Microsoft Word C032885e doc Reference number ISO/TR 17119 2005(E) © ISO 2005 TECHNICAL REPORT ISO/TR 17119 First edition 2005 01 15 Health informatics — Health informatics profiling framework Informat[.]
General
This Technical Report outlines a unified framework for health informatics standards artefacts The health informatics profiling framework (HIPF) aims to establish a standardized approach for the description and classification of artefacts in the health informatics standards domain.
The Health Informatics Principles Framework (HIPF) provides a unified vocabulary and foundational concepts for navigating the intricate landscape of health informatics standards initiatives and their associated artifacts By utilizing the HIPF, stakeholders can enhance the reuse of health informatics knowledge, facilitating better identification of opportunities for alignment, collaboration, and coordination among health informatics standards.
Purpose
The purpose of the HIPF is to facilitate shared descriptions and comparisons of health informatics standards
In particular, it is the aim of the HIPF to:
provide the capability to comprehensively define and classify health informatics standards artefacts,
facilitate the coordination, communication and comparability of health informatics standards through a common understanding of intended uses and content,
help identify and coordinate health informatics standards development,
provide a potential foundation for the development of a global health informatics standards knowledge base,
promote health informatics standards integration and alignment within and between standards from different jurisdictions, and
provide a framework to assist with the coordination of ISO/TC 215 work items both within the technical committee and with related initiatives from other sources.
Benefits
The potential benefits of the HIPF include:
introduction of classification concepts and terminology for health informatics standards artefacts,
enhancement of health informatics standards development coordination through the identification of potential duplication between standards initiatives, and
enhancement of global understanding of health informatics standards in support of their knowledge management
Target users
The target users of the HIPF include:
health informatics standards developers, and
users of health informatics standards
For the purposes of this Technical Report, the following terms and definitions apply
2.1 artefact any model, document, or work product
2.2 compatibility capability of a functional unit to meet the requirements of a specified interface without appreciable modification [ENV 12443:1996]
2.3 concept units of thought constituted through abstraction on the basis of properties common to a set of objects
2.4 context related conditions and situations that provide a useful understanding and meaning of a subject
“raw” alphanumeric text, objects, and symbols defined without any context in such a way that by itself one cannot tell its correct meaning
2.6 framework a structure for supporting or enclosing something else, often acting to partition something complex into simple components
2.7 granularity the boundary where an object functions as a self-contained, stand-alone unit to support a common vision or goal
HIPF an approach and tool to describe the variety of artefacts within the domain of health informatics standards
HIPF cell the intersection of an HIPF perspective and an HIPF level of specificity that is defined within the context of the HIPF classification matrix
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HIPF classification matrix a structure that includes dimensions for health informatics standards artefacts, levels of specificity, and perspectives
HIPF perspective a classification dimension for differentiating health informatics standards artefacts based on their viewpoints, intended purpose or focus
NOTE This dimension includes the perspectives of what, how, where, who, when and why, which are further described in 4.2.1.2
HIPF specificity a classification dimension for differentiating health informatics standards artefacts based on their level of abstraction with respect to implementation specifications
NOTE This dimension includes the conceptual, logical and physical levels, which are further described in 4.2.1.1
2.13 information data in context that enable interpretation with meaning and relevance
2.14 interface the shared boundary between two functional units defined by various characteristics pertaining to the functions, physical interconnections, signal exchanges and other characteristics as appropriate
2.15 profile a brief description, outline or overview
2.16 top-down method or procedure that starts at the highest level of abstraction and proceeds towards the lowest level [ENV 12443:1996]
3 Health informatics profiling framework — Overview
General
The Health Informatics Standards Framework (HIPF) serves as a foundational management tool that facilitates the coordination of health informatics standards initiatives It offers a systematic approach for classifying health informatics standards artifacts, backed by a flexible and extensible architecture.
