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HealtheVet Requirements Management

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					                     H E A L T H   I N F O R M A T I O N




          Introduction to
    Unified Modeling Language
             and VHIM



HEALTH INFORMATION
           Agenda
Click to edit Master title style


      What is UML?
      What can you do with UML?
      Class Diagram
      Packages
      VHIM Modeling


 HEALTH INFORMATION

                                   2
Click to What is UML?
         edit Master title style
          Unified Modeling Language

    An object-oriented analysis and design language from the
    Object Management Group

    Standardizes several diagramming methods, including
        Grady Booch's Object-Oriented Design
        James Rumbaugh's Object Modeling Technique
        Ivar Jacobson's work on use cases

     Supports thirteen different diagrams


 HEALTH INFORMATION

                                                               3
 Click to you Model title UML?
What canedit Master with style

       Structure Diagrams
          Class, Object, Component, Package, Deployment,
          Composite Structure

      Behavior Diagrams
           Use Case, Activity, and State Machine



       Interaction Diagrams
           Sequence, Interaction Overview, Communication, and
           Timing

  HEALTH INFORMATION

                                                                4
    Other Usages of UML
Click to edit Master title style

  Business modeling

  Existing source code decomposition

  Program language code generation

  Test and Verification Suite generation



 HEALTH INFORMATION

                                            5
       Role of Modeling
Click to edit Master title style

  Communicating the business
   requirements

  Better understanding of the system or
   process description

  Comprehensible expression of the
   system for all stakeholders


 HEALTH INFORMATION

                                           6
   VHA edit Master Model
Click toInformation title style

 The VHIM is a UML model
 The VHIM builds on the HL7 RIM model
  • RIM = Reference Information Model
 The VHIM is composed of
  • Class definitions
  • Class diagrams



 HEALTH INFORMATION

                                        7
          Disclaimer
Click to edit Master title style

  Examples in this section are not
   taken from the VHIM model
  The examples are contrived
       • For simplicity’s sake
       • For ease of understanding
  But examples will help you
   understand class models including
   VHIM models
 HEALTH INFORMATION

                                       8
              Diagram
        ClassMaster title style
Click to edit
A Class Diagram is a graphical representation of object
types in the domain of interest and their relationships

                                                              Person
                                                         (from Demographics)
                                This is a               id : Vpid                                     Employee
     This is a Note
                                Package                 ssn : String
                                                        name : String
                                                                                                       0..n    occupant
                                                        address : Address




                      Patient
             (from Demographics)                                                                                 Facility
   genderCode : Gender                        patient         careGiver     Practitioner
   birthDate : Date                           0..*                   0..*
   <<Opt>> religionCode : Religion
   guardianId : Integer




                                                                                                        0..n     careUnit
                                                    Encounter                                    1     ExamRoom
                                        appointmentDateTime : DateTime                     location




   HEALTH INFORMATION

                                                                                                                            9
    Class Representation
Click to edit Master title style
Representation of a set of like objects

Class Name                        Patient
  Patient                    genderCode
                             birthDate
Attributes                   religionCode
  genderCode, birthDate,     gardianID
  religionCode, guardianId

Operations                   admit()
  admit(), register()        register()

  HEALTH INFORMATION

                                            10
  Single Class with title style
Click to edit Master Details

          Class
        Stereotype
                                             <<entity>>
                                               Person
         Package that
                                        (from Demographic)
        owns the class
                                    + id : String
                                    + name : PersonName
         Attribute
         Visibility                 <<opt>> + ssn : SSN
                                    - address : Address
         Attribute
        Stereotype       Datatype

     <<opt>> optional               Simple Datatype: Text, Date, Integer
     <<set>> multiple               Composite Datatype: PersonName, Address




 HEALTH INFORMATION

                                                                              11
    Class Display Options
Click to edit Master title style
                            Suppress Operations
 Class with all details             <<entity>>
                                     Person
         <<entity>>              (from Demographic)
           Person            + id : String
                             + name : PersonName
     (from Demographic)
                             <<opt>> + ssn : SSN
 + id : String               - address : Address
 + name : PersonName
 <<opt>> + ssn : SSN
 - address : Address
                          Hide attributes & operations
 + addNewPerson()
 + changeAddress()                  <<entity>>
                                     Person
                                (from Demographic)



