Using detailed clinical models to bridge the gap between clinicians and HIT

Two level object modelling has been introduced in recent health care IT standards, such as Health Level 7 version 3, CEN/ISO 13606 and OpenEHR. Generic functions of electronic health records and electronic messages can be developed in such a way that they become independent of the clinical data, but allow its data management. Clinical data are elicited from clinicians and modelled in the form of clinical statements or archetypes. Such clinical statements or archetypes can be standardized and inserted into the technology upon choice of clinicians. This allows flexibility in development using collections of standardized models. Detailed clinical models (DCM) thus make clinical data explicit, allowing its use in multiple standards and multiple technologies. This paper presents an overview of work for DCM including a workshop in Brisbane in 2007 and project proposals for HL7, CEN and ISO joint standardization work.