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NH LIM V 0 0 9_20100701

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					National Healthcare - Logical Information Model
Revision History

LIM Model    Version    Author                     Date
             LIM



             0.0        Cheong Yu Chye             1/25/2010

Archetypes   Version     Author                    Date
             DG1. Participation




             0.0        Cheong Yu Chye             2/22/2010
                                                   2/26/2010



             DG2. Patient




             0.0        Cheong Yu Chye             1/25/2010
                                                   1/29/2010
                                                   2/10/2010



             DG3. Patient HCO (Healthcare Organisation)




             0.0        Cheong Yu Chye             2/5/2010
                                                   2/26/2010



             DG4. Patient EI (Event Information)




             0.0        Cheong Yu Chye             2/5/2010
                                                   2/26/2010
DG5. Message Control


0.0        Cheong Yu Chye   2/5/2010
                            2/26/2010



DG6. Document Control


0.0        Cheong Yu Chye   2/5/2010
                            2/26/2010



DG7. Medication Item




0.0        Cheong Yu Chye   2/5/2010
                            6/2/2010



E1. Problem Diagnosis




0.0        Cheong Yu Chye   2/5/2010
                            2/26/2010



E6. Medication Order

0.0        Cheong Yu Chye   6/1/2010
                            6/2/2010
E11. Investigation Result




0.0          Cheong Yu Chye   2/25/2010
                              2/26/2010



E6. Procedure




0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010



E6. Adverse Reaction




0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010



E11. Alert


0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010



E11. Observation


0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010
E11. Medication Dispense


0.0         Cheong Yu Chye      6/1/2010
                                6/2/2010



E11.Medication Administration


0.0         Cheong Yu Chye      6/1/2010
                                6/2/2010



S1. Problem Diagnosis List




0.0         Cheong Yu Chye      3/1/2010
                                3/25/2010



S2. Medication List




0.0         Cheong Yu Chye      3/1/2010
                                3/25/2010



C1. Investigation Report




0.0         Cheong Yu Chye      3/1/2010
                                3/25/2010
C2. Patient Event Report




0.0        Cheong Yu Chye           3/1/2010
                                    3/25/2010



C3. Summary Care View




0.0        Cheong Yu Chye           3/1/2010




M1. Medication Message



0.0        Cheong Yu Chye           3/1/2010
                                    3/25/2010



M2. Investigation Results Message




0.0        Cheong Yu Chye           3/1/2010
                                    3/25/2010



M3. Event Message


0.0        Cheong Yu Chye           3/1/2010
                                    3/25/2010



R1. Data Types

0.0        Cheong Yu Chye           2/17/2010
                                    2/26/2010
T1. Design Patterns

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010
cal Information Model

      Description
      The Logical Information Model (LIM) is a shared, implementation-
      independent representation of the healthcare information that is
      exchanged across Singapore, and that which is required as part of the
      National Electronic Health Record (NEHR).
      Initial Draft

      Description
      This worksheet includes those archetypes used to model individual
      people, healthcare providers and organisations that operate within
      the healthcare domain (participants) and the roles that they may play
      within these domains. The participation model is defined in this way,
      so that healthcare participants can be represented consistently across
      all the other archetypes.
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Patient' archetype, and includes those
      data elements that pertain to patients. The Patient data group is a
      specialisation of the PERSON PARTICIPATION data group, and
      tEHRefore inEHRits all of its data elements. In addition to the PERSON
      PARTICIPATION data elements, the Patient data group also includes
      'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

      Initial Draft
      Internal Review
      NHIS Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Patient Healthcare Organisation'
      archetype, and includes data elements that pertain to the
      organisation at which the patient receives healthcare. This data group
      is modelled as a specialisation of the Organisation Participation data
      group.
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Patient Event Information' archetype,
      and includes data elements that pertain to the event during which the
      patient receives healthcare. This data group includes information,
      such as the start and end dates of the event, the participants and the
      event location.
      Initial Draft
      Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Document Control' archetype, and
includes data elements that describe the identity, type, status, dates
and authorship of documents, such as discharge summaries.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication Item' archetype and
includes data elements that pertain to the name, status, dates and
participants of a medication item. The medication item name is
defined in terms of a design pattern, which allows source systems to
use a variety of different structural and terminology patterns to
represent the same medication item.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Problem Diagnosis' archetype, and
includes data elements that pertain to the name, type, status and
dates of each problem or diagnosis associated with the patient. The
problem diagnosis name is defined in terms of a design pattern, which
allows source systems to use a variety of different structural and
terminology patterns to represent the same problem or diagnosis.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication Order' archetype and
includes data elements that pertain to the medication order.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Investigation Result' archetype and
includes data elements that pertain to the name, type, status, dates
and structured results (where relevant) of investigations which have
been (or are expected to be) performed on the patient. The
investigation name is defined in terms of a design pattern, which
allows source systems to use a variety of different structural and
terminology patterns to represent the same investigation item.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Procedure' archetype and includes data
elements that pertain to the name, type, dates and report of
procedures which have been (or are expected to be) performed on the
patient. The procedure name is defiend in terms of a design pattern,
which allows source systems to use a variety of different structural
and terminology patterns to represent the same investigation item.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Adverse Reaction' archetype and
includes data elements that pertain to individual adverse reactions
(also known as allergies, sensitivities or intolerances) that the patient
has experienced, or is at risk of experiencing. These data elements
include the adverse reaction category, relevant dates, the causative
agent, participants and episode details.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Alert' archetype and includes data
elements that pertain to individual alerts that may be relevant to the
patient.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Observation' archetype and includes
data elements that pertain to an individual observation that was
performed.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Medication Dispense' archetype and
includes data elements that pertain to an a medication item that is
dispensed.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication Administration' archetype
and includes data elements that pertain to an a medication item that
is administered.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Problem Diagnosis List' archetype. It
captures information about a list of diagnostic labels or problem
statements assigned by the clinician to describe the diagnoses and
medical/health problems associated with the patient during the
healthcare episode. It allows the list to be represented as eitEHR a
single free text summary, or individual problem/diagnosis entries (or
both).
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication List' archetype. It captures
information about a list of medications that is relevant to the patient,
such as medication orders, medications dispensed, current
medications and reconciled medications. It allows the list to be
represented as eitEHR a single free text summary, or individual
medication entries (or both).
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Investigation Report' composition
archetype and includes data elements that pertain to a single
laboratory or radiology report, such as document control information,
the report contents (as a single encapsulated data), and individual
investigation results (where relevant).
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Patient Event Report' archetype and
includes data elements that capture clinically relevant information
about a particular patient event (e.g. Discharge Summary). The data
elements describe information captured before, during and after the
patient event, such as adverse reactions, alerts, clinical synopsis,
problem diagnosis lists, medication lists, procedures, follow-up
services and triage information.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Summary Care View' archetype and
includes data elements that pertain to the NEHR Summary Care View.
This health record includes information about the patient's reconciled
problems/diagnoses, problem/diagnosis history, laboratory and
radiology investigation results, medication history and
current/reconciled medications list.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes a Medication Message and includes data
elements pertaining to the message control, the patient, the
healthcare event, the healthcare organisation, and the relevant
medication details that are exchanged in a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes an Investigation Results Message and
includes data elements pertaining to the message control, the patient,
the healthcare event, the healthcare organisation, and the relevant
investigation results that are exchanged in a message.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes an Event Message and includes data
elements pertaining to message control, and the patient event report
being exchanged in the message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the LIM.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the design patterns that are in use within
the LIM.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the LIM.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
Guide for Use
1.   The columns in each of the worksheets (except for this Coversheet and the 'Term Lists')
     can be read as follows:
     ID Ref:              This is a unique identifier for the LIM data item. The ID references
                          are indented to show the nesting of the respective data item
                          within the corresponding 'parent' data group.
     LIM Data Item        This is the name of the data element. where the data element has
     Name:                been inEHRited from a specialised datagroup, the original name
                          appears in brackets under the new data element name.
                          "Synonyms", which denote alternative name(s), are also shown
                          for some data elements.

                          Names that are preceded with two asterisks(**) indicate elements
                          that can be derived from other elements for the purposes of
                          querying.

                        Names that have the label [National] under them indicate
                        elements that are used in the national mapping of that clinical
                        concept. The national mapping provides a common semantic
                        representation of each clinical concept that is consistent across all
                        source systems.
     Data Type:         The type of the data element or group (refer to 'Data Types'
                        worksheet for data element types). Components of shared data
                        groups (e.g. "Address") are prefixed with a dash (e.g. "- Street
                        Name").
     LIM Cardinality:   The number of values that can populate the given data item,
                        within the parent data group. Examples:
                        - [0..1]: At most one instance of this data item may exist, for each
                        instance of the parent data group.
                        - [1]: Exactly one instance of this data item must exist, for each
                        instance of the parent data group.
                        - [1..Many]: One or more instances of the data item may exist, for
                        each instance of the parent data group.
                        - [0..Many]: Zero to many instances of the data item may exist, for
     LIM Definition:    A description of the data element or group.
     Value Domain:      A value domain constrains the permissible values for a data
                        element. Value domains are reusable and, as such, the same value
                        domain can be used by different data elements. The 'Term Lists'
                        worksheet contains a list of all the value domains that are
                        referenced in the various LIM worksheets.
     Format Constraint: A constraint on the format of the data element, where applicable.
                        A common format constraint is "YYYYMMDD[HHMMSS]" which
                        applies to the DateTime data type. The components appearing in
                        square brackets are optional. In other words, this particular
                        format constraint can be interpreted as year (YYYY), month (MM)
                        and day (DD) being mandatory components, while hour (HH),
                        month (MM) and second (SS) being optional components of the
                        date.
     other Constraints: other constraint(s) that apply to the data item. e.g. default values
                        or other conditions.
Example (for    A sample value of the data element as it would be exchanged
Exchange):      between IT systems. Typically the corresponding sample value is
                shown for both the Example (for Exchange) and Example (for
                Display) columns.
Example (for    A sample value of the data element as it may appear on a
Display):       standard user interface. Typically the same sample value is shown
                for both the Example (for Exchange) and Example (for Display)
                columns.
LIM Comments:   Additional comments pertaining to the data element.
NDDS Template   All LIM elements listed are part of the NDDS. This column gives
                additional constraints on the LIM element which apply for the
                NDDS, where applicable. These constraints may in the form of
                default/fixed values or constraints in terms of cardinality -- i.e.
                where the NDDS cardinality is "stricter" than the LIM cardinality.
Summary
                                                                                        Reviewers
S/N   Worksheets                              Type                           NEHR          EA       CTS


DG1   Participation                           Data Group                               (NHIS)    
DG2   Patient                                 Data Group                               (NHIS)    
DG3   Patient HCO                             Data Group                                          
DG4   Patient EI                              Data Group                                           
DG5   Message Control                         Data Group                                    
DG6   Document Control                        Data Group                                   
DG7   Medication Item                         Data Group                                           
E1    Problem Diagnosis                       ENTRY                                                
E6    Medication Order                        ENTRY                                                
E11   Investigation Result                    ENTRY                                                
E6    Procedure                               ENTRY                                                
E6    Adverse Reaction                        ENTRY                                                
E11   Alert                                   ENTRY                                                
E11   Observation                             ENTRY                                                
E11   Medication Dispense                     ENTRY                                                
E11   Medication Administration               ENTRY                                                 
S1    Problem Diagnosis List                  SECTION                                              
S2    Medication List                         SECTION                                              
C1    Investigation Report                    Composition                                          
C2    Patient Event Report                    Composition                                          
C3    Summary Care View                       Composition                                          
M1    Medication Message                      Message                                               
M2    Investigation Results Message           Message                                               
M3    Event Message                           Message                                               
R1    Data Types                              Reference Model                                     
T1    Design Patterns                         Terminology Patterns                                 
T2    Term Lists                              Terminology                                          

      Legend
      x = Worksheet has elements that are referenced in the template/list
      tick = (For templates) Worksheet (i.e. archetype) is constrained by the template
      tick = (For NEHR/NHIS lists) Worksheet (i.e. archetype) has elements included in the list
      tick = (For Reviewers) Worksheet to be reviewed by respective reviewer
                                                NEHR Lists
Summary Care Patient   Laboratory   Radiology    Diagnosis   Reconciled   Medication
View         Event     Results      Results      Problem     Diagnosis    History
                                                 History     Problem
     x            x          x           x              x            x          x
                 x          x           x              x            x          x
                                                                          
                                                                          

                                                                           
                                                                               
                 
                                                                              
                                       


     
                  
                                                                              

                                                                 
                                                                               
                                       
                 
     



     x            x          x            x            x            x           x
     x            x          x            x            x            x           x
     x            x          x            x            x            x           x
              NHIS List                       NDDS Templates                           Discharge Summary Templates
Current &                 ADT       Lab         Radiology Meds    Meds       ACIDS     ACIDS
Reconciled                                                Order   Dispense   Phase 1   Phase 2
Medications
       x         x                                                          x         x
       x                                                                             
                                                                                    
                                                                                    
                                                                 
                                                                                         
                                                                                        
                                                                                         
                                                                                        
                                                   

                                                                   
                                
                                                                    
                                                                                         

                                                                                         
                                                                                       

                                                                                         

                                                                    
                                                   
                                
      x          x                                                          x         x
      x                                                                          x         x
      x          x                                                          x         x
Discharge Summary Templates
            ACIDS Goal CHIDS
            State      (Community )
                       Phase 1
                  x            x
                              
                              
                              

                             
               
                             
               
               
               
               
               
                             
               

                             
               

                             




               x              x
               x              x
               x              x
Glossary
Term             Description
Archetype        A reusable model for describing a particular clinical concept.
Cardinality      The number of elements in a set or group. Examples:
                 [0..1]: At most one instance of this data element/group may exist, for each instance
                 of the parent data group.
                 [1]: One and only one instance of the data element/group may exist, for each
                 instance of the parent data group.
                 [1..Many]: One or more instances of the data element/group may exist, for each
                 instance of the parent data group.
                 [0..Many]: Zero to many instances of the data element/group may exist, for each
                 instance of the parent data group.
Composition      A group of archetypes assembled for a particular purpose, e.g. a discharge
                 summary is an assembly of various archetypes such as problem diagnosis list,
                 medication list and so on.
Design Pattern   A reusable model for describing a particular clinical concept (e.g. procedures,
                 medications and problem diagnoses), in which different source systems may use a
                 different split between information model and terminology model.

ENTRY            A single 'clinical statement', which may be a single, short narrative phrase, or may
                 contain a significant amount of data, e.g. a microbiology result, a psychiatric
                 examination, a complex prescription.
IDDS             Individual Data Definition Specification.
NDDS             National Data Definition Specification. The NDDS is a domain-specific information
                 template for a specific domain and use case, such as exchanging laboratory results,
                 medication dispense, etc. NDDS is derived from LIM with use case specific
                 variations & restrictions on values and terminology bindings, and other use case
                 specific validation rules. Depending on the clinical capability, different NDDS can be
                 derived from the same LIM with different clinical conformance level. Messages
                 from individual source system will be transformed to NDDS structurally conformed
                 to LIM via structural mapping and mapping of code sets from locally defined code
                 set to national reference sets.
NEHR             National Electronic Health Record. The NEHR is a national system that will
                 revolutionise the timely and accurate communication of clinical information, so
                 that patients will have confidence that clinicians have critical clinical information
                 available to deliver high quality care. The NEHR will help transform the way
                 clinicians make decisions, deliver care and interact with other members of the
                 health system.
NHIS             National Healthcare Identification Service.
Participation    An act in which a healthcare participant participates in a given role.
SECTION          A SECTION is an organising container that gives a reader a clue as to the expected
                 content. The primary purpose of a SECTION is to organise information to suit the
                 purpose for its collection and facilitate navigation. SECTIONs are also meant to be
                 safely reused for secondary purposes, e.g. clinical coding or inclusion in a
                 summarised form in an electronic health record. A SECTION is context-specific to
                 the document in which it resides.
Template         A means of constraining the LIM for a given use case or purpose. An NDDS is an
                 example of a template used for a specific national purpose.
Value Domain     A value domain constrains the permissible values for a data element. Value
                 domains are reusable components and, as such, the same value domain can be
                 used by different data elements.
Issues Tracker
S/N Issue
  20 Requirements for
     Investigation Results

  19 Understanding
     Context of Radiology
     Data Elements

  18 Concomitant
     Causative Agent
     Indicator
  17 Medication Dispenser
     Order Number



  16 Ordered vs Executed
     Priority




  15 Use of abnormal as
     well as normal
     indicator/flags




   1 Relationship between
     Status, Type and
     Design Patterns




   2 Problem Diagnosis
     ENTRY




   3 Medications List
 4 Use of ‘SECTION’




 6 LIM Update to NHIS




 7 Consolidate ‘Patient’
   and ‘Participation’
   worksheets




 8 Relationship of
   Accident Code to
   Causative Agent

 9 Capturing the context
   of entries
10 Removal of ‘Lists’
11 Decomposition of
   composite LIM
   elements to individual
   components

14 ‘Past Medical History’
   SECTION in C2.Patient
   Event Report

 5 InEHRitance of
   Clinical Context



12 Including Check Digits
   and Check Digit
   Schemes into
   Identifier Data Type




13 Review of
   Participation Model
Description
NEHR requirements to date for lab and rad reports state only the MINIMUM of what is required -- still
need to study EMRs

Need to verify with IHIS what RIS (Aurora?) they are using and whehter info from Z segments (e.g. ZBX-4)
is actually being consumed. NEHR (Florence) needs to incorporate same business rules that govern how
this data is used/displayed by their consuming systems (e.g. EMR). Sessions needed with NEHR Team to
get IHIS to show us the flow of data.
Within E6.1.2 (Causative Agent DG): We may need to add an additional indicator to denote causative
agent(s) that are concomitant

E11.1.2.3 (Medicaton Dispenser Order Number) -- Chee Leong suspects that even if the same med order
is dispensed multiple times, a differnent dispense ID is issued. Change the name to "Medication Dispense
Identifier" -- need to seek clarification from IHIS whether a new Dispense Identifier is indeed issued for
the same med order. If the same dispense ID is used, How do we differentiate between a corrected med
dispense or a new med dispense?
E11.1.2.1.3 (Priority) - This LIM field is probably meant to represent the ‘Ordered Priority’. TEHRe is a
need to find out from IHIS whether this priority is the ordered priority or the executed priority, and then
discuss with CTS (Chee Leong) whether tEHRe is a need to keep these two distinct from each other – or
whether one is more important than the other.



Need to assess whether our Investigation model can cater for different types of investigations (e.g.
histopathology/cytology)




I think we need to review how we’re handling the combination of Status, Type and Design Patterns. In
many cases, tEHRe is a strong overlap between Status (e.g. ("P", "Provisional"), ("A", "Active"), ("I",
"Inactive"), ("C", "Canceled")), Type (ie “Primary”, “Secondary”, “Past History”, “Family History”), Finding
Context (e.g. “Suspected”), Temporal Context (e.g. “Past”) and Subject-Relationship Context (e.g. “Family
history of”). I don’t think we have this sorted yet … but need to address this fairly urgently.


I’m concerned that we should be accessing the ‘Problem Diagnosis ENTRY’ directly from the Discharge
Summary, ratEHR than going through the ‘Problem Diagnosis List’ (which was originally created for
consistency with the Medication list). This ‘Problem Diagnosis List’ will still be useful for the SUMMARY
CARE VIEW – however, eitEHR way I suspect that we should be adding the “Problem Diagnosis Type”
information directly attached to each Problem/Diagnosis ENTRY (next to the “Problem Diagnosis
Status”). This seems to be the more common way of modeling this (not sure if that makes it right ;-)).

<Linda> I have decided that we need to go through the list, so that we can have a ‘Problems Diagnoses
Summary’ for each type of Problem Diagnosis List (ie. A ‘Primary Diagnosis summary’, a ‘Secondary
Diagnoses summary’, a ‘past diagnoses summary’ etc). However, in order to make the ‘ENTRY’
independently queriable, I have added a ‘Problem/Diagnosis Type’ to the PD ENTRY. This may appear to
be redundant, but unless we use Context, tEHRe seems to be no other solution.
Based on the above, we need to consider if tEHRe are any implications to the Medications List.
<Linda> Should ‘Medication Set Type’ be added to the ‘Medication Set’ (even though this may repeat the
List Type?
I’m conscious that we may be using the ‘SECTION’ inappropriately. I think it is important to understand
that “SECTIONs provide both a logical structure for the author to arrange Entries, and a navigational
structure for readers of the record, whether they be human or machine. . . . SECTION structures are not
essential in a Composition – they can always be removed or ignored (typically in machine processing
such as querying) without losing the meaning of the Entries in the Composition. While SECTIONs are
often used to group Entries according to status, e.g. “family history”, “problems”, “observations”, it is
the Entries themselves that indicate the definitive category of information contained tEHRein.” We
tEHRefore need to make sure that we have not erroneously used SECTIONs to capture clinical content
(e.g. Problem Diagnosis Type)

<Linda> This could be resolved by adding ‘Medicaiton Set Type’ to the Medication Set (although this may
appear redundant.
Update Anthony (NHIS):
·     In our current HL7 source messages, we are seeing a ‘Line 3’ component as part of the Patient’s
address. We have tEHRefore added this ‘Line 3’ component into the Address data group (ID# 2) found in
the ‘DG1. Participation’ worksheet of the LIM, to be able to model this in the LIM accordingly.
·     If you recall, we had earlier included in a LIM element called ‘EHR Opt-out Exceptions’ indicator
(ID# 1.4.7) in the ‘DG2. Patient’ worksheet to model this indicator in NHIS. Could you please advise us if
the cardinality of this element (as captured in NHIS) is ‘0..1’, or ‘0..Many’.
·     We are assuming that Next of Kin ‘Job Title’ is not required. NOK Occupation is provided (as per
Anthony’s requirement), and ‘NOK Job Title’ in the HL7 messages seems to be populated with
Occupation codes by SH (and is not provided by NHG).
Remove all components from data type column - put a link to participation page, then just add an ‘other
Constraint’ to specify all individual cardinalities that differ from the default (i.e. anything extra that is
mandatory).
. I agree that what we should be doing is including ALL or NONE of the core PERSON PARTICIPATION
attributes in the Patient data group. The advantage of including ALL is that tEHRe are fewer pages that
require templates (ie no need to add new template columns to the ‘Participation’ page for Patient and
NOK). The disadvantage is that it becomes redundant (for maintenance), and its harder to tell what is
added for Patient. Perhaps the best solution would be (and I apologise for suggesting this);
o Remove the ‘Patient’ tab all togetEHR, and instead, on the ‘Participation tab’ add all additional
‘Biodata’ data elements to the ‘PERSON PARTICIPATION’ (note this will then also cover the ‘Next of Kin’
attributes when occupation and Birth DateTime are all tEHRe (note, I’m assuming that Occupation and
Job Title are the same, but if they’re not, then we’d need to add job title as well. We would then have a
‘Patient Participation’ specialization on this same page, which includes the ‘Indicators’ and ‘Finanical
Information’ (although I’d probably tend to put ‘resident status’ in Person, because it may be relevant to
doctors as well.
Accident Code (ACC-2) [0..1]
We need to consider the relationship (if any) to the 'Causative Agent' data element in the Problem
Diagnosis archetype - our goal is to ensure that the same logical piece of information is only recorded in
one place in the LIM (where possible).
We need to log an issue to look into how we will capture the context of entries so that we can use
elements of the context such as 'ENTRY date' in our LIM@@
Each Problem Diagnosis List should have a ‘List Type’ (in this case it will be repeat of the
‘Problem/Diagnosis Category’ – e.g. “Admission Diagnosis”, “Discharge Diagnosis”). What I am starting
to suspect, however, is that we could probably remove the ‘Problem Diagnosis List’ and just include a
‘Problem Diagnosis Summary’ (as per the other data groups) on the ‘C2. Patient Event Report Page’ (as
per the other ones). I think this is another example of where the list was added as a grouping mechanism
on the NEHR ‘view’, but is not actually required in the message exchange. The same may apply for the
Medication List. Happy for you to leave it as is for the moment (but please define the List Type in the
same way as Problem/Diagnosis Category was mapped) …. But we will need to discuss this bigger change
for the next major release of the LIM.
Break up composite LIM elements to individual line items (e.g. address).




The KTPH discharge summary requires a SECTION called ‘Past Medical History’. We need to discuss with
Chee Leong the feasibility of introducing this new SECTION under C2.Patient Event Report that allows a
combination of problem/diagnoses, events and procedures to be recorded.

I suspect that tEHRe are some places in the model where the clinical context is inEHRited, and tEHRefore
does not need to be included separately. The main example I am thinking of EHRe is E11.1.3.2.1.1.2
(Investigation Test Details’ Procedure Context Group) and E11.1.3.2.1.2 (Investigation Test Details’
Source Attributes). I believe that all of these should be inEHRited from the main Investigation
Description (in 1.2).
Patient Identifier List (PID-3) [1]
- code identifying the check digit scheme employed (PID-3.3) [1]
[Recommendation: Add new Designation.check digit method LIM element]
<Linda: I would prefer not to add check digits and check digit schemes into this datatype, as neitEHR
openEHR, ISO21090 or HL7v3 includes check digits in identifiers. I suggest that we put this on the Issues
List with a question "Do we really need to support this requirement?" It looks like SH uses them, but not
NHG.
<Yu Chye> We have already included ‘Check Digit’ and ‘Check Digit Method’ into the Identifier data type.
As discussed, we will need to get ‘Patient’ and ‘Next of Kin’ aligning more closely with the participation
model (and extend the participation model to suit).
Action                      Status
                            11/6: Open


To include this with        11/6: Open
discussions between IHIS,
NEHR and STDS

                            11/6: Open


To check with IHIS          11/6: Open




To check with IHIS          8/6: Open (questions
                            to IHIS have been
                            added to IDDS
                            columns within the
                            LIM)


To discuss with Chee Leong. 2/6: Open




To discuss with Chee Leong. 12/3: Open




For discussion.             12/3: Open
                            17/3: Revised.




                            12/3: Open
12/3: Open




12/3: Open
17/3: Revised




19/3: Open




6/5: Open



9/4: Open

6/5: Open
                             12/3: Open




                             4/5: Open



Fixed                        12/3: Open
                             17/3: Closed



                             7/4: Open
                             29/4: Closed




The ‘Participation’ model    12/3: Open
has been revised to better   17/3: Closed
support both ‘Patient’ and
‘Next of Kin’.
The ‘Patient’ and ‘Next of
Kin’ data groups have been
aligned with the revised
‘Participation’ model.
PARTICIPANT and PARTICIPATION
LIM ID Ref                      LIM Data Item Name




P1                              PARTICIPANT


P2                              PERSON


P3                              HEALTHCARE PROVIDER

P4                              ORGANISATION

P5                              PARTICIPATION

P6                              PERSON PARTICIPATION


P7                              HEALTHCARE PROVIDER
                                PARTICIPATION
P8                              ORGANISATION
                                PARTICIPATION
P9                              PERSON NAME

P10                             ADDRESS

P11                             HEALTHCARE FACILITY
                                LOCATION
LIM Data Type   LIM           LIM Definition
                Cardinality



Class           <Undefined> A person or organisation that participates in the healthcare
                            domain.
Class           <Undefined> A person who participates in the healthcare domain.


Class           <Undefined> A person who provides healthcare.

Class           <Undefined> An organisation that participates in the healthcare domain.

Class           <Undefined> The act of a participant performing a role.

Class           <Undefined> A participation in which the participant is a person.


Class           <Undefined> A participation in which the participant is a person and a
                            healthcare provider.
Class           <Undefined> A participation in which the participant is a organisation


Class           <Undefined>

Class           <Undefined> The address of the participant.

Class           <Undefined> Information describing a particular location within a
                            healthcare facility.
LIM Value Domain   LIM Format Constraint
other LIM Constraints                                         LIM Example (for Exchange)




EitEHR 'Complete Name' or 'Family Name' must always be
recorded.
EitEHR 'Complete Name' or 'Family Name' must always be
recorded.
EitEHR 'Complete Name' or 'Family Name' must always be
recorded.
EitEHR 'Complete Name' or 'Family Name' must always be
recorded.



PARTICIPATION.Participant.Participant_Type = "Person"


PARTICIPATION.Participant.Participant_Type = "Healthcare
Provider"
PARTICIPATION.Participant.Participant_Type = "Organisation"
LIM Example (for   LIM Comments   LIM Change Log   NEHR Review
Display)                                           Comments
                                                   (pls indicate date of
                                                   comment)
EA Review Comments      CTS Review Comments
(pls indicate date of   (pls indicate date of
comment)                comment)
PATIENT PARTICIPANT
LIM ID Ref


P12



P13
LIM Data Item Name      LIM Data Type          LIM Cardinality


PATIENT PARTICIPATION   PERSON PARTICIPATION   <Undefined>



PATIENT                 PERSON                 <Undefined>
LIM Definition                                     LIM Value Domain   LIM Format Constraint


A participation, whose participant is a patient.



A participant who is a patient.
other LIM Constraints                       LIM Example (for Exchange) LIM Example (for Display)


P12.1.1: Participation Type = "Patient"
P12.1.2: Healthcare Role = "Subject"
P12.1.8: Relationship to Patient = "Self"
P13.1.1: Participation Type = "Patient"
P13.1.2: Healthcare Role = "Subject"
LIM Comments   Finance-related LIM Change Log   NEHR Phase 1
                                                Core

                                                Yes



                                                Yes
  SUMMARY CARE VIEW - NEHR LIST     PATIENT DEMOGRAPHICS DRILL-DOWN                       NHIS LIST
                                                 VIEW
Term                              Term                                NHIS Phase 1 Core


                                                                      Yes



                                                                      Yes




UNMAPPED                          UNMAPPED                            UNMAPPED NHIS
                                                                      FIELDS
              NHIS LIST

NHIS Data Item Name                                           NEHR Review Comments
                                                              (pls indicate date of comment)




src [1] (Source & Source ID)

Source: NHIS product terminology & used in technical
trial. Needs to be informed by both sending application
and sending facility. To be clarified during the current
Initiate consultancy.

Source ID: NHIS product generated ID for 'Source' field
mentioned above.


createdate [1] (Creation Date)

The date the patient record was created in the source.
Applies to extract only, not ongoing interfaces. A valuable
piece of information for NHIS.
updatedate [1] (Last Update Date)

The date that any field within the patient demographic
record was last updated. Applies to extract only, not
ongoing interfaces. Another valuable piece of
information for NHIS.
EA Review Comments               CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
ADT NDDS   ADT NDDS
           Cardinality
               ADT - NDDS TEMPLATE

SCM


Patient Info



Patient Info
                          ADT - NDDS TEMPLATE

ADT IDDS (SHS)


PID [1]
MRG [0..1]
PV1 [0..1]
PID [1]
MRG [0..1]




UNMAPPED FIELDS FOR IHIS CLARIFICATION/ATTENTION




Driver's License Number - Patient (PID-20) [0..1]

[12042010 MOHH} Please clarify if the purpose of this HL7 component is to capture (a) 'Patient
Document Type' (or 'Type of Identification') and (b) the 'Subvention Document Type' (or 'Type of
Identification for Subvention'). Can some sample values be provided to us so that we can decide
on the mappings to appropriate LIM elements?]




NOTES FOR MOHH USE ONLY




- Set ID - Next of Kin (NK1 - 1)
[Recommendation: Ignore since this is just a system-generated ID]
<Linda: Agreed>
PID-3 id's realm/issuer should be set to the Patient's HCO
- Driver's License Number - Patient (PID-20) [0..1]
[Recommendation: Add new LIM element for this]
<Linda: Looking at the original specification, this actually stores the 'Patient Document Type' (or
'Type of Identification') and the 'Subvention Document Type' (or 'Type of Identification for
Subvention'). I can't find any values for the second part in the data - not sure if it's used. Yes, we
should add one (or two?) data elements for this - but perhaps need to clarify its values a bit
furtEHR. From what I can see it's valid values are "X", "P" and "B".