 HEALTH INFORMATION

                                                         12
ClickClass Relationships style
      to edit Master title
        Two types of relationships
                     Inheritance relationship
                      - Superclass / Subclass


                     Association relationship
                      -   Unidirectional
                      -   Bidirectional
                      -   Aggregation
                      -   Composition



 HEALTH INFORMATION

                                                 13
      Inheritance relationship
    Click to edit Master title style

                      Person     Patient



   The subclass Patient inherits the Attributes and
    Operations of the superclass Person.
   A Patient is a Person with additional
    characteristics.
   A superclass may have multiple subclasses.


     HEALTH INFORMATION

                                                  14
 Other Inheritance title style
Click to edit MasterExample


                      <<PatientEncounter>>
                         EncounterEvent




  <<PatientEncounter>>                   <<PatientEncounter>>
 InpatientEncounterEvent                OutpatientEncounterEvent




 HEALTH INFORMATION

                                                                   15
   Association Cardinality
Click to edit Master title style
 Definition:
     The number of instances that may participate in the given
     relationship.
 Cardinality Values:
     0..1                   Zero or one instance
     1                      Exactly one instance
     0..n                   Zero to many instances
     1..n                   One to many instances

     Physician        +requestor   +orderRecord   LabRequest
                      1                   0..n



 HEALTH INFORMATION

                                                                 16
 Unidirectional Association
Click to edit Master title style

                    Patient       careRecord    Encounter
                              1          0..n


    The arrowhead appears at only one end of
     the line
    A Patient object is aware of the Encounter
     object, but not vice versa.
    One Patient object references zero to many
     Encounter objects as careRecords.
    HEALTH INFORMATION

                                                            17
  Bidirectional Association
Click to edit Master title style

    Patient       careRecord       Encounter   Patient       careRecord    Encounter
              1             0..n                         1          0..n

    Represented as either:
      • Arrowheads at both ends of the line, or
      • The absence of arrowheads at both ends of the line
    A Patient object is aware of Encounter objects and
     An Encounter object is aware of a Patient object.
    One Patient object references zero to many Encounter
     objects as careRecords.

       HEALTH INFORMATION

                                                                                       18
  Aggregation Association
Click to edit Master title style

             Company     +employer          Employee
                                     0..n


    Has a hollow diamond at one end; the tip of
     diamond points toward the whole class.
    An Employee object is part of a Company object
    A part object can exist even if the parent object is
     eliminated.
    One Company object aggregates zero to many
     Employee objects.


    HEALTH INFORMATION

                                                            19
  Composition Association
Click to edit Master title style
                  Facility   careUnit   ExamRoom
                                 0..n

 Has a solid diamond at one end, the tip of diamond
  points toward the whole class.
 A Facility object is (partially) composed of
  ExamRoom objects.
 A part object can not exist if the parent object is
  eliminated.
 One Facility object is composed of zero to many
  ExamRoom objects as careUnits.

   HEALTH INFORMATION

                                                        20
Click to edit Master title style
           Packages

 A container for related model elements (Use Cases,
 Classes, Interaction Diagrams, etc.) and other packages
                      VHA Health Information Model (VHIM)
                      DRAFT Version 3.3
                      2/15/2006




                       <<Domain Package>>     <<Domain Package>>   <<Domain Package>>     <<Domain Package>>    <<Domain Package>>      <<Domain Package>>     <<Domain Package>>
                       AdverseEventReportin      Allergies3304        Common3303          CompensationAndPen      Consultation3302          Dental3301            Dietetics3301
                              g3302                                                            sion3302




