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Version 2 (modified by KOBAYASHI, Shinji, 16 years ago) ( diff )
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Editors: {T Beale, S Heard}a, {D Kalra, D Lloyd}b
Revision: 1.6.0	Pages: 67	Date of issue: 08 Apr 2007

a.: Ocean Informatics
b.: Centre for Health Informatics and Multi-professional Education, University College London

Keywords: EHR, openehr, reference model

EHR Extract
EHR	Demographic	Integration	Template OM
Composition	openEHR Archetype Profile
Security	Common	Archetype OM	ADL

Data Structures
Data Types
Support

© 2003-2007 The openEHR Foundation.

The openEHR Foundation is an independent, non-profit community, facilitating the sharing of health records by consumers and clinicians via open-source, standards-based implementations

Founding	David Ingram, Professor of Health Informatics,
Chairman	CHIME, University College London
Founding	Dr P Schloeffel, Dr S Heard, Dr D Kalra, D Lloyd, T Beale
Members
email: info@openEHR.org web: http://www.openEHR.org

Support Information Model

Rev 1.6.0

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Date of Issue:08 Apr 2007 Page 2 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model

Rev 1.6.0

Amendment Record

Issue	Details	Raiser	Completed
R E L E A S E 1.0.1
1.6.0	CR-000215: Merge DV_PARTIAL_XX date/time classes and move ISO 8601 semantics to Support IM. CR-000209: Minor changes to correctly define AUTHORED_RESOURCE.current_revision. Add minimal definition for List<T> class. CR-000200: Correct Release 1.0 typographical errors. Move INTERVAL class definition to correct section. Add two invariants. Improved explanation of identifiers. CR-000202: Correct minor errors in VERSION.preceding_version_id. Added is_first function and invariant to VERSION_TREE_ID class. Added invariants for 1-based numbering CR-000203: Release 1.0 explanatory text improvements. CR-000204: Add generic id subtype of OBJECT_ID. CR-000216: Allow mixture of W, D etc in ISO8601 Duration (deviation from standard). CR-000219: Use constants instead of literals to refer to terminology in RM. CR-000220: Tighten semantics of HISTORY.period and EVENT.time. CR-000144: Add new Ratio type: DV_PROPORTION. Add Real.floor. CR-000221: Add normal status to DV_ORDERED. Add “normal statuses” code set. CR-000228: Add minor deviations from ISO 8601 to assumed date/time types. CR-000229: Minor date/time corrections. Allow 2-digit time-zones. CR-000236: Change use of Character to Octet in DV_MULTIMEDIA. CR-000239: Add common parent type of OBJECT_VERSION_ID and HIER_OBJECT_ID. CR-000243: Add template_id to ARCHETYPED class CR-000246: Correct openEHR terminology rubrics.	T Beale Y S Lim S Heard G Grieve D Lloyd S Heard, H Frankel Y S Lim A Patterson G Grieve H Frankel S Heard R Chen A Patterson S Heard H Frankel T Beale H Frankel H Frankel G Grieve H Frankel T Beale B Verhees M Forss	08 Apr 2007
R E L E A S E 1.0
1.5	CR-000162. Allow party identifiers when no demographic data. Relax invariant on PARTY_REF. CR-000184. Separate out terminology from Support IM. CR-000188: Add generating_type function to ANY for use in invariants CR-000161. Support distributed versioning. Move OBJECT_ID.version to subtypes. Add OBJECT_VERSION_ID, VERSION_TREE_ID and LOCATABLE_REF types.	S Heard H Frankel T Beale T Beale T Beale H Frankel	06 Feb 2006
R E L E A S E 0.96

Editors:{T Beale, S Heard}, {D Kalra, D Lloyd} Page 3 of 67 Date of Issue:08 Apr 2007