[7/4 YC: To discuss furtEHR with WH]
[12/4 YC: Will seek clarification from IHIS]




Patient Identifier List (PID-3) [1]
- code identifying the check digit scheme employed (PID-3.3) [1]
[Recommendation: Add new Designation.check digit method LIM element]
<Linda: I would prefer not to add check digits and check digit schemes into this datatype, as
neitEHR openEHR, ISO21090 or HL7v3 includes check digits in identifiers. I suggest that we put this
on the Issues List with a question "Do we really need to support this requirement?" It looks like SH
uses them, but not NHG.
Patient Address (PID-11) [0..Many]
- state or province (PID-11.4) [0..1]
- other geographic designation (PID-11.8) [0..1]
- county/parish code (PID-11.9) [0..1]
- census tract (PID-11.10) [0..1]
[Recommendation: Add new components to 'Identifier' data type to cater for the above]
<Linda: Looking back at the IDDS, the stucture constraint seems to be defined incorrectly. For
example, even though the 'census tract' component is used, it is not populated with this. The
'Local Database Column' shows that the data used is: Street^Building Name^Block/House
Number^Unit Number^Level^City^District^Geographical Area^Postal Code^Country Code~other
Address^Street^Building Name^Block/House Number^
Unit Number^Level^City^District^Geographical Area^Postal Code^Country Code
I would tend to populate this as follows:
  - LIM.StreetName = Street
  - LIM.Block/House =Block/House number
  - LIM.Level = Level
  - LIM.Unit = Unit Number
  - LIM.Line 1 = Building Name
  - LIM.Line 2 = ['Unit ' + Unit Number + ' '] + ['Level ' + Level] Block/House Number + ' ' Street
  - LIM.Line 3 = City [+ ', ' District'] [ + ', ' + other Geographical Area]
  - LIM.City = City
  - LIM.Postal Code = Postal Code
  - LIM.Country = Country Code
Patient Address (NK1-4) [0..Many]
- state or province (NK1-4.4) [0..1]
- other geographic designation (NK1-4.8) [0..1]
- county/parish code (NK1-4.9) [0..1]
- census tract (NK1-4.10) [0..1]
[Recommendation: Add new components to 'Identifier' data type to cater for the above]
<Linda: Note, this it the Next of Kin address, but could be resolved as above. Note 'Census tract'
and State-or-province are NOT required.>
Patient Account Number (PID-18) [0..1]
- code identifying the check digit scheme employed [0..1]
[Recommendation: Add new Designation.check digit method LIM element]
<Linda: Once again I'm hesitant to add the check-digits to the identifier datatype. I would like to
confirm this requirement before doing so. Perhaps we need a general rule when mapping to HL7
v2 that we allow these components to be optional, but that we don't create check digits in other
formats - unless this is a requirement?>




Prior Patient Identifier List (MRG-1) [1]
- check digit scheme (MRG-1.3)
[Recommendation: Add new LIM.Identifier.Check Digit Method field]
<Linda: As above … we need to check this requirement.>
Insurance Company Address (IN1-5) [0..1]
- Building Name
[Recommendation: Add new element LIM.Address.other designation]
- District
[Recommendation: Add new element LIM.Address.State or Province]
- Geographical Area
[Recommendation: Add new element LIM.Address.other geographic designation]
<Linda: I don't have the original spec at hand - however I would be tempted to instead add
'Building Name', 'District' and 'other Geographical Area (as above).
KIV FOR MOHH
Patient Identifier List (PID-3) [1]
- code identifying the check digit scheme employed (PID-3.3) [1]
[Recommendation: Add new Designation.check digit method LIM element]
<Linda: I would prefer not to add check digits and check digit schemes into this datatype, as
neitEHR openEHR, ISO21090 or HL7v3 includes check digits in identifiers. I suggest that we put this
on the Issues List with a question "Do we really need to support this requirement?" It looks like SH
uses them, but not NHG.
ADT IDDS (NHG)


PID [1]
MRG [0..1]
PD1 [0..1]
PID [1]
MRG [0..1]




UNMAPPED FIELDS FOR IHIS CLARIFICATION/ATTENTION




NOTES FOR MOHH USE ONLY
Patient Address (PID-11) [0..Many]
- state or province (PID-11.4) [0..1]
- other geographic designation (PID-11.8) [0..1]
- county/parish code (PID-11.9) [0..1]
- census tract (PID-11.10) [0..1]
[Recommendation: Add new components to 'Identifier' data type to cater for the above]
<Linda. Do not add components to the 'Identifier' data type. Instead add to P13.2: Address, the fields
that we don't have in the LIM that are used in this specification. This IDDS populates the address field
with the following components:
SAP TABLE/FIELD:
   NADR-BUILD
   NADR-FLOOR
   NADR-ROOM
   NADR-STRAS
   NADR-PSTLZ
   NADR-LAND
   NADR-STRAZ
If we can work out what each of these means, then we can work out what we have and what we
don't have. I would guess (but this needs to be confirmed) that:
   NADR-BUILD --> LIM.Block/House (N.B.: Should we rename this to 'Block/House Number'?)
   NADR-FLOOR --> LIM.Level
    NADR-ROOM --> LIM.Unit
   NADR-STRAS --> LIM.Street Name
   NADR-PSTLZ --> LIM.Postal Code
   NADR-LAND --> LIM.Country
   NADR-STRAZ --> ??? Unless this is the Street Number, and NADR-BUILD is the Building Name??
(Note: It's hard to tell as we don't have any sample data for this field)
- Patient ID (PID-2) [0..1]
[Recommendation: Ignore since this is always the same value as PID-3]
<Linda: In the NUH data PID-2 and PID-3 values are always different. If you look at the Local Database
field column of the IDDS, you'll see that PID-2 is populated with the 'External Patient ID' and PID-3 is
populated with the 'Internal Patient ID'. They both should tEHRefore be mapped to the same field,
but the PID-3 id's realm/issuer should be set to the Patient's HCO, whereas I don't think we can find
out the Realm/Issuer of the PID-2's Patient ID, so this should just be left blank.
- Mother's Maiden Name (PID-6) [0..1]
[Recommendation: Add new LIM element 'Mother's Maiden Name']
<Linda: Agreed. I would consider adding this to PERSON PARTICIPATION's Additional Demographics,
as it may, at some stage be relevant for Healthcare Providers as well.>
- Cause of Patient's Death - local field (PID-31) [0..1]
[Recommendation: Add new LIM element]
<Linda: We need to make sure that tEHRe is only one way to model 'Cause of Death' in the LIM. At
the moment, you can eitEHR put the cause of death in PID-31 OR put the cause of death in P1-4 (or
P1-1 if coded) while setting P13.20 (Cause of Death Indicator). In the LIM, we need a single way of
representing this. I would probably tend to map this to the Problem/ Diganosis archetype (with Cause
of Death indicator set), as this allows more information to be captured about the cause of death (and
is tEHRefore more complete).
Prior Patient ID (MRG-4) [0..1]
- id
[29/3: WH to check with IHIS how this is different from MRG-1]
<Linda: MRG-1 seems to record the prior 'internal' patient id (ie. from the same hospital), whereas
MRG-4 seems to record the prior 'external' patient id (presumably from another facility). I think these
can be mapped to the same 'Prior Patient Id' data element, but the MRG-1 ids should get the 'realm'
assigned based on the Patient HCO, while MRG-4 doesn't (I assume we can't find a realm or issuer for
these)>




Patient Address (NK1-4) [0..1]
- state or province (NK1-4.4) [0..1]
[Recommendation: Add new component to 'Identifier' data type to cater for the above]
<Linda: I think that the structure constraint EHRe is actually quite misleading, and instead we should
be looking at the meaning of the database elements that are put into these fields. In this case SAP
populated these with:
SAP TABLE/FIELD:
NADR-BUILD
NADR-FLOOR
NADR-ROOM
NADR-STRAS
NADR-PSTLZ
NADR-LAND
We need to understand what each of these fields really mean ... but my first guess would be:
<Block/House>^<Level>^<Unit>^<StreetName>^<Postal Code>^<Country>
in which case we've got all the required bits in the LIM ... we just need to map it properly (and fix up
the IDDS structure constraint).>
KIV FOR MOHH
                         LABORATORY - NDDS TEMPLATE

ADT HL7 v2 NXDS   LAB NDDS




                  UNMAPPED
    RADIOLOGY (RAD) - NDDS TEMPLATE     MEDS ORDER (MO) - NDDS TEMPLATE

RAD NDDS                              MO NDDS




UNMAPPED                              UNMAPPED
  MEDS DISPENSE (MD) - NDDS TEMPLATE                        DISCHARGE SUMMARY TEMPL

MD NDDS                                ACIDS Phase 1 NDDS




UNMAPPED                               UNMAPPED
DISCHARGE SUMMARY TEMPLATES

     ACIDS Phase 2   ACIDS Goal State   CHIDS
                                        (Community ) Phase
                                        1




     UNMAPPED        UNMAPPED           UNMAPPED
PATIENT HEALTHCARE ORGANISATION PARTICIPATION

LIM ID Ref                   LIM Data Item Name     LIM Data Type



P14                          PATIENT HEALTHCARE ORGANISATION
                             ORGANISATION       PARTICIPATION

             P14.1           LOCATABLE              Class

             P14.2           Participation Type     Coded Text


             P14.3           Healthcare Role        Codeable Text


             P14.4           Participation Period   DateTime Interval


             P14.5           Participation Mode     Codeable Text

             P14.6           Participant            PERSON
LIM Cardinality LIM Definition                                LIM Value Domain        LIM Format
                                                                                      Constraint


                The healthcare establishment (e.g.
                hospital) at which the healthcare event
                occurred.
0               Root class of all information model classes
                that can be archetyped.
1               The type of participation played by the       Participation_Type_VD   Fixed: "Next
                participant.                                                          of Kin"
0..1            The role that the employer plays in the       NOK_Role_VD
                patient's healthcare (if applicable).

0..1            The time interval during which the patient
                was employed by this employer.

0               The mode in which the participation took
                place - e.g. 'Phone', 'Email', 'Direct'
1               Details about the patient's employre.
other LIM Constraints                    LIM Example (for          LIM Example (for
                                         Exchange)                 Display)


DG1.3.1: Participation Type = "Patient
Healthcare Establishment"
DG1.3.2: Healthcare Role = "Healthcare
Provider Organisation"

                                         ("xxx", "Next of Kin")    "Next of Kin")


                                         ("xxx", "Carer")          "Carer"


                                         ("20100105", "20100108", "5 Jan 2010 - 8 Jan
                                         "")                      2010"
                                                       SUMMARY CARE VIEW - NEHR LIST


LIM Comments   LIM Change Log   NEHR Phase 1 Term
                                Core


                                Yes




                                            Yes


                                            Yes




                                            UNMAPPED
ARY CARE VIEW - NEHR LIST                 EVENT DRILL-DOWN LIST (LIST VIEW) - NEHR LIST        EVENT SUMMARY VIEW - NEHR LIST


                   Definition & Comments Term                     Definition & Comments Term




                   UNMAPPED             UNMAPPED                  UNMAPPED                UNMAPPED
EVENT SUMMARY VIEW - NEHR LIST        PROBLEM/DIAGNOSIS HISTORY (DRILL-DOWN VIEW) -     RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIS
                                                       NEHR LIST                                         NEHR LIST

               Definition & Comments Term                   Definition & Comments     Term




               UNMAPPED             UNMAPPED                UNMAPPED
PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST) -      RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST
           NEHR LIST                                         VIEW) - NEHR LIST

                  Definition & Comments      Term                         Definition & Comments




                                             LIM.Participation Type [1]   1


                                             LIM.Healthcare Role [0..1]   0..1
                                             - Code
                                             - Term
                                             - Code System ID Period
                                             LIM.Participation            0..1
                                             [0..1]




                                             UNMAPPED                     UNMAPPED
 MEDICATION HISTORY (DRILL-DOWN LIST VIEW) - NEHR          CURR MEDS LIST (DRILL-DOWN LIST VIEW)
                      LIST

Term                     Definition & Comments      Term




Role [0..1]              N/A                        N/A


N/A                      N/A                        N/A




UNMAPPED                 UNMAPPED
CURR MEDS LIST (DRILL-DOWN LIST VIEW)            RECON MEDS LIST (DRILL-DOWN LIST VIEW)


                  Definition & Comments   Term                         Definition & Comments   NEHR Review
                                                                                               Comments
                                                                                               (pls indicate date of
                                                                                               comment)




                                          LIM.Participation Type [1]


                                          LIM.Healthcare Role [0..1]   0..1                    N/A
                                          - Code
                                          - Term
                                          - Code System ID Period
                                          LIM.Participation            0..1                    N/A
                                          [0..1]
                                                           ADT - NDDS TEMPLAT


EA Review Comments      CTS Review Comments     ADT NDDS
(pls indicate date of   (pls indicate date of
comment)                comment)




N/A                     N/A                     N/A


N/A                     N/A                     N/A




                                                UNMAPPED
              ADT - NDDS TEMPLATE


ADT NDDS       ADT IDDS (SHS)                   ADT IDDS (NHG)   ADT HL7 v2 NXDS
Cardinality


               MSH [1]                          MSH [1]




               LIM.Participation Type [1]


               LIM.Healthcare Role [0..1]       0..1             N/A
               - Code
               - Term
               - Code System ID Period [0..1]
               LIM.Participation                0..1             N/A




               UNMAPPED                         UNMAPPED         UNMAPPED
                                          LABORATORY - NDDS TEMPLATE


LAB NDDS   Lab NDDS      LAB IDDS (KKH)
           Cardinality


                         PV1 [0..1]




N/A        N/A           N/A


N/A        N/A           N/A




UNMAPPED                 UNMAPPED
LABORATORY - NDDS TEMPLATE


    LAB IDDS (SGH)           LAB IDDS (CGH)   LAB IDDS (NHG)               LAB HL7 v2 NXDS



    PV1 [0..1]               N/A              N/A




                                              LIM.Participation Type [1]   1


    N/A                                       N/A                          N/A


    N/A                                       N/A                          N/A




    UNMAPPED                 UNMAPPED         UNMAPPED                     UNMAPPED
                                           RADIOL


RAD NDDS   Radiology NDDS RAD IDDS (KKH)
           Cardinality


                          PV1 [0..1]




N/A        N/A


N/A        N/A




UNMAPPED                  UNMAPPED
                             RADIOLOGY (RAD) - NDDS TEMPLATE


RAD IDDS (SGH)                 RAD IDDS (CGH)



PV1 [0..1]                     PV1 [0..1]




LIM.Participation Type [1]


N/A                            N/A


N/A                            N/A




UNMAPPED                       UNMAPPED
) - NDDS TEMPLATE


                    RAD IDDS (NHG)   RAD IDDS (NHGP)



                    MSH [1]          MSH [1]
                    PV1 [0..1]
                    ZOR [0..Many]




                    N/A              N/A


                    N/A              N/A




                    UNMAPPED
                                       MEDS ORDER (MO) - NDDS TEMPLATE


RAD HL7 v2 NXDS   MO NDDS    Med Order
                             NDDS
                             Cardinality




                  N/A


                  N/A        N/A


                  N/A        N/A




UNMAPPED          UNMAPPED
MEDS ORDER (MO) - NDDS TEMPLATE


      MO IDDS (NHG)               MO IDDS (KKH)   MO HL7 v2 NXDS



      MSH [1]                     PV1 [1]




      N/A


      N/A




      UNMAPPED                    UNMAPPED        UNMAPPED
                                          MEDS DISPENSE (MD) - NDDS TEMPLATE


MD NDDS                           Med Dispense   MD IDDS (NHG)
                                  NDDS
                                  Cardinality

                                                 ORC [1..Many]




LIM.Participation Type [1]


LIM.Healthcare Role [0..1]


LIM.Participation Period [0..1]




UNMAPPED                                         UNMAPPED
D) - NDDS TEMPLATE


                     MD IDDS (CGH)   MD HL7 v2 NXDS   ACIDS Phase 1 NDDS



                     PV1 [0..1]                       LIM.Patient Healthcare Organisation




                     UNMAPPED        UNMAPPED         UNMAPPED
                               DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 IDDS (NHG)



Healthcare Establishment [1]
                               DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 IDDS (SHS)



Healthcare Establishment [1]
CHARGE SUMMARY TEMPLATES


                ACIDS Phase 1 IDDS (KTPH)   ACIDS Phase 2




                                            UNMAPPED
ACIDS Goal State   CHIDS
                   (Community )
                   Phase 1




UNMAPPED           UNMAPPED
MEDICATION CLUSTER
                     LIM ID Ref

CL1
      CL1.1
      CL1.2
      CL1.3
      CL1.4
      CL1.5
      CL1.6
LIM Data Item Name             LIM Data Type   LIM Cardinality

MEDICATION                     CLUSTER
LOCATABLE                      Class           1
DATA ITEM                      Class           1
CLUSTER                        Class           1
CARE ENTRY OBJECT              Class           1
MATERIAL ENTITY                Class           1
Medication Product Component   Data Group      0..Many
LIM Definition                                                   LIM Value Domain

Information pertaining to a single medication item.




A distinct type of medicinal preparation contained within the
medication product, identified by a unique set of ingredients,
LIM Format   other LIM Constraints   LIM Example (for Exchange)
Constraint
LIM Example (for Display)   LIM Comments   LIM Change Log
                   SUMMARY CARE VIEW - NEHR LIST         MEDICATION HISTORY (DRILL-DOWN LIST VIEW) -
                                                                         NEHR LIST
NEHR Phase Term                                         Term
1 Core
Yes




           UNMAPPED                                     UNMAPPED
           Medication History.Event Summary Available   Medication History.Event Summary Available
           Curr & Recon Meds.Event Summary Available
  MEDICAL ALERT VIEW - NEHR LIST    CURR & RECON MEDS LIST
                                    (DRILL-DOWN LIST) - NEHR
Term                               Term




                                   UNMAPPED
  CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST     RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR
                                                                             LIST
Term                                                  Term




UNMAPPED                                              UNMAPPED
Curr & Recon Meds.Event Summary Available             Curr & Recon Meds.Event Summary Available
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
                                                                                                               MEDS ORDER
MO NDDS                                      Med Order   SCM
                                             NDDS
                                                         Ordered Meds




LIM.Medication Product Component [0..Many]   0..Many     Ordered Meds




                                                         UNMAPPED
                                                         Order Priority [0..1] (Indicates the urgency of the
                                                         order)
                                                         POM (Patient's own medicine) [1] (To indicate
                                                         whether this medication is prescribed by the
MEDS ORDER (MO) - NDDS TEMPLATE
MO IDDS (NHG)

ORC [1..Many]
RXO [0..Many]




RXO [0..Many]




UNMAPPED
Order Control (ORC-1) [1]
Filler Order NumberAdd new [0] element]
[Recommendation: (ORC-3) LIM
[Recommendation: Add new LIM element]
Requested Give per (Time Unit) (RXO-17) [0..1]
[Recommendation: Add new LIM (For ordering of controlled substance
Ordering Provider's DEA Number element for this; this element is only
(eg: Narcotics) (RXO14) [0..Many]
[Recommendation: Add new LIM element "Ordering Provider's DEA
Number"]
<L.B. - E6.1.6.2 (Ordered By).Participant Identifier.Designation, where
Identifier_Type = "DEA Number", Issue = ??, Realm = ??>
[1/4 YC: No, this is a number pertaining to a medication item, not a
healthcare individual; recommend creating a new LIM element
"Medication Item DEA Number"]



Needs Human Review (RXO-16) [0..1]
[Recommendation: Add new LIM element; set to 'Yes' if tEHRe is a risk
that the patient is likely to experience an Adverse Drug Reaction]
<L.B.: E6.1.6.9 Intervention Recommended Reason. Note, I've added
'Review_Required_Reason_VD'> I assume this is the correct
interpretation of this field.
[1/4 YC: RXO-16 should be mapped to LIM.Intervention Recommended
Indicator and not LIM.Intervention Recommended Reason. Recommend
we delete the LIM.Intervention Recommended Reason element]
Observation Value (OBX-5)
- weight (OBX-5.1)
- height (OBX-5.2)
[Recommendation: Add new composite LIM element called "Body
Measurement" with Height (Quantity.Value), Weight (Quantity.Value) as
component elements.]
<L.B.: This needs to use an 'Observation' ENTRY archetype (as used in
the Discharge Summary). I have tEHRefore removed the Observation
Archetype details from Patient Event, and added a reference to a new
E11. Observation worksheet. The Medication message now also refers to
the E11 Observation worksheet. These fields now map to E11.1.4.1,
where E11.1.1.1 = "Height" and "Width".
Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
<L.B.: E11.1.4.2 - Observation's Value Type>




Units (relating to observations) (OBX-6) [0..1]
[Recommendation: This should be associated with new suggested "Body
Measurement" LIM field (see above)]
<L.B. E11.1.4.1 (Observation Value).Units>




Update Date (ZXO-4) [0..1]
[Recommendation: Create new LIM element "Last Updated DateTime"
under Medication Change Details DG]
<L.B.: E6.1.2.2 Medication Item Update Date>
NHG: Provider's Administration Instructions (RXO-7) [0..1]
[Recommendation: Include (?) Adverse Reaction fields EHRe, specifically:
E6.1.1.3 "Adverse Reaction Category", and E6.1.1.4 "Adverse Reaction
Remarks"]
<L.B.: Are we sure that this field is used? If it is, then we will need to add
a single Codeable Text data element ... may need more information on
this one.>
[1/4 YC: Unfortunately no POC data; IHIS mentioned that this in use at
NHGP, and will soon be used at TTSH and NUH. Example in IDDS is
"ADR_Reason_Code" and "ADR_Reason_Description". Please see
recommendation above]
Frequency (ZXO-1) [1]
[Recommendation: create new LIM element "Frequency Description"
since ZXO-1 includes both frequency, frequency qualifier and PRN
reason info]
<L.B. I've changed E6.1.5.1 (Frequency) to Codeable Text, which allows
this to be entered as a description. If, however, we need both a coded
term, and an additional frequency description text, then we may need
to add a new data element. But at this stage I don't think so.>
Duration Code (ZXO-2)
- Duration Code (ZXO-2.1) [1]
- Duration Text (ZXO-2.2) [1]
[Recommendation: change data type of "Duration" to Coded Text?]
<L.B. E6.1.6.6 is now a Codeable Text. I'm hesitant to use CodedText in
case sometimes tEHRe is no code?>
Request Dispense Unit (RXO-12) [0..1]
- Dispense Unit of Measurement (RXO-12.2) [0..1]
[Recommendatin: Ignore since this is just RXO-12.1 (unit code) spelt out]
<L.B.: E6.1.4 (Dispensed Quantity).Units. Note that the 'Request
Dispense Value' gets mapped to the same data element (but just the
'Value' component, ratEHR than the 'Units' component.>
[1/4 YC: Our recommendation to ignore this element is based on our
observation that this element is the spelt out equivalent of RXO-12.1,
which is already mapped to E6.1.6.4 (Ordered Quantity). E.g. when
E6.1.6.4 (Ordered Quantity) = "BTL", RXO-12.2 will be "Bottle". So this
element (RXO-12.2) appears to be redundant. Recommend we ignore it]

Requested Give Strength (RXO-18) [0..1]
(Note: this is a free text field that includes both the value and units of a
Quantity)
[Recommendation: Ignore this field as it is always the same value as ZXO-
8 which is mapped to LIM.Dose Quantity)]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only be
used when the medication product is single ingredient>
Order Status (ORC-5) [1]
[Recommendation: this field was mapped to "LIM.Medication Set
Status" in the previous version of the LIM but somehow this
LIM.Medication Set Status has been removed, so this is now an
unmapped field. SCM's "Order Status" was also mapped to this
LIM.Medication Set Status.]
MO IDDS (KKH)                                                         MO HL7 v2 NXDS

ORC [1..Many]
OBX [0..Many]




RXO [0..Many]




UNMAPPED                                                              UNMAPPED
Order Control (ORC-1) [1]
[Recommendation: Add new LIM element]
Placer Order Number (OBR-2) [0..1]
[Recommendation: Ignore since ORC-2 (Placer Order Number)
Filler Order Number (ORC-3) [1]
Filler Order Number+ (OBR-3) [0..1]
Universal Service ID (OBR-4) [1]
- id (OBR-4.1) [1] (ancillary name item catalog; probably a product
code, e.g. "8602")
- name of coding system (OBR-4.3) [1] (has fixed value of
"KKHPHXIN")
[Recommendation: to revisit after other IDDS have been
incorporated into LIM]
<L.B.: It looks like this may map to E6.1.3.1 Medication Name … but
it's a little unclear>
[1/4 YC: We have discovered that the id component is equal to the
medication name, and the name of coding system is always a fixed
value] Field 1 (OBR-18) [0..1]
Placer
[Recommendation: Ignore since the value is always the same as
OBR-3, which is currently mapped to Ingredient Strength]
<L.B.: Why is 'Filler Order Number' mapped to 'Ingredient
Strength'??? This does not seem right.> Filler Order Number should
map to 'Medication Dispense Number'. Please read about 'Placers'
and 'Fillers' in the HL7v2 spec.>
[1/4 YC: Sorry, must have made a typo in my note above. Please
see note above on OBR-3 (Filler Order Number+), for which we are
recommending the creation of a new LIM element. Recommend
that we map this 'Placer Field 1' element to this new LIM element]
Quantity/Timing (OBR-27) [0..Many] (relating to the services to
performed during Observations)
[YC: Need furtEHR clarification from IHIS on how this is different
from Date & Time of Transaction (ORC-9)]
<L.B.: It looks like it may be Medication Start DateTime and
Medication Stop DateTime ??>
[YC 31/3: IHIS has clarified that OBR-27 and ORC-9 are identical; have
indicated ORC-9 as '1st Choice' and OBR-27 as '2nd Choice' under
E6.1.6.3 (Ordered DateTime)]




Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
Agreed. No mapping. This would be a fixed value in the NXDS.
[YC 31/3: I assume that this should instead be mapped to E11.1.4.2
(Observation Value Type) to be consistent with what is done for NHG
case)]

Observation Result Status (OBX-11) [1]
[Recommendation: Ignore as this is always set to "F" for Final]
Agreed. No Maping. As above, this would be a fixed value in the
NXDS.
[YC 31/3: I assume that this should instead be mapped to E11.1.4.4
(Observation Status)]




Observation Identifier (OBX-3)
- Pharmacy Instructions (OBX-3.1) [0..1]
[Recommendation: create new "Frequency Description" field that
covers both frequency, frequency qualifier and PRN reason in a
single value]
<L.B.: No - This maps to E6.1.4.5 Dose Instructions.>
                                                            MEDS D
MD NDDS                                      Med Dispense
                                             NDDS




LIM.Medication Product Component [0..Many]   0..Many
                                                         MEDS DISPENSE (MD) - NDDS TEMPLATE
SCM

Dispensed Meds




Dispensed Meds




UNMAPPED
Filler Order Number [1] (The ancillary reference code)
[Recommendation:
Drug Strength [0..1]Add new LIM element]
[Recommendation: Add new LIM element
MEDS DISPENSE (MD) - NDDS TEMPLATE
MD IDDS (NHG)

ORC [1..Many]
RXD [1..Many]




RXD [1..Many]




UNMAPPED
Filler Order Number (ORC-3) *0…1+
- entity identifier (ORC-3.1)
Order Control (ORC-1) [1] *0…1+
[Recommendation: Add new LIM element]
Entered By (ORC-10) *0…Many+
- id number (ORC-10.1) *0…1+
Enterer's Location (ORC-13) *0…1+
- point of care (ORC-13) *0…1+
[Recommendation: Add new LIM element "Enterer's Location"]
<L.B.: E6.1.2.10 Medication Item ENTRY Location>




Date/Time of Transaction (ORC-9) *0…1+ (Refers to new/cancelled/ modified
order date/time
[Recommendation: Add new LIM element "Last Updated DateTime" under
Medication Change Details DG]
<L.B.: E6.1.2.2 Medication Item Update Date>
Dispense to Location (RXD-13) *0…1+
- point of care (RXD-13.1) [1] (refers to location of pharmacy)
[Recommendation: Add new LIM element "Dispensed To" under "Medication Set
Information" DG]
<L.B.: E6.1.7.6: Dispensed To Location>




Prescription Number (RXD-7) [1]
[Recommendation: Add new LIM element "Prescription ID" under "Medication
Set Information" DG]
<L.B.: E6.1.1.1 Medication Item Order Number>
[YC 31/3: Filler Order Number.entity identifer (ORC-3.1) is already mapped to this
field as per instruction above; prescription Number is for medication set.
Recommend that a new LIM element "Medication Set Number".]

Pharmacist Intervention For Item (ZXO-6) *0…1+
- intervention flag (ZXO-6.1) [1]
[Recommendation: Add new LIM element "Pharmacist Intervention" under
"Medication Item Administer Details" DG]
<L.B.: E6.1.7.7 Intervention Required Indicator>




Medication Type (ZCO-4) *0…1+ (eg outpatient, inpatient medication)
[Recommendation: Add new LIM element "Medication Set Type" under
"Medication Set Information" DG]
<L.B. E6.1.2.6 Medication Item Type. Note, I've added
'Medication_Item_Type_VD'
1. Actual Dosage Form (RXD-6) *0…1+
- identifier (RXD-6.1) [1]
2. Dosage (ZXO-8) *0…1+
[Recommendation: create new "Dosage Description" LIM element]
<L.B. - I have changed E6.1.4.5 Dose Instructions to Codeable Text, and now this
should be mapped to E6.1.4.5>




Update Date (ZXO-4) *0…1+
[YC: Need furtEHR clarification from IHIS - is it different from Order Effective
Date/Time (ORC-15)]
<L.B.: I assume this maps to E6.1.2.2 Medication Item Update Date.>

[YC 31/3: IHIS has clarified that this field is NOT always the same as ORC-15.
Recommend that we create a new LIM.Additional Med Dispense Information
element with Information Type = "Update Date", and Information Value = ZXO-4]




Actual Strength (RXD-16) *0…1+
Actual Strength Unit (RXD-17) *0…1+
[Recommendation: Add new LIM element "Medication Item Strength" for these
IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only be used when
the medication product is single ingredient>
                                                                                                  DISCHARGE SUMMA
MD IDDS (CGH)                                                      MD HL7 v2 NXDS ACIDS Phase 2

ORC [1..Many]
OBX [0..Many]




OBX [0..Many]




UNMAPPED                                                           UNMAPPED        UNMAPPED
Filler Order Number (ORC-3) [1]
Order Control (ORC-1) [1] [1]
- entity identifier (ORC-3.1)
[Recommendation: Add new LIM element]
1. Quantity/Timing (ORC-7) [1]
- end date/time (ORC-7.5) *0…1+
Entered By (ORC-10) *1…Many+
- id number (ORC-10.1) [1]
- family name (ORC-10.2) [1]
[Recommendation: Add new LIM element "Entered By"]
<E6.1.2.9 Medication Item Entered By>




2. Give Code (RXE-2) [1]
- identifier (RXE-2.1) [1]
- description (RXE-2.2) [1]
- ancillary coding standard (RXE-2.3) [1]
[Recommendation: Ignore since this is always the same as similar
fields under Requested Give Code]
<L.B. This still needs to be mapped, even if it maps to the same
thing. Should map to E6.1.3.1 Medicaiton Name (and its component
bits), including id, term, coding system, mappings>
Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E11.1.4.2 (Observation
Result Value Type) to be consistent with other institutions]




Observation Result Status (OBX-11) [1]
[Recommendation: Ignore as this is always set to "F" for Final]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E11.1.4.4 (Observation
Result Status; is this ok?]



Observation Value (OBX-5) [1] when value of OBX-3 = "Pharmacy
Instructions"
(currently one single text string contains:
- Medication Item Set Connecting Term
- Dose Instructions
- Frequency Qualifier)
[Recommendation: create new LIM text element "Pharmacy
Instructions" under Medication Item, i.e. a new E6.1.4.1 element]
<L.B. E6.1.4.5 Dosage Instructions.>
<L.B. If tEHRe is any consistency in the pattern in which Medication
Connecting Term is provided, it would be great to be able to 'Parse'
this out, into the appropriate Data Element. Not sure if this is
possible - depends on how reliable the text pattern is.>

[8/4 YC: Unfortunately, tEHRe is no consistency in the structure of
the text string which would allow us to parse the relevant data.
However, we have now mapped this field to 'Additional Order
Instructions']

Observation Value (OBX-5) [1] when value of OBX-3 = "Strength"
[Recommendation: Add new LIM element "Medication Item
Strength" for these IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only
be used when the medication product is single ingredient>
Observation Value (OBX-5) (trade product name) when value of OBX-
3 [0..1] = "Brand Name"
[Recommendation: This brand name may be different from
medication name; suggest we create a new LIM element to track
this information]
       DISCHARGE SUMMARY TEMPLATES
ACIDS Goal State




LIM.Medication Product Component [0..Many]




UNMAPPED
MEDICATION ITEM CLUSTER
                        LIM ID Ref

CL2
      CL2.1

      CL2.2


      CL2.3

      CL2.4

      CL2.5

      CL2.5

      CL2.6

              CL2.6.1

              CL2.6.2

              CL2.6.3

              CL2.6.4

              CL2.6.5


      CL2.7


      CL2.8
      CL2.9
LIM Data Item Name                          LIM Data Type   LIM Cardinality

MEDICATION ITEM                             CLUSTER
MEDICATION                                  Class           1

MATERIAL ITEM                               Class           1


Medication Dosage                           CLUSTER         0..1

Medication Frequency                        CLUSTER         0..1

Medication Dispensing Information           CLUSTER         0..1

Medication Administration Information       CLUSTER         0..1

Medication Item General Information         CLUSTER         0..1

Item Number                                 Text            0..1

Set Number                                  Integer         0..1

Set Item Sequence Number                    Integer         0..1

Item Connecting Term                        Coded Text      0..1

Indication                                  Codeable Text   0..1


ADR Override Information                    CLUSTER         0..1


Controlled Substance Ordering Information   CLUSTER         0..1
Medication Item Update Details              CLUSTER         0..1
LIM Definition                                                   LIM Value Domain

Information pertaining to a single medication item.
The Medication entity on which this medication item is based.

A single item used to describe a material for an order, action
(such as dispensing), or other purpose.
A description of the dosage in which the medication should be
or has been taken.
A description of the frequency that the medication should be
taken.
A description of how the medication should be or has been
administered.
A description of how the medication should be or has been
administered.
Information about the Medication Set associated with the
Medication Order Item.
A number that identifies and sequences this medication item
within the given Medication Order.
A number that identifies the medication set to which this
medication item belongs, within the given Medication Order.
A number that indicates the order of the medication item within
the associated medication set.
A term used to describe how this medication item is connected Medication_Item_Set_Connecting_Ter
to the next medication item in the same set.                    m_VD
The clinical justification (or indication) for the use of this   Medication_Indication_VD
medication.

