott Marshall" <mscottmarshall@gmail.com>*
>
> 12/16/2010 03:47 PM
>   To
> conor dowling <conor-dowling@caregraf.com>
>  cc
> Michael Miller <mmiller@systemsbiology.org>, Peter
> Hendler/CA/KAIPERM@KAIPERM, twclark@nmr.mgh.harvard.edu,
> public-semweb-lifesci@w3.org, public-semweb-lifesci-request@w3.org
> Subject
> Re: Wait a sec...What about the HL7 RIM An Universal Exchange Language
>
>
>
>
> I like Eric Neumann's description of RDF as "recombinant data".
>
> Agreed. Choosing something other than HL7 as the lingua franca for
> assertions doesn't devalue HL7! We can be happy that we got the information
> from one machine to another! It's a long haul from the days of big-endian,
> little-endian. The value is not in the messages (or message syntax) but what
> is in them (the cargo, the payload). But how will we interoperate between
> HL7 and CDISC? I suppose that an ontology will help.. BRIDG anyone ;) Cecil?
>
> The way that XML quietly infiltrated all our computer systems was by making
> it easy to describe and parse data of all shapes and sizes. Will OWL/RDF do
> the same by making it reasonably easy to describe the meaning of messages
> and documents?
>
> HL7 isn't going away. It is the standard. So, how can its users take
> advantage of other (non-HL7) sources of information that are related to the
> contents of its messages? And how can other systems, for example, clinical
> research systems relate their information and constraints to HL7 data? See
> *http://hcls.deri.org/coi/demo/* <http://hcls.deri.org/coi/demo/> (makes
> use of pseudo-CDISC and HL7, and Drug Ontology), presented at AMIA. There
> should be machine-readable and reason-able links from one set of assertions
> to the other, that can make use of context (read: provenance). Could the HL7
> provenance help us make use of the 'cargo' in another context? i.e.
> assertion came from message issued by..
>
> -Scott
>
> --
> M. Scott Marshall, W3C HCLS IG co-chair, *http://www.w3.org/blog/hcls*<http://www.w3.org/blog/hcls>
> Leiden University Medical Center / University of Amsterdam*
> **http://staff.science.uva.nl/~marshall*<http://staff.science.uva.nl/~marshall>
> <http://staff.science.uva.nl/~marshall>
> On Thu, Dec 16, 2010 at 11:06 PM, conor dowling <*
> conor-dowling@caregraf.com* <conor-dowling@caregraf.com>> wrote:
>
>
> On Wed, Dec 15, 2010 at 8:47 AM, Michael Miller <*
> mmiller@systemsbiology.org* <mmiller@systemsbiology.org>> wrote:
> hi all,
>
>
>
> "unambiguous identifier for "things""
>
>
>
> i agree, this has been a known issue for many years (as you well know, tim)
> but its importance is just now growing as multi-omics studies and sharing of
> EHR records is becoming more common.
>
>
>
> "It is HL7 V3"
>
>
>
> i also agree, in a sense, with this.  HL7 messages capture information as a
> whole, as an entity, so in that representation it is also true that semantic
> web technologies would have a hard time, as is, making sense of them because
> semantic web technologies wants a fact by fact representation, e.g. triple
> store.
>
>
> But turn this on its head. HL7 messages come from "islands of data" which
> have undetermined linkage. Think of a lab result that has a local code,
> rather than LOINC. LOINC is equivalent to a link to the outside. Effectively
> the local code is meaningless outside.
>
> By its nature, linked data should resolve. If there is a url, you should be
> able to chase it down. The equivalent of a local code is a resolvable URL
> which presumably leads to some sort of description of what that local
> concept means, perhaps enough to translate it to a more commonly understood
> equivalent.
>
> You ask for any number of triples from a semantic endpoint, enough to
> capture what you need - all lab result assertions over a period for
> such-and-such a person. That's no different than a query in HL7 (or any
> other RPC like mechanism).
>
> The key difference with linked data (specifically) and "islands with
> protocol access" is linkage: the idea that links always resolve to something
> meaningful as opposed to identifiers that while unambiguous, may lead you no
> where. The problem with the old school which Parsa's "30 years of XML and
> HL7 experience" captures nicely is wrapped up in this.
>
> I've coded this stuff a good bit and everyone gets fixated on the syntax of
> messages/xml blocks. People are happy if a coded element is "correct", that
> it "conforms" as opposed to being useful or meaningful. And the problem lies
> not with them, but the mechanism. It's put the focus on "truck", not
> "cargo".
>
> Conor
>
>
>
> cheers,
>
> michael
>
>
>
>
>
> *From:* *public-semweb-lifesci-request@w3.org*<public-semweb-lifesci-request@w3.org>[mailto:
> *public-semweb-lifesci-request@w3.org*<public-semweb-lifesci-request@w3.org>]
> *On Behalf Of **Peter.Hendler@kp.org* <Peter.Hendler@kp.org>*
> Sent:* Wednesday, December 15, 2010 8:18 AM*
> To:* *markw@illuminae.com* <markw@illuminae.com>*
> Cc:* *public-semweb-lifesci@w3.org* <public-semweb-lifesci@w3.org>; *
> public-semweb-lifesci-request@w3.org*<public-semweb-lifesci-request@w3.org>;
> *twclark@nmr.mgh.harvard.edu* <twclark@nmr.mgh.harvard.edu>
>
> *
> Subject:* Wait a sec...What about the HL7 RIM An Universal Exchange
> Language
>
>
>
> The PCAST did not take into consideration (maybe they don't even know)
> there is an universal exchange language for healthcare.  It is HL7 V3.  The
> CDA is merely one of virtually infinite structures that can be constructed
> from the RIM.  The meta information as well as the clinical data is
> unambiguously represented by RIM.  There is no reason to ignore the
> thousands of man years that went into designing the RIM.  The RIM Based
> Application Architecture  (RIMBAA) work group at HL7 has had many
> demonstrations of RIM based applications.  We don't need to re invent the
> wheel.  CDA is only one particular RIM structure designed for one particular
> use case.  Those of us who have been working at HL7 for years are blown away
> by the suggestion that there needs to be a different wheel invented.
>
> *
> NOTICE TO RECIPIENT:*  If you are not the intended recipient of this
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>  Thank you.
>
>   *Mark <**markw@illuminae.com* <markw@illuminae.com>*>*
> Sent by: *public-semweb-lifesci-request@w3.org*<public-semweb-lifesci-request@w3.org>
>
> 12/14/2010 06:44 PM
>
>  To "Tim Clark" <*twclark@nmr.mgh.harvard.edu*<twclark@nmr.mgh.harvard.edu>>
>  cc *public-semweb-lifesci@w3.org* <public-semweb-lifesci@w3.org>  Subject Re:
> An Universal Exchange Language
>
>
>
>
>
>
>
>
> But seriously, Tim, if we were to pursue this problem, we would need some
> form of unambiguous identifier for "things"... and given the distributed
> nature of the biomedical domain, we'd want to make sure that there was
> some way of resolving that identifier to obtain metadata about it from a
> variety of disparate sources who might have very different information -
> clinical, molecular, demographic, etc...
>
> hmmmm....
>
>
>
>
>
>
>
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>