Support Information Model

Rev 1.6.0

Issue	Details	Raiser	Completed
1.3	CR-000135: Minor corrections to rm.support.terminology package. CR-000145: Add class for access to external environment. CR-000137: Add definitions class to support.definition package.	D Lloyd D Lloyd D Lloyd	25 Jun 2005
R E L E A S E 0.95
1.2.1	CR-000129. Fix errors in UML & specs of Identification package. Adjust invariants & postcondition of OBJECT_ID, HIER_OBJECT_ID, ARCHETYPE_ID and TERMINOLOGY_ID. Improve text to do with assumed abstract types Any and Ordered_numeric.	D Lloyd	25 Feb 2005
1.2	CR-000128. Update Support assumed types to ISO !11404:2003. CR-000107. Add support for exclusion and inclusion of Interval limits. CR-000116. Add PARTICIPATION.function vocabulary and invariant. CR-000122. Fix UML in Terminology_access classes in Support model. CR-000118. Make package names lower case. CR-000111. Move Identification Package to Support. CR-000064. Re-evaluate COMPOSITION.is_persistent attribute. Add “composition category” vocabulary. Re-ordered vocabularies alphabetically.	T Beale A Goodchild T Beale D Lloyd T Beale DSTC D Kalra	10 Feb 2005
R E L E A S E 0.9
1.1	CR-000047. Improve handling of codes for structural attributes. Populated Terminology and code_set codes.	S Heard	11 Mar 2004
1.0	CR-000091. Correct anomalies in use of CODE_PHRASE and DV_CODED_TEXT. Add simple terminology service interface. CR-000095. Remove property attribute from Quantity package. Add simple measurement interface. Formally validated using ISE Eiffel 5.4.	T Beale DSTC, S Heard	09 Mar 2004
0.9.9	CR-000063. ATTESTATION should have a status attribute.	D Kalra	13 Feb 2004
0.9.8	CR-000068. Correct errors in INTERVAL class.	T Beale	20 Dec 2003
0.9.7	CR-000032. Basic numeric type assumptions need to be stated CR-000041. Visually differentiate primitive types in openEHR documents. CR-000043. Move External package to Common RM and rename to Identification (incorporates CR-000036 -Add HIER_OBJECT_ID class, make OBJECT_ID class abstract.)	DSTC, D Lloyd, T Beale	09 Oct 2003
0.9.6	CR-000013. Rename key classes. Based on CEN ENV13606. CR-000038. Remove archetype_originator from multi-axial archetype id. CR-000039. Change archetype_id section separator from ':' to '-'.	T Beale	18 Sep 2003
0.9.5	CR-000036. Add HIER_OBJECT_ID class, make OBJECT_ID class abstract.	T Beale	16 Aug 2003
0.9.4	CR-000022. Code TERM_MAPPING.purpose.	G Grieve	20 Jun 2003

Date of Issue:08 Apr 2007 Page 4 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model

Rev 1.6.0

Issue	Details	Raiser	Completed
0.9.3	CR-000007. Added forgotten terminologies for Subject_relationships and Provider_functions.	T Beale	11 Apr 2003
0.9.2	Detailed review by Ocean, DSTC, Grahame Grieve. Updated valid characters in OBJECT_ID.namespace.	G Grieve	25 Mar 2003
0.9.1	Added specification for BOOLEAN type. Corrected minor error in ISO 639 standard strings -now conformant to TERMINOLOGY_ID. OBJECT_ID.version_id now optional. Improved document structure.	T Beale	18 Mar 2003
0.9	Initial Writing. Taken from Data types and Common Reference Models. Formally validated using ISE Eiffel 5.2.	T Beale	25 Feb 2003

Acknowledgements

The work reported in this paper has been funded in by a number of organisations, including The University College, London and Ocean Informatics, Australia.

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Support Information Model

Rev 1.6.0

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Support Information Model

Rev 1.6.0

1 Introduction.............................................................................. 9

1.1 Purpose...................................................................................................9

1.2 Related Documents ................................................................................9

1.3 Status......................................................................................................9

1.4 Peer review ............................................................................................9

1.5 Conformance..........................................................................................9

2 Support Package .....................................................................11

2.1 Overview..............................................................................................11

2.2 Class Definitions..................................................................................11

2.2.1 EXTERNAL_ENVIRONMENT_ACCESS Class ........................11

3 Assumed Types ....................................................................... 13

3.1 Overview..............................................................................................13

3.2 Inbuilt Primitive Types ........................................................................14

3.2.1 Any Type........................................................................................15

3.2.2 Ordered Type .................................................................................15

3.2.3 Numeric Type.................................................................................15

3.2.4 Ordered_numeric Type ..................................................................16

3.2.5 Boolean Type .................................................................................16

3.2.6 Real Type .......................................................................................18

3.3 Assumed Library Types .......................................................................18

3.3.1 String Type.....................................................................................19

3.3.1.1 UNICODE ...................................................................................................19

3.3.2 Aggregate Type..............................................................................19

3.3.3 List Type ........................................................................................20

3.3.4 Set Type .........................................................................................20

3.3.5 Array Type .....................................................................................20

3.3.6 Hash Type ......................................................................................21

3.3.7 Interval Type ..................................................................................21

3.4 Date/Time Types ..................................................................................22

3.4.1 TIME_DEFINITIONS Class .........................................................23

3.4.2 ISO8601_DATE Class ...................................................................25

3.4.3 ISO8601_TIME Class....................................................................26

3.4.4 ISO8601_DATE_TIME Class .......................................................28

3.4.5 ISO8601_TIMEZONE Class.........................................................30

3.4.6 ISO8601_DURATION Class.........................................................31

4 Identification Package ........................................................... 33

4.1 Overview..............................................................................................33

4.1.1 Requirements .................................................................................33

4.2 Design ..................................................................................................35

4.2.1 Primitive Identifiers .......................................................................35

4.2.2 Composite Identifiers.....................................................................36

4.2.3 References......................................................................................36

4.3 Class Descriptions................................................................................37

4.3.1 UID Class.......................................................................................37

4.3.2 ISO_OID Class ..............................................................................37

4.3.3 UUID Class....................................................................................37

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4.3.4 INTERNET_ID Class....................................................................38