Information relating to the overriding of ADR (Adverse Drug
Reaction) warnings.
Information related to the ordering of controlled substances.
Change-related details associated with the Medication Item.
LIM Format   other LIM Constraints            LIM Example (for Exchange)
Constraint




             This is recorded exactly when    "1.01"
             tEHRe is a medication Set ID.    "2"
                                              "1"
                                              "2"
                                              "01"
                                              "02"
             This is recorded exactly when    ("T", "Then")
             tEHRe is a medication Set Number ("A", "And")
                                              ("81680005", "Neck pain")
LIM Example (for Display)   LIM Comments   LIM Change Log




"1.01"
"2"
"1"
"2"
"01"
"02"
("Then")
("And")
"Neck pain"
                   SUMMARY CARE VIEW - NEHR LIST
NEHR Phase Term
1 Core
Yes



Yes


Yes

Yes

Yes

Yes

Yes

Yes




Yes        Medication History.Medication order set connecting
           term
Yes




Yes




           UNMAPPED
           Medication History.Event Summary Available
           Curr & Recon Meds.Event Summary Available
 MEDICATION HISTORY (DRILL-DOWN LIST VIEW) -    MEDICAL ALERT VIEW - NEHR LIST
                 NEHR LIST
Term                                         Term




Medication History.Medication Order/Dispense
Sequence Number




Medication History.Medication order set connecting
term
Medication History.Comments (e.g. reason for
medication, changes made, reason for changes etc.)




UNMAPPED
Medication History.Event Summary Available
 CURR & RECON MEDS LIST      CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST
 (DRILL-DOWN LIST) - NEHR
Term                      Term




                          Curr & Recon Meds.Medication order set connecting term

                          Curr & Recon Meds.Reason for Medication




UNMAPPED                  UNMAPPED
                          Curr & Recon Meds.Event Summary Available
 RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR
                      LIST
Term                                           NEHR Review Comments
                                               (pls indicate date of comment)




Curr & Recon Meds.Medication order set connecting
term
Curr & Recon Meds.Reason for Medication




UNMAPPED
Curr & Recon Meds.Event Summary Available
CTS Review Comments              MO NDDS                                               Med Order
(pls indicate date of comment)                                                         NDDS




                                 LIM.Medication Dosage [1]                             1


                                 LIM.Medication Dosage [1]                             1

                                 LIM.Medication Frequency [1]                          1

                                 LIM.Medication Administration [0..1]                  0..1

                                 LIM.Medication Administration [0..1]                  0..1

                                 LIM.Medication Order Set Details [1]                  1

                                 LIM.Medication Order Item Number [1]                  1

                                 LIM.Medication Set Number [0..1] (fixed: <x> where    0..1
                                 LIM.Medication Item Number = <x>"."<y> (i.e. number
                                 before decimal point) Sequence Number [0..1]
                                 LIM.Medication Set Item                               0..1
                                 (fixed: <y> where LIM.Medication Item Number =
                                 <x>"."<y> (i.e .number after decimal point)
                                 LIM.Medication Item Connecting Term [0..1]            0..1
                                 - Code
                                 - Term
                                 LIM.Reason for Medication [0..1]                      0..1
                                 - Code
                                 - Term
                                 LIM.ADR Override Information [0..1]                   0..1


                                 LIM.Controlled Substance Ordering Information [0..1] 0..1
                                 LIM.Medication Item Update Details [0..1]             0..1
                                                      MEDS ORDER (MO) - NDDS TEMPLATE
SCM

Ordered Meds



Ordered Meds


Ordered Meds

Ordered Meds

Ordered Meds

Ordered Meds

N/A

N/A

N/A

N/A

N/A

N/A


N/A


N/A
N/A




UNMAPPED
Order Priority [0..1] (Indicates the urgency of the
order)
POM (Patient's own medicine) [1] (To indicate
whether this medication is prescribed by the
MEDS ORDER (MO) - NDDS TEMPLATE
MO IDDS (NHG)

ORC [1..Many]
RXO [0..Many]

RXO [0..Many]
ZXO [0..Many]
RXO [0..Many]
ZXO [0..Many]
ZXO [0..Many]

RXR [0..Many]

RXR [0..Many]

N/A

Item Sequence No (ZXO-7) [1]

N/A

N/A

N/A

N/A


RXO [0..Many]


RXO [0..Many]
ORC [1..Many]
ZXO [0..Many]



UNMAPPED
Order Control (ORC-1) [1]
[Recommendation: (ORC-3) LIM
Filler Order NumberAdd new [0] element]
[Recommendation: Add new LIM element]
Requested Give per (Time Unit) (RXO-17) [0..1]
Ordering Provider's Add new LIM (For ordering of controlled substance
[Recommendation: DEA Number element for this; this element is only
(eg: Narcotics) (RXO14) [0..Many]
[Recommendation: Add new LIM element "Ordering Provider's DEA
Number"]
<L.B. - E6.1.6.2 (Ordered By).Participant Identifier.Designation, where
Identifier_Type = "DEA Number", Issue = ??, Realm = ??>
[1/4 YC: No, this is a number pertaining to a medication item, not a
healthcare individual; recommend creating a new LIM element
"Medication Item DEA Number"]
Needs Human Review (RXO-16) [0..1]
[Recommendation: Add new LIM element; set to 'Yes' if tEHRe is a risk
that the patient is likely to experience an Adverse Drug Reaction]
<L.B.: E6.1.6.9 Intervention Recommended Reason. Note, I've added
'Review_Required_Reason_VD'> I assume this is the correct
interpretation of this field.
[1/4 YC: RXO-16 should be mapped to LIM.Intervention Recommended
Indicator and not LIM.Intervention Recommended Reason. Recommend
we delete the LIM.Intervention Recommended Reason element]



Observation Value (OBX-5)
- weight (OBX-5.1)
- height (OBX-5.2)
[Recommendation: Add new composite LIM element called "Body
Measurement" with Height (Quantity.Value), Weight (Quantity.Value) as
component elements.]
<L.B.: This needs to use an 'Observation' ENTRY archetype (as used in
the Discharge Summary). I have tEHRefore removed the Observation
Archetype details from Patient Event, and added a reference to a new
E11. Observation worksheet. The Medication message now also refers
to the E11 Observation worksheet. These fields now map to E11.1.4.1,
where E11.1.1.1 = "Height" and "Width".
Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
<L.B.: E11.1.4.2 - Observation's Value Type>




Units (relating to observations) (OBX-6) [0..1]
[Recommendation: This should be associated with new suggested "Body
Measurement" LIM field (see above)]
<L.B. E11.1.4.1 (Observation Value).Units>
Update Date (ZXO-4) [0..1]
[Recommendation: Create new LIM element "Last Updated DateTime"
under Medication Change Details DG]
<L.B.: E6.1.2.2 Medication Item Update Date>



NHG: Provider's Administration Instructions (RXO-7) [0..1]
[Recommendation: Include (?) Adverse Reaction fields EHRe,
specifically: E6.1.1.3 "Adverse Reaction Category", and E6.1.1.4
"Adverse Reaction Remarks"]
<L.B.: Are we sure that this field is used? If it is, then we will need to add
a single Codeable Text data element ... may need more information on
this one.>
[1/4 YC: Unfortunately no POC data; IHIS mentioned that this in use at
NHGP, and will soon be used at TTSH and NUH. Example in IDDS is
"ADR_Reason_Code" and "ADR_Reason_Description". Please see
recommendation above]
Frequency (ZXO-1) [1]
[Recommendation: create new LIM element "Frequency Description"
since ZXO-1 includes both frequency, frequency qualifier and PRN
reason info]
<L.B. I've changed E6.1.5.1 (Frequency) to Codeable Text, which allows
this to be entered as a description. If, however, we need both a coded
term, and an additional frequency description text, then we may need
to add a new data element. But at this stage I don't think so.>
Duration Code (ZXO-2)
- Duration Code (ZXO-2.1) [1]
- Duration Text (ZXO-2.2) [1]
[Recommendation: change data type of "Duration" to Coded Text?]
<L.B. E6.1.6.6 is now a Codeable Text. I'm hesitant to use CodedText in
case sometimes tEHRe is no code?>
Request Dispense Unit (RXO-12) [0..1]
- Dispense Unit of Measurement (RXO-12.2) [0..1]
[Recommendatin: Ignore since this is just RXO-12.1 (unit code) spelt out]
<L.B.: E6.1.4 (Dispensed Quantity).Units. Note that the 'Request
Dispense Value' gets mapped to the same data element (but just the
'Value' component, ratEHR than the 'Units' component.>
[1/4 YC: Our recommendation to ignore this element is based on our
observation that this element is the spelt out equivalent of RXO-12.1,
which is already mapped to E6.1.6.4 (Ordered Quantity). E.g. when
E6.1.6.4 (Ordered Quantity) = "BTL", RXO-12.2 will be "Bottle". So this
element (RXO-12.2) appears to be redundant. Recommend we ignore it]


Requested Give Strength (RXO-18) [0..1]
(Note: this is a free text field that includes both the value and units of a
Quantity)
[Recommendation: Ignore this field as it is always the same value as ZXO-
8 which is mapped to LIM.Dose Quantity)]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only be
used when the medication product is single ingredient>
Order Status (ORC-5) [1]
[Recommendation: this field was mapped to "LIM.Medication Set
Status" in the previous version of the LIM but somehow this
LIM.Medication Set Status has been removed, so this is now an
unmapped field. SCM's "Order Status" was also mapped to this
LIM.Medication Set Status.]
MO IDDS (KKH)                                                         MO HL7 v2 NXDS

ORC [1..Many]
OBX [0..Many]

RXO [0..Many]
OBX [0..Many]
RXO [0..Many]
OBX [0..Many]
ORC [1..Many]

RXR [0..Many]

RXR [0..Many]

N/A

N/A

N/A

N/A

N/A

N/A


N/A


N/A
NTE [0..1]




UNMAPPED                                                              UNMAPPED
Order Control (ORC-1) [1]
[Recommendation: Add new LIM element]
Placer Order Number (OBR-2) [0..1]
[Recommendation: Ignore since ORC-2 (Placer Order Number)
Filler Order Number (ORC-3) [1]
Filler Order Number+ (OBR-3) [0..1]
Universal Service ID (OBR-4) [1]
- id (OBR-4.1) [1] (ancillary name item catalog; probably a product
code, e.g. "8602")
- name of coding system (OBR-4.3) [1] (has fixed value of
"KKHPHXIN")
[Recommendation: to revisit after other IDDS have been
incorporated into LIM]
<L.B.: It looks like this may map to E6.1.3.1 Medication Name … but
it's a little unclear>
[1/4 YC: We have discovered that the id component is equal to the
medication name, and the name of coding system is always a fixed
value]
Placer Field 1 (OBR-18) [0..1]
[Recommendation: Ignore since the value is always the same as
OBR-3, which is currently mapped to Ingredient Strength]
<L.B.: Why is 'Filler Order Number' mapped to 'Ingredient
Strength'??? This does not seem right.> Filler Order Number should
map to 'Medication Dispense Number'. Please read about 'Placers'
and 'Fillers' in the HL7v2 spec.>
[1/4 YC: Sorry, must have made a typo in my note above. Please
see note above on OBR-3 (Filler Order Number+), for which we are
recommending the creation of a new LIM element. Recommend
that we map this 'Placer Field 1' element to this new LIM element]
Quantity/Timing (OBR-27) [0..Many] (relating to the services to
performed during Observations)
[YC: Need furtEHR clarification from IHIS on how this is different
from Date & Time of Transaction (ORC-9)]
<L.B.: It looks like it may be Medication Start DateTime and
Medication Stop DateTime ??>
[YC 31/3: IHIS has clarified that OBR-27 and ORC-9 are identical;
have indicated ORC-9 as '1st Choice' and OBR-27 as '2nd Choice'
under E6.1.6.3 (Ordered DateTime)]




Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
Agreed. No mapping. This would be a fixed value in the NXDS.
[YC 31/3: I assume that this should instead be mapped to E11.1.4.2
(Observation Value Type) to be consistent with what is done for NHG
case)]

Observation Result Status (OBX-11) [1]
[Recommendation: Ignore as this is always set to "F" for Final]
Agreed. No Maping. As above, this would be a fixed value in the
NXDS.
[YC 31/3: I assume that this should instead be mapped to E11.1.4.4
(Observation Status)]
Observation Identifier (OBX-3)
- Pharmacy Instructions (OBX-3.1) [0..1]
[Recommendation: create new "Frequency Description" field that
covers both frequency, frequency qualifier and PRN reason in a
single value]
<L.B.: No - This maps to E6.1.4.5 Dose Instructions.>
                                                                       MEDS DISPE
MD NDDS                                                 Med Dispense
                                                        NDDS




LIM.Medication Dosage [1]                               1


LIM.Medication Dosage [1]                               1

LIM.Medication Frequency [1]                            1

LIM.Medication Administration [0..1]                    0..1

LIM.Medication Administration [0..1]                    0..1

LIM.Medication Order Set Details [0..1]                 0..1

LIM.Medication Order Item Number [0..1]                 0..1

LIM.Medication Set Number [1] (fixed: <x> where         1
LIM.Medication Item Number = <x>"."<y> (i.e. number
before decimal point) Sequence Number [0..1] (fixed:
LIM.Medication Set Item                                 0..1
<y> where LIM.Medication Item Number = <x>"."<y> (i.e
.number after decimal point)
LIM.Medication Item Connecting Term [0..1]              0..1
- Code
- Term
LIM.Reason for Medication [0..1]                        0..1
- Code
- Term
LIM.ADR Override Information [0..1]                     0..1


LIM.Controlled Substance Ordering Information [0..1]    0..1
LIM.Medication Item Update Details [0..1]               0..1
                                                   MEDS DISPENSE (MD) - NDDS TEMPLATE
SCM

Dispensed Meds



Dispensed Meds


Dispensed Meds

Dispensed Meds

Dispensed Meds

Dispensed Meds

N/A

N/A

N/A

N/A

N/A

N/A


N/A


N/A
N/A




UNMAPPED
Filler Order Number [1] (The ancillary reference
code)
Drug Strength [0..1]
[Recommendation: Add new LIM element
MEDS DISPENSE (MD) - NDDS TEMPLATE
 MD IDDS (NHG)

 ORC [1..Many]
 RXD [1..Many]

 RXD [1..Many]
 ZXO [0..Many]
 RXD [1..Many]
 ZXO [0..Many]
 ZXO [0..Many]

 N/A

 N/A

 N/A

 Item Sequence Number (ZXO-7) *0…1+

 N/A

 N/A

 N/A

 N/A


 N/A


 N/A
 ORC [1..Many]




 UNMAPPED
 Filler Order Number (ORC-3) *0…1+
 Order Control (ORC-1) [1] *0…1+
 - entity identifier (ORC-3.1)
 [Recommendation: Add new LIM element]
 Entered By (ORC-10) *0…Many+
 - id number (ORC-10.1) *0…1+
 Enterer's Location (ORC-13) *0…1+
 - point of care (ORC-13) *0…1+
 [Recommendation: Add new LIM element "Enterer's Location"]
 <L.B.: E6.1.2.10 Medication Item ENTRY Location>
Date/Time of Transaction (ORC-9) *0…1+ (Refers to new/cancelled/ modified
order date/time
[Recommendation: Add new LIM element "Last Updated DateTime" under
Medication Change Details DG]
<L.B.: E6.1.2.2 Medication Item Update Date>




Dispense to Location (RXD-13) *0…1+
- point of care (RXD-13.1) [1] (refers to location of pharmacy)
[Recommendation: Add new LIM element "Dispensed To" under "Medication Set
Information" DG]
<L.B.: E6.1.7.6: Dispensed To Location>




Prescription Number (RXD-7) [1]
[Recommendation: Add new LIM element "Prescription ID" under "Medication
Set Information" DG]
<L.B.: E6.1.1.1 Medication Item Order Number>
[YC 31/3: Filler Order Number.entity identifer (ORC-3.1) is already mapped to
this field as per instruction above; prescription Number is for medication set.
Recommend that a new LIM element "Medication Set Number".]

Pharmacist Intervention For Item (ZXO-6) *0…1+
- intervention flag (ZXO-6.1) [1]
[Recommendation: Add new LIM element "Pharmacist Intervention" under
"Medication Item Administer Details" DG]
<L.B.: E6.1.7.7 Intervention Required Indicator>
Medication Type (ZCO-4) *0…1+ (eg outpatient, inpatient medication)
[Recommendation: Add new LIM element "Medication Set Type" under
"Medication Set Information" DG]
<L.B. E6.1.2.6 Medication Item Type. Note, I've added
'Medication_Item_Type_VD'


1. Actual Dosage Form (RXD-6) *0…1+
- identifier (RXD-6.1) [1]
2. Dosage (ZXO-8) *0…1+
[Recommendation: create new "Dosage Description" LIM element]
<L.B. - I have changed E6.1.4.5 Dose Instructions to Codeable Text, and now this
should be mapped to E6.1.4.5>




Update Date (ZXO-4) *0…1+
[YC: Need furtEHR clarification from IHIS - is it different from Order Effective
Date/Time (ORC-15)]
<L.B.: I assume this maps to E6.1.2.2 Medication Item Update Date.>

[YC 31/3: IHIS has clarified that this field is NOT always the same as ORC-15.
Recommend that we create a new LIM.Additional Med Dispense Information
element with Information Type = "Update Date", and Information Value = ZXO-4]




Actual Strength (RXD-16) *0…1+
Actual Strength Unit (RXD-17) *0…1+
[Recommendation: Add new LIM element "Medication Item Strength" for these
IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only be used when
the medication product is single ingredient>
                                                                                    DISCHARGE SUMMARY T
MD IDDS (CGH)                                        MD HL7 v2 NXDS ACIDS Phase 2

ORC [1..Many]
OBX [0..Many]

OBX [0..Many]
RXO [0..Many]
OBX [0..Many]
RXO [0..Many]
ORC [1..Many]

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A


N/A


N/A
OBX [0..Many]
ORC [1..Many]



UNMAPPED                                             UNMAPPED       UNMAPPED
Filler Order Number (ORC-3) [1]
Order Control (ORC-1) [1] [1]
- entity identifier (ORC-3.1)
[Recommendation: Add new LIM element]
1. Quantity/Timing (ORC-7) [1]
- end date/time (ORC-7.5) *0…1+
Entered By (ORC-10) *1…Many+
- id number (ORC-10.1) [1]
- family name (ORC-10.2) [1]
[Recommendation: Add new LIM element "Entered By"]
<E6.1.2.9 Medication Item Entered By>
2. Give Code (RXE-2) [1]
- identifier (RXE-2.1) [1]
- description (RXE-2.2) [1]
- ancillary coding standard (RXE-2.3) [1]
[Recommendation: Ignore since this is always the same as similar
fields under Requested Give Code]
<L.B. This still needs to be mapped, even if it maps to the same
thing. Should map to E6.1.3.1 Medicaiton Name (and its component
bits), including id, term, coding system, mappings>



Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E11.1.4.2 (Observation
Result Value Type) to be consistent with other institutions]




Observation Result Status (OBX-11) [1]
[Recommendation: Ignore as this is always set to "F" for Final]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E11.1.4.4 (Observation
Result Status; is this ok?]



Observation Value (OBX-5) [1] when value of OBX-3 = "Pharmacy
Instructions"
(currently one single text string contains:
- Medication Item Set Connecting Term
- Dose Instructions
- Frequency Qualifier)
[Recommendation: create new LIM text element "Pharmacy
Instructions" under Medication Item, i.e. a new E6.1.4.1 element]
<L.B. E6.1.4.5 Dosage Instructions.>
<L.B. If tEHRe is any consistency in the pattern in which Medication
Connecting Term is provided, it would be great to be able to 'Parse'
this out, into the appropriate Data Element. Not sure if this is
possible - depends on how reliable the text pattern is.>

[8/4 YC: Unfortunately, tEHRe is no consistency in the structure of
the text string which would allow us to parse the relevant data.
However, we have now mapped this field to 'Additional Order
Instructions']
Observation Value (OBX-5) [1] when value of OBX-3 = "Strength"
[Recommendation: Add new LIM element "Medication Item
Strength" for these IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only
be used when the medication product is single ingredient>


Observation Value (OBX-5) (trade product name) when value of
OBX-3 [0..1] = "Brand Name"
[Recommendation: This brand name may be different from
medication name; suggest we create a new LIM element to track
this information]
       DISCHARGE SUMMARY TEMPLATES
ACIDS Goal State




LIM.Medication Dosage [0..1]


LIM.Medication Dosage [0..1]

LIM.Medication Frequency [0..1]

LIM.Medication Administration [0..1]

LIM.Medication Administration [0..1]

LIM.Medication Set Details [1]

LIM.Medication Order Item Number [0..1]

LIM.Medication Set Number [0..1]

LIM.Medication Set Sequence Number [0..1]

LIM.Medication Item Connecting Term [0..1]

LIM.Reason for Medication [0..1]


N/A


N/A
LIM.Medication Item Update Details [0..1]




UNMAPPED
PATIENT EVENT CONTEXT ENTRY
     LIM ID Ref               LIM Data Item Name        LIM Data Type



E1                            PATIENT EVENT             ADMINISTRATION ENTRY
                              CONTEXT
     E1.1                     LOCATABLE                 Class

     E1.2                     CONTENT ITEM              Class

     E1.3                     ENTRY                     Class

     E1.4                     ADMINISTRATION ENTRY Class

     E1.5                     Patient Event General     CLUSTER
                              Information
     E1.6                     Patient Admission         CLUSTER
                              Information
     E1.7                     Patient Discharge         CLUSTER
                              Information
     E1.8                     Patient Event Location    CLUSTER
                              Information
     E1.9                     Patient Event Dates       CLUSTER

     E1.10                    Patient Event Financial   CLUSTER
                              Information
LIM Cardinality LIM Definition                                                LIM Value Domain



                General information about the patient event.


1               Root class of all information model classes that can be
                archetyped.
1               An abstract class of all concrete content types.

1               A class that mainly defines the semantics of all the ‘hard’
                information in the EHR. An ENTRY is also the minimal unit
1               of information any query should return, subtypes. A
                The abstract parent of all clinical ENTRY since a whole
                CARE_ENTRY defines protocol
1               Details that help to identify the patient event.

0..1            Information pertaining to the admission of the patient.

0..1            General information about the discharge of the patient.


0..1            Information pertaining to the location of the patient.

0..1            Dates associated with the sending and receiving of the
                message.
0..1            Financial information related to the patient event.
LIM Format   other LIM Constraints   LIM Example (for Exchange)
Constraint
LIM Example (for Display)   LIM Comments   Finance-   LIM Change Log   NEHR Phase
                                           related                     1 Core

                                                                       Yes




                                                                       Yes




                                                                       Yes




                                                                       Yes

                                           Yes
 SUMMARY CARE VIEW - NEHR EVENT DRILL-DOWN LIST       EVENT SUMMARY VIEW -    PROBLEM/DIAGNOSIS
          LIST             (LIST VIEW) - NEHR LIST          NEHR LIST      HISTORY (DRILL-DOWN VIEW)
Term                     Term                        Term                  Term




UNMAPPED                   UNMAPPED                                         UNMAPPED
RECON PROBLEM/DIAGNOSIS MEDICATION HISTORY (DRILL- PROCEDURES (DRILL-DOWN
LIST (DRILL-DOWN LIST VIEW) DOWN LIST VIEW) - NEHR      VIEW) - NEHR LIST
Term                       Term                    Term




UNMAPPED                UNMAPPED
   LAB REPORT - NEHR LIST    RADIOLOGY REPORT - NEHR   INVESTIGATIONS (DRILL-
                                      LIST              DOWN LIST) - NEHR LIST
Term                        Term                     Term




0..1                        Major Diagnostic Category
                            (DG1-7) [0..1]




UNMAPPED                    UNMAPPED
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
                   ADT - NDDS TEMPLATE                  LABORATORY - NDDS TEMPLATE

ADT NDDS                                         LAB NDDS




LIM.Patient Event Identification [1]             LIM.Patient Event Identification [1]

LIM.Patient Admission Information [0..1]         N/A

LIM.Patient Discharge Information [0..1]         N/A


LIM.Patient Event Location Information [0..1]    LIM.Patient Event Location Information [0..1]

LIM.Patient Event Dates [0..1]                   LIM.Patient Event Dates [0..1]

LIM.Patient Event Financial Information [0..1]   N/A
UNMAPPED
        RADIOLOGY (RAD) - NDDS TEMPLATE              MEDS ORDER (MO) - NDDS TEMPLATE

RAD NDDS                                         MO NDDS




LIM.Patient Event Identification [1]             LIM.Patient Event Identification [1]

N/A                                              N/A

N/A                                              N/A


LIM.Patient Event Location Information [0..1]    LIM.Patient Event Location Information [0..1]

LIM.Patient Event Dates [0..1]                   LIM.Patient Event Dates [0..1]

LIM.Patient Event Financial Information [0..1]   LIM.Patient Event Financial Information [0..1]
UNMAPPED   UNMAPPED
    MEDS DISPENSE (MD) - NDDS TEMPLATE                                                           DIS

MD NDDS                                          ACIDS Phase 1 NDDS




LIM.Patient Event Identification [1]             LIM.Patient Event Identification [1]

N/A                                              N/A

N/A                                              LIM.Patient Discharge Information [1]


LIM.Patient Event Location Information [0..1]    LIM.Patient Event Location Information [0..1]

LIM.Patient Event Dates [0..1]                   LIM.Patient Event Dates [1]

LIM.Patient Event Financial Information [0..1]   N/A



                                                 UNMAPPED
UNMAPPED
                DISCHARGE SUMMARY TEMPLATES

ACIDS Phase 2        ACIDS Goal State




N/A

                     LIM.Patient Event Identification [1]

                     LIM.Patient Admission Information [0..1]




                     LIM.Patient Event Location Information [0..1]

                     LIM.Patient Event Dates [0..1]

                     LIM.Patient Event Financial Information [0..1]



UNMAPPED             UNMAPPED
CHIDS
(Community )
Phase 1




UNMAPPED
DOCUMENT CONTROL ENTRY

LIM ID Ref               LIM Data Item Name



E2                       DOCUMENT CONTROL


             E2.1        LOCATABLE


             E2.2        CONTENT ITEM

             E2.3        ENTRY

             E2.4        ADMINISTRATION ENTRY

             E2.5        Document Control
                         Information
             E2.6        Document Reference
                         Information
LIM Data Type          LIM Cardinality   LIM Definition



ADMINISTRATION ENTRY                     Information about a document that is used to
                                         manage, identify or locate the document.
Class                  1                 Root class of all information model classes
                                         that can be archetyped.
Class                  1                 An abstract class of all concrete content
                                         types.
Class                  1                 A class that mainly defines the semantics of
                                         all the ‘hard’ information in the EHR. An
Class                  1                 The abstract the minimal unit of information
                                         ENTRY is alsoparent of all clinical ENTRY
                                         subtypes. A CARE_ENTRY defines protocol
CLUSTER                1                 Information about the given document, not
                                         captured elsewhere.
DOCUMENT REFERENCE     1                 Information about the given document, not
                                         captured elsewhere.
LIM Value Domain   LIM Format Constraint   other LIM Constraints   LIM Example (for Exchange)
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase 1
                                                            Core

                                                            Yes
       SUMMARY CARE VIEW - NEHR LIST         EVENT DRILL-DOWN LIST (LIST VIEW) -
                                                         NEHR LIST


Term                        Definition &   Term               Definition &
                            Comments                          Comments
  EVENT SUMMARY VIEW - NEHR LIST    RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST) - NEHR
                                                          LIST


Term             Definition &      Term                       Definition & Comments
                 Comments
RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST          CURR & RECON MEDS LIST (DRILL-DOWN LIST) - NEHR LIS



Term                           Definition & Comments              Term
RECON MEDS LIST (DRILL-DOWN LIST) - NEHR LIST          CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST



                   Definition & Comments        Term                           Definition & Comments
       RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST          MEDICAL ALERTS VIEW - NEHR LIST



Term                            Definition & Comments       Term
MEDICAL ALERTS VIEW - NEHR LIST               DOCUMENT LIST VIEW - NEHR LIST



               Definition & Comments   Term      Definition & Comments
       LAB REPORT - NEHR LIST              RADIOLOGY REPORT - NEHR LIST



Term                 Definition &   Term
                     Comments
RADIOLOGY REPORT - NEHR LIST



     Definition & Comments     NEHR Review Comments
                               (pls indicate date of comment)
EA Review Comments               ACIDS Phase 1 NDDS
(pls indicate date of comment)

                                 LIM.Document Control
ACIDS Phase 1 IDDS (NHG)



Document Control
                           DISCHARGE SUMMARY TEMPLATES



ACIDS Phase 1 IDDS (SHS)



Document Control
DISCHARGE SUMMARY TEMPLATES



    ACIDS Phase 1 IDDS (KTPH)
ACIDS Phase 1 - NEHR Mapping   ACIDS Phase 2
ACIDS Goal State   CHIDS
                   (Community ) Phase 1
N/A
PROBLEM DIAGNOSIS ENTRY

LIM ID Ref                LIM Data Item Name

E3                        PROBLEM DIAGNOSIS ENTRY


      E3.1                LOCATABLE

      E3.2                CONTENT ITEM

      E3.3                ENTRY

      E3.4                CARE ENTRY

      E3.5                EVALUATION ENTRY

      E3.6                Problem Diagnosis Dates

      E3.7                Problem Diagnosis Additional
                          Information
LIM Data Type      LIM Cardinality

EVALUATION ENTRY   <Undefined>


Class              1

Class              1

Class              1

Class              1

Class              1

CLUSTER            0..1

CLUSTER            0..1
LIM Definition

Information pertaining to a single problem or diagnosis ENTRY.


Root class of all information model classes that can be archetyped.

An abstract class of all concrete content types.

A class that mainly defines the semantics of all the ‘hard’ information in the EHR. An
ENTRY is also the minimal unit of information any query should return, since a whole
The abstract parent of all clinical ENTRY subtypes. A CARE_ENTRY defines and
ENTRY (including sub-parts) records spatial structure, timing information, protocol
and guideline attributes for all clinical ENTRY subtypes.
ENTRY type for evaluation statements. Used for all kinds of statements which evaluate
other information, such as interpretations
of obvservations, diagnoses, differential
Dates related to this problem diagnosis. diagnoses, hypotheses, risk

Additional details about the problem diagnosis being described.
LIM Value Domain   LIM Format other LIM Constraints   LIM Example (for Exchange)
                   Constraint
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase 1
                                                            Core
                                                            Yes
       SUMMARY CARE VIEW - NEHR LIST   EVENT DRILL-DOWN LIST (LIST
                                            VIEW) - NEHR LIST

Term                                   Term
 PROBLEM/DIAGNOSIS HISTORY (DRILL-DOWN     RECON PROBLEM/DIAGNOSIS LIST (DRILL-
            VIEW) - NEHR LIST                     DOWN LIST) - NEHR LIST

Term                                     Term
  RECON PROBLEM/DIAGNOSIS LIST (DRILL-          MEDICAL ALERT VIEW - NEHR LIST
      DOWN LIST VIEW) - NEHR LIST

Term                                     Term
                                                                             ADT - NDDS TEMPLATE


NEHR Review Comments             CTS Review Comments              ADT NDDS
(pls indicate date of comment)   (pls indicate date of comment)




                                                                  LIM.Problem Diagnosis Dates[0..1]

                                                                  LIM.Problem Diagnosis Additional Information
                                                                  [0..1]
                           DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 NDDS   ACIDS Phase 2




N/A                  N/A
SCHARGE SUMMARY TEMPLATES


         ACIDS Goal State                                      CHIDS
                                                               (Community )
                                                               Phase 1




         LIM.Problem Diagnosis Dates[0..1]

         LIM.Problem Diagnosis Additional Information [0..1]
MEDICATION ORDER ENTRY
            LIM ID Ref   LIM Data Item Name

E4                       MEDICATION ORDER


     E4.1                LOCATABLE

     E4.2                CONTENT ITEM

     E4.3                ENTRY

     E4.4                CARE ENTRY

     E4.5                INSTRUCTION ENTRY
     E4.6                ORDER ENTRY
     E4.7                MATERIAL ORDER
LIM Data Type   LIM Cardinality

ENTRY           <Undefined>


Class           1

Class           1

Class           1

Class           1

Class           1
Class           1
Class           1
LIM Definition                                                 LIM Value Domain

Information pertaining to a single medication item that is
ordered.

Root class of all information model classes that can be
archetyped.
An abstract class of all concrete content types.