 VHIM                  <<Domain Package>>
                          Encounter3303
                                              <<Domain Package>>
                                               EventCapture3301
                                                                   <<Domain Package>>
                                                                    HealthFactors3302
                                                                                          <<Domain Package>>
                                                                                          HomeBasedPrimaryCa
                                                                                                                <<Domain Package>>
                                                                                                                   Im aging3303
                                                                                                                                        <<Domain Package>>
                                                                                                                                        Im munizationandSkin
                                                                                                                                                               <<Domain Package>>
                                                                                                                                                                    Lab3303
                                                                                               re3301                                        Test3302


 Packages
                       <<Domain Package>>     <<Domain Package>>   <<Domain Package>>     <<Domain Package>>    <<Domain Package>>      <<Domain Package>>     <<Domain Package>>
                        MentalHealth3302          Orders3303       PatientEducation3301   PersonDemographics3   PersonEligibility3302      Pharmacy3304          Prosthetics3301
                                                                                                  304




                       <<Domain Package>>     <<Domain Package>>   <<Domain Package>>     <<Domain Package>>    <<Domain Package>>      <<Domain Package>>
                         ProblemList3303         Specim en3303         Surgery3302             TIU3303             VitalSigns3304        WomensHealth3301




                          Integrated3304          Datatypes3304          RIM3304               Templates




 HEALTH INFORMATION

                                                                                                                                                                                    21
   HL7 “Act – Role – Entity”
 Click to edit Master title style
            Pattern
• Clinical Act          • Entities play Roles
   – Observation          in clinically relevant
   – Procedure            Acts
• Role                  • Participations
   – Patient              specifies HOW a
   – Practitioner         role is involved in an
• Entity                  act
   – Person                – Author
   – Organization          – Verifier
                           – Subject of…
   HEALTH INFORMATION

                                                   22
Example: “Act – Role – Entity”
Click to edit Master title style

                                     Person




                           Patient        Practitioner   0..
                                                         1

                               1
                                                  1
                        Record Target         Author     Verifier


                        Observation


A “Person” (Entity) who plays the “Patient” (Role), is the
“Record Target” (Participation) of an “Ovservation” (Act).
   HEALTH INFORMATION

                                                                    23
    VHIM to Master title style
Click to edit HL7 Mapping
                           HL7                                    VHIM
                             Act                                    <<Act>>
         + classCode : CS = SBADM                        SubstanceAdministrationPropose
         + moodCode : CS = PRP, RQO, PRMS, EVN
                                                 ...
         ...



                                                                    <<Act>>
                                                         SubstanceAdministrationRequest
                                                 ...



                                                                    <<Act>>
                                                         SubstanceAdminstrationPromise
                                                 ...



                                                                    <<Act>>
                                                          SubstanceAdministrationEvent
                                                   ...




                   Relationship between VHIM RIM and VHIM Classes

 HEALTH INFORMATION

                                                                                          24
 VHIM edit Master title style
Click to Refined Data Types
                                                         GTS
                          Act
              + classCode : CS
              + moodCode : CS
              + effectiveTime : GTS
              ...
                                                    EffectiveTime




         Transformation of RIM attributes to VHIM RDTs

                                                          <<Act>>
                         Act                SubstanceAdministrationRequest
             + classCode : CS = SBADM   + doseFrequency : EffectiveTime
             + moodCode : CS = RQO      + doseDuration : EffectiveTime
             + effectiveTime : GTS      + startDate : EffectiveTime
             ...                        + stopDate : EffectiveTime
                                        ...




           Using RDTs to explicitly convey hidden concepts
 HEALTH INFORMATION

                                                                             25
         Specialized Refined Data
                edit Master title style
       Click toTypes (SRDT)
                                  Code
                                   (from Act)
           + codingSystem : String = "99USAVHAVUID"                   Explicitly subclass the concept
           + nullFlavor : String = "NI"
                                                                       of CodeSet and CodedValue


         StateCodeSet                            CountryCodeSet
+ codeSet : String = "1234567"           + codeSet : String = "7654321"
                                                                                            Address
                                                                              +   streetLine1 : String
                                                                              +   streetLine2 : String
                                                                              +   city : String
                                                                              +   state : StateCodedValue
                                                                              +   postalCode : String
       StateCodedValue                        CountryCodedValue               +   country : CountryCodedValue
    + code : String                          + code : String
    + displayName : String                   + displayName : String