4.3.4.1 Syntax .........................................................................................................38

4.3.5 OBJECT_ID Class ........................................................................ 38

4.3.6 UID_BASED_ID Class.................................................................39

4.3.6.1 Identifier Syntax ..........................................................................................39

4.3.7 HIER_OBJECT_ID Class ............................................................. 39

4.3.8 OBJECT_VERSION_ID Class ..................................................... 40

4.3.8.1 Identifier Syntax ..........................................................................................40

4.3.9 VERSION_TREE_ID Class..........................................................41

4.3.9.1 Syntax .........................................................................................................41

4.3.10 ARCHETYPE_ID Class................................................................ 42

4.3.10.1 Archetype ID Syntax ...................................................................................43

4.3.11 TEMPLATE_ID Class...................................................................43

4.3.12 TERMINOLOGY_ID Class..........................................................44

4.3.12.1 Identifier Syntax ..........................................................................................44

4.3.13 GENERIC_ID Class......................................................................45

4.3.14 OBJECT_REF Class ..................................................................... 45

4.3.15 ACCESS_GROUP_REF Class ..................................................... 46

4.3.16 PARTY_REF Class........................................................................ 46

4.3.17 LOCATABLE_REF Class.............................................................47

5 Terminology Package............................................................. 49

5.1 Overview ............................................................................................. 49

5.2 Service Interface..................................................................................49

5.2.1 Code Sets.......................................................................................49

5.2.2 Terminologies ................................................................................ 49

5.2.3 Terms and Codes in the openEHR Reference Model....................49

5.3 Identifiers............................................................................................. 51

5.3.1 Code Set Identifiers.......................................................................51

5.3.2 Terminology Identifiers ................................................................. 51

5.4 Class Definitions .................................................................................56

5.4.1 TERMINOLOGY_SERVICE Class.............................................. 56

5.4.2 TERMINOLOGY_ACCESS Class...............................................57

5.4.3 CODE_SET_ACCESS Class ........................................................58

5.4.4 OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS Class..58

5.4.5 OPENEHR_CODE_SET_IDENTIFIERS Class........................... 59

6 Measurement Package........................................................... 61

6.1 Overview ............................................................................................. 61

6.2 Service Interface..................................................................................61

6.2.1 Class Definitions ........................................................................... 61

6.2.1.1 MEASUREMENT_SERVICE Class ..........................................................61

7 Definition Package ................................................................. 63

7.1 Overview ............................................................................................. 63

7.2 Class Definitions .................................................................................63

7.2.1 OPENEHR_DEFINITIONS Class ................................................ 63

7.2.2 BASIC_DEFINITIONS Class....................................................... 63

A References............................................................................... 65

A.1 General ................................................................................................65

Date of Issue:08 Apr 2007 Page 8 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model Introduction Rev 1.6.0

Introduction

1.1 Purpose

This document describes the openEHR Support Reference Model, whose semantics are used by all openEHR Reference Models. The intended audience includes:

Standards bodies producing health informatics standards;
Software development organisations developing EHR systems;
Academic groups studying the EHR;
The open source healthcare community.

1.2 Related Documents

Prerequisite documents for reading this document include:

The openEHR Architecture Overview
The openEHR Modelling Guide

1.3 Status

This document is under development, and is published as a proposal for input to standards processes and implementation works.

This document is available at http://svn.openehr.org/specification/TAGS/Release 1.0.1/publishing/architecture/rm/support_im.pdf.

The latest version of this document can be found at http://svn.openehr.org/specifica tion/TRUNK/publishing/architecture/rm/support_im.pdf.

Blue text indicates sections under active development.

1.4 Peer review

Areas where more analysis or explanation is required are indicated with “to be continued” paragraphs like the following:

To Be Continued: more work required

Reviewers are encouraged to comment on and/or advise on these paragraphs as well as the main content. Please send requests for information to info@… provided on the mailing list openehr-technical@…, or by private email.