The HIPF serves as a descriptive tool featuring a straightforward two-dimensional classification matrix that highlights the dimensions of specificity and perspective Despite its simplicity, this matrix effectively captures complexity by illustrating various relationships between a standard artifact and the components of the HIPF matrix These relationships facilitate a thorough and comparable description of health informatics standards.
Artefact profiles may be further enhanced through the use of optional HIPF attributes, in addition to the classification matrix
This Technical Report outlines a methodological approach for utilizing the HIPF matrix to profile health informatics standards, highlighting how these classifications can enhance the development of a health informatics standards knowledge base The approach encompasses several key processes.
health informatics standards profiling, and
These processes are intended to support the goal of sharing knowledge about and supporting the comparison of health informatics standards artefacts.
What is the health informatics profiling framework?
The first component to be addressed is the concept of a “framework” A framework is a structure for supporting or enclosing something else The HIPF is such a structure
Frameworks and models are crucial for simplifying complex systems, making them easier to understand While models focus on visually representing desired outcomes or available resources, frameworks are typically employed to outline and organize enterprise architectures and other extensive domains.
The classification matrix of the HIPF was developed using Zachman's renowned Enterprise Architecture Framework as a foundational reference This framework's "domain" serves as a critical component in structuring the classification matrix effectively.
“Enterprise”, which this architectural framework is to support, is the domain of “health informatics”
Frameworks have the following properties
They partition the universe of interest into manageable chunks
They are comprehensive yet simple
They are composed of two or more dimensions Most frameworks have two core dimensions though multidimensional (e.g cube) frameworks may also be used
One dimension is often contextual (e.g concerned with a specific perspective) Often this is related to the user of the information (e.g designer, database builder) or domain (e.g party, recipient)
One can create one’s own framework or use an existing one if an appropriate structure is available for the domain of interest
The HIPF classification matrix categorizes health informatics standards artifacts based on specificity and focus area, providing a consistent and generic framework Additionally, the profile of an artifact can be enriched with extra attributes, including approval status and other optional details.
In the HIPF, a “profile” is a brief description (including a classification) of a health informatics standards artefact.
How to use the health informatics profiling framework
The HIPF offers classification guidelines that enable the categorization of a model or other standards artifact within one or more cells of the defined matrix This matrix effectively divides the health informatics domain into distinct areas.
The classification matrix, consisting of 18 distinct sub-domains, serves to prevent confusion by clearly indicating which artefacts are suitable for comparison or integration Artefacts positioned within the same cell share common characteristics, establishing a foundation for effective comparison and collaboration.
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To classify a model or standard artifact, it is essential to analyze it using the matrix's rows and columns This matrix facilitates the grouping of artifacts with similar characteristics, enabling effective co-location.
The alignment of artefacts is not guaranteed and should be approached as a separate task The framework breaks down the health informatics landscape into more digestible segments Before comparing models within a specific category, it is essential to identify necessary transformations and perform scope alignment According to set theory, meaningful comparisons can only occur within the intersection of the two sets or models.
The framework will require updating and re-versioning A versioning process will enable the ongoing
“greening” of the framework and will continue to increase the validity and value for its using community
The HIPF serves as a foundational tool rather than a final solution The initial step involves placing standards artifacts within the framework, but the true advantages emerge when collaborating within a primary cell or a related group of cells to meet objectives, such as aligning or comparing design artifacts.
The two-dimensional HIPF classification matrix consists of three rows representing specificity and six columns representing perspectives, enabling the identification and classification of health informatics standards artefacts Each intersection of these dimensions forms a framework cell, and the classification process is finalized when an artefact is assigned to one or more of these framework cells.
This matrix represents a unique adaptation of Zachman's “Enterprise Architecture Framework,” featuring distinct rows based on insights into various domains of interest and specificity While Zachman categorizes perspectives according to the roles of individuals within the enterprise, this report identifies “levels of specificity” as a more suitable criterion for classifying artifacts relevant to the health informatics standards community.