A class that mainly defines the semantics of all the ‘hard’
information in the EHR. An ENTRY is also the minimal unit of
The abstract parent of all clinical ENTRY subtypes. A
CARE_ENTRY defines protocol
LIM Format   other LIM Constraints   LIM Example (for Exchange)
Constraint
LIM Example (for Display)   LIM Comments   LIM Change Log




                                                            UNMAPPE
                                                            Medication




                                                            Curr & Rec
                   SUMMARY CARE VIEW - NEHR LIST
NEHR Phase Term
1 Core
Yes




           UNMAPPED
           Medication History.Event Summary Available




           Curr & Recon Meds.Event Summary Available
 MEDICATION HISTORY (DRILL-DOWN LIST VIEW) -    MEDICAL ALERT VIEW - NEHR LIST
                 NEHR LIST
Term                                         Term




UNMAPPED
Medication History.Event Summary Available
 CURR & RECON MEDS LIST      CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST
 (DRILL-DOWN LIST) - NEHR
Term                      Term




UNMAPPED                  UNMAPPED
                          Curr & Recon Meds.Event Summary Available
 RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR
                      LIST
Term                                           NEHR Review Comments
                                               (pls indicate date of comment)




UNMAPPED
Curr & Recon Meds.Event Summary Available
                                       MEDS ORDER (MO) - NDDS TEMPLATE
CTS Review Comments              MO NDDS
(pls indicate date of comment)



                                 N/A
      MEDS DISPENSE (MD) - NDDS TEMPLATE                   DISCHARGE SUMMARY TEMPLATES
MD NDDS                                    ACIDS Phase 2




                                           N/A




                                           UNMAPPED
       DISCHARGE SUMMARY TEMPLATES
ACIDS Goal State




N/A




UNMAPPED
MEDICATION DISPENSE ENTRY
LIM ID Ref                  LIM Data Item Name


E5                          MEDICATION DISPENSE


      E5.1                  LOCATABLE

      E5.2                  CONTENT ITEM

      E5.3                  ENTRY

      E5.4                  CARE ENTRY

      E5.5                  ACTIVITY ENTRY
      E5.6                  MATERIAL ACTIVITY
      E5.7                  MEDICATION ACTIVITY
      E5.8                  Medication Dispense
                            Additional Information
LIM Data Type   LIM Cardinality   LIM Definition


ENTRY           <Undefined>       Information pertaining to a single medication item that is
                                  dispensed.

Class           1                 Root class of all information model classes that can be
                                  archetyped.
Class           1                 An abstract class of all concrete content types.

Class           1                 A class that mainly defines the semantics of all the ‘hard’
                                  information in the EHR. An ENTRY is also the minimal unit of
Class           1                 The abstract parent of all clinical ENTRY subtypes. A
                                  CARE_ENTRY defines protocol
Class           1                 and guideline attributes for all clinical ENTRY subtypes.
Class           1
Class           1
CLUSTER         0..1              Additional information about the Medication Dispense action.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)
LIM Comments   LIM Change Log   NEHR Phase
                                1 Core

                                Yes
        SUMMARY CARE VIEW - NEHR LIST         MEDICATION HISTORY (DRILL-DOWN LIST VIEW) -
                                                              NEHR LIST
Term                                         Term




Medication History.Event Summary Available   Medication History.Event Summary Available




Curr & Recon Meds.Event Summary Available
  MEDICAL ALERT VIEW - NEHR LIST    CURR & RECON MEDS LIST
                                    (DRILL-DOWN LIST) - NEHR
Term                               Term
  CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST    RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR
                                                                            LIST
Term                                                  Term




Curr & Recon Meds.Event Summary Available             Curr & Recon Meds.Event Summary Available
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
MD NDDS                           Med Dispense
                                  NDDS
                                  Cardinality




Medication Dispense Details [1]   1
                                                         MEDS DISPENSE (MD) - NDDS TEMPLATE
SCM


Dispensed Meds




Dispensed Meds




NOTES FOR MOHH USE ONLY
Filler Order Number [1] (The ancillary reference
code)
[Recommendation: Add new LIM element]
<L.B.: E6.1.1.1 Medication Order Number>




Drug Strength [0..1]
[Recommendation: Add new LIM element
"Medication Item Strength" for these IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this
field can only be used when the medication product
is single ingredient>
    MEDS DISPENSE (MD) - NDDS TEMPLATE
MD IDDS (NHG)


ORC [1..Many]
RXD [1..Many]
ZXO [0..Many]
ZCO [0..Many]




ORC [1..Many]
ZXO [0..Many]
RXD [1..Many]

NOTES FOR MOHH USE ONLY
Filler Order Number (ORC-3) *0…1+
- entity identifier (ORC-3.1) *0…1+
[Recommendation: Add new LIM element]
<L.B.: E6.1.1.1 Medication Order Number>




Order Control (ORC-1) [1]
[Recommendation: Add new LIM element]
<L.B.: E6.1.2.1 Medication Item Status>




Entered By (ORC-10) *0…Many+
- id number (ORC-10.1) *0…1+
(This refers to pharmacy staff)
[Recommendation: Add new LIM participation "Entered By"]
<E6.1.2.9 Medication Item Entered By>




Enterer's Location (ORC-13) *0…1+
- point of care (ORC-13) *0…1+
[Recommendation: Add new LIM element "Enterer's Location"]
<L.B.: E6.1.2.10 Medication Item ENTRY Location>
Date/Time of Transaction (ORC-9) *0…1+ (Refers to new/cancelled/ modified
order date/time
[Recommendation: Add new LIM element "Last Updated DateTime" under
Medication Change Details DG]
<L.B.: E6.1.2.2 Medication Item Update Date>




Dispense to Location (RXD-13) *0…1+
- point of care (RXD-13.1) [1] (refers to location of pharmacy)
[Recommendation: Add new LIM element "Dispensed To" under "Medication Set
Information" DG]
<L.B.: E6.1.7.6: Dispensed To Location>

Prescription Number (RXD-7) [1]
[Recommendation: Add new LIM element "Prescription ID" under "Medication
Set Information" DG]
<L.B.: E6.1.1.1 Medication Item Order Number>
[YC 31/3: Filler Order Number.entity identifer (ORC-3.1) is already mapped to
this field as per instruction above; prescription Number is for medication set.
Recommend that a new LIM element "Medication Set Number".]

Pharmacist Intervention For Item (ZXO-6) *0…1+
- intervention flag (ZXO-6.1) [1]
[Recommendation: Add new LIM element "Pharmacist Intervention" under
"Medication Item Administer Details" DG]
<L.B.: E6.1.7.7 Intervention Required Indicator>




Medication Type (ZCO-4) *0…1+ (eg outpatient, inpatient medication)
[Recommendation: Add new LIM element "Medication Set Type" under
"Medication Set Information" DG]
<L.B. E6.1.2.6 Medication Item Type. Note, I've added
'Medication_Item_Type_VD'


1. Actual Dosage Form (RXD-6) *0…1+
- identifier (RXD-6.1) [1]
2. Dosage (ZXO-8) *0…1+
[Recommendation: create new "Dosage Description" LIM element]
<L.B. - I have changed E6.1.4.5 Dose Instructions to Codeable Text, and now this
should be mapped to E6.1.4.5>
Update Date (ZXO-4) *0…1+
[YC: Need furtEHR clarification from IHIS - is it different from Order Effective
Date/Time (ORC-15)]
<L.B.: I assume this maps to E6.1.2.2 Medication Item Update Date.>

[YC 31/3: IHIS has clarified that this field is NOT always the same as ORC-15.
Recommend that we create a new LIM.Additional Med Dispense Information
element with Information Type = "Update Date", and Information Value = ZXO-4]


Actual Strength (RXD-16) *0…1+
Actual Strength Unit (RXD-17) *0…1+
[Recommendation: Add new LIM element "Medication Item Strength" for these
IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only be used when
the medication product is single ingredient>
MD IDDS (CGH)                                                      MD HL7 v2 NXDS


PV1 [0..Many]
ORC [1..Many]
OBX [0..Many]
RXO [0..Many]




ORC [1..Many]
PV1 [0..Many]



NOTES FOR MOHH USE ONLY
Filler Order Number (ORC-3) [1]
- entity identifier (ORC-3.1) [1]
- namespace ID (ORC-3.2) [1]
[Recommendation: Add new LIM element]
<L.B.: E6.1.1.1 Medication Order Number. Note, entity identifier
maps to 'Designation' and Namespace ID maps to 'Realm' - and
possibly 'Issuer', depending on how namespaces are allocated.>




Order Control (ORC-1) [1]
[Recommendation: Add new LIM element]
<L.B.: E6.1.2.1 Medication Item Status>




1. Quantity/Timing (ORC-7) [1]
- end date/time (ORC-7.5) *0…1+
2. Quantity/Timing (RXE-1) [1]
- end date/time (RXE-1.5) *0…1+
[Recommendation: Add new LIM element called "Collect Stop
DateTime" - this field refers to the datetime that the dispensed
medication will run out.]
<L.B.: E6.1.7.5 (Dispensed Quantity Time Interval).End DateTIme>
Entered By (ORC-10) *1…Many+
- id number (ORC-10.1) [1]
- family name (ORC-10.2) [1]
[Recommendation: Add new LIM element "Entered By"]
<E6.1.2.9 Medication Item Entered By>
2. Give Code (RXE-2) [1]
- identifier (RXE-2.1) [1]
- description (RXE-2.2) [1]
- ancillary coding standard (RXE-2.3) [1]
[Recommendation: Ignore since this is always the same as similar
fields under Requested Give Code]
<L.B. This still needs to be mapped, even if it maps to the same
thing. Should map to E6.1.3.1 Medicaiton Name (and its component
bits), including id, term, coding system, mappings>
Value Type (OBX-2) [1]
[Recommendation: Ignore as this is always set to "TX" (Text Data
(Display))]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E5.1.4.2 (Observation Result
Value Type) to be consistent with other institutions]
Observation Result Status (OBX-11) [1]
[Recommendation: Ignore as this is always set to "F" for Final]
<L.B.: Agreed>
[YC 31/3: Have mapped this instead to E5.1.4.4 (Observation Result
Status; is this ok?]



Observation Value (OBX-5) [1] when value of OBX-3 = "Pharmacy
Instructions"
(currently one single text string contains:
- Medication Item Set Connecting Term
- Dose Instructions
- Frequency Qualifier)
[Recommendation: create new LIM text element "Pharmacy
Instructions" under Medication Item, i.e. a new E6.1.4.1 element]
<L.B. E6.1.4.5 Dosage Instructions.>
<L.B. If tEHRe is any consistency in the pattern in which Medication
Connecting Term is provided, it would be great to be able to 'Parse'
this out, into the appropriate Data Element. Not sure if this is
possible - depends on how reliable the text pattern is.>

[8/4 YC: Unfortunately, tEHRe is no consistency in the structure of
the text string which would allow us to parse the relevant data.
However, we have now mapped this field to 'Additional Order
Instructions']

Observation Value (OBX-5) [1] when value of OBX-3 = "Strength"
[Recommendation: Add new LIM element "Medication Item
Strength" for these IDDS elements]
<L.B.: E6.1.3.3.2> Ingredient Strength. Note that this field can only
be used when the medication product is single ingredient>


Observation Value (OBX-5) (trade product name) when value of
OBX-3 [0..1] = "Brand Name"
[Recommendation: This brand name may be different from
medication name; suggest we create a new LIM element to track
this information]
                       DISCHARGE SUMMARY TEMPLATES
ACIDS Phase 2   ACIDS Goal State




                LIM.Medication Dispense Details [0..1]
MEDICATION ADMINISTRATION ENTRY
LIM ID Ref                        LIM Data Item Name



E6                                MEDICATION ADMINISTRATION


      E6.1                        LOCATABLE


      E6.2                        CONTENT ITEM

      E6.3                        ENTRY

      E6.4                        CARE ENTRY

      E6.5                        ACTIVITY ENTRY
      E6.6                        MATERIAL ACTIVITY
      E6.7                        MEDICATION ACTIVITY
LIM Data Type   LIM Cardinality



ENTRY           <Undefined>


Class           1


Class           1

Class           1

Class           1

Class           1
Class           1
Class           1
LIM Definition                                                 LIM Value Domain



Information pertaining to a single medication that is
administered.

Root class of all information model classes that can be
archetyped.
An abstract class of all concrete content types.

A class that mainly defines the semantics of all the ‘hard’
information in the EHR. An ENTRY is also the minimal unit of
The abstract parent of all clinical ENTRY subtypes. A
CARE_ENTRY defines protocol
and guideline attributes for all clinical ENTRY subtypes.
LIM Format   other LIM Constraints   LIM Example (for Exchange)
Constraint
LIM Example (for Display)   LIM Comments   LIM Change Log
                  SUMMARY CARE VIEW - NEHR LIST

NEHR Phase Term
1 Core
SUMMARY CARE VIEW - NEHR LIST             MEDICATION HISTORY (DRILL-DOWN LIST VIEW) - NEHR LIST

           Definition & Comments   Term
HISTORY (DRILL-DOWN LIST VIEW) - NEHR LIST          MEDICAL ALERT VIEW - NEHR LIST

                   Definition & Comments     Term
MEDICAL ALERT VIEW - NEHR LIST                CURR & RECON MEDS LIST (DRILL-DOWN LIST) - NEHR LIST

               Definition & Comments   Term                     Definition & Comments
       CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST

Term                                  Definition & Comments
       RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST

Term                               Definition & Comments
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
                       DISCHARGE SUMMARY TEMPLATES

ACIDS Phase 2   ACIDS Goal State
INVESTIGATION ORDER ENTRY

                    LIM ID Ref   LIM Data Item Name


E7                               INVESTIGATION ORDER



     E7.1                        LOCATABLE

     E7.2                        CONTENT ITEM

     E7.3                        ENTRY

     E7.4                        CARE ENTRY


     E7.5                        INSTRUCTION ENTRY
     E7.6                        ORDER ENTRY
LIM Data Type   LIM Cardinality   LIM Definition


ENTRY           <Undefined>       Each relevant investigations performed on the
                                  patient during the healthcare event, as individual
                                  result entries.
Class           1                 Root class of all information model classes that
                                  can be archetyped.
Class           1                 An abstract class of all concrete content types.

Class           1                 A class that mainly defines the semantics of all the
                                  ‘hard’ information in the EHR. An ENTRY is also the
Class           1                 The abstract parent of all clinical ENTRY subtypes.
                                  A CARE_ENTRY defines protocol
                                  and guideline attributes for all clinical ENTRY
Class           1
Class           1
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
                                   SUMMARY CARE VIEW - NEHR LIST


LIM Change Log   NEHR Phase Term
                 1 Core

                 Yes
UNMAPPED
Investigation.Event Summary Available
SUMMARY CARE VIEW - NEHR LIST                    INVESTIGATIONS (DRILL-DOWN LIST) - NEHR LIST


                  Definition & Comments   Term
UNMAPPED                                     UNMAPPED
[STD20100513] We will look into the          Investigation.Ordering Institution
incorporation of a 'Event Summary
Document Identifier' LIM element (or
something similar to this) for events,
procedures, medication items,
investigations, problem/diagnosis which will
capture the Set Identifier and Version
Number. The NEHR 'Event Summary
Available' can then be derived from the
presence of this 'Event Summary Document
Identifier'.
                                             Investigation.Event Summary Available
TIGATIONS (DRILL-DOWN LIST) - NEHR LIST           LAB REPORT - NEHR LIST


                   Definition & Comments   Term
UNMAPPED                                        UNMAPPED
                                                Investigation.Ordering Institution




[STD20100513] We will look into the
incorporation of a 'Event Summary Document
Identifier' LIM element (or something similar
to this) for events, procedures, medication
items, investigations, problem/diagnosis
which will capture the Set Identifier and
Version Number. The NEHR 'Event Summary
Available' can then be derived from the
presence of this 'Event Summary Document
Identifier'.
LAB REPORT - NEHR LIST                  RADIOLOGY REPORT - NEHR LIST


         Definition & Comments   Term
UNMAPPED   UNMAPPED
           Investigation.Ordering Institution
RADIOLOGY REPORT - NEHR LIST


   Definition & Comments
UNMAPPED
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
LAB NDDS   Lab NDDS
           Cardinality
SCM
UNMAPPED
                                                                                                           LABORATORY - NDDS T


LAB IDDS (KKH)




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [1] when Observation Identifier [1].catalog id (OBX-3.1) [1] = "HISTOPATHOLOGY
KKH"




Observation Value (OBX-5) [1] when Observation Identifier [1].catalog id (OBX-3.1) [1] = "CYTOLOGY KKH"
UNMAPPED




Quantity/Timing (OBR-27) [1]
- quantity (OBR-27.1) [1]
[Recommendation: Ignore since this is always a fixed value of "1"]

- duration (OBR-27.3) [1]
[Recommendation: Ignore since this is always a fixed value of "0"]




Action By (ORC-19) [0..1]
- ID Number (ORC-19.1) [1]
- Full Name (ORC-19.2) [1]

[MOHH20100527] IHIS to confirm what role this person has, e.g. clinical (performs the test), administrative
(change the order control code), etc.

Order Control (ORC-1) [1]




Order Control Code Reason (ORC-16) [0..1]
- identifier (ORC-16.1) [1]
- text (ORC-16.2) [1]



Entering Device (ORC-18) [0..1]
- identifier (ORC-18.1) [1]
- text (ORC-18.2) [1]
     LABORATORY - NDDS TEMPLATE


LAB IDDS (SGH)




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-3.1) [1] =
"HISTOPATHOLOGY SGH"




Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-3.1) [1] =
"CYTOLOGY NEW SGH"
UNMAPPED
LAB IDDS (CGH)




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-
3.1) [1] = "HISTOPATHOLOGY CGH"




Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-
3.1) [1] = "CYTOLOGY NEW CGH"
UNMAPPED




Diagnostic Serv Sect ID (OBR-24) [0..1]
- discipline short text (OBR-24.1)
- discipline number (OBR-24.2)
- chapter number (OBR-24.3)
- printing index number (OBR-24.4)

[28/4 YC: Linda, it appears that we can't map even OBR-24.1 to LIM.Investigation
SubType as OBR-24.1 has values that map to LIM.Investigation Type as well (e.g.
"LAB"). I'm unsure whether we need to create dedicated LIM elements to map
the 4 components above to.
Enterer's Location (ORC-13) [0..1]
- Location code (ORC-13.1) [1]
- Room (ORC-13.2) [1]
- Location description (ORC-13.5) [1]
LAB IDDS (NHG)   LAB HL7 v2 NXDS
UNMAPPED




Diagnostic Serv Sect ID (OBR-24) [1]
- Lab Type (OBR-24.1)
- Discipline (OBR-24.2)
- Chapter (OBR-24.3)
- Print Index (OBR-24.4)

[28/4 YC: Linda, although we don't have the complete value domain for OBR-
24.1 in the IDDS, I suspect that the possible values are a mix of both
LIM.Investigation Type and LIM.Investigation SubType. I'm unsure whether we
need to create dedicated LIM elements to map the 4 components above to.
RAD NDDS   Radiology NDDS
           Cardinality
SCM
UNMAPPED
RAD IDDS (KKH)
NOTES FOR MOHH USE ONLY
Specimen Source (OBR-15) [0..1]

This field wil be ignored as it is hardcoded.
                 RADIOLOGY (RAD) - NDDS TEMPLATE


RAD IDDS (SGH)
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]
RADIOLOGY (RAD) - NDDS TEMPLATE


            RAD IDDS (CGH)
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]
RAD IDDS (NHG)




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Exam Procedure Component ID (ZEX-4) [0..1]

AH: "technical";
NUH: "profession";
TTSH: "profession", "NOCHG", "technical", "Global"

[MOHH 28042010] Please give the definition of this element (e.g. how it is used) so that we can determine how best to map
it to the LIM.
Exam Indications (ZEX-6) [0..1]
(free text)
TTSH: "5 pt chg appt frm 2/6", "2 s2a", "25 w12d/b128 op ward req"

[MOHH 28042010] IHIS has previously clarified that this is field consists of free-text remarks used by staff and is not relevant
for external use. Nevertheless, as the LIM is meant to capture all the information currently being exchanged in HL7
messages, we need to understand the definition (e.g. purpose) of this element so that we can map it to the LIM accordingly.
Please give the definition (e.g. purpose) of this element.
Order CLUSTER (ZOR-4) [0..1]

"1" [TTSH]

[MOHH 28042010] IHIS has earlier shared that this is the CLUSTER hospital interface code which is "1". This is not the
organisation of the Requesting Clinician. As the LIM is meant to capture all the information currently being exchanged in HL7
messages, we need to understand the definition (e.g. purpose) of this element so that we can map it to the LIM accordingly.
Please give the definition (e.g. purpose) of this element.
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation Result General Information" DG.]




Filler Field 1 (OBR-20) [0..3]

[Recommendation: Add new LIM.Procedure Modifier [0..3] element under "Investigation Result General Information" DG.
IHIS has only clarified that this is a procedure repeated subsequent to the original procedure.]




Results Rpt/Status Chng - Date/Time (OBR-22) [0..1]

[Recommendation: Add new LIM.Request Status Update DateTime element under "Request Information" DG, as this
element stores the date/time of the order status change]



Entered By (ORC-10) [0..1]

[Recommendation: Add new LIM.Entered By element under "Request Information" DG - this may differ from existing
LIM.Performing Clinician element.]



Order Control Code Reason (ORC-16) [0..1]

[Recommendation: Ignore since IHIS has clarified that this is a RIS-specific application event code]



Transcriptionist (OBR-35) [0..1]
- Transcriptionist Code (OBR-35.1) [0..1] (identifier)
- Last Name (OBR-35.2) [0..1] (complete name)

[Recommendation: Add new LIM.Transcriptionist under "Request Information" DG]
Technician (OBR-34) [0..1]
- Interface Code (OBR-34.1) [0..1] (identifier.designation)
- Last Name (OBR-34.2) [0..1] (complete name)

[Recommendation: Change LIM element 'Performing Clinician' to 'Performed By' with cardinality [0..Many]]
Assistant Result Interpreter (OBR-33) [0..1]
- ID Value (OBR-33.1) [0..1]
= LIM.Participant Identifier.Designation
- Last Name (OBR-33.2) [0..1]
= LIM.Person Name
- Suffix (OBR-33.5) [0..1]
= LIM.Person Name.Tiltle?
- Prefix (OBR-33.6) [0..1]
= LIM.Person Name.Tiltle?
[Recommendation: Change LIM element 'Performing Clinician' to 'Performed By' with cardinality [0..Many]]
Order Internal ID (ZOR-2) [0..1]
(stores the RIS Internal Order ID)

This field is different from placer order and filler order number -> unmapped.

[Recommendation: Change cardinality of LIM.Request Identifier to 0..2 to cater for existing (external) ID (i.e. placer order
number) and this internal ID]
Ordering Physician Office (ZOR-6) [0..1]

This field is used as Ordering Room id, e.g. 'T12754Z', 'TP6375J' -> unmapped

[MOHH 14042010] This is apparently the office ID of the office where the order was entered, based on IHIS clarification.
Recommend adding a new LIM.Request Entered Location [0..1] element under "Request Information" DG.
Patient Mobility For Order (ZOR-11) [0..1]

(free text)
e.g. NUH & TTSH: "WHEELCHAIR", "TROLLEY", "PORTABLE", "WALK", "WHEELCHAIRWITHNURSE"

[Recommendation: Add new LIM.Patient Mobility for Order element]
Result Report Appendix Number (ZBX-2) [0..1]

E.g. "0", "1" -> unmapped

[Recommendation: Add new LIM.Result Report Appendix Number element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix Status (ZBX-3) [0..1]

E.g. "APRV", "TRANS", "RAPRV"

[Recommendation: Add new LIM.Result Report Appendix Status element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix Normal Flag (ZBX-4) [0..1]

E.g. "Y", "N"

[Recommendation: Add new LIM.Result Report Appendix Normal Flag element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix
Dictated Timestamp (ZBX-5) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Transcribed Timestamp (ZBX-6) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Resident Timestamp (ZBX-7) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Approved Timestamp (ZBX-8) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Report Appendix Dictating
Physician (ZBX-9) [0..1]
- Radiologist Code (ZBX-9.1) [1]
- Last Name (ZBX-9.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Appendix
Transcriptionist (ZBX-10) [0..1]
- Transcriptionist Code (ZBX-10.1) [1]
- Last Name (ZBX-10.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Resident Physician (ZBX-11) [0..1]
- Physician ID (ZBX-11.1) [1]
- Last Name (ZBX-11.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Staff Physician (ZBX-12) [0..1]
- Physician ID (ZBX-12.1) [1]
- Last Name (ZBX-12.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Approving Physician (ZBX-13) [0..1]
- Dictating Doctor (13.1) [1]
- Last Name (13.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Exam Cancelled Timestamp (ZEX-10) [0..1]

[Recommendation: Add new LIM.Cancellation DateTime element] under "Investigation Result Dates" DG]
Exam Arrived Timestamp (ZEX-11) [0..1]

[Recommendation: Add new LIM.Arrival DateTime element] under "Investigation Result Dates" DG.]
Exam Resident Timestamp (ZEX-13) [0..1]

[Recommendation: Add new LIM.Resident DateTime element] under "Investigation Result Dates" DG. This is the datetime a
draft of the report was completed by a resident clinician.]
Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request Information" DG as the value domain differs from
OBR-25 (Result Status)]
Enterer's Location (ORC-13) [0..1]

Examples:
NUH: "NW88", "NADDI", "NCKSUR";
TTSH: "TW09A", "TCSOCK", "b1a" - radiology

[Recommendation: IHIS has clarified that this is not the same as PV1-3 (Assigned Patient Location) -- PV1-3 refers to an
inpatient location. As such, we recommend adding a new element LIM.Requester Location under "Request Information" DG.]
RAD IDDS (NHGP)   RAD HL7 v2 NXDS
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]




Entering Organisation (ORC-17) [1]

[Refers to Ordering OU] [need to add as new LIM element]

[Recommendation: Add new LIM.Entered By element under "Request
Information" DG - this may differ from existing LIM.Performing Clinician
element.]
Technician (OBR-34) [0..1]
- (OBR-34.1) [0..1]
= LIM.Participant Identifier.Designation
- (OBR-34.2) [0..1]
= LIM.Person Name
[Recommendation: Change LIM element 'Performing Clinician' to
'Performed By' with cardinality [0..Many]]
Principal Result Interpreter (OBR-32) [0..1]
- ID number (OBR-32.1)
- Family Name & Last Name Prefix (OBR-32.2)

[Recommendation: Add a new HPI LIM.other Participant [0..Many] element to
capture this]
Dictation Date/Time (ZBX-5) [0..1]

[Recommendation: Add new LIM.Dictation DateTime element] under
"Investigation Result Dates" DG.]

Transcribed Date/Time (ZBX-6) [0..1]
Transcribed Date/Time (ZEX-12) [0..1]

[Recommendation: IHIS has clarified that the 2 elements above are
identical. We should add new LIM.Transcription DateTime element] under
"Investigation Result Dates" DG.]
Exam Status (ZEX-8) [0..1]
- Code (ZEX-8.1) [0..1]
- Description (ZEX-8.2) [0..1]

(same meaning as OBX-11 but use different set of codes)

[14/4 YC: Linda, if a ZEX-8 has a different value domain from OBX-11, can we
still map it to LIM.Result Status, but indicate somehow that some form of
mapping will need to be done from the ZEX-8 value domain to the OBX-11
value domain?]
                   DISCHARGE SUMMARY TEMPLATES


ACIDS Goal State
UNMAPPED
INVESTIGATION ACTIVITY ENTRY
                           LIM ID Ref   LIM Data Item Name


E8                                      INVESTIGATION ACTIVITY


     E8.1                               LOCATABLE

     E8.2                               CONTENT ITEM

     E8.3                               ENTRY

            E8.9.3.1                    Language
            E8.9.3.2                    Encoding
            E8.9.3.3                    Subject
            E8.9.3.4                    Authored By
            E8.9.3.5                    Investigation Reported DateTime
                                        (Authored DateTime)
            E8.9.3.6                    Updated By

            E8.9.3.7                    Updated DateTime


            E8.9.3.8                    Update Reason


            E8.9.3.9                    Update Type


            E8.9.3.10                   Authorised By
            E8.9.3.11                   Investigation Approved DateTime
                                        (Authorised DateTime)
            E8.9.3.12                   Entry Status
                                        (Synonym: Investigation Result
                                        Status)



            E8.9.3.13                   Information Provider
            E8.9.3.14                   Participation
                        E8.9.3.14.1     Healthcare Provider Participant
        E8.9.3.14.3   Performing Investigation Facility




E8.4                  CARE ENTRY

E8.5                  ACTIVITY ENTRY
E8.6                  PROCEDURE ACTIVITY
E8.7                  OBSERVATION ENTRY

E8.8                  PROPERTY OBSERVATION

E8.9                  Structured Test Results
                      (Laboratory Test)
E8.10                 Investigation Interpretation


E8.11                 Investigation Dates


E8.12                 Investigation Additional
                      Information
LIM Data Type          LIM Cardinality   LIM Definition


ENTRY                  <Undefined>       Each relevant investigations performed on the
                                         patient during the healthcare event.
Class                  1                 Root class of all information model classes that
                                         can be archetyped.
Class                  1                 An abstract class of all concrete content types.

Class                  1                 A class that mainly defines the semantics of all the
                                         ‘hard’ information in the EHR. An ENTRY is also the
Coded Text             0..1              Mandatory indicator of the localised language in
                                         which this ENTRY is written. Coded from openEHR
Coded Text             0..1              Name of character set in which text values in this
                                         ENTRY are encoded. Coded from openEHR Code Set
PERSON PARTICIPATION   0..*              Id of human subject of this ENTRY, e.g., organ
                                         donor, foetus, a family member, another clinically
PERSON PARTICIPATION   0..1              Optional identification of provider of the
                                         information in this ENTRY, which might be: the
DateTime               0..1              The date (and optionally time) at which the
                                         investigation report was reported.
PERSON PARTICIPATION   0..1              The person who provided the most recent updates
                                         to the information in this ENTRY.
DateTime               0..1              The date (and optionally time) the adverse reaction
                                         record was updated.

Codeable Text          0..1              The reason that the most recent update was
                                         performed.
Codeable Text          0..1              The type of update most recently performed.


PERSON PARTICIPATION   0..1              A person who authorized for an ENTRY object.
DateTime               0..1              The date (and optionally time) at which the
                                         investigation report was approved.
Coded Text             1                 The status of the results of the investigation.




Codeable Text          0..1              A description of the person, organisation or any
                                         other source that provided the information about
PARTICIPATION          0..Many           A generic domain concept that defines an
                                         association between an act and an entity (person or
HEALTHCARE PROVIDER    0..Many           Individual healthcare providers who were involved
PARTICIPATION                            in the investigation. This should include the
                                         reporting clinician.
ORGANISATION PARTICIPANT 0..1        The healthcare facility, that actually performed the
                                     investigation. This may or may not be the same as
                                     the Ordered Investigation Facility.

Class                    1           The abstract parent of all clinical ENTRY subtypes.
                                     A CARE_ENTRY defines protocol
Class                    1           and guideline attributes for all clinical ENTRY
Class                    1
Class                    0..Many     Information and Results about the individual test
                                     observations that were made.
Class                    1           An observation that assigns values to specific
                                     properties.
OBSERVATION ENTRY        0..Many     The test results of each individual test of a
                                     laboratory panel.
CLINICAL SYNOPSIS        0..Many     Clinical interpretation of the observation results.

CLUSTER                            1 Additional dates associated with the investigation.