1.5 Conformance

Conformance of a data or software artifact to an openEHR Reference Model specification is determined by a formal test of that artifact against the relevant openEHR Implementation Technology Specification(s) (ITSs), such as an IDL interface or an XML-schema. Since ITSs are formal, automated derivations from the Reference Model, ITS conformance indicates RM conformance.

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Introduction Support Information Model Rev 1.6.0

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Support Information Model Support Package Rev 1.6.0

Support Package

2.1 Overview

The Support Reference Model comprises types used throughout the openEHR models, including assumed primitive types defined outside of openEHR. The package structure is illustrated in FIGURE

1. The assumed_types ‘pseudo-package’ stands for types assumed by the openEHR specifcations to exist in an implementation technology, such as a programming language, schema language or database environment. The four Support packages define the semantics respectively for constants, terminology access, access to externally defined scientific units and conversion information. The class EXTERNAL_ENVIRONMENT_ACCESS is a mixin class providing access to the service interface classes.

support

definition

identification

assumed_types
FIGURE 1	rm.support and assumed_types Packages
2.2 2.2.1	Class Definitions EXTERNAL_ENVIRONMENT_ACCESS Class

CLASS	EXTERNAL_ENVIRONMENT_ACCESS (abstract)
Purpose	A mixin class providing access to services in the external environment.
Functions	Signature	Meaning
eea_terminology_svc: TERMINOLOGY_SERVICE		Return an interface to the terminology service
eea_measurement_svc: MEASUREMENT_SERVICE		Return an interface to the measurement service

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Support Package Support Information Model Rev 1.6.0

Terminology_service_exists: eea_terminology_svc /= Void Measurement_service_exists: eea_measurement_svc /= Void

Date of Issue:08 Apr 2007 Page 12 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model Assumed Types Rev 1.6.0

Assumed Types

3.1 Overview

This section describes types assumed by all openEHR models. The set of types chosen here is based on a common set from various published sources, including:

ISO 11404 (2003 revision) general purpose data types;
ISO 8601 (2004) date/time specification;
Well-known interoperability formalisms, including OMG IDL, W3C XML-schema;
Well-known object-oriented programming languages, including Java, C#, C++ and Eiffel.

The intention in openEHR is twofold. Firstly, to ensure that openEHR software based on the models integrates as easily as possible with existing implementation technologies, and secondly, to make the minimum possible assumptions about types found in implementation formalisms, while making sufficient assumptions to both enable openEHR models to be conveniently specified. The ISO 11404 (2003) standard contains basic semantics of “general purpose data types” (GPDs) for information technology, and is used here as a normative basis for describing assumptions about types. The operations and properties described here are compatible with those used in ISO 11404, but not always the same, as 11404 does not use object-oriented functions. For example, the notional function has(x:T) (test for presence of a value in a set) defined on the type Set<T> below is not defined on the ISO 11404 Set type; instead, the function IsIn(x: T; s: Set<T>) is defined. However, in object-oriented formalisms, the function IsIn defined on a Set type would usually mean ‘subset of’. In the interests of clarity for developers, an object-oriented style of functions and properties has been used here.

ISO8601:2004 is used as the definitional basis for assumed date/time types, since it is commonly used around the world, and is also the basis for the date/time types in W3C XML-schema. See section 3.4 on page 22 below for details of dates and times.

Two groups of assumed types are identified: primitive types, which are those built in to a formalism’s type system, and library types, which are assumed to be available in a (class) library defined in the formalism. Thus, the type Boolean is always assumed to exist in a formalism, while the type Array<T> is assumed to be available in a library. For practical purposes, these two categories do not matter that much - whether String is really a library class (the usual case) or an inbuilt type doesn’t make much difference to the programmer. They are shown separately here mainly as an explanatory convenience.

The assumptions that openEHR makes about existing types are documented below in terms of interface definitions. Each of these definitions contains only the assumptions required for the given type to be used in the openEHR Reference Model -it is not by any means a complete interface definition. The name and semantics of any function used here for an assumed type might not be identical to those found in some implementation technologies. Any mapping required should be stated in the relevant implementation technology specification (ITS). To give a concrete example, where the assumed Set<T> type defined below has an operation has(item: T): Boolean which is used throughout the openEHR specifications, Java has the method contains() on its Set<T> class. In a Java implementation, the contains() method should then be used throughout the openEHR classes as expressed in Java, in place of the has() method.

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Assumed Types Support Information Model Rev 1.6.0

3.2 Inbuilt Primitive Types

The following types consititute the minimum set of primitive types assumed by openEHR of an implementation formalism.