Figure 1 — Health informatics profiling framework classification matrix
Some of the background to the evolution of this framework has been provided in Annex A
A formalized method for defining and classifying artefacts has been proposed, accompanied by an example meta-model designed to aid in artefact profiling and the development of a knowledge base This meta-model illustrates the inter-relationships among HIPF constructs and is detailed in Annex B.
4 Health informatics profiling framework approach
Overview of approach
The HIPF approach consists of two key processes: artefact profiling and framework evolution These processes are designed to enhance the profiling of health informatics artefacts while facilitating the continuous development of the HIPF knowledge base.
The artefact profiling process offers a concise overview and standard classification for health informatics artefacts This process is often iterative, allowing for the enhancement of understanding regarding the definition and classification of artefacts over time By compiling profiled artefacts, a comprehensive knowledge base of health informatics artefacts can be established.
Continuous framework evolution is essential for proactively meeting artefact profiling requirements The outcomes of this evolution can serve as critical success factors in the artefact profiling process.
Artefact profiling
The artefact profiling process includes artefact classification, mapping assessment and artefact definition (with optional attributes)
The iterative nature of this multi-step process allows for the definition of an artefact to evolve over time, reflecting the accumulation of knowledge and adjustments in the HIPF definition.
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Artefact classification includes the mapping (placement) of an artefact with respect to one or many matrix cells
An artefact is classified when it is contextualized within the HIPF dimensions of specificity and perspective, enabling the cross-referencing of multiple mapped artefacts.
The HIPF classification matrix offers a two-dimensional perspective, featuring six columns that represent various viewpoints and three rows indicating levels of specificity This framework aims to cover the entire spectrum of health informatics artifacts, effectively categorizing the domain of health informatics standards.
18 separate content sub-domains These artefacts include models, standards, documents and other such components of health informatics that provide the design or “architecture” for health information
Example mappings to the HIPF matrix may be found in Annex C
Health informatics standards artifacts are differentiated by levels of specificity, transitioning from abstract concepts to precise implementation specifications This framework allows for a progression from general population characteristics to the specific attributes of individuals The primary categories within this framework include conceptual, logical, and physical design.
This specificity level encompasses various classes of interest in health informatics, focusing on shared fundamental meanings rather than detailed characteristics of health information It may also address health information management and administration from a strategic perspective.
Key mapping question: Does the artefact define fundamental meanings, without any detailed characteristics and health information inter-relationships?
Examples: High-level and generic classifications of healthcare organizations or of health information, guidelines for health information management, governance rules and regulations
This specificity level encompasses generalized models and informatics standards, focusing on elements that ensure coherence while disregarding technological limitations It addresses health information management and administration from a tactical perspective.
Key mapping question: Does the artefact define characteristics of information, without concern for technological constraints?
Examples: Inter-related and detailed roles and responsibilities, data flow diagrams, interaction models, business rules
This specificity level contains models and protocols with defined technological constraints This level addresses health information management and administration from an operational level
Key mapping question: Does the artefact define information with technological constraints?
Examples: Information storage architectures, physical layouts, application system models
Perspectives form the columns of the HIPF classification matrix
Many models, documents, or artifacts often exhibit traits from multiple perspectives The challenge in categorizing them within a matrix is identifying the predominant characteristics of the model or standard, specifically regarding its primary purpose in health informatics standards, and determining which matrix cells are intrinsic to the model or standard.
In certain situations, it is essential to assign a specific artefact to multiple framework cells When implementing multi-cell mapping, it is advisable to clearly distinguish between primary and secondary mappings For more details on multi-cell mapping, refer to section 4.2.2.
Interrogatives serve as fundamental questions that can be analyzed for any model or standard to explore the perspective dimension By aligning health informatics standards artifacts with the interrogatives at conceptual, logical, and physical levels, comprehensive information can be gathered to aid in the classification of these artifacts For specific examples of artifacts corresponding to each matrix cell, refer to Annex D.
The "what" perspective encompasses models and documents that outline relevant health information These artifacts are valuable for strategizing the collection, utilization, and distribution of health data, serving as crucial resources for both business and scientific purposes.