CLUSTER                  1           Additional information about the Investigation
                                     Order
LIM Value Domain                   LIM Format    other LIM Constraints
                                   Constraint




                                   YYYYMMDD[HH
                                   MMSS]
                                   YYYYMMDD[HH
                                   MMSS]
                                   YYYYMMDD[HH
                                   MMSS]

Update_Reason_VD


Update_Type_VD




                                   YYYYMMDD[HH
                                   MMSS]
Investigation_Result_Status_VD




Participation Type Value Domain:                 Default Value(s):
For Lab NDDS:                                    Participant Identifier.Type =
Laboratory_Participation_Type_VD                 "MCRN"
For Radiology NDDS:                              Participant Identifier.Realm =
Radiology_Participation_Type_VD                  "Singapore"
Participant Identifier.Designation:   Participation Type = "Reference
Organisation_VD.Code                  Facility"
Organisation Name =                   Participant Identifier.Type =
Organisation_VD.Term                  "Organisation ID"
LIM Example (for Exchange)             LIM Example (for Display)   LIM Comments




"20090915"                             "15 Sep 2009"
"20081227213000"                       "27 Dec 2008, 21:30:00"
"20090915"                             "15 Sep 2009"
"20081227213000"                       "27 Dec 2008, 21:30:00"
"20090915"                             "15 Sep 2009"
"20081227213000"                       "27 Dec 2008, 21:30:00"




"New"                                  "New"
"Updated"                              "Updated"
"Updated - Details"                    "Updated - Details"

"20090915"                             "15 Sep 2009"
"20081227213000"                       "27 Dec 2008, 21:30:00"
("xxx", "Interim")                     "Interim"
("xxx", "Final")                       "Final"
("xxx", "Supplementary")               "Supplementary"
("xxx", "Corrected")                   "Corrected"
("xxx", "Aborted")                     "Aborted"




("Reporting Clinician",                ("Dr Lim Chee Yang",        Healthcare Provider
"Cardiologist",                        "Consultant",               Individual.Participant
("11266F","MCRN", "", "Singapore"),    "MCRN 11266F")              Identifier is equivalent to the
"",                                                                MOH Data Dictionary
"",                                                                element 'Healthcare Provider
"",                                                                Identifier'
("Dr Lim Chee Yang","Dr","Lim","Chee
Yang","",""),
"",
("Reference Facility",                         "AH"
"",
("AH", "Organisation ID", "MOH", "Singapore"),
"",
"",
                                                                        SUMMARY CARE VIEW - NEHR LIST

LIM Change Log                NEHR Phase Term
                              1 Core

                              Yes




                              Yes


                              Yes        Investigation.Investigation Result Status/Report
                                         Status (e.g. pending, preliminary, final)




[YC20100531] Element
added (based on CTS
feedback) to capture
different roles involved in
the participation besides
reporting clinician.
Yes




Yes


Yes
UNMAPPED
Investigation.Event Summary Available
SUMMARY CARE VIEW - NEHR LIST                                    INVESTIGATIONS (DRILL-DOWN LIST) - NEHR LIST

                  Definition & Comments   Term




                                          Investigation.Investigation Report Date and Time


                                          Investigation.Investigation Result Status/Report
                                          Status (e.g. pending, preliminary, final)
UNMAPPED                                     UNMAPPED
[STD20100513] We will look into the          Investigation.Ordering Institution
incorporation of a 'Event Summary
Document Identifier' LIM element (or
something similar to this) for events,
procedures, medication items,
investigations, problem/diagnosis which will
capture the Set Identifier and Version
Number. The NEHR 'Event Summary
Available' can then be derived from the
presence of this 'Event Summary Document
Identifier'.
                                             Investigation.Event Summary Available
TIGATIONS (DRILL-DOWN LIST) - NEHR LIST                                          LAB REPORT - NEHR LIST

                   Definition & Comments   Term




                                           Investigation.Investigation Report Date and
                                           Time
                                           Investigation.Investigation Result
                                           Status/Report Status (e.g. pending,
                                           preliminary, final)
UNMAPPED                                        UNMAPPED
                                                Investigation.Ordering Institution




[STD20100513] We will look into the
incorporation of a 'Event Summary Document
Identifier' LIM element (or something similar
to this) for events, procedures, medication
items, investigations, problem/diagnosis
which will capture the Set Identifier and
Version Number. The NEHR 'Event Summary
Available' can then be derived from the
presence of this 'Event Summary Document
Identifier'.
LAB REPORT - NEHR LIST                                                                                      RADIOLOGY REPORT - NEHR LIST

         Definition & Comments                                Term




                                                              t_CMIS_ADR.Update_Reason


                                                              t_CMIS_ADR.Update_Type




                                                              Investigation.Investigation Report Date and
                                                              Time
         Altertive term used : Status of Report i.e. Report   Investigation.Investigation Result
         Status                                               Status/Report Status (e.g. pending, preliminary,
                                                              final)
UNMAPPED   UNMAPPED
           Investigation.Ordering Institution
RADIOLOGY REPORT - NEHR LIST

   Definition & Comments




   LIM.Updated DateTime [0..1]




   Altertive term used : Status of Report i.e. Report Status
UNMAPPED
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)




0..1                             N/A

0..1                             N/A
LAB NDDS                                              Lab NDDS
                                                      Cardinality




LIM.Investigation Reported DateTime [0..1]            0..1


DateTime of Message (MSH-7)                           DateTime of
                                                      Message (MSH-
DateTime of Message (MSH-7)                           7)
                                                      DateTime of
                                                      Message (MSH-
                                                      7)




LIM.Investigation Approved Date Time [0..1]           0..1


LIM.Investigation Result Status [1]                   1
- Code
- Term
- Code System ID
- Code System Name
- Code System Version



LIM.Healthcare Provider Participant [0..Many]         0..Many
- Participation Type [1]
- Healthcare Role [0..1]
- Participant Identifier [0..1]
  > Designation [1]
  > Type [1] (fixed: "User ID")
  > Issuer [1] (fixed: LIM.Patient HCO.Organisation
Identifier.Designation)
  > Realm [1] (fixed: LIM.Patient HCO.Organisation
LIM.Reference Facility [0..1]         0..1




LIM.Request General Information [1]   1




LIM.Request General Information [1]   1


LIM.Request General Information [1]   1
SCM


Lab




N/A




N/A


Result Status [1]

Examples:
"RESF"
"RESC"




N/A
N/A




Lab




Lab


Lab
UNMAPPED
                                                                                                             LABORATORY - NDDS T

LAB IDDS (KKH)


PV1 [0..1]
OBR [1..Many]
ORC [1..Many]




N/A




LIM.Updated DateTime [0..1]




N/A


Result Status (OBR-25) [1]




LIM.Healthcare Provider Participant (1)
- Participation Type = "Action By"
- Participant Identifier.Designation = Action By [0..1].ID Number (ORC-19.1) [1]
- Person Name.Complete Name = Action By [0..1].Full Name (ORC-19.2) [1]

LIM.Healthcare Provider (2)
- Participation Type = "Consultant-in-Charge"
- Person Name.Complete Name = portion of Observation Value (OBX-5) [1] after ".<sp><sp>" prefix (if found)
when Observation Identifier [1].catalog id (OBX-3.1) [1] = "Consultant-In-Charge"
N/A




OBX [0..Many]




OBX [0..Many]


OBX [0..Many]




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [1] when Observation Identifier [1].catalog id (OBX-3.1) [1] = "HISTOPATHOLOGY
KKH"




Observation Value (OBX-5) [1] when Observation Identifier [1].catalog id (OBX-3.1) [1] = "CYTOLOGY KKH"
UNMAPPED




Quantity/Timing (OBR-27) [1]
- quantity (OBR-27.1) [1]
[Recommendation: Ignore since this is always a fixed value of "1"]

- duration (OBR-27.3) [1]
[Recommendation: Ignore since this is always a fixed value of "0"]




Action By (ORC-19) [0..1]
- ID Number (ORC-19.1) [1]
- Full Name (ORC-19.2) [1]

[MOHH20100527] IHIS to confirm what role this person has, e.g. clinical (performs the test), administrative
(change the order control code), etc.

Order Control (ORC-1) [1]




Order Control Code Reason (ORC-16) [0..1]
- identifier (ORC-16.1) [1]
- text (ORC-16.2) [1]



Entering Device (ORC-18) [0..1]
- identifier (ORC-18.1) [1]
- text (ORC-18.2) [1]
       LABORATORY - NDDS TEMPLATE

LAB IDDS (SGH)


OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]




Observation Date/Time (OBR-7) [0..1]

[MOHH20100527] IHIS to confirm what OBR-7 contains: observation date/time, specimen
0..1

0..1




N/A


Result Status (OBR-25) [0..1]




LIM.Healthcare Provider Participant (1)
- Participation Type = "Consultant In Charge"
- Person Name.Complete Name = Observation Value (OBX-5) [0..1] when Observation
Identifier [1].identifier (OBX-3.1) [1] = "Consultant-In-Charge"

LIM.Healthcare Provider Participant (2)
- Participation Type = "Submitting Physician"
- Person Name.Complete Name = Observation Value (OBX-5) [0..1] when Observation
Identifier [1].identifier (OBX-3.1) [1] = "Submitting Physician"
N/A




N/A




N/A


N/A




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-3.1) [1] =
"HISTOPATHOLOGY SGH"




Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-3.1) [1] =
"CYTOLOGY NEW SGH"
UNMAPPED
LAB IDDS (CGH)


OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]




N/A




N/A


Result Status (OBR-25) [0..1]




LIM.Healthcare Provider Participant (1)
- Participation Type = "Consultant In Charge"
- Person Name.Complete Name = Observation Value (OBX-5) [0..1] when
Observation Identifier [1].identifier (OBX-3.1) [1] = "Consultant-In-Charge"

LIM.Healthcare Provider Participant (2)
- Participation Type = "Submitting Physician"
- Person Name.Complete Name = Observation Value (OBX-5) [0..1] when
Observation Identifier [1].identifier (OBX-3.1) [1] = "Submitting Physician"
N/A




ORC [1..Many]
OBR [1..Many]




ORC [1..Many]
OBR [1..Many]
ORC [1..Many]
OBR [1..Many]




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-
3.1) [1] = "HISTOPATHOLOGY CGH"




Observation Value (OBX-5) [0..1] when Observation Identifier [1].identifier (OBX-
3.1) [1] = "CYTOLOGY NEW CGH"
UNMAPPED




Diagnostic Serv Sect ID (OBR-24) [0..1]
- discipline short text (OBR-24.1)
- discipline number (OBR-24.2)
- chapter number (OBR-24.3)
- printing index number (OBR-24.4)

[28/4 YC: Linda, it appears that we can't map even OBR-24.1 to LIM.Investigation
SubType as OBR-24.1 has values that map to LIM.Investigation Type as well (e.g.
"LAB"). I'm unsure whether we need to create dedicated LIM elements to map
the 4 components above to.
Enterer's Location (ORC-13) [0..1]
- Location code (ORC-13.1) [1]
- Room (ORC-13.2) [1]
- Location description (ORC-13.5) [1]
LAB IDDS (NHG)                LAB HL7 v2 NXDS


OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]




N/A


                              0..1

LIM.Updated DateTime [0..1]   0..1




N/A


Result Status (OBR-25) [1]




N/A
N/A




OBR [1..Many]




OBR [1..Many]


OBR [1..Many]
UNMAPPED




Diagnostic Serv Sect ID (OBR-24) [1]
- Lab Type (OBR-24.1)
- Discipline (OBR-24.2)
- Chapter (OBR-24.3)
- Print Index (OBR-24.4)

[28/4 YC: Linda, although we don't have the complete value domain for OBR-
24.1 in the IDDS, I suspect that the possible values are a mix of both
LIM.Investigation Type and LIM.Investigation SubType. I'm unsure whether we
need to create dedicated LIM elements to map the 4 components above to.
RAD NDDS                                              Radiology NDDS
                                                      Cardinality




LIM.Investigation Reported DateTime [0..1]            0..1




                                                      LIM.Updated
                                                      DateTime [0..1]




LIM.Investigation Approved DateTime [0..1]            0..1


LIM.Investigation Result Status [1]                   1
- Code
- Term
- Code System ID
- Code System Name
- Code System Version



LIM.Healthcare Provider Participant [0..Many]         0..Many
- Participation Type [1]
- Healthcare Role [0..1]
- Participant Identifier [0..1]
  > Designation [1]
  > Type [1] (fixed: "User ID")
  > Issuer [1] (fixed: LIM.Patient HCO.Organisation
Identifier.Designation)
  > Realm [1] (fixed: LIM.Patient HCO.Organisation
LIM.Reference Facility [0..1]         0..1




LIM.Request General Information [1]   1




LIM.Request General Information [1]   1


LIM.Request General Information [1]   1
SCM


Radiology




N/A




N/A


1. Result Status [1]
2. Observation Result Information
[1..Many].Observation Result Status [1]




N/A
N/A




Radiology




Radiology


Radiology
UNMAPPED
RAD IDDS (KKH)


ORC [0..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]




N/A




N/A


1. Result Status (OBR-25) [0..1]
2. Observation Result Status (OBX-11) [1]




LIM.Healthcare Provider Participant (1)
- Participation Type = "Transcriptionist"
- Participant Identifier.Designation = Transcriptionist [0..1].ID Number (OBR-
35.1.1) [1]
- Person Name
  > Complete Name = Transcriptionist [0..1].Full Name (OBR-35.1.2) [1]
  > Title = Transcriptionist [0..1].Salutation (OBR-35.1.3) [1]

LIM.Healthcare Provider Participant (2)
N/A




ORC [0..Many]
OBR [1..Many]
NTE [0..Many]




ORC [0..Many]
OBR [1..Many]
NTE [0..Many]
ORC [0..Many]
OBR [1..Many]
NTE [0..Many]
NOTES FOR MOHH USE ONLY
Specimen Source (OBR-15) [0..1]

This field wil be ignored as it is hardcoded.
                                            RADIOLOGY (RAD) - NDDS TEMPLATE

RAD IDDS (SGH)


ORC [1..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]




N/A




N/A


1. Result Status (OBR-25) [0..1]
2. Observation Result Status (OBX-11) [1]




N/A
N/A




ORC [1..Many]
OBR [1..Many]




ORC [1..Many]
OBR [1..Many]
ORC [1..Many]
OBR [1..Many]
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]
RADIOLOGY (RAD) - NDDS TEMPLATE

            RAD IDDS (CGH)


            ORC [1..Many]
            OBR [1..Many]
            {OBX [0..Many]} [0..Many]




            N/A




            N/A


            1. Result Status (OBR-25) [1]
            2. Observation Result Status (OBX-11) [1]




            N/A
N/A




ORC [1..Many]
OBR [1..Many]




ORC [1..Many]
OBR [1..Many]
ORC [1..Many]
OBR [1..Many]
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]
RAD IDDS (NHG)


ORC [0..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]




Exam Resident Timestamp (ZEX-13) [0..1]




Exam Approved Timestamp (ZEX-14) [0..1]


1. Result Status (OBR-25) [0..1]
2. Observation Result Status (OBX-11) [1]




LIM.Healthcare Provider Participant (1)
- Participation Type = "Transcriptionist"
- Participant Identifier.Designation = Transcriptionist + [0..1].Transcriptionist Code (OBR-35.1) [0..1] {LEN=20}
- Person Name.Complete Name = Transcriptionist + [0..1].Last Name (OBR-35.2) [0..1] {LEN=15}

LIM.Healthcare Provider Participant (2)
- Participation Type = "Technician"
- Participant Identifier.Designation = Technician + [0..1].Interface Code (OBR-34.1) [0..1]
- Person Name.Complete Name = Technician + [0..1].Last Name (OBR-34.2) [0..1]
N/A




ORC [0..Many]
OBR [1..Many]




ORC [0..Many]
OBR [1..Many]
ORC [0..Many]
OBR [1..Many]




FIELDS FOR IHIS ATTENTION/CLARIFICATION
Exam Procedure Component ID (ZEX-4) [0..1]

AH: "technical";
NUH: "profession";
TTSH: "profession", "NOCHG", "technical", "Global"

[MOHH 28042010] Please give the definition of this element (e.g. how it is used) so that we can determine how best to map
it to the LIM.
Exam Indications (ZEX-6) [0..1]
(free text)
TTSH: "5 pt chg appt frm 2/6", "2 s2a", "25 w12d/b128 op ward req"

[MOHH 28042010] IHIS has previously clarified that this is field consists of free-text remarks used by staff and is not relevant
for external use. Nevertheless, as the LIM is meant to capture all the information currently being exchanged in HL7
messages, we need to understand the definition (e.g. purpose) of this element so that we can map it to the LIM accordingly.
Please give the definition (e.g. purpose) of this element.
Order CLUSTER (ZOR-4) [0..1]

"1" [TTSH]

[MOHH 28042010] IHIS has earlier shared that this is the CLUSTER hospital interface code which is "1". This is not the
organisation of the Requesting Clinician. As the LIM is meant to capture all the information currently being exchanged in HL7
messages, we need to understand the definition (e.g. purpose) of this element so that we can map it to the LIM accordingly.
Please give the definition (e.g. purpose) of this element.
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation Result General Information" DG.]




Filler Field 1 (OBR-20) [0..3]

[Recommendation: Add new LIM.Procedure Modifier [0..3] element under "Investigation Result General Information" DG.
IHIS has only clarified that this is a procedure repeated subsequent to the original procedure.]




Results Rpt/Status Chng - Date/Time (OBR-22) [0..1]

[Recommendation: Add new LIM.Request Status Update DateTime element under "Request Information" DG, as this
element stores the date/time of the order status change]



Entered By (ORC-10) [0..1]

[Recommendation: Add new LIM.Entered By element under "Request Information" DG - this may differ from existing
LIM.Performing Clinician element.]



Order Control Code Reason (ORC-16) [0..1]

[Recommendation: Ignore since IHIS has clarified that this is a RIS-specific application event code]



Transcriptionist (OBR-35) [0..1]
- Transcriptionist Code (OBR-35.1) [0..1] (identifier)
- Last Name (OBR-35.2) [0..1] (complete name)

[Recommendation: Add new LIM.Transcriptionist under "Request Information" DG]
Technician (OBR-34) [0..1]
- Interface Code (OBR-34.1) [0..1] (identifier.designation)
- Last Name (OBR-34.2) [0..1] (complete name)

[Recommendation: Change LIM element 'Performing Clinician' to 'Performed By' with cardinality [0..Many]]

Assistant Result Interpreter (OBR-33) [0..1]
- ID Value (OBR-33.1) [0..1]
= LIM.Participant Identifier.Designation
- Last Name (OBR-33.2) [0..1]
= LIM.Person Name
- Suffix (OBR-33.5) [0..1]
= LIM.Person Name.Tiltle?
- Prefix (OBR-33.6) [0..1]
= LIM.Person Name.Tiltle?
[Recommendation: Change LIM element 'Performing Clinician' to 'Performed By' with cardinality [0..Many]]
Order Internal ID (ZOR-2) [0..1]
(stores the RIS Internal Order ID)

This field is different from placer order and filler order number -> unmapped.

[Recommendation: Change cardinality of LIM.Request Identifier to 0..2 to cater for existing (external) ID (i.e. placer order
number) and this internal ID]
Ordering Physician Office (ZOR-6) [0..1]

This field is used as Ordering Room id, e.g. 'T12754Z', 'TP6375J' -> unmapped

[MOHH 14042010] This is apparently the office ID of the office where the order was entered, based on IHIS clarification.
Recommend adding a new LIM.Request Entered Location [0..1] element under "Request Information" DG.
Patient Mobility For Order (ZOR-11) [0..1]

(free text)
e.g. NUH & TTSH: "WHEELCHAIR", "TROLLEY", "PORTABLE", "WALK", "WHEELCHAIRWITHNURSE"

[Recommendation: Add new LIM.Patient Mobility for Order element]
Result Report Appendix Number (ZBX-2) [0..1]

E.g. "0", "1" -> unmapped

[Recommendation: Add new LIM.Result Report Appendix Number element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix Status (ZBX-3) [0..1]

E.g. "APRV", "TRANS", "RAPRV"

[Recommendation: Add new LIM.Result Report Appendix Status element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix Normal Flag (ZBX-4) [0..1]

E.g. "Y", "N"

[Recommendation: Add new LIM.Result Report Appendix Normal Flag element under a new "Investigation Result Appendix
Information" DG]
Result Report Appendix
Dictated Timestamp (ZBX-5) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Transcribed Timestamp (ZBX-6) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Resident Timestamp (ZBX-7) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Approved Timestamp (ZBX-8) [0..1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Report Appendix Dictating
Physician (ZBX-9) [0..1]
- Radiologist Code (ZBX-9.1) [1]
- Last Name (ZBX-9.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Appendix
Transcriptionist (ZBX-10) [0..1]
- Transcriptionist Code (ZBX-10.1) [1]
- Last Name (ZBX-10.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Resident Physician (ZBX-11) [0..1]
- Physician ID (ZBX-11.1) [1]
- Last Name (ZBX-11.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Staff Physician (ZBX-12) [0..1]
- Physician ID (ZBX-12.1) [1]
- Last Name (ZBX-12.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Result Report Appendix
Approving Physician (ZBX-13) [0..1]
- Dictating Doctor (13.1) [1]
- Last Name (13.2) [1]

[Recommendation: Add new LIM element under a new "Investigation Result Appendix Information" DG]
Exam Cancelled Timestamp (ZEX-10) [0..1]

[Recommendation: Add new LIM.Cancellation DateTime element] under "Investigation Result Dates" DG]
Exam Arrived Timestamp (ZEX-11) [0..1]

[Recommendation: Add new LIM.Arrival DateTime element] under "Investigation Result Dates" DG.]
Exam Resident Timestamp (ZEX-13) [0..1]

[Recommendation: Add new LIM.Resident DateTime element] under "Investigation Result Dates" DG. This is the datetime a
draft of the report was completed by a resident clinician.]
Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request Information" DG as the value domain differs from
OBR-25 (Result Status)]
Enterer's Location (ORC-13) [0..1]

Examples:
NUH: "NW88", "NADDI", "NCKSUR";
TTSH: "TW09A", "TCSOCK", "b1a" - radiology

[Recommendation: IHIS has clarified that this is not the same as PV1-3 (Assigned Patient Location) -- PV1-3 refers to an
inpatient location. As such, we recommend adding a new element LIM.Requester Location under "Request Information" DG.]
RAD IDDS (NHGP)                                                                  RAD HL7 v2 NXDS


ORC [0..Many]
OBR [0..Many]
{OBX [0..Many]} [0..Many]




1. Date/Time of Observation (OBX-14) [0..1]

2. Exam Status Date/Time (ZEX-9) [0..1]




1. Approved Date/Time (ZBX-8) [0..1]

2. Approved Date/Time (ZEX-14) [0..1]
1. Result Status (OBR-25) [0..1]
2. Report Status (ZBX-3) [0..1]
3. Observation Result Status (OBX-11) [1]




LIM.Healthcare Provider Participant (1)
- Person Name.Complete Name = Responsible Observer (OBX-16) [0..1]

LIM.Healthcare Provider Participant (2)
- Participant Identifier.Designation = Dictation Radiologist (ZBX-9) [0..1].ID
Number (ZBX-9.1) [1]
- Person Name.Complete Name = Dictation Radiologist (ZBX-9) [0..1].Family
Name & Last Name Prefix (ZBX-9.2) [1]
N/A




ORC [0..Many]
OBR [0..Many]




ORC [0..Many]
OBR [0..Many]
ORC [0..Many]
OBR [0..Many]
UNMAPPED
Order Control (ORC-1) [1]

[Recommendation: Add new LIM.Result Type element under "Investigation
Result General Information" DG.]




Order Status (ORC-5) [0..1]

[Recommendation: Add new LIM.Request Status element under "Request
Information" DG as the value domain differs from OBR-25 (Result Status)]




Entering Organisation (ORC-17) [1]

[Refers to Ordering OU] [need to add as new LIM element]

[Recommendation: Add new LIM.Entered By element under "Request
Information" DG - this may differ from existing LIM.Performing Clinician
element.]
Technician (OBR-34) [0..1]
- (OBR-34.1) [0..1]
= LIM.Participant Identifier.Designation
- (OBR-34.2) [0..1]
= LIM.Person Name
[Recommendation: Change LIM element 'Performing Clinician' to
'Performed By' with cardinality [0..Many]]
Principal Result Interpreter (OBR-32) [0..1]
- ID number (OBR-32.1)
- Family Name & Last Name Prefix (OBR-32.2)

[Recommendation: Add a new HPI LIM.other Participant [0..Many] element to
capture this]
Dictation Date/Time (ZBX-5) [0..1]

[Recommendation: Add new LIM.Dictation DateTime element] under
"Investigation Result Dates" DG.]
Transcribed Date/Time (ZBX-6) [0..1]
Transcribed Date/Time (ZEX-12) [0..1]

[Recommendation: IHIS has clarified that the 2 elements above are
identical. We should add new LIM.Transcription DateTime element] under
"Investigation Result Dates" DG.]
Exam Status (ZEX-8) [0..1]
- Code (ZEX-8.1) [0..1]
- Description (ZEX-8.2) [0..1]

(same meaning as OBX-11 but use different set of codes)

[14/4 YC: Linda, if a ZEX-8 has a different value domain from OBX-11, can we
still map it to LIM.Result Status, but indicate somehow that some form of
mapping will need to be done from the ZEX-8 value domain to the OBX-11
value domain?]
                         DISCHARGE SUMMARY TEMPLATES

ACIDS Goal State




LIM.Investigation Reported DateTime [0..1]




LIM.Investigation Approved DateTime [0..1]


LIM.Investigation Result Status [1]

other Constraint(s):
Result status can be reflected only after the investigation was performed

Example(s):



LIM.Healthcare Provider Participant [0..Many]
LIM.Reference Facility [0..1]




LIM.Request General Information [1]




LIM.Request General Information [1]


LIM.Request General Information [1]
UNMAPPED
LABORATORY TEST ENTRY

                 LIM ID Ref   LIM Data Item Name

E9                            LABORATORY TEST


     E9.1                     LOCATABLE

     E9.2                     CONTENT ITEM

     E9.3                     ENTRY

     E9.4                     CARE ENTRY

     E9.5                     OBSERVATION ENTRY


     E9.6                     PROPERTY OBSERVATION
LIM Data Type       LIM Cardinality   LIM Definition

OBSERVATION ENTRY   <Undefined>       Result findings about an individual laboratory test
                                      observation.

Class               0                 Root class of all information model classes that
                                      can be archetyped.
Class               0                 An abstract class of all concrete content types.

Class               0                 A class that mainly defines the semantics of all the
                                      ‘hard’ information in the EHR. An ENTRY is also the
Class               1                 minimal unit parent of all clinicalquery should
                                      The abstract of information any ENTRY subtypes.
                                      A CARE_ENTRY defines protocol
Class               1                 and guideline attributes for all clinical Used
                                      ENTRY type for evaluation statements.ENTRYfor all
                                      kinds of statements which evaluate other
                                      information, such as interpretations
Class               1                 An observation that assigns values to specific
                                      properties.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
                                   SUMMARY CARE VIEW - NEHR LIST


LIM Change Log   NEHR Phase Term
                 1 Core
                 Yes
RY CARE VIEW - NEHR LIST                   INVESTIGATIONS (DRILL-DOWN LIST) - NEHR LIST


            Definition & Comments   Term
ONS (DRILL-DOWN LIST) - NEHR LIST           LAB REPORT - NEHR LIST


             Definition & Comments   Term
LAB REPORT - NEHR LIST                  RADIOLOGY REPORT - NEHR LIST


         Definition & Comments   Term
RADIOLOGY REPORT - NEHR LIST


   Definition & Comments
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
LAB NDDS   Lab NDDS
           Cardinality
SCM

Lab
                 LABORATORY - ND


LAB IDDS (KKH)

PV1 [0..1]
OBR [1..Many]
ORC [1..Many]
    LABORATORY - NDDS TEMPLATE


LAB IDDS (SGH)

OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]
LAB IDDS (CGH)

OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]
LAB IDDS (NHG)              LAB HL7 v2 NXDS

OBR [1..Many]
ORC [1..Many]
{OBX [0..Many]} [0..Many]
RAD NDDS   Radiology NDDS
           Cardinality
SCM

Radiology
RAD IDDS (KKH)

ORC [0..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]
                            RADIOLOGY (RAD) - NDDS TEMPLATE


RAD IDDS (SGH)

ORC [1..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]
DIOLOGY (RAD) - NDDS TEMPLATE


            RAD IDDS (CGH)

            ORC [1..Many]
            OBR [1..Many]
            {OBX [0..Many]} [0..Many]
RAD IDDS (NHG)

ORC [0..Many]
OBR [1..Many]
{OBX [0..Many]} [0..Many]
RAD IDDS (NHGP)             RAD HL7 v2 NXDS

ORC [0..Many]
OBR [0..Many]
{OBX [0..Many]} [0..Many]
                   DISCHARGE SUMMARY TEMPLATES


ACIDS Goal State
PROCEDURE ACTIVITY ENTRY
LIM ID Ref                 LIM Data Item Name



E10                        PROCEDURE ACTIVITY


       E10.1               LOCATABLE

       E10.2               CONTENT ITEM

       E10.3               ENTRY

       E10.4               CARE ENTRY


       E10.5               ACTIVITY ENTRY
       E10.6               Procedure Report
LIM Data Type        LIM Cardinality   LIM Definition



ENTRY                                  Details about an individual procedure.


Class                1                 Root class of all information model classes that
                                       can be archetyped.
Class                1                 An abstract class of all concrete content types.

Class                1                 A class that mainly defines the semantics of all the
                                       ‘hard’ information in the EHR. An ENTRY is also the
Class                1                 minimal unit parent of all clinicalquery should
                                       The abstract of information any ENTRY subtypes.
                                       A CARE_ENTRY defines protocol
                                       and guideline attributes for all clinical ENTRY
Class                1                 subtypes.

DOCUMENT REFERENCE   0..1              The procedure report that was written as a result
                                       of the procedure being performed.
LIM Value Domain   LIM Format Constraint   other LIM Constraints
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
                                                                 SUMMARY CARE VIEW - NEHR LIST

LIM Change Log   NEHR Phase Term
                 1 Core

                 Yes




                 Yes


                            UNMAPPED
                            Procedures.Procedure Report Date




                            Procedures.Institution




                            Procedures.Event Summary Available
SUMMARY CARE VIEW - NEHR LIST                                                                     PROCEDURES (DRILL-DOWN VIEW) - NEHR LIST

                Definition & Comments                                   Term




                UNMAPPED                                                UNMAPPED
                [STD20100513] We will assess the feasibility of         Procedures.Procedure Report Date
                creating a new "Procedure Report Date" LIM element
                under the "Procedure Report" Data Group (DG) above
                to map this NEHR field to. Note: CTS has clarified that
                conceptually, this should be the date/time report is
                completed/finalized and may be part of document
                control information.


                Procedure report should have it's own institution field. Procedures.Institution

                [STD20100513] We will assess the feasibility of
                creating a new "Procedure Institution" LIM element
                under the "Procedure Report" DG above to map this
                NEHR field to.


                [STD20100513] We will look into the incorporation of a Procedures.Event Summary Available
                'Event Summary Document Identifier' LIM element (or
                something similar to this) for events, procedures,
                medication items, investigations, problem/diagnosis
                which will capture the Set Identifier and Version
                Number. The NEHR 'Event Summary Available' can then
                be derived from the presence of this 'Event Summary
                Document Identifier'.
ES (DRILL-DOWN VIEW) - NEHR LIST

                   Definition & Comments                         NEHR Review Comments
                                                                 (pls indicate date of comment)




                   UNMAPPED
                   [STD20100513] We will assess the
                   feasibility of creating a new "Procedure
                   Report Date" LIM element under the
                   "Procedure Report" Data Group (DG)
                   above to map this NEHR field to.




                   Procedure report should have it's own
                   institution field.

                   [STD20100513] We will assess the
                   feasibility of creating a new "Procedure
                   Institution" LIM element under the
                   "Procedure Report" DG above to map
                   this NEHR field to.
                   [STD20100513] We will look into the
                   incorporation of a 'Event Summary
                   Document Identifier' LIM element (or
                   something similar to this) for events,
                   procedures, medication items,
                   investigations, problem/diagnosis which
                   will capture the Set Identifier and Version
                   Number. The NEHR 'Event Summary
                   Available' can then be derived from the
                   presence of this 'Event Summary
                   Document Identifier'.
                                                    DISCHARGE SUMMARY TEMPLATES

CTS Review Comments              ACIDS Phase NDDS
(pls indicate date of comment)
DISCHARGE SUMMARY TEMPLATES

            ACIDS Goal State




            LIM.Procedure Report [0..1]
ADVERSE REACTION ENTRY
LIM ID Ref               LIM Data Item Name


E11                      Adverse Reaction


        E11.1            LOCATABLE

        E11.2            CONTENT ITEM

        E11.3            ENTRY

        E11.4            CARE ENTRY

        E11.5            EVALUATION ENTRY


        E11.6            Causative Agent




        E11.7            Adverse Reaction General
                         Information
LIM Data Type   LIM Cardinality   LIM Definition


ENTRY                             An individual adverse reaction (e.g. allergy,
                                  sensitivity or intolerance) that the patient has
                                  experienced, or is at risk of experiencing.
Class           1                 Root class of all information model classes that
                                  can be archetyped.
Class           1                 An abstract class of all concrete content types.

Class           1                 A class that mainly defines the semantics of all the
                                  ‘hard’ information in the EHR. An ENTRY is also the
Class           1                 minimal unit parent of all clinicalquery should
                                  The abstract of information any ENTRY subtypes.
                                  A CARE_ENTRY defines protocol
Class           1                 and guideline attributes for all clinical ENTRYfor all
                                  ENTRY type for evaluation statements. Used
                                  kinds of statements which evaluate other
                                  information, such as interpretations
Cluster         1..Many           Information about the causative agent(s) of the
                                  adverse reaction. When multiple casuative agents
                                  are concomitant and are suspected or confirmed
                                  to cause the reaction, then each of these casuative
                                  agents are recorded in the ENTRY.
Cluster         0..1              Details about the adverse reaction that the patient
                                  has experienced to this causative agent, or is at
                                  risk of experiencing.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
                                  SUMMARY CARE VIEW - NEHR LIST

LIM Change Log   NEHR      Term                 Definition & Comments
                 Phase 1
                 Core
                 Yes




                 Yes




                 Yes
       ALLERGY/ADR (DRILL-DOWN LIST) - NEHR LIST

Term                                  Definition & Comments
NEHR Review Comments             CTS Review Comments
(pls indicate date of comment)   (pls indicate date of comment)
                              ADT - NDDS TEMPLATE

CMIS              ADT NDDS




t_CMIS_ADR_Drug   LIM.Causative Agent [1..Many]




t_CMIS_ADR        LIM.Adverse Reaction Details [0..1]
       MEDS ORDER (MO) - NDDS TEMPLATE         MEDS DISPENSE (MD) - NDDS TEMPLATE

MO NDDS                                  MD NDDS




                                         N/A

                                         N/A


LIM.Causative Agent [1..Many]            LIM.Causative Agent [1..Many]




LIM.Adverse Reaction Details [0..1]      LIM.Adverse Reaction Details [0..1]
             DISCHARGE SUMMARY TEMPLATES

ACIDS Goal State




                                           N/A

                                           LIM.Problem Diagnosis Diagnosis/Problem
                                           Notes [0..1]          Additional Remarks
                                                                 [0..1] {LEN=255}
LIM.Causative Agent [1]




LIM.Adverse Reaction Details [0..1]


UNMAPPED
      LIM.Problem
      Diagnosis Type [0..1]
N/A   LIM.Problem
      Diagnosis Notes [0..1]
Alert - ENTRY
LIM ID Ref      LIM Data Item Name



E12.1           Alert

        E12.1   LOCATABLE

        E12.2   CONTENT ITEM

        E12.3   ENTRY

        E12.4   CARE ENTRY

        E12.5   EVALUATION ENTRY


        E12.6   Alert Active Interval
LIM Data Type       LIM Cardinality   LIM Definition



ENTRY                                 An individual alert that may be relevant to the
                                      patient.
Class               1                 Root class of all information model classes that
                                      can be archetyped.
Class               1                 An abstract class of all concrete content types.