Type name in openEHR	Description	ISO 11404 Type
Octet	represents a type whose value is an 8-bit value.	Octet
Character	represents a type whose value is a member of an 8-bit character-set (ISO: “repertoire”).	Character
Boolean	represents logical True/False values; usually physically represented as an integer, but need not be	Boolean

Integer	represents 32-bit integers	Integer
Real	represents 32-bit real numbers in any interoperable representation, including single-width IEEE floating point	Real
Double	type which represents 64-bit real numbers, in any interoperable representation including double-precision IEEE floating point.	Real

FIGURE 2 illustrates the built-in primitive types. Simple inheritance relationships are shown which facilitate the type descriptions below. A class “Any” is used to stand for the usual top-level class in all object-oriented type systems, typically called something like “Any” or “Object”. Inheritance from or subsitutability for an Any class is not assumed in openEHR (hence the dotted lines in the UML). It is used here to enable basic operations like ‘=’ to be described once for the type Any, rather than in every subtype. The type Ordered_numeric is on the other hand assumed for purposes of specification in the openEHR data_types.quantity package, and is intended to be mapped to an equivalent type in a real type system (e.g. in Java, java.lang.Number). Here it is assumed that the operations defined on Ordered_numericare available on the types Integer, Realand Double in implementation type systems, where relevant. Data-oriented implementation type systems such as XML-schema do not have such operations.

Any

Octet

Character

Boolean

Ordered

Numeric

Ordered_numeric

FIGURE 2 Primitive Types Assumed by openEHR

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Support Information Model Assumed Types Rev 1.6.0

3.2.1 Any Type

INTERFACE	Any (abstract)
Description	Abstract supertype. Usually maps to a type like “Any” or “Object” in an object system. Defined here to provide the value and reference equality semantics.
Abstract	Signature	Meaning
is_equal (other: Any): Boolean		Value equality
Functions	Signature	Meaning
infix ‘=’ (other: Any): Boolean		Reference equality
instance_of (a_type: String)		Dynamic type of object as a String. Used for type name matching.
Invariants

3.2.2 Ordered Type

INTERFACE	Ordered (abstract)
Purpose	Abstract notional parent class of ordered, types i.e. types on which the ‘<‘ operator is defined.
Abstract	Signature	Meaning
infix ‘<’ (other: like Current): Boolean		Arithmetic comparison. In conjunction with ‘=’, enables the definition of the operators ‘>’, ‘>=’, ‘<=’, ‘<>’. In real type systems, this operator might be defined on another class for comparability.
Invariants

3.2.3 Numeric Type

INTERFACE	Numeric (abstract)
Purpose	Abstract notional parent class of numeric types, which are types which have various arithmetic and comparison operators defined.
Abstract	Signature	Meaning

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Assumed Types Support Information Model Rev 1.6.0

INTERFACE	Numeric (abstract)
infix "*" (other: like Current): like Current require other_exists: other /= void ensure result_exists: Result /= void		Product by `other'. Actual type of result depends on arithmetic balancing rules.
infix "+" (other: like Current): like Current require other_exists: other /= void ensure result_exists: Result /= void commutative: equal (Result, other + Current)		Sum with `other' (commutative). Actual type of result depends on arithmetic balancing rules.
infix "-" (other: like Current): like Current require other_exists: other /= void ensure result_exists: Result /= void		Result of subtracting `other'. Actual type of result depends on arithmetic balancing rules.
Invariants

3.2.4 Ordered_numeric Type

INTERFACE	Ordered_numeric (abstract)
Purpose	Abstract notional parent class of ordered, numeric types, which are types with ‘<‘ and arithmetic operators defined.
Inherit	ORDERED, NUMERIC
Function	Signature	Meaning
Invariants

3.2.5 Boolean Type

INTERFACE	Boolean
Purpose	Boolean type used for two-valued mathematical logic.
Function	Signature	Meaning

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Support Information Model Assumed Types Rev 1.6.0

INTERFACE	Boolean
infix "and" (other: Boolean): Boolean require other_exists: other /= void ensure de_morgan: Result = not (not Current or not other) commutative: Result = (other and Current)		Logical conjunction
infix "and then" (other: Boolean): Boolean require other_exists: other /= void ensure de_morgan: Result = not (not Current or else not other)		Boolean semi-strict conjunction with other
infix "or" (other: Boolean): Boolean require other_exists: other /= void ensure de_morgan: Result = not (not Current and not other) commutative: Result = (other or Current) consistent_with_semi_strict: Result implies (Current or else other)		Boolean disjunction with other
infix "or else" (other: Boolean): Boolean require other_exists: other /= void ensure de_morgan: Result = not (not Current and then not other)		Boolean semi-strict disjunction with `other'
infix "xor" (other: Boolean): Boolean require other_exists: other /= void ensure definition: Result = ((Current or other) and not (Current and other))		Boolean exclusive or with `other'

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Assumed Types Support Information Model Rev 1.6.0