Key mapping question: Does the artefact define the subjects, topics or categories of interest in health data and information?
Examples: Vocabularies and terminology definitions, data and information models and classes, clinical models, models to measure treatment effectiveness, population health characteristics and economic viability and sustainability models
The “how” perspective contains models or directions for the way things should be done
Key mapping question: Does the artefact define methods, processes, architectures, or procedures in health information management or use?
Examples: Procedural business process models, application architectures, functionality standards, methodologies, procedures, guidelines and data flow diagrams
The "where" perspective focuses on artefacts related to location definitions, encompassing factors such as geography, climate, and environment It can be viewed from geographical, jurisdictional (e.g., a nation), or functional (e.g., a surgery room) standpoints.
Key mapping question: Does the artefact define physical or logical locations for health information management or use?
Examples: Climate models, facility infrastructure and blueprints, controlled environment models, technical architecture and network architectures
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The “who” perspective includes artefacts that address the management and administration of people in health informatics
Key mapping question: Does the artefact define the attributes of people involved in health information management and use? For example, does it define any of the following:
Organization charts and workflow models clarify roles and responsibilities, detailing who does what within an organization They also define access levels through security profiles and classifications, ensuring that personnel have the appropriate permissions Additionally, skills descriptions and personnel classifications help in understanding the capabilities of the workforce, while scope models and population models provide insights into the structure and size of the organization.
The “when” perspective includes artefacts that define time-related factors
Key mapping question: Does the artefact define schedules, events, cycles, timeframes or frequencies for health information management or use?
Examples: Schedules, events, cycles, timeframes, frequencies, state transitions, critical paths and reproductive cycles
The "why" perspective in health informatics standards encompasses artefacts that explain the rationale behind actions taken While few models concentrate solely on the "why," some elements of health informatics standards artefacts are indeed oriented towards this aspect Additionally, "why" artefacts can intersect with procedural elements, addressing the "how" of implementation.
Key mapping question: Does the artefact define strategy, goals, success criteria, purpose, policies or governance for health information management or use?
Examples: Mission and strategic statements, clinical guidelines, goal models, success factors, objectives, statements of purpose, rules and policies
The framework provides for multi-cell mapping of artefacts Every artefact mapping definition requires a mapping designation that indicates the relative strength of the artefact mapping
The HIPF classification matrix diagram illustrates how to map artefacts based on their specificity and perspective By posing questions regarding the intentions of health informatics standards artefacts, one can determine their appropriate placement within the matrix cells, with answers limited to specific categories of specificity and perspective.
yes, it is a primary focus of the artefact,
yes, it is a secondary focus of the artefact, or
no, it is not a focus (or is a negligible focus) of the artefact
This section describes optional attributes for further refining a health informatics standards profile
Optional HIPF artefact attribute sets have been suggested as follows:
title (e.g “Health informatics profiling framework”),
level of standards approval (e.g “working draft”),
technical or organizational implementation considerations (e.g “local implementation profiles may be needed”),
target groups (expected primary users),
other standards classification (e.g referencing another standards category),
Framework evolution
The evolution of the framework is essential for adapting to the dynamic nature of health informatics standards artifacts Key products of this process, including the HIPF meta-model, knowledge base, and framework definition, will continuously adapt to meet the needs of standards artifacts profiling As artifacts are profiled and re-profiled, the HIPF knowledge base will expand, enhancing our understanding of the profiling process and its patterns Additionally, the framework definition will remain flexible, informed by insights from the HIPF knowledge base and feedback from the community of users and stakeholders.
Analyzing profiled artefacts within a HIPF knowledge base is essential for defining the meta-model and framework This analysis helps identify artefact profiling patterns and reveals gaps in the HIPF meta-model.
