Background
Since 2003, the Health Level 7 (HL7) Pediatric Data Standard, Special Interest Group (PeDS-SIG) has been defining pediatric data standards for an interoperable Electronic Medical Record (EMR) systems. Pediatrics requirements for EMR systems are distinct from those necessary in other medical specialties.1 Pediatric growth charts are the most widely used tools by pediatricians to track growth and development in children and assist in signaling potential growth problems. EMR systems supporting pediatrics should assist in growth monitoring.1 Studies have shown that pediatricians readily adopted electronic growth charts when the charts were integrated into an EMR system. Achieving interoperability between various EMR systems with growth charting capability requires that new standards be developed. Such standards will facilitate information exchange and may enhance decision support in EMR systems.
This paper storyboards a use case addressing the growth charting activities in the HL7 Reference Information Model (RIM) model representing pediatric knowledge, processes and information exchange.
Methods
Storyboards were developed from five growth charting scenarios. We represented the growth charting process as a dynamic sequence of phases and used Unified Modeling Language (UML), an object-oriented analysis and design method for developing information systems, to represent growth chart monitoring event in models. These use cases, presented as activity diagrams, were mapped to the HL7 V3 RIM, a comprehensive, non-discipline-specific, object-oriented information model of patient care and of the providers, institutions, and activities involved. The HL7 RIM represents the relevant concepts in health care for which information needs to be available and processed and their mutual relationships. The goal was to evaluate the feasibility of representing growth charting process with HL7 Standards.
Results
A UML activity diagram of the growth chart monitoring process in the pediatric domain is illustrated in Figure 1.
Figure 1.
UML Activity Diagram
Discussion
It is feasible to map growth monitoring information to the HL7 RIM. The cross-referencing built between the pediatric domain and the domain-independent model HL7 V3 RIM described in this paper, is necessary for the communication and exchange of pediatric information.
REFERENCES
- 1.American Academy of Pediatrics: Task Force on Medical Informatics. Special requirements for electronic medical record systems in pediatrics. Pediatrics. 2001;108(2):513–5. doi: 10.1542/peds.108.2.513. [DOI] [PubMed] [Google Scholar]