Class               1                 A class that mainly defines the semantics of all the
                                      ‘hard’ information in the EHR. An ENTRY is also the
Class               1                 minimal unit parent of all clinicalquery should
                                      The abstract of information any ENTRY subtypes.
                                      A CARE_ENTRY defines protocol
Class               1                 and guideline attributes for all clinical ENTRYfor all
                                      ENTRY type for evaluation statements. Used
                                      kinds of statements which evaluate other
                                      information, such as interpretations
DateTime Interval   0..Many           One or more time intervals during which the alert
                                      is/was active - each including the date (and
                                      optionally time) when the alert started and ended.
LIM Value Domain   LIM Format other LIM Constraints
                   Constraint




                   YYYYMMDD
                   [HHMMSS]
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments




"20090915"                   "15 Sep 2009"
"20081227213000"             "27 Dec 2008, 21:30:00"
                             MEDICAL ALERTS (DRILL-DOWN LIST) - NEHR LIST

LIM Change Log   Term                              Definition & Comments




                 1. Medical Alerts.Alert Start
                 DateTime (KIV)

                 2. Medical Alerts.Alert End
NEHR Review Comments             CTS Review Comments              NEHR Phase 1
(pls indicate date of comment)   (pls indicate date of comment)   Core
             ADT - NDDS TEMPLATE

ADT NDDS




LIM.Alert Active Interval [0..Many]
                   DISCHARGE SUMMARY TEMPLATES

ACIDS Goal State




LIM.Alert Active Interval [0..Many]
LIM.Problem            0..1   N/A
Diagnosis Type [0..1]
- Code
LIM.Problem            0..1   N/A
Diagnosis Notes [0..1]
Major Diagnostic   Diagnosis Type   N/A
Category (DG1-7)   (DG1-6) [0..1]
[0..1]
N/A                N/A              LIM.Proble Diagnosis/ N/A
                                    m          Problem
                                    Diagnosis Additional
LIM.Problem
Diagnosis Type
[0..1]
LIM.Problem
Diagnosis
Notes [0..1]
Observation - ENTRY (Finding or Property)

LIM ID Ref                                  LIM Data Item Name



E13.1                                       Observation

        E13.1                               LOCATABLE

        E13.2                               CONTENT ITEM

        E13.3                               ENTRY

        E13.4                               CARE ENTRY

        E13.5                               OBSERVATION ENTRY


        E13.6                               PROPERTY OBSERVATION
LIM Data Type   LIM           LIM Definition
                Cardinality


ENTRY                         An individual observation that was performed.

Class           1             Root class of all information model classes
                              that can be archetyped.
Class           1             An abstract class of all concrete content types.

Class           1             A class that mainly defines the semantics of all
                              the ‘hard’ information in the EHR. An ENTRY is
Class           1             also abstract parent ofof information any query
                              The the minimal unit all clinical ENTRY
                              subtypes. A CARE_ENTRY defines protocol
Class           1             and guideline attributes for all clinical Used
                              ENTRY type for evaluation statements.ENTRY
                              for all kinds of statements which evaluate
                              other information, such as interpretations
Class           1             An observation that assigns values to specific
                              properties.
LIM Value Domain   LIM Format Constraint   other LIM Constraints
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
LIM Change Log   NEHR Review Comments           CTS Review Comments            NEHR Phase 1
                 (pls indicate date of comment) (pls indicate date of comment) Core
                                        MEDS ORDER (MO) - NDDS TEMPLATE


MO NDDS   Med Order     MO IDDS (NHG)
          NDDS
          Cardinality

                        OBX [0..Many]
NDDS TEMPLATE                                              MEDS DISPEN


                MO IDDS (KKH)   MO HL7 v2 NXDS   MD NDDS



                N/A
            MEDS DISPENSE (MD) - NDDS TEMPLATE


Med Dispense MD IDDS (NHG)       MD IDDS (CGH)   MD HL7 v2 NXDS
NDDS
Cardinality

            N/A                  N/A
                                                DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1   ACIDS Phase 1 - NEHR Mapping   ACIDS Phase 2
UMMARY TEMPLATES


               ACIDS Goal State   CHIDS
                                  (Community ) Phase 1
CLINICAL SYNOPSIS ENTRY


                   LIM ID Ref   LIM Data Item Name




E14                             CLINICAL SYNOPSIS ENTRY


      E14.1                     LOCATABLE

      E14.2                     CONTENT ITEM

      E14.3                     ENTRY

      E14.4                     CARE ENTRY

      E14.5                     EVALUATION ENTRY


      E14.6                     Clinical Synopsis Additional
                                Information
LIM Data Type      LIM Cardinality




EVALUATION ENTRY   <Undefined>


Class              1

Class              1

Class              1

Class              1

Class              1


CLUSTER            1
LIM Definition




Information pertaining to a single clinical synopsis ENTRY.


Root class of all information model classes that can be archetyped.

An abstract class of all concrete content types.

A class that mainly defines the semantics of all the ‘hard’ information in the EHR. An
ENTRY is also the minimal unit of information any query should return, since a whole
The abstract parent of all clinical ENTRY subtypes. A CARE_ENTRY defines and
ENTRY (including sub-parts) records spatial structure, timing information, protocol
and guideline attributes for all clinical ENTRY subtypes.
ENTRY type for evaluation statements. Used for all kinds of statements which evaluate
other information, such as interpretations
of obvservations, diagnoses, differential diagnoses, hypotheses, risk
Additional information about the clinical synopsis.
LIM Value Domain   LIM Format other LIM Constraints   LIM Example (for Exchange)
                   Constraint
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase 1
                                                            Core



                                                            Yes
       SUMMARY CARE VIEW - NEHR LIST   INVESTIGATIONS (DRILL-DOWN
                                             LIST) - NEHR LIST


Term                                   Term
       LAB REPORT - NEHR LIST          RADIOLOGY REPORT - NEHR LIST



Term                            Term
NEHR Review Comments             LAB NDDS
(pls indicate date of comment)
                       LABORATORY - NDDS TEMPLATE



SCM   LAB IDDS (KKH)       LAB IDDS (SGH)




                           LIM.Problem Diagnosis Type [0..1]
                           - Code
                           - Term
                           LIM.Problem Diagnosis Notes [0..1]
LAB IDDS (CGH) LAB IDDS (NHG)   LAB HL7 v2 NXDS




               Patient Info     DG1 [0..Many]




0..1           N/A              Major Diagnostic Category (DG1-7) [0..1]

0..1           N/A              Examples:
                                N/A
                                                 RADIOLOGY (RAD) -



RAD NDDS                        Radiology NDDS
                                Cardinality



DG1 [0..Many]




Diagnosis Type (DG1-6) [0..1]

Examples:
N/A
                                     RADIOLOGY (RAD) - NDDS TEMPLATE



SCM                                                              RAD IDDS (NHG)




N/A

LIM.Problem Diagnosis Notes [0..1]
RAD IDDS (NHGP)   RAD HL7 v2 NXDS
ACIDS Phase 1 NDDS
                           DISCH



ACIDS Phase 1 IDDS (NHG)
                           DISCHARGE SUMMARY TEMPLATES



ACIDS Phase 1 IDDS (SHS)
MARY TEMPLATES



           ACIDS Phase 1 IDDS (KTPH)   ACIDS Phase 2
ACIDS Goal State   CHIDS
                   (Community )
                   Phase 1
Problem Diagnosis List - SECTION
LIM ID Ref                         LIM Data Item Name


S1                                 Problem Diagnosis List



      S1.1                         LOCATABLE

      S1.2                         CONTENT ITEM

      S1.3                         List Type
                                   (SECTION Type)

      S1.4                         List Status
                                   (SECTION Status)
      S1.5                         List Summary
                                   (SECTION Summary)
      S1.6                         Problem Diagnosis ENTRY
LIM Data Type   LIM Cardinality


SECTION         <Undefined>



Class           1

Class           1

Coded Text      1


Coded Text      0..1

Text            1


ENTRY           0..Many
LIM Definition                                                                            LIM Value Domain


A list of diagnostic labels or problem statements assigned by the clinician (or Medical
Records Officer) to describe the diagnoses and medical/health problems pertaining to
the patient during the healthcare episode.
Root class of all information model classes that can be archetyped.

An abstract class of all concrete content types.

The type of the list.                                                                     Problem_Diagnosis_Type
                                                                                          _VD

The status of the list.                                                                   List_Status_VD

The textual summary of the list.


Information pertaining to a single problem or diagnosis ENTRY.
LIM Format   other LIM Constraints   LIM Example (for Exchange)   LIM Example (for Display)
Constraint




                                     ("C", "Chief Complaint")     "Chief Complaint"
                                     ("H", "History")             "History"
                                     ("P", "Discharge Primary")   "Discharge Primary"
                                     ("xxx", "Preliminary")       "Preliminary"
                                     ("xxx", "Final")             "Final"
                                                            SUMMARY CARE VIEW - NEHR LIST


LIM Comments   LIM Change Log   NEHR Phase Term
                                1 Core

                                Yes




                                Yes       Recon
                                          Diagnosis/Problem.Document
                                          Title/List Type i.e. Reconciled
                                Yes       Recon Diagnosis/Problem.List
                                          Status (e.g. Interim, Final)



                                Yes




                                          UNMAPPED
                                          Recon Problem/Diagnosis.Date and
                                          Time(List was Created)
SUMMARY CARE VIEW - NEHR LIST          RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST) - NEHR
                                                             LIST
              Definition & Comments   Term                              Definition & Comments




                                      Recon
                                      Diagnosis/Problem.Document
                                      Title/List Type i.e. Reconciled
                                      Recon Diagnosis/Problem.List
                                      Status (e.g. Interim, Final)




              UNMAPPED                UNMAPPED                     UNMAPPED
                                      Recon Problem/Diagnosis.Date
                                      and Time(List was Created)
 RECON PROBLEM/DIAGNOSIS LIST (DRILL-DOWN LIST VIEW) -
                    NEHR LIST
Term                       Definition & Comments         NEHR Review Comments
                                                         (pls indicate date of comment)




UNMAPPED                     UNMAPPED
Recon Problem/Diagnosis.Date
and Time(List was Created)
                                                                             ADT - NDDS TEMPLATE


CTS Review Comments              ADT NDDS                      ADT NDDS
(pls indicate date of comment)                                 Cardinality




                                 N/A                           N/A


                                 N/A                           N/A

                                 LIM.List Summary Text [1]     1


                                 LIM.Problem Diagnosis ENTRY   0..Many
                                 [0..Many]
             ADT - NDDS TEMPLATE


ADT IDDS (SHS)                 ADT IDDS (NHG)              ADT HL7 v2 NXDS


{DG1 [0..Many]} [0..Many]      {DG1 [0..Many]} [0..Many]




N/A                            N/A


N/A                            N/A

N/A                            N/A


DG1 [0..Many]                  DG1 [0..Many]
                                                                      DIS


ACIDS Phase 1 NDDS                      ACIDS Phase 1 IDDS (NHG)


LIM.Problem Diagnosis List [1..Many]    Diagnosis/Problem [1..Many]




N/A                                     N/A


N/A                                     N/A

N/A                                     N/A


LIM.Problem Diagnosis ENTRY [1..Many]   Diagnosis/Problem [1..Many]




UNMAPPED
                   DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 IDDS (SHS)                         ACIDS Phase 1 IDDS (KTPH)


Diagnosis/Problem [1..Many]




N/A


N/A

N/A


Diagnosis/Problem [1..Many]
ACIDS Phase 2   ACIDS Goal State              CHIDS
                                              (Community )
                                              Phase 1




N/A             N/A


N/A             N/A

N/A             N/A


                LIM.Problem Diagnosis ENTRY
                [0..Many]


UNMAPPED        UNMAPPED                      UNMAPPED
Medication List - SECTION

LIM ID Ref                  LIM Data Item Name


S2.1                        Medication List




       S2.1                 LOCATABLE

       S2.2                 CONTENT ITEM

       S2.3                 List Type
                            (SECTION Type)
       S2.4                 List Status
                            (SECTION Status)
       S2.5                 List Summary
                            (SECTION Summary)
       S2.6                 Medication ENTRY
LIM Data Type   LIM Cardinality   LIM Definition


SECTION                           Medication lists that are captured during or
                                  relevant to the patient event - e.g. medication
                                  orders, medications dispensed, current
                                  medications, reconciled medications.
Class           1                 Root class of all information model classes that
                                  can be archetyped.
Class           1                 An abstract class of all concrete content types.

Coded Text      1                 The type of the list.

Coded Text      0..1              The status of the list.

Text            1                 The textual summary of the list.

ENTRY           0..Many           Information pertaining to a single medication
                                  ENTRY - e.g. Medication Order ENTRY or
                                  Medication Dispense ENTRY.
LIM Value Domain            LIM Format   other LIM Constraints
                            Constraint

                                         If List Type (S2.1.1.1) = "Ceased
                                         Medications", then the Medication Set
                                         should use the following data elements:
                                         - Medication (E6.1.4.2)
                                         - Medication Set Status (E6.1.1.2) = "Ceased



Medication_List_Type_VD

Medication_List_Status_VD
LIM Example (for Exchange)       LIM Example (for Display)   LIM Comments




("C", "Current Medications")     "Current Medications"
("D", "Discharge Medications")   "Discharge Medications"
("xxx", "Preliminary")           "Preliminary"
("xxx", "Final")                 "Final"
                                      SUMMARY CARE VIEW - NEHR LIST


LIM Change Log   NEHR Phase 1 Term                           Definition &
                 Core                                        Comments

                 Yes




                 Yes         Curr & Recon Meds
                             List.Document Title/List Type
                 Yes         Curr & Recon Meds List.List
                             Status (e.g. Interim, Final)


                 Yes




                             UNMAPPED                        UNMAPPED

                             Curr & Recon Meds.DateTime
                             (List was created)
     CURR & RECON MEDS LIST (DRILL-DOWN LIST) - NEHR LIST        CURR MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST


Term                                 Definition & Comments   Term




Curr & Recon Meds List.Document
Title/List Type (e.g. Current
Curr & Recon Meds List.List Status
(e.g. Interim, Final)




UNMAPPED                             UNMAPPED                UNMAPPED

Curr & Recon Meds.DateTime (List                             Curr & Recon Meds.DateTime
was created)                                                 (List was created)
MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST      RECON MEDS LIST (DRILL-DOWN LIST VIEW) - NEHR LIST


                   Definition & Comments       Term                         Definition & Comments




                   UNMAPPED                    UNMAPPED                     UNMAPPED

                                               Curr & Recon Meds.DateTime
                                               (List was created)
              MEDICAL ALERTS VIEW - NEHR LIST


Term                            Definition & Comments   NEHR Review Comments
                                                        (pls indicate date of comment)




Curr & Recon Meds
List.Document Title/List Type




UNMAPPED                        UNMAPPED

Curr & Recon Meds.DateTime
(List was created)
                                                                           MEDS ORDER (MO) - NDDS TEMPLATE


CTS Review Comments              MO NDDS                     Med Order
(pls indicate date of comment)                               NDDS
                                                             Cardinality




                                 LIM.List Type [1] (fixed:   1
                                 "Ordered Medications")
                                 N/A                         N/A

                                 N/A                         N/A

                                 LIM.Medication Item         0..Many
                                 [0..Many]
      MEDS ORDER (MO) - NDDS TEMPLATE


MO IDDS (NHG)                   MO IDDS (KKH)               MO HL7 v2 NXDS


{ORC [1..Many]} [0..Many]       {ORC [1..Many]} [0..Many]
{RXO [0..Many]} [0..Many]       {OBX [0..Many]} [0..Many]
{RXR [0..Many]} [0..Many]       {OBR [0..Many]} [0..Many]
{ZXO [0..Many]} [0..Many]       {RXO [0..Many]} [0..Many]
{ZCO [0..Many]} [0..Many]       {RXR [0..Many]} [0..Many]



N/A                             N/A

N/A                             N/A

N/A                             N/A

ORC [1..Many]                   ORC [1..Many]
RXO [0..Many]                   OBX [0..Many]
RXR [0..Many]                   RXO [0..Many]
ZXO [0..Many]                   RXR [0..Many]
                                                     MEDS DISPENSE (MD) - NDDS TEMPLATE


MD NDDS                     Med Dispense   MD IDDS (NHG)
                            NDDS
                            Cardinality
                                           {ORC [1..Many]} [0..Many]
                                           {RXD [1..Many]} [0..Many]
                                           {ZXO [0..Many]} [0..Many]
                                           {ZCO [0..Many]} [0..Many]




LIM.List Type [1] (fixed:   1              N/A
"Dispensed Medications")
N/A                         N/A            N/A

N/A                         N/A            N/A

LIM.Medication Item         0..Many        ORC [1..Many]
[0..Many]                                  RXD [1..Many]
                                           ZXO [0..Many]
                                           ZCO [0..Many]
DISPENSE (MD) - NDDS TEMPLATE


                 MD IDDS (CGH)               MD HL7 v2 NXDS


                 {ORC [1..Many]} [0..Many]
                 {OBX [0..Many]} [0..Many]
                 {RXO [0..Many]} [0..Many]
                 {RXE [1..Many]} [0..Many]




                 N/A

                 N/A

                 N/A

                 ORC [1..Many]
                 OBX [0..Many]
                 RXO [0..Many]
                 RXE [1..Many]
ACIDS Phase 1 NDDS


LIM.Medication List




N/A

N/A

LIM.List Summary Text [0..1] {LEN: 2GB}

N/A
                                              DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 IDDS (NHG)


Medication Orders
(a.k.a Discharge Medications)




N/A

N/A

Medication Orders Summary [0..1] {LEN: 2GB}

N/A
                           DISCHARGE SUMMARY TEMPLATES


ACIDS Phase 1 IDDS (SHS)


Medication Orders
(a.k.a Discharge Medications)




N/A

N/A

Medication Orders Summary [0..1] {LEN=7000}

N/A
EMPLATES


           ACIDS Phase 1 IDDS (KTPH)   ACIDS Phase 2
ACIDS Goal State




LIM.List Type [1]

N/A

LIM.List Summary Text [1]

LIM.Medication Item [0..Many]
INVESTIGATION RESULTS COMPOSITION

LIM ID Ref                          LIM Data Item Name



C1                                  INVESTIGATION RESULTS
                                    COMPOSITION

      C1.1                          LOCATABLE


      C1.2                          EXTRACT COMPOSITION

      C1.3                          Patient Event Context


      C1.4                          Document Context


      C1.5                          Investigation Activity
LIM Data Type   LIM Cardinality   LIM Definition



Composition     <Undefined>       A composition that includes information about
                                  (laboratory or radiology) investigation activities.

Class           1                 Root class of all information model classes that
                                  can be archetyped.
Class           1                 An abstract class of all concrete content types.

ENTRY           1                 General information about the patient event
                                  about which this event summary is related.
ENTRY           0..1              General information pertaining to the report as a
                                  whole, including the author of the report, and the
                                  datetime it was completed (if relevant).
ENTRY           1..Many           Details about the results of an individual
                                  requested investigation.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint




                                LIM.Document Type Name (DG6.1.3.1) =
                                "Radiology Results Report"
LIM Example (for Exchange) LIM Example (for Display)   LIM Comments
                                   INVESTIGATIONS (DRILL-DOWN LIST) - NEHR LIST


LIM Change Log   NEHR Phase 1   Term                       Definition & Comments
                 Core

                 Yes




                 Yes


                 Yes


                 Yes



                                UNMAPPED                   UNMAPPED
           LAB REPORT - NEHR LIST                RADIOLOGY REPORT - NEHR LIST


Term                       Definition &   Term                       Definition &
                           Comments                                  Comments




UNMAPPED                   UNMAPPED       UNMAPPED                   UNMAPPED
NEHR Review Comments             CTS Review Comments              LAB NDDS
(pls indicate date of comment)   (pls indicate date of comment)




                                                                  LIM.Patient Event
                                                                  Information [1]
                                                                  N/A


                                                                  LIM.Investigation Result
                                                                  [1..Many]
                                            LABORATORY - NDDS TEMPLATE


Lab NDDS      LAB IDDS (KKH)   LAB IDDS (SGH)
Cardinality

              PID [1]          PID [1]
              PV1 [0..1]       PV1 [0..1]
              OBR [1..Many]    OBR [1..Many]
              OBX [0..Many]    OBX [0..Many]




1             PV1 [0..1]       PV1 [0..1]


N/A           N/A              N/A


1..Many       PV1 [0..1]       OBR [1..Many]
              OBR [1..Many]    ORC [1..Many]
              ORC [1..Many]    {OBX [0..Many]} [0..Many]

              UNMAPPED         UNMAPPED
ATORY - NDDS TEMPLATE


                 LAB IDDS (CGH)              LAB IDDS (NHG)              LAB HL7 v2 NXDS



                 PID [1]                     PID [1]
                 PV1 [0..1]                  PV1 [0..1]
                 OBR [1..Many]               OBR [1..Many]
                 OBX [0..Many]               ORC [1..Many]




                 PV1 [0..1]                  PV1 [0..1]


                 N/A                         N/A


                 OBR [1..Many]               OBR [1..Many]
                 ORC [1..Many]               ORC [1..Many]
                 {OBX [0..Many]} [0..Many]   {OBX [0..Many]} [0..Many]

                 UNMAPPED                    UNMAPPED                    UNMAPPED
                                                                        RADIOLOGY (RAD) - NDDS TEM


RAD NDDS                   Radiology NDDS   RAD IDDS (KKH)
                           Cardinality

                                            PID [1]
                                            PV1 [0..1]
                                            ORC [0..Many]
                                            OBR [1..Many]




LIM.Patient Event          1                PV1 [0..1]
Information [1]
N/A                        N/A              N/A


LIM.Investigation Result   1..Many          ORC [0..Many]
[1..Many]                                   OBR [1..Many]
                                            {OBX [0..Many]} [0..Many]

                                            UNMAPPED
                      RADIOLOGY (RAD) - NDDS TEMPLATE


RAD IDDS (SGH)                 RAD IDDS (CGH)              RAD IDDS (NHG)



PID [1]                        PID [1]                     MSH [1]
PV1 [0..1]                     PV1 [0..1]                  PID [0..Many]
ORC [1..Many]                  ORC [1..Many]               PV1 [0..Many]
OBR [1..Many]                  OBR [1..Many]               ORC [0..Many]




PV1 [0..1]                     PV1 [0..1]                  PV1 [0..1]
                               ORC [1..Many]               ZOR [0..Many]
N/A                            N/A                         N/A


ORC [1..Many]                  ORC [1..Many]               ORC [0..Many]
OBR [1..Many]                  OBR [1..Many]               OBR [1..Many]
{OBX [0..Many]} [0..Many]      {OBX [0..Many]} [0..Many]   {OBX [0..Many]} [0..Many]

UNMAPPED                       UNMAPPED                    UNMAPPED
RAD IDDS (NHGP)             RAD HL7 v2 NXDS



MSH [1]
PID [0..Many]
PV1 [0..Many]
ORC [0..Many]




PV1 [0..Many]


N/A


ORC [0..Many]
OBR [0..Many]
{OBX [0..Many]} [0..Many]

UNMAPPED                    UNMAPPED
PATIENT EVENT COMPOSITION
               LIM ID Ref   LIM Data Item Name


C2.1                        PATIENT EVENT
                            COMPOSITION
       C2.1                 LOCATABLE


       C2.2                 EXTRACT COMPOSITION

       C2.3                 Patient Event Context



       C2.4                 Document Context



       C2.5                 Adverse Reactions

       C2.6                 Alerts




       C2.7                 Clinical Synopsis




       C2.8                 Problem/Diagnosis List



       C2.9                 Medication List


       C2.10                Investigations


       C2.11                Procedures


       C2.12                Follow-up Services

       C2.13                Triage

       C2.14                Travel History
       C2.15                Medical Certificates

       C2.16                Observations

       C2.17                Accident Details

       C2.18                Attachment
                            (Document Context)
LIM Data Type   LIM
                Cardinality

Composition

Class           1


Class           1

ENTRY           0..1



ENTRY           0..1



SECTION         0..1

SECTION         0..1




ENTRY           0..Many



SECTION         0..Many



SECTION         0..Many


SECTION         1


SECTION         0..1


SECTION         0..1

ENTRY           0..Many

ENTRY           0..1
SECTION         0..1

SECTION         0..1

ENTRY           0..1

ENTRY           0..Many
LIM Definition


A composition describing a particular healthcare event.

Root class of all information model classes that can be archetyped.


An abstract class of all concrete content types.

General information about the patient event about which this event summary is
related.


General information pertaining to the report as a whole, including the author of the
report, and the datetime it was completed (if relevant).

An allergy, sensitivity or intolerance caused by a substance.

Information pertaining to a patient that may need special consideration by a
healthcare provider before making a decision in order to avert an unfavourable
healthcare event, or relate to the safety of subject or providers, or pertain to special
circumstances relevant to the delivery of care.
Summary information or comments about the clinical management of the patient,
and the prognosis of diagnoses/problems identified during the healthcare event. It
may also include health related information pertinant to the patient, a clinical
interpretation of relevant investigations performed on the patient, and suggestions
A list of diagnostic labels or problem statements assigned by the clinician to
describe the diagnoses and medical/health problems pertaining to the patient
during the healthcare event.
Medication lists that are captured during or relevant to the patient event - e.g.
medication orders, medications dispensed, current medications, reconciled
medications.
The most important investigations performed on the patient during the healthcare
event, that are considered relevant to the patient's ongoing care.
Describes the most important procedures performed on the patient during the
healthcare event, that are considered relevant to the patient's ongoing care.
Services and follow-up care that have been recommended or arranged for the
patient.
Information on the prioritisation of the patient based on severity of their condition.

A history of the locations the patient has travelled to.
Information related to the medical certificates issued to the patient.

Observations of the patient that were performed during the healthcare event.

Details about an accident that the patient was involved in that resulted in this
patient event.
Documents that have been attached to the discharge summary because they are
relevant to the ongoing care of the patient.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)
                                                     SUMMARY CARE VIEW - NEHR LIST

LIM Comments   LIM Change Log   NEHR Phase Term
                                1 Core




                                          UNMAPPED
SUMMARY CARE VIEW - NEHR LIST              PATIENT EVENT - NEHR LIST

        Definition & Comments   Term            Definition & Comments




        UNMAPPED                UNMAPPED        UNMAPPED
NEHR Review Comments             CTS Review Comments              ADT NDDS
(pls indicate date of comment)   (pls indicate date of comment)




                                                                  LIM.Patient Event Information [0..1]



                                                                  N/A



                                                                  LIM.Adverse Reactions [0..1]

                                                                  Alerts [0..1]




                                                                  N/A



                                                                  LIM.Problem/Diagnosis List [0..1]



                                                                  N/A


                                                                  N/A


                                                                  N/A


                                                                  N/A

                                                                  N/A

                                                                  N/A
                                                                  N/A

                                                                  N/A

                                                                  LIM.Accident Details [0..1]

                                                                  N/A



                                                                  UNMAPPED
                                          ADT - NDDS TEMPLATE

ADT NDDS      ADT IDDS (SHS)
Cardinality

              PID [1]
              MRG [0..1]
              PV1 [0..1]




0..1          PV1 [0..1]
              PV2 [0..1]
              MRG [0..Many]
N/A           N/A



0..1          N/A

0..1          N/A




N/A           N/A



0..1          {DG1 [0..Many]} [0..Many]



N/A           N/A


N/A           N/A


N/A           N/A


N/A           N/A

N/A           N/A

N/A           N/A
N/A           N/A

N/A           N/A

0..1          N/A

N/A           N/A



              UNMAPPED
ADT - NDDS TEMPLATE

  ADT IDDS (NHG)              ADT HL7 v2 NXDS


  PID [1]
  MRG [0..1]
  PD1 [0..1]




  PV1 [0..1]
  PV2 [0..1]
  ACC [0..1]
  N/A



  {AL1 [0..Many]} [0..1]

  {AL1 [0..Many]} [0..1]




  N/A



  {DG1 [0..Many]} [0..Many]



  N/A


  N/A


  N/A


  N/A

  N/A

  N/A
  N/A

  N/A

  ACC [0..1]

  N/A



  UNMAPPED                    UNMAPPED
ACIDS Phase 1 NDDS


Discharge Summary




LIM.Patient Event Information [1]



LIM.Report Document Control [0..1]



LIM.Adverse Reactions [0..1]

LIM.Alerts [0..1]




LIM.Clinical Synopsis [0..Many]



LIM.Problem/Diagnosis List [1..Many]



LIM.Medication List [0..Many]


LIM.Investigations [0..1]


LIM.Procedures [0..1]


N/A

N/A

N/A
LIM.Medical Certificates [0..1]

N/A

N/A

N/A



UNMAPPED
                                    DISCHARG

ACIDS Phase 1 IDDS (NHG)




Patient Event Information



Document Control



Allergy and Adverse Drug Reaction

Alert




Clinical Synopsis [0..Many]



Diagnosis/Problem [1..Many]



Medication Orders [0..1]


Investigations [0..1]


Procedures [0..1]


N/A

N/A

N/A
Medical Certificate [0..Many]

N/A

N/A

N/A
                                    DISCHARGE SUMMARY TEMPLATES

ACIDS Phase 1 IDDS (SHS)




Patient Event Information



Document Control



Allergy and Adverse Drug Reaction

Alert




Clinical Synopsis [0..Many]



Diagnosis/Problem [1..Many]



Medication Orders [0..1]


Investigations [0..1]


Procedures [0..1]


N/A

N/A

N/A
Medical Certificate [0..Many]

N/A

N/A

N/A
GE SUMMARY TEMPLATES

                ACIDS Phase 1 IDDS (KTPH)   ACIDS Phase 2


                                            Discharge Summary




                                            UNMAPPED
ACIDS Goal State                       CHIDS
                                       (Community )
                                       Phase 1
Discharge Summary                      Discharge Summary




LIM.Patient Event Information [1]



LIM.Report Document Control [0..1]



LIM.Adverse Reactions [0..1]

LIM.Alerts [0..1]




LIM.Clinical Synopsis [0..Many]



LIM.Problem/Diagnosis List [1..Many]



LIM.Medication List [0..Many]


LIM.Investigations [1]


LIM.Procedures [0..1]


LIM.Follow-up Services [0..1]

N/A

LIM.Travel History [0..1]


LIM.Observations [0..1]

N/A

LIM.Attachment [0..Many]



UNMAPPED                               UNMAPPED
MEDICATION COMPOSITION
       LIM ID Ref        LIM Data Item Name    LIM Data Type


C3                       MEDICATION            COMPOSITION
                         COMPOSITION

     C3.1                LOCATABLE             Class


     C3.2                EXTRACT               Class
                         COMPOSITION
     C3.3                Patient Event Context ENTRY

     C3.4                Document Context      ENTRY


     C3.5                Medication Order      ENTRY

     C3.6                Medication Dispense   ENTRY

     C3.7                Medication            ENTRY
                         Administration

     C3.8                Observation           ENTRY


     C3.9                Adverse Reaction      ENTRY
LIM           LIM Definition                                                 LIM Value Domain   LIM Format
Cardinality                                                                                     Constraint

              A composition that includes medication order,
              dispensing or administration information.

1             Root class of all information model classes that can be
              archetyped.
1             An abstract class of all concrete content types.


1             General information about the patient event associated
              with the medication message.
0..1          General information pertaining to the report as a whole,
              including the author of the report, and the datetime it was
              completed (if relevant).
0..Many       A medication order ENTRY.

0..Many       A medication dispense ENTRY.

0..Many       A medication administration ENTRY.