             HEALTH INFORMATION

                                                                                                                26
        Using Specialized Refined
       Click to edit Master title style
                 Data Types
  Specialized Refined Data Types                                    Domain Model using a
                                                                    Specialized Refined Data Type

                  ActCode
                   (from Act)
+ codingSystem : String = "VHAERTVUID"                                                    <<Observ ation>>
<<opt>> + nullFlavor : String = "NI"                                                VitalSignsObservationEvent
                                                               + id : Id
                                         Includes
                                                               + noValueIndicator : NegationInd = false
                                         "Blood Pressure",     + observationT ime : EffectiveTime
                                         "Respiration", etc.   + observedCharacteristic : VitalSignTypeCodedValue
             VitalSignTypeCodeSet                              <<Set>> + reasonEnteredInError : EntryErrorReasonCodedValue
       + codeSet : String = "120.51"                           + statusCode : StatusCodedValue
                                                               + value : PhysicalValue




          VitalSignTypeCodedValue
        + code : String
        + displayName : String




              HEALTH INFORMATION

                                                                                                                             27
       Adding Master HL7
   Click to editRigor to title style
                                                                         Value
                                                            + nullFlavor : String = "NI"




                                                                                                    <<RTO>>
     <<BL>>                                     <<TS>>                                                                            <<ST>>
                                                                                                   RatioValue
   BooleanValue                                DateValue                                                                         TextValue
                                                                                             + numerator : REAL
+ value : Boolean                     + value : TimeStamp                                                                    + value : String
                                                                                             + denominator : REAL




                                                                               <<PQ>>                               <<REAL>>
                         <<CV>>
                                                                             PhysicalValue                          RealValue
                       CodedValue
                                                                   + value : REAL                            + value : REAL
+ codingSystem : String = "2.16.840.1.113883.6.233"
                                                                   + unit : UnitOfM easureCode               + precision : Integer




           Note: Subclasses of this class
           (SRDTs) should be created in each
           Domain




           HEALTH INFORMATION

                                                                                                                                                28
  The VHIM and Enterprise Reference
    Terminology Master title style
   Click to edit (ERT) (concluded)
Reference Terminology                                         Information Model
                                          <<CodeSet>>                           <<CodeSet>>
                                      ReactantCodeSet                     ReactionCodeSet
• Allergy domain                   + codeSet : Vuid = 65535            + codeSet : Vuid = 65531

   – Reactants | 65535
       •    Pollen | 65534
                                         <<CodedValue>>                     <<CodedValue>>
       •    Bees | 65533            ReactantCodedValue                  ReactionCodedValue
       •    Penicillin | 65532   + code : Vuid                       + code : Vuid
                                 + displayText : String              + displayText : String
       •    …
   – Reactions | 65531
       •    Rash | 65530                                      <<Observation>>
                                                  anAllergy : IntoleranceObservation
       •    Headache | 65529            + date : dateTime = 1/15/2005
                                        + reactant : ReactantCodedValue = 65532
       •    Diarrhea | 65529            + reaction : ReactionCodedValue = 65530
       •    …                           ...




           HEALTH INFORMATION

                                                                                              29
            Summary
  Click to edit Master title style
 UML is the most commonly used modeling language for objected-
  oriented systems.
 A class diagram displays the graphical view of the classes and their
  relationship.
 A class has Name, Attributes, and Operations.
 Two types of class relationships:
      • Inheritance
      • Association (Unidirectional, Bidirectional, Aggregation and
        Composition)
 Package: Grouping of related model elements

      HEALTH INFORMATION

                                                                      30
          References
Click to edit Master title style

 Object Management Group web site
 (http://www.omg.org/gettingstarted/what
 _is_uml.htm)
 UML Distilled by Martin Fowler, 3rd
 addition, 2004.




   HEALTH INFORMATION

                                           31

				
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