INTERFACE	Boolean
infix "implies" (other: Boolean): Boolean require other_exists: other /= void ensure definition: Result = (not Current or else other)		Boolean implication of `other' (semi-strict)
Invariants	involutive_negation: is_equal (not (not Current)) non_contradiction: not (Current and (not Current)) completeness: Current or else (not Current)

3.2.6 Real Type

INTERFACE	Real
Purpose	Type used to represent decimal numbers. Typically corresponds to a single-precision floating point value in most languages.
Function	Signature	Meaning
floor: Integer		Return the greatest integer no greater than the value of this object.
Invariants

3.3 Assumed Library Types

The types described in this section are also assumed to be fairly standard in implementation technologies by openEHR, but usually come from type libraries rather than being built into the type system of implementation formalisms.

Type name in openEHR	Description	ISO 11404: 2003 Type
String	represents unicode-enabled strings	Character-String/Sequence
Array<T>	physical container of items indexed by number	Array
List<T>	container of items, implied order, non-unique membership	Sequence
Set<T>	container of items, no order, unique membership	Set
Hash<T,U:Comparable>	a table of values of any type T, keyed by values of any basic comparable type U, typically String or Integer, but may be more complex types, e.g. a coded term type.	Table
Interval<T>	Intervals with open or closed upper and lower bounds.	-

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Support Information Model Assumed Types Rev 1.6.0

FIGURE 3 illustrates the assumed library types. As with the assumed primitive types, inheritance and abstract classes are used for convenience of the definitions below, but are not formally assumed in openEHR.

Any

T->Ordered

Aggregate

String

Interval

FIGURE 3 Library Types Assumed by openEHR

3.3.1 String Type

INTERFACE	String
Description	Strings of characters, as used to represent textual data in any natural or formal language.
Functions	Signature	Meaning
infix ‘+’ (other: String): String		Concatenation operator - causes ‘other’ to be appended to this string
is_empty: Boolean		True if string is empty, i.e. equal to “”.
is_integer: Boolean		True if string can be parsed as an integer.
as_integer: Integer require is_integer		Return the integer corresponding to the integer value represented in this string.
Invariants

3.3.1.1 UNICODE

It is assumed in the openEHR specifications that Unicode is supported by the type String. Unicode is needed for all Asian, Arabic and other script languages, for both data values (particularly plain text and coded text) and for many predefined string attributes of the classes in the openEHR Reference Model. It encompasses all existing character sets. In openEHR, UTF-8 encoding is assumed.

3.3.2 Aggregate Type

Abstract parent of of the aggregate types List<T>, Set<T>, Array<T> and Hash<T,K>.

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Assumed Types Support Information Model Rev 1.6.0

INTERFACE	Aggregate <T> (abstract)
Functions	Signature	Meaning
has (v: T): Boolean		Test for membership of a value
count: Integer		Number of items in container
is_empty: Boolean		True if container is empty.
Invariants

3.3.3 List Type

INTERFACE	List <T> (abstract)
Description	Ordered container that may contain duplicates.
Functions	Signature	Meaning
first: T		Return first element.
last: T		Return last element.
Invariants	First_validity: not is_empty implies first /= Void Last_validity: not is_empty implies last /= Void

3.3.4 Set Type

INTERFACE	Set <T> (abstract)
Description	Unordered container that may not contain duplicates.
Functions	Signature	Meaning
Invariants

3.3.5 Array Type

INTERFACE	Array <T> (abstract)
Description	Container whose storage is assumed to be contiguous.
Functions	Signature	Meaning
Invariants

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3.3.6 Hash Type

INTERFACE	Hash <T, U: Comparable>
Description	Type representing a keyed table of values. T is the value type, and U the type of the keys.
Functions	Signature	Meaning
has_key (a_key: U): Boolean		Test for membership of a key
item (a_key: U): T		Return item for key ‘a_key’. Equivalent to ISO 11404 fetch operation.
Invariants

3.3.7 Interval Type

INTERFACE	Interval <T:Ordered>
Purpose	Interval of ordered items.
Attributes	Signature	Meaning
lower: T		lower bound
upper: T		upper bound
lower_unbounded: Boolean		lower boundary open (i.e. = -infinity)
upper_unbounded: Boolean		upper boundary open (i.e. = +infinity)
lower_included: Boolean		lower boundary value included in range if not lower_unbounded
upper_included: Boolean		upper boundary value included in range if not upper_unbounded
Functions	Signature	Meaning
has(e:T): Boolean		True if (lower_unbounded or ((lower_included and v >= lower) or v > lower)) and (upper_unbounded or ((upper_included and v <= upper or v < upper)))

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Lower_included_valid: lower_unbounded implies not lower_included Upper_included_valid: upper_unbounded implies not upper_included Limits_consistent: (not upper_unbounded and not lower_unbounded) implies lower <= upper Limits_comparable: (not upper_unbounded and not lower_unbounded) implies lower.strictly_comparable_to(upper)

3.4 Date/Time Types

Although the ISO 11404 (2003) standard defines a date-and-time type generator (section 8.1.6), and a timeinterval type (section 10.1.6), a more widely used specification of date/times is given by ISO !8601:2004, which is used as the normative basis for both string literal representation and properties used within openEHR. The types are shown in FIGURE 4.