0..Many       An individual observation that was performed on the
              patient - specifically used to capture 'Weight' and
              'Height'.
0..Many       An individual adverse reaction (e.g. allergy, sensitivity or
              intolerance) that the patient has experienced, or is at
              risk of experiencing.
other LIM Constraints         LIM Example (for Exchange)   LIM Example (for Display)




Observation Type = 'Weight'
or 'Height'
LIM Comments   LIM Change Log   NEHR Review Comments
                                (pls indicate date of comment)
                                                                                   MEDS ORDER (MO) - NDDS TEMPL

CTS Review Comments              MO NDDS                             Med Order
(pls indicate date of comment)                                       NDDS
                                                                     Cardinality




                                 LIM.Patient Event Information [1]   1




                                 LIM.Medication Order ENTRY [1]      1

                                 N/A                                 N/A

                                 N/A                                 N/A


                                 LIM.Observation [0..Many]           0..Many


                                 LIM.Adverse Reaction [0..Many]      0..Many
      MEDS ORDER (MO) - NDDS TEMPLATE

MO IDDS (NHG)                  MO IDDS (KKH)   MO HL7 v2 NXDS


MSH [1]                        MSH [1]
PID [0..1]                     PID [1]
PV1 [0..1]                     PV1 [1]




PV1 [0..1]                     PV1 [1]




ORC [1..Many]                  ORC [1..Many]
RXO [0..Many]                  OBX [0..Many]
N/A [0..Many]
RXR                            RXO
                               N/A [0..Many]

N/A                            N/A


OBX [0..Many]                  N/A


N/A                            N/A
                                                     MEDS DISPENSE (MD) - NDDS TEMPLATE

MD NDDS                             Med        MD IDDS (NHG)
                                    Dispense
                                    NDDS
                                               MSH [1]
                                               PID [1]
                                               PV1 [1]




LIM.Patient Event Information [1]   1          PV1 [1]




LIM.Medication Order ENTRY [0..1]   0..1       ORC [1..Many]
                                               RXD [1..Many]
LIM.Medication Dispense ENTRY [1]   1          ZXO [1..Many]
                                               ORC [0..Many]
                                               RXD [1..Many]
N/A                                 N/A        ZXO [0..Many]
                                               N/A


LIM.Observation [0..Many]           0..Many    N/A


LIM.Adverse Reaction [0..Many]      0..Many    N/A
PENSE (MD) - NDDS TEMPLATE

                  MD IDDS (CGH)   MD HL7 v2 NXDS


                  MSH [1]
                  PID [1]
                  PV1 [0..1]




                  PV1 [0..1]




                  ORC [1..Many]
                  OBX [0..Many]
                  RXO [0..Many]
                  PV1 [0..Many]
                  ORC [1..Many]
                  OBX [0..Many]
                  N/A


                  N/A


                  N/A
Summary Care View - Composition
               LIM ID Ref         LIM Data Item Name



C3.1                              Summary Care View



       C3.1                       LOCATABLE


       C3.2                       EXTRACT COMPOSITION

       C3.3                       Patient Event Context



       C3.4                       Healthcare Providers



       C3.5                       Laboratory Investigation
                                  Result

       C3.6                       Radiology Investigation
                                  Result

       C3.7                       Patient Event


       C3.8                       Problem Diagnosis History
                                  (Problem Diagnosis List)

       C3.9                       Reconciled Problem
                                  Diagnosis List
                                  (Problem Diagnosis List)

       C3.10                      Medication History
                                  (Medication List)

       C3.11                      Current Medications List
                                  (Medication List)


       C3.12                      Reconciled Medications
                                  List
                                  (Medication List)

       C3.13                      Document
                                  (Document Context)
LIM Data Type   LIM           LIM Definition
                Cardinality

Composition                   A summary of pertinant healthcare information relating
                              to a specific patient.

Class           1             Root class of all information model classes that can be
                              archetyped.
Class           1             An abstract class of all concrete content types.

ENTRY           0..1          General information about the patient event about which
                              this event summary is related.


PARTICIPATION   0..Many       The individual providers involved in the patient's
                              healthcare.

COMPOSITION     0..Many       A list of the laboratory result reports for this patient,
                              grouped by investigation ENTRY.

COMPOSITION     0..Many       A list of the radiology result reports for this patient,
                              grouped by investigaiton ENTRY.

COMPOSITION     0..Many       A list of the healthcare events that the given patient has
                              been involved in, linked to the relevant report.

SECTION         0..1          A list of the diagnostic labels or problem statements
                              that have been associated with the given patient.

SECTION         0..Many       A list of the diagnostic labels or problem statements
                              associated with the given patient, that have been
                              reconciled by a clinician.

SECTION         0..1          A history of the medications that have been prescribed
                              for, dispensed for or administered to the given patient.

SECTION         0..Many       A list of the medications that are believed to be
                              currently taken by the patient.


SECTION         0..Many       A list of the medications that are currently being taken
                              by the patient, that has been reconciled by a clinician.



ENTRY           0..Many       A list of other documents, not included above, that are
                              relevant to the care of the patient – e.g. OT Notes.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
                                                                  SUMMARY CARE VIEW - NEHR LIST

LIM Change Log                                             Term                 Definition &
                                                                                Comments




[YC30100531] Cardinality changed to 0..Many based on
clarification from CTS that this is a SECTION containing
potentially more than one list.




[YC30100531] Cardinality changed to 0..Many based on
clarification from CTS that this is a SECTION containing
potentially more than one list.

[YC30100531] Cardinality changed to 0..Many based on
clarification from CTS that this is a SECTION containing
potentially more than one list.
NEHR Review Comments             CTS Review Comments              NEHR Phase
(pls indicate date of comment)   (pls indicate date of comment)   1 Core
INVESTIGATION MESSAGE
LIM ID Ref                       LIM Data Item Name            LIM Data Type


M1                               INVESTIGATION MESSAGE         MESSAGE


     M1.1                        LOCATABLE                     Class

     M1.2                        Sending Information           Data Group
     M1.3                        Receiving Information         Data Group
     M1.3                        General Message Information   Data Group
     M1.4                        Event Information             Data Group
     M1.5                        Content                       EXTRACT
             M1.5.1              Created DateTime              DateTime

             M1.5.2              Created System                Codeable Text
             M1.5.3              Created Organisation          ORGANISATION
                                                               PARTICIPATION
             M1.5.4              Participant Chapter           PARTICIPANT CHAPTER

             M1.5.5              Patient Chapter               PATIENT CHAPTER

                      M1.5.5.1   Investigation Composition     INVESTIGATION
                                 (Content)                     COMPOSITION
             M1.5.6              Participation                 PARTICIPATION
LIM Cardinality   LIM Definition                                      LIM Value Domain


<Undefined>       A message that is used to exchange clinical
                  investigation information between two
                  systems.
1                 Root class of all information model classes that
                  can be archetyped.
1
1
1
1
0..1              The content (or payload) of the message.
0..1              The date (and optionally time) at which the
                  extract was created.
0..1              The system that created the extract.
0..1              The organisation that created the extract.

1                 A chapter (or folder) containing information
                  about each of the participants referred to in the
1                 extract. (or folder) containing information
                  A chapter
                  about a particular patient.
0..Many           The investigation composition exchanged by this
                  message.
0..Many           Participations of the extract.
LIM Format Constraint   other LIM Constraints   LIM Example (for Exchange)
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase
                                                            1 Core

                                                            Yes
  INVESTIGATIONS (DRILL-     LAB REPORT - NEHR LIST    RADIOLOGY REPORT - NEHR
  DOWN LIST) - NEHR LIST                                        LIST
Term                       Term                       Term
                                            ADT - NDDS TEMPLATE

EA Review Comments               ADT NDDS
(pls indicate date of comment)




                                 UNMAPPED
      LABORATORY - NDDS TEMPLATE         RADIOLOGY - NDDS TEMPLATE

LAB NDDS                           RAD NDDS




UNMAPPED                           UNMAPPED
    MEDS ORDER (MO) - NDDS TEMPLATE        MEDS DISPENSE (MD) - NDDS TEMPLATE

MO NDDS                               MD NDDS




UNMAPPED                              UNMAPPED
PATIENT EVENT MESSAGE
LIM ID Ref                       LIM Data Item Name            LIM Data Type

M2                               PATIENT EVENT MESSAGE         MESSAGE


     M2.1                        LOCATABLE                     Class

     M2.2                        Sending Information           Data Group
     M2.3                        Receiving Information         Data Group
     M2.3                        General Message Information   Data Group
     M2.4                        Event Information             Data Group
     M2.5                        Content                       EXTRACT

             M2.5.1              Created DateTime              DateTime

             M2.5.2              Created System                Codeable Text
             M2.5.3              Created Organisation          ORGANISATION
                                                               PARTICIPATION
             M2.5.4              Participant Chapter           PARTICIPANT CHAPTER

             M2.5.5              Patient Chapter               PATIENT CHAPTER

                      M2.5.5.1   Patient Event Composition     PATIENT EVENT
                                 (Content)                     COMPOSITION
             M2.5.6              Participation                 PARTICIPATION
LIM Cardinality   LIM Definition                                      LIM Value Domain

<Undefined>       A message that is used to exchange healthcare
                  information between two systems.

1                 Root class of all information model classes that
                  can be archetyped.
1
1
1
1
0..1              The content (or payload) of the message.

0..1              The date (and optionally time) at which the
                  extract was created.
0..1              The system that created the extract.
0..1              The organisation that created the extract.

1                 A chapter (or folder) containing information
                  about each of the participants referred to in the
1                 extract. (or folder) containing information
                  A chapter
                  about a particular patient.
0..Many           The patient event composition exchanged by
                  this message.
0..Many           Participations of the extract.
LIM Format Constraint   other LIM Constraints   LIM Example (for Exchange)
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase
                                                            1 Core
                                                            Yes
   INVESTIGATIONS (DRILL-     LAB REPORT - NEHR LIST    RADIOLOGY REPORT - NEHR
   DOWN LIST) - NEHR LIST                                        LIST
Term                        Term                       Term
                                            ADT - NDDS TEMPLATE

EA Review Comments               ADT NDDS
(pls indicate date of comment)




                                 UNMAPPED
      LABORATORY - NDDS TEMPLATE         RADIOLOGY - NDDS TEMPLATE

LAB NDDS                           RAD NDDS




UNMAPPED                           UNMAPPED
    MEDS ORDER (MO) - NDDS TEMPLATE        MEDS DISPENSE (MD) - NDDS TEMPLATE

MO NDDS                               MD NDDS




UNMAPPED                              UNMAPPED
MEDICATION MESSAGE
LIM ID Ref                       LIM Data Item Name            LIM Data Type


M3                               MEDICATION MESSAGE            MESSAGE


     M3.1                        LOCATABLE                     Class

     M3.2                        Sending Information           Data Group
     M3.3                        Receiving Information         Data Group
     M3.3                        General Message Information   Data Group
     M3.4                        Event Information             Data Group
     M3.5                        Content                       EXTRACT
             M3.5.1              Created DateTime              DateTime

             M3.5.2              Created System                Codeable Text
             M3.5.3              Created Organisation          ORGANISATION
                                                               PARTICIPATION
             M3.5.4              Participant Chapter           PARTICIPANT CHAPTER

             M3.5.5              Patient Chapter               PATIENT CHAPTER

                      M3.5.5.1   Medication Composition        MEDICATION COMPOSITION
                                 (Content)

             M3.5.6              Participation                 PARTICIPATION
LIM Cardinality   LIM Definition                                      LIM Value Domain


<Undefined>       A message that is used to exchange healthcare
                  information between two systems.

1                 Root class of all information model classes that
                  can be archetyped.
1
1
1
1
0..1              The content (or payload) of the message.
0..1              The date (and optionally time) at which the
                  extract was created.
0..1              The system that created the extract.
0..1              The organisation that created the extract.

1                 A chapter (or folder) containing information
                  about each of the participants referred to in the
1                 extract. (or folder) containing information
                  A chapter
                  about a particular patient.
0..Many           The Medication Composition (either Order,
                  Dispense or Administration) exchanged by this
                  message.
0..Many           Participations of the extract.
LIM Format Constraint   other LIM Constraints   LIM Example (for Exchange)
LIM Example (for Display)   LIM Comments   LIM Change Log   NEHR Phase
                                                            1 Core

                                                            Yes
  INVESTIGATIONS (DRILL-     LAB REPORT - NEHR LIST    RADIOLOGY REPORT - NEHR
  DOWN LIST) - NEHR LIST                                        LIST
Term                       Term                       Term
                                            ADT - NDDS TEMPLATE


EA Review Comments               ADT NDDS
(pls indicate date of comment)




                                 UNMAPPED
      LABORATORY - NDDS TEMPLATE         RADIOLOGY - NDDS TEMPLATE


LAB NDDS                           RAD NDDS




UNMAPPED                           UNMAPPED
    MEDS ORDER (MO) - NDDS TEMPLATE        MEDS DISPENSE (MD) - NDDS TEMPLATE


MO NDDS                               MD NDDS




UNMAPPED                              UNMAPPED
Data Types
LIM ID Ref   LIM Data Type Component      LIM Type   LIM Cardinality
             Name
1            Boolean


2            Coded Text




3            Codeable Text


4            DateTime

5            DateTime Interval



6            Duration                     Quantity

7            Electronic Contact Details


8            Encapsulated Data


9            Identifier
10           Integer


11           Quantity



12           Quantity Range


13           Quantity Ratio


14           Real




15           Text


16           UID

17           URI
LIM Definition                                                        LIM Value Domain

A mathematical datatype associated with two-valued logic, e.g.
"true" or "false".
Coded text without exceptions; text with code mappings. Values
in this datatype must come from the bound value domain, with
no exceptions.

Coded text with exceptions; flexible datatype to support various
ways of holding text, both free text and coded text.
A single date and/or time.

The start datetime (optional) and end datetime (optional) of a
period of time, and the length of time (width, optional) between
the start and end of the time interval.

The period of time during which something continues

This data group contains data elements used to capture and
store the electronic communication details of entities.

Data that is primarily intended for human interpretation or for
furtEHR machine processing.


A mathematical datatype comprising exact integral values.


Used for recording the result of measurements and observations.



Two Quantity values that define the minimum and maximum
values, i.e. lower and upper bounds.

The relative magnitude of two Quantity (UCUM) values (usually
expressed as a quotient).
A computational approximation to the standard mathematical
concept of real numbers.




A character string.


A universally unique identifier.

A string of characters used to identify a resource on the Internet,
or a node within an EHR.
LIM Format Constraint   other LIM Constraints                     LIM Example (for LIM Example (for
                                                                  Exchange)        Display)




YYYYMMDD [HHMMSS]

                        Unbounded time intervals can be
                        defined by not including a start and/or
                        end datetime value.




                        Unbounded quantity ranges can be
                        defined by not including a minimum
                        and/or maximum quantity value.
LIM Comments                                          LIM Change Log




This is typically used for defining the valid range
of values for a particular measurement or
observation.
Design Patterns                Design Patterns
                  LIM ID Ref            LIM Data Item Name


1                                       Problem Diagnosis Pattern

2                                       Procedure Pattern

3                                       Evaluation Procedure Pattern

4                                       Specimen

5                                       Medication Product

6                                       Investigation Pattern
LIM Data Type/Group           LIM Cardinality


Data Group

Data Group

Extension of Procedure
Pattern
Design Pattern

Design Pattern

Specialisation of Procedure
Pattern
LIM Definition


A design pattern used to describe a problem diagnosis. The national representation of a problem
diagnosis will include data items 1.1, 1.2 and 1.3.
A design pattern used to describe a procedure.

A design pattern used to describe an evaluation procedure.

A design pattern used to describe a specimen.

A design pattern used to describe a medication product.

A design pattern used to describe an investigation.
LIM Value Domain   LIM Format   other LIM Constraints
                   Constraint
LIM Example (for Exchange)   LIM Example (for Display)   LIM Comments
LIM Change Log
Term Lists                                       Term Lists


                                      National   National Map                Classification
        Value Domain Name                                         Required
                                      or Local     Available                    Scheme


Address_Type_VD                   National       Yes            Mandatory



Administration_Method_VD          National       No             Optional

Admission_Source_Type_VD          National       No             Optional

ADR_Override_Reason_VD            National       Yes            Mandatory

Adverse_Reaction_Category_VD      National       Yes            Mandatory

Adverse_Reaction_Description_VD   National       Yes            Mandatory

Adverse_Reaction_Presence_VD      National       Yes            Mandatory

Adverse_Reaction_Status_VD        National       Yes            Mandatory

Alert_Certainty_VD                National       Yes            Mandatory

Alert_Description_VD              National       Yes            Mandatory

Alert_Status_VD                   National       Yes            Optional

Alert_Type_VD                     National       Yes            Mandatory

Allergen_Route_VD                 National       Yes            Optional

Application_Event_Trigger_VD      Local          No             Optional

Application_VD                    National       N/A            Mandatory




Arrival_Mode_VD                   National       No             Optional

Associated_Finding_VD             National       Yes            Optional
                                                      Optional




Associated_Procedure_VD              National   Yes   Optional




Bed_VD                               Local      No    Optional




Bill_Status_VD                       Local      No    Optional

Billing_Program_Type_VD              Local      No    Mandatory

Brand_Substituted_VD                 National   Yes   Optional

Building_VD                          Local      No    Optional

Case_Classification_Category_VD      National   No    Optional

Case_Classification_Type_VD          Local      No    Optional

Causative_Agent_Category_VD (SIN)    National   Yes   Mandatory

Causative_Agent_VD                   National   Yes   Mandatory




Cause_of_Death_Diagnosis_Indicator_V National   Yes   Mandatory
D
Check_Digit_Method_VD                National   No    Mandatory
Choice_of_Ward_Class_VD          Local      No    Optional

CIP_Status_VD                    National   Yes   Mandatory

City_VD                          Local      No    Optional

Clinical_Course_VD               National   Yes   Optional

Confidentiality_Requirement_VD   National   Yes   Mandatory

Consultation_Indicator_VD        National         Optional

Contact_Type_VD                  National   No    Mandatory




Contact_Use_VD                   National   No    Mandatory




Container_Type_VD                National   Yes   Mandatory

Country_VD                       National   No    Mandatory




Coverage_Type_VD                 National   No    Optional
Data_Format_VD (SIN)                 National   No           Mandatory




DateTime_Description_VD              Local      No           Optional




Deactivation_Reason_VD               National   No           Mandatory

Death_Indicator_VD                   National   No           Mandatory




Department_VD                        Local      No           Optional

Diagnostic_Related_Group_VD          National   No           Mandatory

Dialect_Group_VD                     Local      No           Optional




Discharge_Outcome_VD                 National   Yes          Mandatory

Discharge_Status_VD                  National   No           Mandatory

Dispensed_Administration_Schedule_D Local       No           Optional
escription_VD
Dispensed_Indicator_VD              National                 Mandatory

Dispensed_To_Location_VD             Local      No           Optional

Document_Category_VD                 National   N/A (Must use Optional
                                                National)
Document_Confidentiality_Status_VD   National   N/A (Must use Mandatory
                                                National)
Document_Status_VD       National   Yes          Mandatory

Document_SubType_VD      National   N/A (Must use Mandatory
                                    National)
Document_Type_VD         National   N/A (Must use Mandatory
                                    National)
Doctor_MCR_VD            National   No            Mandatory




Dosage_Form_VD           National   Yes          Mandatory




Dose_Instructions_VD     National   No           Mandatory

Emergency_Indicator_VD   National   Yes          Optional
Employer_VD                        Local      No    Optional

ENTRY_Location_VD                  Loca       No    Optional

Episodicity_VD                     National   Yes   Optional

Facility_VD                        National   Yes   Mandatory




Financial_Class_VD                 National   No    Optional

Finding_Context_VD                 National   Yes   Optional

Floor_VD                           Local      No    Optional

Foreigner_Status_VD                National   No    Optional

Gender_VD                          National   Yes   Mandatory




Healthcare_Establishment_Type_VD   National   No    Mandatory

Healthcare_Facility_VD             National   Yes   Optional




Healthcare_Role_VD                 National   No    Mandatory

Hospital_Service_VD                Local      No    Mandatory

Identifier_Type_VD                 National   Yes   Mandatory
Ingredient_VD                      National   Yes   Optional




Intervention_Required_Reason_VD    Local      No    Optional

Investigation_Name_VD              National   Yes   Mandatory

Investigation_SubType_VD           National   Yes   Mandatory

Investigation_Type_VD              National   Yes   Mandatory

Laboratory_Participation_Type_VD   National   Yes   Mandatory

Laboratory_Test_VD                 National   No    Mandatory

Language_VD                        National   No    Mandatory




Laterality_VD                      National   Yes   Mandatory




List_Status_VD                     National   Yes   Mandatory

Location_Status_VD                 Local      No    Optional


Location_Type_VD                   Local      No    Mandatory

Marital_Status_VD                  National   No    Mandatory
Medical_Leave_Description_VD        Local      No              Optional

Medical_Leave_Type_VD               National   No              Optional

Medication_Changes_VD               National   Yes             Mandatory

Medication_Dose_Units_VD            National   Yes             Mandatory




Medication_Frequency_Qualifier_VD   National   No              Mandatory

Medication_Frequency_VD             National   No              Mandatory

Medication_Item_Compliance_VD       National   No              Mandatory

Medication_Item_Connecting_Term_V National     No              Mandatory
D
Medication_Item_Dispense_Type_VD National      Yes             Mandatory

Medication_Item_Order_Priority_VD   National   No              Optional

Medication_Item_Treatment_Status_V National    No              Mandatory
D
Medication_List_Status_VD          National    N/A (? - Same   Mandatory
                                               as other list
Medication_List_Type_VD             National   Yes             Mandatory

Medication_Name_VD                  National   Yes             Optional

Medication_Quantity_Units_VD        National   Yes             Mandatory




Medication_Reason_VD                National   No              Mandatory
Medication_Strength_Units_VD         National   Yes       Mandatory




Message_Type_VD                      National   Yes       Mandatory




Mode_of_Transport_VD                 Local      No        Optional

Movement_Plan_Registration_Indicator Local      No        Optional
_VD

Name_Suffix_VD                       Local      No        Optional




Name_Title_VD                        National   No        Optional




Name_Type_VD                         Local      No        Optional




Nationality_VD                       National   No        Mandatory




NOK_Role_VD                          National   No        Optional

Observation_Name_VD                  National   Yes (?)   Mandatory

Observation_Result_Value_Type_VD     National   Yes       Mandatory

Observation_Setting_VD               Local      No        Optional

Observation_Status_VD                National   Yes       Mandatory

Observation_Type_VD                  National   No        Optional

Occupation_VD                        Local      No        Mandatory
                                                          Mandatory




Opt_Out_Exception_VD              National   N/A (Must use Optional
                                             National)
Opt_Out_Indicator_VD              National   N/A (Must use Optional
                                             National)
Ordered_Duration_Description_VD   Local      No            Mandatory

Ordered_Indicator_VD              Local      National     Mandatory

Organ_Donor_Indicator_VD          National   Yes          Optional

Organisation_Role_VD              Local      No           Mandatory

Organisation_Type_VD              National   No           Mandatory

Organisation_VD                   National   Yes          Mandatory
other_Component_Identifying_Informa National   No    Optional
tion_VD
Participation_Type_VD               National   Yes   Mandatory

Patient_Class_VD                    National   No    Mandatory

Patient_Event_Location_VD           Local      No    Optional

Patient_Event_Status_VD             National   Yes   Mandatory

Patient_Event_Type_VD               National   Yes   Mandatory

Plan_Type_VD                        Local      No    Mandatory




Point_of_Care_VD                    Local      No    Optional
Priority_VD                       National   Yes   Optional




PRN_Reason_VD                     Local      No    Optional

Probability_of_Causation_VD       National   Yes   Mandatory

Problem_Diagnosis_Category_VD     National   Yes   Mandatory

Problem_Diagnosis_Frequency_VD    National   No    Mandatory

Problem_Diagnosis_Status_VD       National   Yes   Mandatory

Problem_Diagnosis_Type_VD         National   Yes   Mandatory




Problem_Diagnosis_Name_VD         National   Yes   Mandatory

Procedure_Context_VD              National   No    Optional




Procedure_Type_VD                 National   Yes   Mandatory

Processing_ID_VD                  National   Yes   Mandatory

Race_VD                           National   No    Mandatory




Radiology_Participation_Type_VD   National   Yes   Mandatory

Reaction_Site_VD                  National   No    Mandatory

Realm_VD                          National   No    Mandatory
Reason_For_Change_VD                 National         No    Mandatory

Reason_For_Investigation_VD          National         No    Mandatory

Referral_Type_VD                     National         No    Optional

Region_VD                            Local            No    Optional

Registration_Document_Type_VD        National         No    Optional

Relationship_VD                      National         No    Optional




Religion_VD                          National         No    Mandatory




Request_Status_Update_Reason_VD      Local            No    Mandatory

Requested_Action_VD                  National         Yes   Optional
                                     ** Try to make
Resident_Status_VD                   National         No    Mandatory




Result_Interpretation_Normal_Flag_VD National         Yes   Optional

Result_Interpretation_Status_VD      National         Yes   Optional

Result_Status_VD                     National         Yes   Mandatory

Room_VD                              Local            No    Optional


Route_of_Administration_VD           National         Yes   Mandatory

Service_Category_VD                  National         Yes   Mandatory
Service_Description_VD            Local      No    Mandatory

Severity_VD                       National   Yes   Mandatory


Site_of_Administration_VD         National   No    Optional

Site_VD                           National   No    Mandatory




Specialty_VD                      National   No    Mandatory

Specimen_VD                       National   Yes   Optional


Subject_Relationship_Context_VD   National   Yes   Optional

Subvention_Document_Type_VD       National   No    Optional

Synopsis_Type_VD                  National   Yes   Mandatory

Temporal_Context_VD               National   Yes   Optional




Temporal_Units_VD                 National   Yes   Optional

Test_Result_Status_VD             National   Yes   Mandatory

Test_Result_Value_Type_VD         National   Yes   Mandatory

Time_Units_UCUM_VD                National   Yes   Optional

Treatment_Category_VD             National   No    Mandatory
Triage_Category_VD                National   No    Optional    Singapore
                                                               Emergency
                                                               Patient Acuity
                                                               Category
                                                               Scale (PACS)

Trigger_Event_Type_VD             National   Yes   Mandatory
Trigger_Event_VD                  National   Yes   Mandatory
Units_UCUM_VD                     National   Yes   Optional
Units_VD                      National   Yes   Optional
VIP_Status_VD                 National   Yes   Mandatory
Visit_Downtime_Indicator_VD   Local      No    Optional

Visit_Payment_Class_VD        Local      No    Mandatory
VVIP_Status_VD                National   Yes   Mandatory
                                        Data Element / Component
Comments          Worksheet        Data Element    Data Element Name         Component Name
                                        ID
           DG2. Patient            DG2.1.4        Address                 Address Type

           DG3. Patient HCO        DG1.3.4        Organisation Address    Address Type

           DG7. Medication Item    DG7.1.4.4      Administration Method

           DG4. Patient EI         DG4.1.3.3      Admission Source Type

           E6. Medication Order    E6.1.4.7.2     ADR Override Reason

           E6. Adverse Reaction    E6.1.1.3       Adverse Reaction
                                                  Category
           E6. Adverse Reaction    E6.1.3.1       Reaction Description

           E6. Adverse Reaction    E6.1.1.2       Adverse Reaction
                                                  Presence
           E6. Adverse Reaction    E6.1.1.1       Adverse Reaction
                                                  Status
           E11. Alert              E11.1.4        Alert Certainty

           E11. Alert              E11.1.2        Alert Description

           E11. Alert              E11.1.3        Alert Status

           E11. Alert              E11.1.1        Alert Type

           E6. Adverse Reaction    E6.1.2.2       Allergen Route

           DG5. Message Control    DG5.1.2.4      Application Event
                                                  Trigger
           DG5. Message Control    DG5.1.5.2      Sending Application

           DG5. Message Control    DG5.1.6.2      Target Application

           DG6. Document Control   DG6.1.6.4      Creating Application

           DG4. Patient EI         DG4.1.3.4      Arrival Mode

           DG7. Medication Item    DG7.1.1.2.2    Associated Finding
E11. Investigation Result   E11.1.2.1.2.3   Associated Finding

E6. Procedure               E6.1.1.2.2      Associated Finding

DG7. Medication Item        DG7.1.1.2.1     Associated Procedure

E11. Investigation Result   E11.1.2.1.2.2   Associated Procedure

DG4. Patient EI             DG4.1.5.1       Patient Event Location

DG1. Participation          DG1.7.3         Bed


DG4. Patient EI             DG4.1.8.6       Bill Status

DG4. Patient EI             DG4.1.8.5       Billing Program Type

E11. Medication Dispense E11.1.4.7          Brand Substituted

DG1. Participation          DG1.7.7         Building

DG4. Patient EI             DG4.1.2.2       Case Classification
                                            Category
DG4. Patient EI             DG4.1.2.3       Case Classification
                                            Type
E6. Adverse Reaction        E6.1.2.3        Causative Agent
                                            Category
E1. Problem Diagnosis       E1.1.4.2        Causative Agent

E6. Adverse Reaction        E6.1.2.1        Causative Agent Name

E1. Problem Diagnosis       E1.1.4.3        Cause of Death
                                            Diagnosis Indicator
R1. Data Types              8.3             Identifier               Check Digit Method

DG2. Patient                DG2.1.3         Patient Identifier       Check Digit Method

DG3. Patient HCO            DG1.3.3         Organisation Identifier Check Digit Method

DG2. Patient                DG2.1.11.3      NOK identifier           Check Digit Method

DG2. Patient                DG2.1.12.1      Account Number           Check Digit Method

DG2. Patient                DG2.1.9.15      Prior Patient Identifier Check Digit Method

DG2. Patient                DG2.1.14.1      Insurance Plan           Check Digit Method
                                            identifier
DG2. Patient               DG2.1.13.3      Employer Number          Check Digit Method

DG2. Patient               DG2.1.14.6.3    Insured Person           Check Digit Method
                                           Identifier
DG2. Patient               DG2.1.15.3      Guarantor Identifier     Check Digit Method

DG4. Patient EI            DG4.1.8.9       Choice of Ward Class

DG2. Patient               DG2.1.10.1.3    CIP Status

C2. Patient Event Report   C2.1.15.2.1.3   City Visited

E1. Problem Diagnosis      E1.1.1.4        Clinical Course

DG2. Patient               DG2.1.10.5      Confidentiality
                                           Requirement
DG4. Patient EI            DG4.1.3.1       Consultation Indicator

DG1. Participation         DG1.3.5         Electronic Contact       Contact Type

R1. Data Types             6.2             Electronic Contact       Contact Type
                                           Details
DG1. Participation         DG1.3.5         Electronic Contact       Contact Use

DG2. Patient               DG2.1.5         Electronic Contact       Contact Use

R1. Data Types             6.3             Electronic Contact       Contact Use
                                           Details
DG7. Medication Item       DG7.1.1.5       Container Type

DG1. Participation         DG1.2.14        Country

DG1. Participation         DG1.4.3.3       Birth Country

DG2. Patient               DG2.1.9.3       Birth Country

DG3. Patient HCO           DG1.3.4         Organisation Address     Country

DG5. Message Control       DG5.1.5.3       Country of Origin

C2. Patient Event Report   C2.1.15.2.1.1   Country Visited

DG2. Patient               DG2.1.4         Address                  Country

DG2. Patient               DG2.1.14.12     Coverage Type
C1. Investigation Report   C1.1.5.2      Report Contents
                                         Format
C2. Patient Event Report   C2.1.13.2.3   Document Data Format

C2. Patient Event Report   C2.1.16.4.3   Medical Certificate
                                         Data Format
C3. Summary Care Record C3.1.11.2.3      Document Data Format

E6. Procedure              E6.1.5.3      Procedure Report Data
                                         Format
E1. Problem Diagnosis      E1.1.3.6      Resolution DateTime
                                         Description
E1. Problem Diagnosis      E1.1.3.4      Clinically Recognised
                                         DateTime Description
E1. Problem Diagnosis      E1.1.3.8      Last Occurrence
                                         DateTime Description
E1. Problem Diagnosis      E1.1.3.2      Onset DateTime
                                         Description

E6. Adverse Reaction       E6.1.1.5      Reason for
                                         Deactivation
DG1. Participation         DG1.4.3.4     Death Indicator

DG2. Patient               DG2.1.9.4     Death Indicator

DG4. Patient EI            DG4.1.3.5     Admitting Department

E1. Problem Diagnosis      E1.1.2.4      Diagnostic Related
                                         Group
DG1. Participation         DG1.4.3.9     Dialect Group

DG2. Patient               DG2.1.9.9     Dialect Group

DG4. Patient EI            DG4.1.4.3     Discharge Outcome

DG4. Patient EI            DG4.1.4.1     Discharge Status

E11. Medication Dispense E11.1.4.3       Dispensed
                                         Administration
E11. Medication Dispense E11.1.4.8       Dispensed Indicator

E11. Medication Dispense E11.1.4.4       Dispensed To Location

DG6. Document Control      DG6.1.2.2     Document Category

DG6. Document Control      DG6.1.4.2     Document
                                         Confidentiality Status
DG6. Document Control       DG6.1.4.1       Document Status
                                            Name
DG6. Document Control       DG6.1.3.3       Document SubType
                                            Name
DG6. Document Control       DG6.1.3.1       Document Type Name

DG4. Patient EI             DG4.1.7.1       Referred By             Participant
                                                                    identifier.Designation
DG4. Patient EI             DG4.1.7.2       Admitting Clinician     Participant
                                                                    identifier.Designation
DG4. Patient EI             DG4.1.7.3       Discharging Clinician   Participant
                                                                    identifier.Designation
C2. Patient Event Report    C2.1.7.4        Synopsis Author         Participant
                                                                    identifier.Designation
C2. Patient Event Report    C2.1.12.2.3.1   Service Provider        Participant
                                                                    identifier.Designation
C2. Patient Event Report    C2.1.14.3.1     Triage Performed By     Participant
                                                                    identifier.Designation
C2. Patient Event Report    C2.1.16.3.1     Issued By               Participant
                                                                    identifier.Designation
DG6. Document Control       DG6.1.6.1       Document Author         Participant
                                                                    identifier.Designation