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The Healthcare Information Framework (HIPF) and its adaptable meta-model architecture will consistently evolve to align with the ever-changing landscape of healthcare and health informatics A significant aspect of the HIPF is its extensible meta-model structure, which underpins the core concepts of the HIPF approach by facilitating inter-relationships among its meta-model constructs.
The meta-model step involves analyzing the current HIPF meta-model within a comprehensive knowledge base assessment to define a framework This step aims to proactively design meta-model constructs that adapt to the dynamic nature of health informatics standards artifacts and the evolving patterns of artifact profiling.
The definition of the framework will adapt as we acquire more knowledge about different artefact types and their applications This evolving definition will enhance the predictive modeling of essential framework elements, including artefact type and objectives.
In the framework definition step, previously mapped artefacts are analyzed to identify patterns related to indirect artefact types and their objective mappings to the HIPF classification matrix cells This analysis helps in determining potential mappings of artefact types, objectives, and other meta-model concepts to the HIPF classification matrix, which will be utilized in the mapping assessment phase.
5 Reference and comparisons of health informatics profiling framework to other initiatives
In recent years, numerous health informatics frameworks have been developed and published A thorough analysis of several key frameworks and reference models was conducted, focusing on their purpose, scope, and differences to assess their potential as informatics standards profiling frameworks The primary objective was to establish a method for coordinating, communicating, and comparing models of health informatics and health information standards.
See Annex D for a comparison of the HIPF to the Health Level Seven Version 3 Reference Information Model, the Zachman Enterprise Architecture — A Framework, ENV 12443:1996 [3] , and ISO/IEC 10746-2:1996 [5]
In addition, a prototype HIPF mapping and knowledge base tool is described in Annex E, along with a short discussion of potential opportunities for future exploration
Health information is inherently complex, particularly at the level of individual clinical encounters Often, health service providers cannot, and perhaps should not, address issues independently Achieving successful health outcomes typically necessitates a collaborative network that integrates various skills, information, technologies, and facilities.
Health information models are essential for managing complexity in healthcare These models serve as patterns, plans, or standards for imitation and comparison A significant advantage of modeling is its ability to break down complex systems into manageable components Moreover, a crucial aspect of medical education involves students learning to assimilate these models effectively.
ISO/TC 215’s Working Group 1 (WG1) aims to coordinate health information models and standards across different jurisdictions, focusing on how to interrelate these models In the late 1990s, WG1 faced challenges in defining a "general domain model" and aligning existing health information models Recent discussions revealed varying interpretations among participants regarding the model's objectives, highlighting that the models were created to meet different needs, making fair comparisons difficult.
WG1 discovered that the models suggested by various participants for the "General Domain Model" were overly limited in scope to fulfill all objectives There were instances of comparing models that operated at different abstraction levels; some were physical models detailing specific data elements, types, and sizes, while others were conceptual, focusing on general relationships between entities without specifying attributes Valid comparisons would require preliminary transformations of the models.
During the July 2000 WG1 meeting in Vancouver, Canada, members determined that creating a single, comprehensive health information model is likely unfeasible due to its complexity, which would undermine the purpose of an ISO model It is crucial to recognize that multiple health information models exist, including those based on standard medical practices and procedures, as well as other specific frameworks.
what information needs to be recorded,
how they are to be done,
where they need to be done,
who needs to be involved,
when tasks or activities need to be done and in what sequence, and
why they need to be done
The complexity of governance is heightened at both government and inter-jurisdictional levels, including ISO standards Certain models are tailored to specific jurisdictions or particular purposes, adding another layer to this intricate framework.
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ISO/TC 215 aims to enhance health and maintain standards in informatics, facilitating the delivery of healthcare products, services, and information across distances and borders This mission encompasses a broad perspective on health, including health services, alternative medicine, and socio-economic and environmental health factors Effective coordination and facilitation of health models must consider this wide and complex context.
In June 2000, ISO/TC 215 WG1 resolved to redefine and restart the "General Domain Model" Work Item at Stage 0, considering its historical context and previous efforts The new proposal will include an initial draft focused on establishing a high-level data framework.