Any

Ordered

TIME_DEFINITIONS

ISO 8601 semantics not used in openEHR include:

“expanded” dates, which have year numbers of greater than 4 digits, and may be negative; in openEHR, only 4-digit year numbers are assumed;
the YYYY-WW-DD method of expressing dates (since this is imprecise and difficult to compute with due to variable week starting dates, and not required in health);
partial date/times with fractional minutes or hours, e.g. hh,hhh or mm,mm; in openEHR, only fractional seconds are supported;
the interval syntax. Intervals of date/times are supported in openEHR, but their syntax form is defined by ADL, and is standardised across all comparable types, not just dates and times.

Deviations from the published standard include the following:

durations are supposed to take the form of PnnW or PnnYnnMnnDTnnHnnMnnS, but in openEHR, the W (week) designator can be used in combination with the other designators, since it is very common to state durations of pregnancy as some combination of weeks and days.
partial variants of ISO8601_DATE_TIME can include missing hours, days and months, whereas ISO !8601:2004 (section 4.3.3 c) only allows missing seconds and minutes. The reasons for this deviation are:

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-the same deviation is used in HL7v2 and HL7v3 TS (timestamp) type, i.e. there are data in existing clinical systems matching this specification;

-in a typed object model, this deviation is more sensible anyway; the ISO 8601 rule is most likely a limitation of the purely syntactic means of expression. In real systems where a timestamp/date-time is specified in a screen form, it makes sense to allow it to be as partial as possible, rather than artifically restricted to only missing seconds and minutes.

the time !24:00:00 (or 240000) is not allowed anywhere, whereas in ISO8601:2004 it appears to be legal at least for times. This deviation is also appears to be used in HL7v2 and HL7v3 (where midnight is defined as the time !00:00:00), and is preferable to the documented standard, since a date/time with time of !24:00:00 is really the next day, i.e. the date part is then incorrect.

The following class definitions provide an object-oriented expression of the semantics of the subset of ISO !8601:2004 used by openEHR.

See http://www.cl.cam.ac.uk/~mgk25/iso-time.html and the official ISO standard for ISO 8601 details. Note that in the date, time and date_time formats shown below, ‘Z’ and ‘T’ are literals. In the duration class shown below, ‘P’, ‘Y’, ‘M’, ‘W’, ‘D’, ‘H’, ‘S’ and ‘T’ are literals.

3.4.1 TIME_DEFINITIONS Class

INTERFACE	TIME_DEFINITIONS
Purpose	Definitions for date/time classes. Note that the timezone limits are set by where the international dateline is. Thus, time in New Zealand is quoted using !+12:00, not !-12:00.
Constants	Signature	Meaning
1..1	Seconds_in_minute: Integer = 60
1..1	Minutes_in_hour: Integer = 60
1..1	Hours_in_day: Integer = 24
1..1	Nominal_days_in_month: Real = 30.42	Used for conversions of durations containing months to days and / or seconds.
1..1	Max_days_in_month: Integer = 31	Used for validity checking.
1..1	Days_in_year: Integer = 365
1..1	Days_in_leap_year: Integer = 366
1..1	Max_days_in_year: Integer = Days_in_leap_year	Used for validity checking.

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INTERFACE	TIME_DEFINITIONS
1..1	Nominal_days_in_year: Real = 365.24	Used for conversions of durations containing years to days and / or seconds.
1..1	Days_in_week: Integer = 7
1..1	Months_in_year: Integer = 12
1..1	Min_timezone_hour: Integer ensure Result = 12	Minimum hour value of a timezone (note that the -ve sign is supplied in the ISO8601_TIMEZONE class).
1..1	Max_timezone_hour: Integer ensure Result = 13	Maximum hour value of a timezone.
Functions	Signature	Meaning
valid_year (y: Integer): Boolean ensure Result = y >= 0		True if y >= 0
valid_month (m: Integer): Boolean ensure Result = m >= 1 and m <= Months_in_year		True if m >= 1 and m <= Months_in_year
valid_day (y, m, d: Integer): Boolean ensure Result = d >= 1 and d <= days_in_month(m, y)		True if d >= 1 and d <= days_in_month(m, y)
valid_hour (h, m, s: Integer): Boolean ensure Result = (h >= 0 and h < Hours_in_day) or (h = Hours_in_day and m = 0 and s = 0)		True if (h >= 0 and h < Hours_in_day) or (h = Hours_in_day and m = 0 and s = 0)
valid_minute (m: Integer): Boolean ensure Result = m >= 0 and m < Minutes_in_hour		True if m >= 0 and m < Minutes_in_hour