DG6. Document Control       DG6.1.6.2       Document Authoriser     Participant
                                                                    identifier.Designation
E1. Problem Diagnosis       E1.1.5.1        Diagnosing Clincian     Participant
                                                                    identifier.Designation
E6. Medication Order        E6.1.2.3        Ordered By              Participant
                                                                    identifier.Designation
E11. Medication Admin       E11.1.2.7       Administered By

E11. Investigation Result   E11.1.1.3       Requesting Clinician    Participant
                                                                    identifier.Designation
E6. Procedure               E6.1.4.1        Performed By            Participant
                                                                    identifier.Designation
DG2. Patient                DG2.1.16.1      Care Team member        Participant
                                                                    identifier.Designation
DG7. Medication Item        DG7.1.1.5.3     Dosage Form

DG7. Medication Item        DG7.1.1.5.11.1 Formulation Input
                            .4             Dosage Form
DG7. Medication Item        DG7.1.2.6      Dose Instructions

DG4. Patient EI             DG4.1.2.7       Emergency Indicator
              DG2. Patient            DG2.1.13.7     Employer Name

              DG7. Medication Item    DG7.1.6.5      Medication Item
                                                     ENTRY Location
              E1. Problem Diagnosis   E1.1.1.3       Episodicity

              DG1. Participation      DG1.7.4        Facility

              DG4. Patient EI         DG4.1.5.1      Patient Event Location

              DG4. Patient EI         DG4.1.8.1      Financial Class

              E1. Problem Diagnosis   E1.1.1.2.1     Finding Context

              DG1. Participation      DG1.7.8        Floor

              DG2. Patient            DG2.1.9.16     Foreigner Status

              DG2. Patient            DG2.1.9.1      Gender

              DG1. Participation      DG1.4.3.1      Gender

              DG2. Patient            DG2.1.11.9.1   NOK Gender

              DG2. Patient            DG2.1.14.6.9.1 Insured Person Gender

              DG3. Patient HCO        DG1.6.2        Organisation Type

              DG5. Message Control    DG5.1.5.1      Sending Organisation

              DG5. Message Control    DG5.1.6.1      Target Organisation

              DG5. Message Control    DG5.1.5.2      Sending Application

              DG1. Participation      DG1.3.2        Healthcare Role

Hierarchy     DG4. Patient EI         DG4.1.2.6      Service or Specialty
needed.
Singapore     R1. Data Types          8.4            Identifier               Type
Blue and Pink
              DG2. Patient            DG2.1.3        Patient Identifier       Type

              DG2. Patient            DG2.1.11.3     NOK Identifier           Type

              DG2. Patient            DG2.1.9.15     Prior Patient Identifier Type
DG3. Patient HCO            DG1.3.3         Organisation Identifier Type

DG7. Medication Item     DG7.1.1.5.1.11     Formulation Input
                         .3.1               Ingredient
DG7. Medication Item     DG7.1.1.5.1.11     Formulation Input
                         .3.2               BOSS Ingredient
E11. Medication Dispense E11.1.4.6          Intervention Required
                                            Reason
E11. Investigation Result   E11.1.2.1.1     Investigation Name

E11. Investigation Result   E11.1.2.2.2     Investigation SubType

E11. Investigation Result   E11.1.2.2.1     Investigation Type

E11. Investigation Result   E11.1.3.1.4.1   Healthcare Provider
                                            Participant
E11. Investigation Result   E11.1.3.3.1.1   Test Name

DG1. Participation          DG1.4.3.8       Language

DG2. Patient                DG2.1.9.8       Language

DG2. Patient                DG2.1.11.9.3    NOK Language

DG5. Message Control        DG5.1.3.4       Language

E1. Problem Diagnosis       E1.1.1.5.2      Laterality

E11. Investigation Result   E11.1.2.1.4.2   Laterality

E6. Procedure               E6.1.1.4.2      Laterality


S1. Problem Diagnosis List S1.1.1.2         List Status

DG1. Participation          DG1.7.5         Location Status


DG1. Participation          DG1.7.6         Location Type

DG1. Participation          DG1.4.3.12      Marital Status


DG2. Patient                DG2.1.9.12      Marital Status
C2. Patient Event Report   C2.1.16.2.2   Medical Leave
                                         Description
C2. Patient Event Report   C2.1.16.2.1   Medical Leave Type

DG7. Medication Item       DG7.1.6.1     Changes Made

DG7. Medication Item       DG7.1.2.1     Dose Quantity           Units

DG7. Medication Item       DG7.1.2.3     Dose Quantity Range     Units

DG7. Medication Item       DG7.1.2.5     Daily Dose Range        Units

DG7. Medication Item       DG7.1.2.4     Dose Quantity Rate      Units

DG7. Medication item       DG7.1.3.2     Frequency Qualifier

DG7. Medication item       DG7.1.3.1     Frequency

DG7. Medication Item       DG7.1.5.3     Medication Item
                                         Compliance
E6. Medication Order       E6.1.3.3      Medication Item
                                         Connecting Term
DG7. Medication Item       DG7.1.5.4     Medication Item
                                         Dispense Type
E6. Medication Order       E6.1.2.6      Order Priority

DG7. Medication item       DG7.1.5.2     Medication Item
                                         Treatment Status
S2. Medication List        S2.1.1.2      List Status

S2. Medication List        S2.1.1.1      List Type

DG7. Medication Item       DG7.1.1.1     Medication Name

E6. Medication Order       E6.1.4.1      Requested Quantity      Units

DG7. Medication Item       DG7.1.1.5.4  Total Component          Units
                                        Quantity
DG7. Medication Item     DG7.1.1.5.6    Component Quantity       Container Size
                                        per Container
DG7. Medication Item     DG7.1.1.5.11.1 Formulation Input        Units
                         .5             Total Quantity
E11. Medication Dispense E11.1.4.1      Dispensed Quantity       Units

DG7. Medication Item       DG7.1.5.1     Reason for Medication
DG7. Medication Item       DG7.1.1.5.2.3   Ingredient Strength      Units

DG7. Medication Item                      Formulation input
                           DG7.1.1.5.1.11.3.3                       Units
                                          Ingredient Strength
DG5. Message Control       DG5.1.2.1      Message Type




C2. Patient Event Report   C2.1.14.1.1     Mode of Transport

DG4. Patient EI            DG4.1.5.3       Movement Plan
                                           Registration Indicator

DG1. Participation         DG1.1.5         Suffix

DG2. Patient                               Patient Name             Suffix

DG1. Participation         DG1.1.2         Title

DG2. Patient               DG2.1.7         Patient name             Title

DG1. Participation         DG1.1.6         Name Type

DG2. Patient               DG2.1.7         Name Type                Name Type

DG1. Participation         DG1.4.3.6       Nationality

DG2. Patient               DG2.1.9.6       Nationality

DG2. Patient               DG2.1.11.2      Healthcare Role

E11. Observation           E11.1.1.1       Observation Name

E11. Observation           E11.1.4.2       Observation Result
                                           Value Type
E11. Observation           E11.1.1.3       Observation Setting

E11. Observation           E11.1.4.4       Observation Status

E11. Observation           E11.1.1.2       Observation Type

DG1. Participation         DG1.4.3.11      Occupation

DG2. Patient               DG2.1.11.9.4    NOK Occupation
            DG2. Patient               DG2.1.9.11      Occupation

            DG2. Patient               DG2.1.10.4      EHR Opt-out Exception

            DG2. Patient               DG2.1.10.3      EHR Opt-out Indicator

            E6. Medication Order       E6.1.4.3        Ordered Duration
                                                       Description
            E6. Medication Order       E6.1.2.7        Ordered Indicator

            DG2. Patient               DG2.1.10.6      Organ Donor Indicator

            DG1. Participation         DG1.5.2.2       Organisation Role

            DG1. Participation         DG1.6.2         Organisation Type

Hierarchy   DG1. Participation         DG1.6.1         Organisation Name
needed.
            DG3. Patient HCO           DG1.6.1         Organisation Name

            DG3. Patient HCO           DG1.3.3         Organisation identifier Issuer

            DG4. Patient EI            DG4.1.4.2       Discharged To           Participant
                                                       Organisation            identifier.Designation
            DG4. Patient EI            DG4.1.4.2       Discharged To           Organisation Name
                                                       Organisation
            DG4. Patient EI            DG4.1.7.1       Referred By             Participant
                                                                               identifier.Designation
            DG6. Document Control      DG6.1.6.3       Creating Organisation   Participant
                                                                               identifier.Designation
            DG6. Document Control      DG6.1.6.3       Creating Organisation   Organisation Name

            C2. Patient Event Report   C2.1.12.2.3.1   Service Provider

            DG5. Message Control       DG5.1.5.1       Sending Organization    Participant
                                                                               identifier.Designation
            DG5. Message Control       DG5.1.5.1       Sending Organization    Organisation Name

            DG5. Message Control       DG5.1.5.4       Content Source          Participant
                                                       Organisation            identifier.Designation
            DG5. Message Control       DG5.1.5.4       Content Source          Organisation Name
                                                       Organisation
            DG5. Message Control       DG5.1.6.1       Target Organisation     Participant
                                                                               identifier.Designation
            DG5. Message Control       DG5.1.6.1       Target Organisation     Organisation Name
E11. Investigation Result   E11.1.3.1.4.2   Requested Performing
                                            Facility
E11. Investigation Result   E11.1.3.1.4.3   Reference Facility   Participant
                                                                 identifier.Designation
E11. Investigation Result   E11.1.3.1.4.3   Reference Facility   Organisation Name

E11. Investigation Result   E11.1.1.4       Requested                 Participant
                                            Investigation Facility    identifier.Designation
E11. Investigation Result   E11.1.1.4       Requested                 Organisation Name
                                            Investigation Facility
DG2. Patient                DG2.1.3         Patient Identifier        Issuer

DG2. Patient                DG2.1.10.1.1    Healthcare Facility       Participant
                                                                      identifier.Designation
DG2. Patient                DG2.1.10.1.1    Healthcare Facility       Organisation Name

DG2. Patient                DG2.1.11.3      NOK Identifier            Issuer

DG2. Patient                DG2.1.9.15      Prior Patient Identifier Issuer

DG2. Patient                DG2.1.16.1      Care Team member          Participant
                                                                      identifier.Designation
C2. Patient Event Report    C2.1.12.2.3.1   Service Provider          Participant
                                                                      identifier.Designation
R1. Data Types              8.5             Issuer

DG7. Medication Item        DG7.1.1.5.8     other Component
                                            Identifying Information
DG1. Participation          DG1.3.1         Participation Type

DG4. Patient EI             DG4.1.8.1       Financial Class

C2. Patient Event Report    C2.1.12.2.3.1   Service Provider          Point of Care

DG4. Patient EI             DG4.1.2.4       Patient Event Control
                                            Status
DG4. Patient EI             DG4.1.2.1       Patient Event Type

DG2. Patient                DG2.1.14.5      Plan Type




DG1. Participation          DG1.7.1         Point of Care
DG4. Patient EI             DG4.1.5.1       Patient Event Location


E11. Investigation Result   E11.1.2.1.3     Priority

E6. Procedure               E6.1.1.3        Priority

DG7. Medication Item        DG7.1.3.3       PRN Reason

E6. Adverse Reaction        E6.1.2.4        Probability of
                                            Causation
E1. Problem Diagnosis       E1.1.2.3        Problem Diagnosis
                                            Category
E1. Problem Diagnosis       E1.1.4.1        Frequency of
                                            Reoccurrence
E1. Problem Diagnosis       E1.1.2.1        Problem Diagnosis
                                            Status
E1. Problem Diagnosis       E1.1.2.2        Problem Diagnosis
                                            Type
S1. Problem Diagnosis List S1.1.1.1         List Type

E1. Problem Diagnosis       E1.1.1.1        Problem Diagnosis
                                            Name
E11. Investigation Result   E11.1.2.1.2.1   Procedure Context

E6. Procedure               E6.1.1.2.1      Procedure Context

E6. Procedure               E6.1.2.1        Procedure Type

DG5. Message Control        DG5.1.1.2       Processing ID

DG1. Participation          DG1.4.3.7       Race

DG2. Patient                DG2.1.9.7       Race

E11. Investigation Result   E11.1.3.1.4.1   Healthcare Provider
                                            Participant
E6. Adverse Reaction        E6.1.3.2        Reaction Site

R1. Data Types              8.4             Identifier               Realm

DG2. Patient                                Patient identifier       Realm

DG2. Patient                                NOK Identifier           Realm

DG2. Patient                                Prior Patient Identifier Realm
DG3. Patient HCO            DG1.3.3         Organisation Identifier Realm

DG7. Medication Item        DG7.1.6.2       Reason for Change

E11. Investigation Result   E11.1.1.5       Reason For
                                            Investigation
DG4. Patient EI             DG4.1.3.2       Referral Type

C2. Patient Event Report    C2.1.15.2.1.2   Region Visited

DG2. Patient                DG2.1.12.3      Registration Document
                                            Type
DG1. Participation          DG2.1.18.6.2    Relationship to Patient

DG2. Patient                DG2.1.14.6.8    Relationship to Patient

DG2. Patient                DG2.1.15.8      Guarantor Relationship
                                            to Patient
DG2. Patient                DG2.1.11.8      NOK Relationship to
                                            Patient
DG1. Participation          DG1.4.3.10      Religion

DG2. Patient                DG2.1.9.10      Religion

E11. Investigation Result   E11.1.1.1.5     Order Control Reason

E11. Investigation Result   E11.1.1.1.3     Requested Action

DG1. Participation          DG1.4.3.13      Resident Status

DG2. Patient                DG2.1.9.13      Resident Status

E11. Investigation Result   E11.1.3.2.3.2   Result Interpretation
                                            Normal Flag
E11. Investigation Result   E11.1.3.2.3.1   Result Interpretation
                                            Status
E11. Investigation Result   E11.1.3.1.2.1   Result Status

DG4. Patient EI             DG4.1.5.1       Patient Event Location

DG1. Participation          DG1.7.2         Room
DG7. Medication Item        DG7.1.4.1       Route of
                                            Administration
C2. Patient Event Report    C2.1.12.2.1.2   Service Category
            C2. Patient Event Report    C2.1.12.2.1.1   Service Description

            E1. Problem Diagnosis       E1.1.1.6        Severity
            E6. Adverse Reaction        E6.1.3.3        Reaction Severity
            E11. Alert                  E11.1.8         Alert Severity
            DG7. Medication Item        DG7.1.4.2       Site of Administration

            E1. Problem Diagnosis       E1.1.1.5.1      Finding Site
            E11. Investigation Result   E11.1.2.1.4.1   Procedure Site Direct

            E6. Procedure               E6.1.1.4.1      Procedure Site Direct

Hierarchy   DG1. Participation          DG1.5.1         Specialty
needed.
            E11. Investigation Result   E11.1.2.3.1.1   Specimen Type Name

            T1. Design Patterns         4.1             Specimen Name
            E1. Problem Diagnosis       E1.1.1.2.3      Subject Relationship
                                                        Context
            DG2. Patient                DG2.1.12.4      Subvention Document
                                                        Type
            C2. Patient Event Report    C2.1.7.2        Synopsis Type

            E1. Problem Diagnosis       E1.1.1.2.2      Temporal Context
            DG7. Medication Item        DG7.1.1.2.3     Temporal Context
            E11. Investigation Result   E11.1.2.1.2.4   Temporal Context

            E6. Procedure               E6.1.1.2.3      Temporal Context
            E1. Problem Diagnosis       E1.1.4.1        Frequency of             Denominator.Units
                                                        Reoccurrence
            E11. Investigation Result   E11.1.3.3.2.3   Test Result Status

            E11. Investigation Result   E11.1.3.3.2.2   Test Result Value Type

            R1. Data Types              5.2             Duration                 Units
            DG7. Medication Item        DG7.1.2.4       Dose Quantity rate       Denominator.Units
            DG4. Patient EI             DG4.1.8.2       Treatment Category
            C2. Patient Event Report    C2.1.14.1.2     Triage Category




            DG5. Message Control        DG5.1.2.3       Trigger Event Type
            DG5. Message Control        DG5.1.2.2       Trigger Event
            R1. Data Types              10.2            Quantity                 Units
            DG7. Medication Item        DG7.1.2.4       Dose Quantity Rate       Denominator.Units
R1. Data Types    10.2           Quantity              Units
DG2. Patient      DG2.1.10.1.2   VIP Status
DG4. Patient EI   DG4.1.8.4      Visit Downtime
                                 Indicator
DG4. Patient EI   DG4.1.8.3      Visit Payment Class
DG2. Patient      DG2.1.10.2     VVIP Status
          NDDS

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ADT - National Data Definition Specification
Revision History

NDDS         Version    Author            Date
             NDDS




             0.0        Cheong Yu Chye    6/7/2010

LIM Model    Version    Author            Date
             LIM



             0.0        Cheong Yu Chye    1/25/2010

Archetypes   Version    Author            Date
             M3. Event Message


             0.0        Cheong Yu Chye    3/1/2010
                                          3/25/2010



             C2. Patient Event Report




             0.0        Cheong Yu Chye    3/1/2010
                                          3/25/2010



             S1. Problem Diagnosis List




             0.0        Cheong Yu Chye    3/1/2010
                                          3/25/2010
E1. Problem Diagnosis


0.0          Cheong Yu Chye   2/5/2010
                              2/26/2010



E6. Adverse Reaction




0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010



E11. Alert


0.0          Cheong Yu Chye   3/1/2010
                              3/25/2010



DG1. Participation




0.0          Cheong Yu Chye   2/22/2010
                              2/26/2010



DG2. Patient




0.0          Cheong Yu Chye   1/25/2010
                              1/29/2010
                              2/10/2010
DG3. Patient HCO (Healthcare Organisation)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG4. Patient EI (Event Information)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG5. Message Control


0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



R1. Data Types

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010
tion Specification

      Description
      The ADT NDDS is a domain-specific information template for the
      exchange of admissions, discharge and transfer (ADT) information.
      The NDDS is derived from the Logical Information Model (LIM) with
      use case-specific validation rules, such as value constraints and
      terminology bindings.
      Initial Draft

      Description
      The Logical Information Model (LIM) is a shared, implementation-
      independent representation of the healthcare information that is
      exchanged across Singapore, and that which is required as part of the
      National Electronic Health Record (NEHR).
      Initial Draft

      Description
      This worksheet describes an Event Message and includes data
      elements pertaining to message control, and the patient event report
      being exchanged in the message.
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Patient Event Report' archetype and
      includes data elements that capture clinically relevant information
      about a particular patient event (e.g. Discharge Summary). The data
      elements describe information captured before, during and after the
      patient event, such as adverse reactions, alerts, clinical synopsis,
      problem diagnosis lists, medication lists, procedures, follow-up
      services and triage information.

      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Problem Diagnosis List' archetype. It
      captures information about a list of diagnostic labels or problem
      statements assigned by the clinician to describe the diagnoses and
      medical/health problems associated with the patient during the
      healthcare episode. It allows the list to be represented as eitEHR a
      single free text summary, or individual problem/diagnosis entries (or
      both).
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Problem Diagnosis' archetype, and
includes data elements that pertain to the name, type, status and
dates of each problem or diagnosis associated with the patient.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Adverse Reaction' archetype and
includes data elements that pertain to individual adverse reactions
(also known as allergies, sensitivities or intolerances) that the patient
has experienced, or is at risk of experiencing. These data elements
include the adverse reaction category, relevant dates, the causative
agent, participants and episode details.

Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Alert' archetype and includes data
elements that pertain to individual alerts that may be relevant to the
patient.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet includes those archetypes used to model individual
people, healthcare providers and organisations that operate within
the healthcare domain (participants) and the roles that they may play
within these domains. The participation model is defined in this way,
so that healthcare participants can be represented consistently across
all the other archetypes.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient' archetype, and includes those
data elements that pertain to patients. The Patient data group is a
specialisation of the PERSON PARTICIPATION data group, and
tEHRefore inEHRits all of its data elements. In addition to the PERSON
PARTICIPATION data elements, the Patient data group also includes
'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

Initial Draft
Internal Review
NHIS Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Patient Healthcare Organisation'
archetype, and includes data elements that pertain to the
organisation at which the patient receives healthcare. This data group
is modelled as a specialisation of the Organisation Participation data
group.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Event Information' archetype,
and includes data elements that pertain to the event during which the
patient receives healthcare. This data group includes information,
such as the start and end dates of the event, the participants and the
event location.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
Laboratory Results - National Data Definition Specification
Revision History

NDDS         Version     Author                  Date
             NDDS




             0.0         Cheong Yu Chye          6/7/2010

LIM Model    Version     Author                  Date
             LIM



             0.0         Cheong Yu Chye          1/25/2010

Archetypes   Version     Author                  Date
             M2. Investigation Results Message




             0.0         Cheong Yu Chye          3/1/2010
                                                 3/25/2010



             E11. Investigation Result




             0.0         Cheong Yu Chye          2/25/2010
                                                 2/26/2010



             DG1. Participation




             0.0         Cheong Yu Chye          2/22/2010
                                                 2/26/2010
DG2. Patient




0.0         Cheong Yu Chye            1/25/2010
                                      1/29/2010
                                      2/10/2010



DG3. Patient HCO (Healthcare Organisation)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG4. Patient EI (Event Information)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG5. Message Control


0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



R1. Data Types

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010
nal Data Definition Specification

      Description
      The Laboratory Results NDDS is a domain-specific information
      template for the exchange of laboratory results information. The
      NDDS is derived from the Logical Information Model (LIM) with use
      case-specific validation rules, such as value constraints and
      terminology bindings.
      Initial Draft

      Description
      The Logical Information Model (LIM) is a shared, implementation-
      independent representation of the healthcare information that is
      exchanged across Singapore, and that which is required as part of the
      National Electronic Health Record (NEHR).
      Initial Draft

      Description
      This worksheet describes an Investigation Results Message and
      includes data elements pertaining to the message control, the patient,
      the healthcare event, the healthcare organisation, and the relevant
      investigation results that are exchanged in a message.

      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Investigation Result' archetype and
      includes data elements that pertain to the name, type, status, dates
      and structured results (where relevant) of investigations which have
      been (or are expected to be) performed on the patient.

      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet includes those archetypes used to model individual
      people, healthcare providers and organisations that operate within
      the healthcare domain (participants) and the roles that they may play
      within these domains. The participation model is defined in this way,
      so that healthcare participants can be represented consistently across
      all the other archetypes.
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Patient' archetype, and includes those
data elements that pertain to patients. The Patient data group is a
specialisation of the PERSON PARTICIPATION data group, and
tEHRefore inEHRits all of its data elements. In addition to the PERSON
PARTICIPATION data elements, the Patient data group also includes
'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

Initial Draft
Internal Review
NHIS Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Healthcare Organisation'
archetype, and includes data elements that pertain to the
organisation at which the patient receives healthcare. This data group
is modelled as a specialisation of the Organisation Participation data
group.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Event Information' archetype,
and includes data elements that pertain to the event during which the
patient receives healthcare. This data group includes information,
such as the start and end dates of the event, the participants and the
event location.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
Radiology Results - National Data Definition Specification
Revision History

NDDS         Version     Author                  Date
             NDDS




             0.0         Cheong Yu Chye          6/7/2010

LIM Model    Version     Author                  Date
             LIM



             0.0         Cheong Yu Chye          1/25/2010

Archetypes   Version     Author                  Date
             M2. Investigation Results Message




             0.0         Cheong Yu Chye          3/1/2010
                                                 3/25/2010



             E11. Investigation Result




             0.0         Cheong Yu Chye          2/25/2010
                                                 2/26/2010



             DG1. Participation




             0.0         Cheong Yu Chye          2/22/2010
                                                 2/26/2010
DG2. Patient




0.0         Cheong Yu Chye            1/25/2010
                                      1/29/2010
                                      2/10/2010



DG3. Patient HCO (Healthcare Organisation)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG4. Patient EI (Event Information)




0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



DG5. Message Control


0.0         Cheong Yu Chye            2/5/2010
                                      2/26/2010



R1. Data Types

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye            2/17/2010
                                      2/26/2010
al Data Definition Specification

      Description
      The Radiology Results NDDS is a domain-specific information template
      for the exchange of radiology results information. The NDDS is derived
      from the Logical Information Model (LIM) with use case-specific
      validation rules, such as value constraints and terminology bindings.

      Initial Draft

      Description
      The Logical Information Model (LIM) is a shared, implementation-
      independent representation of the healthcare information that is
      exchanged across Singapore, and that which is required as part of the
      National Electronic Health Record (NEHR).
      Initial Draft

      Description
      This worksheet describes an Investigation Results Message and
      includes data elements pertaining to the message control, the patient,
      the healthcare event, the healthcare organisation, and the relevant
      investigation results that are exchanged in a message.

      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet describes the 'Investigation Result' archetype and
      includes data elements that pertain to the name, type, status, dates
      and structured results (where relevant) of investigations which have
      been (or are expected to be) performed on the patient.

      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)

      This worksheet includes those archetypes used to model individual
      people, healthcare providers and organisations that operate within
      the healthcare domain (participants) and the roles that they may play
      within these domains. The participation model is defined in this way,
      so that healthcare participants can be represented consistently across
      all the other archetypes.
      Initial Draft
      Internal Review
      Stakeholder Review
      Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Patient' archetype, and includes those
data elements that pertain to patients. The Patient data group is a
specialisation of the PERSON PARTICIPATION data group, and
tEHRefore inEHRits all of its data elements. In addition to the PERSON
PARTICIPATION data elements, the Patient data group also includes
'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

Initial Draft
Internal Review
NHIS Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Healthcare Organisation'
archetype, and includes data elements that pertain to the
organisation at which the patient receives healthcare. This data group
is modelled as a specialisation of the Organisation Participation data
group.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Event Information' archetype,
and includes data elements that pertain to the event during which the
patient receives healthcare. This data group includes information,
such as the start and end dates of the event, the participants and the
event location.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
Medication Order - National Data Definition Specification
Revision History

NDDS         Version    Author           Date
             NDDS




             0.0        Cheong Yu Chye   6/7/2010

LIM Model    Version    Author           Date
             LIM



             0.0        Cheong Yu Chye   1/25/2010

Archetypes   Version   Author            Date
             M1. Medication Message



             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010



             E6. Medication Order

             0.0        Cheong Yu Chye   6/1/2010
                                         6/2/2010



             E6. Adverse Reaction




             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010



             E11. Observation


             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010
DG1. Participation




0.0        Cheong Yu Chye             2/22/2010
                                      2/26/2010



DG2. Patient




0.0        Cheong Yu Chye             1/25/2010
                                      1/29/2010
                                      2/10/2010



DG3. Patient HCO (Healthcare Organisation)




0.0        Cheong Yu Chye             2/5/2010
                                      2/26/2010



DG4. Patient EI (Event Information)




0.0        Cheong Yu Chye             2/5/2010
                                      2/26/2010



DG5. Message Control


0.0        Cheong Yu Chye             2/5/2010
                                      2/26/2010
DG7. Medication Item


0.0         Cheong Yu Chye   2/5/2010
                             6/2/2010



R1. Data Types

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010
al Data Definition Specification

       Description
       The Medication Order NDDS is a domain-specific information template
       for the exchange of medication ordering information. The NDDS is
       derived from the Logical Information Model (LIM) with use case-
       specific validation rules, such as value constraints and terminology
       bindings.
       Initial Draft

       Description
       The Logical Information Model (LIM) is a shared, implementation-
       independent representation of the healthcare information that is
       exchanged across Singapore, and that which is required as part of the
       National Electronic Health Record (NEHR).
       Initial Draft

       Description
       This worksheet describes a Medication Message and includes data
       elements pertaining to the message control, the patient, the
       healthcare event, the healthcare organisation, and the relevant
       medication details that are exchanged in a message.
       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Medication Order' archetype and
       includes data elements that pertain to the medication order.
       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Adverse Reaction' archetype and
       includes data elements that pertain to individual adverse reactions
       (also known as allergies, sensitivities or intolerances) that the patient
       has experienced, or is at risk of experiencing. These data elements
       include the adverse reaction category, relevant dates, the causative
       agent, participants and episode details.

       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Observation' archetype and includes
       data elements that pertain to an individual observation that was
       performed.
       Initial Draft
       Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet includes those archetypes used to model individual
people, healthcare providers and organisations that operate within
the healthcare domain (participants) and the roles that they may play
within these domains. The participation model is defined in this way,
so that healthcare participants can be represented consistently across
all the other archetypes.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient' archetype, and includes those
data elements that pertain to patients. The Patient data group is a
specialisation of the PERSON PARTICIPATION data group, and
tEHRefore inEHRits all of its data elements. In addition to the PERSON
PARTICIPATION data elements, the Patient data group also includes
'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

Initial Draft
Internal Review
NHIS Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Healthcare Organisation'
archetype, and includes data elements that pertain to the
organisation at which the patient receives healthcare. This data group
is modelled as a specialisation of the Organisation Participation data
group.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Event Information' archetype,
and includes data elements that pertain to the event during which the
patient receives healthcare. This data group includes information,
such as the start and end dates of the event, the participants and the
event location.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Medication Item' archetype and
includes data elements that pertain to the name, status, dates and
participants of a medication item.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
Medication Dispense - National Data Definition Specification
Revision History

NDDS         Version    Author           Date
             NDDS




             0.0        Cheong Yu Chye   6/7/2010

LIM Model    Version    Author           Date
             LIM



             0.0        Cheong Yu Chye   1/25/2010

Archetypes   Version   Author            Date
             M1. Medication Message



             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010



             E6. Medication Order

             0.0        Cheong Yu Chye   6/1/2010
                                         6/2/2010



             E6. Adverse Reaction




             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010



             E11. Observation


             0.0        Cheong Yu Chye   3/1/2010
                                         3/25/2010
E11. Medication Dispense


0.0        Cheong Yu Chye             6/1/2010
                                      6/2/2010



DG1. Participation




0.0        Cheong Yu Chye             2/22/2010
                                      2/26/2010



DG2. Patient




0.0        Cheong Yu Chye             1/25/2010
                                      1/29/2010
                                      2/10/2010



DG3. Patient HCO (Healthcare Organisation)




0.0        Cheong Yu Chye             2/5/2010
                                      2/26/2010



DG4. Patient EI (Event Information)




0.0        Cheong Yu Chye             2/5/2010
                                      2/26/2010
DG5. Message Control


0.0         Cheong Yu Chye   2/5/2010
                             2/26/2010



DG7. Medication Item


0.0         Cheong Yu Chye   2/5/2010
                             6/2/2010



R1. Data Types

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010



T2. Term Lists

0.0         Cheong Yu Chye   2/17/2010
                             2/26/2010
ional Data Definition Specification

       Description
       The Medication Dispense NDDS is a domain-specific information
       template for the exchange of medication dispensing information. The
       NDDS is derived from the Logical Information Model (LIM) with use
       case-specific validation rules, such as value constraints and
       terminology bindings.
       Initial Draft

       Description
       The Logical Information Model (LIM) is a shared, implementation-
       independent representation of the healthcare information that is
       exchanged across Singapore, and that which is required as part of the
       National Electronic Health Record (NEHR).
       Initial Draft

       Description
       This worksheet describes a Medication Message and includes data
       elements pertaining to the message control, the patient, the
       healthcare event, the healthcare organisation, and the relevant
       medication details that are exchanged in a message.
       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Medication Order' archetype and
       includes data elements that pertain to the medication order.
       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Adverse Reaction' archetype and
       includes data elements that pertain to individual adverse reactions
       (also known as allergies, sensitivities or intolerances) that the patient
       has experienced, or is at risk of experiencing. These data elements
       include the adverse reaction category, relevant dates, the causative
       agent, participants and episode details.

       Initial Draft
       Internal Review
       Stakeholder Review
       Stakeholder Sign-off (--> v0.1)

       This worksheet describes the 'Observation' archetype and includes
       data elements that pertain to an individual observation that was
       performed.
       Initial Draft
       Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication Dispense' archetype and
includes data elements that pertain to an a medication item that is
dispensed.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet includes those archetypes used to model individual
people, healthcare providers and organisations that operate within
the healthcare domain (participants) and the roles that they may play
within these domains. The participation model is defined in this way,
so that healthcare participants can be represented consistently across
all the other archetypes.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient' archetype, and includes those
data elements that pertain to patients. The Patient data group is a
specialisation of the PERSON PARTICIPATION data group, and
tEHRefore inEHRits all of its data elements. In addition to the PERSON
PARTICIPATION data elements, the Patient data group also includes
'Patient Indicators', 'Next of Kin Details' and 'Financial Information'.

Initial Draft
Internal Review
NHIS Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Healthcare Organisation'
archetype, and includes data elements that pertain to the
organisation at which the patient receives healthcare. This data group
is modelled as a specialisation of the Organisation Participation data
group.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Patient Event Information' archetype,
and includes data elements that pertain to the event during which the
patient receives healthcare. This data group includes information,
such as the start and end dates of the event, the participants and the
event location.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)
This worksheet describes the 'Message Control' archetype, and
includes data elements that describe the source, destination, intent,
authorship and attestation of a message.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the 'Medication Item' archetype and
includes data elements that pertain to the name, status, dates and
participants of a medication item.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the data types that are in use throughout
the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

This worksheet describes the value domains and associated
classification schemes, which are referenced within the NDDS.
Initial Draft
Internal Review
Stakeholder Review
Stakeholder Sign-off (--> v0.1)

				
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