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INTERFACE	TIME_DEFINITIONS
valid_second (s: Integer): Boolean ensure Result = s >= 0 and s < Seconds_in_minute		True if s >= 0 and s < Seconds_in_minute
valid_fractional_second (fs: Double): Boolean ensure Result = fs >= 0.0 and fs < 1.0		True if fs >= 0.0 and fs < 1.0
Invariants

3.4.2 ISO8601_DATE Class

INTERFACE	ISO8601_DATE
Purpose	Represents an absolute point in time, as measured on the Gregorian calendar, and specified only to the day.
Inherit	ORDERED, TIME_DEFINITIONS
Function	Signature	Meaning
as_string: String		ISO8601 string for date, in format YYYYMMDD or YYYY-MM-DD, or a partial invariant. See valid_iso8601_date for validity.
year: Integer		Year.
month: Integer require not month_unknown		Month in year.
day: Integerrequire not day_unknown		Day in month.
month_unknown: Boolean		Indicates whether month in year is unknown. If so, the date is of the form “YYYY”.
day_unknown: Boolean		Indicates whether day in month is unknown. If so, and month is known, the date is of the form “YYYY-MM” or “YYYYMM”.
is_partial: Boolean		True if this date is partial, i.e. if day or more is missing.

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INTERFACE	ISO8601_DATE
is_extended: Boolean		True if this date uses ‘-’ separators.
infix ‘<’ (other: like Current): Boolean		Arithmetic comparison with other date. True if this date is closer to the origin than other.
valid_iso8601_date		String is a valid ISO 8601 date, i.e. takes the
(s: String): Boolean		complete form: • YYYYMMDD or the extended form: • YYYY-MM-DD or one of the partial forms: • YYYYMM • YYYY or the equivalent extended form: • YYYY-MM Where: • YYYY is the string form of any positive number in the range “0000” - “9999” (zero-filled to four digits) • MM is “01” “12” (zero-filled to two digits) • DD is “01” - “31” (zero-filled to two digits) The combinations of YYYY, MM, DD numbers must be correct with respect to the Gregorian calendar.
Invariants	Year_valid: valid_year(year) Month_valid: not month_unknown implies valid_month(month) Day_valid: not day_unknown implies valid_day(year, month, day) Partial_validity: month_unknown implies day_unknown

3.4.3 ISO8601_TIME Class

INTERFACE	ISO8601_TIME
Purpose	Represents an absolute point in time from an origin usually interpreted as meaning the start of the current day, specified to the second. A small deviation to the ISO !8601:2004 standard in this class is that the time !24:00:00 is not allowed, for consistency with ISO8601_DATE_TIME.
Inherit	ORDERED, TIME_DEFINITIONS
Function	Signature	Meaning

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INTERFACE	ISO8601_TIME
as_string: String		ISO8601 string for time, i.e. in form: hhmmss[,sss][Z\|±hh[mm]] or the extended form: hh:mm:ss[,sss][Z\|±hh[mm]], or a partial invariant. See valid_iso8601_time for validity.
hour: Integer		Hour in day, in 24-hour time.
minute: Integer require not minute_unknown		Minute in hour.
second: Integer require not second_unknown		Second in minute.
fractional_second: Double require not second_unknown		Fractional seconds.
has_fractional_second: Boolean		True if the fractional_second part is signficant (i.e. even if = 0.0).
timezone: ISO8601_TIMEZONE minute_unknown: Boolean		Time zone; may be Void. Indicates whether minute is unknown. If so, the time is of the form “hh”.

second_unknown: Boolean		Indicates whether second is unknown. If so and month is known, the time is of the form “hh:mm” or “hhmm”.
is_partial: Boolean		True if this time is partial, i.e. if seconds or more is missing.
is_extended: Boolean		True if this time uses ‘:’ separators.
is_decimal_sign_comma: Boolean		True if this time has a decimal part indicated by ‘,’ (comma) rather than ‘.’ (period).
infix ‘<’ (other: like Current): Boolean		Arithmetic comparison with other time. True if this date is closer to previous midnight than other.

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INTERFACE	ISO8601_TIME
valid_iso8601_time		String is a valid ISO 8601 date, i.e. takes the
(s: String): Boolean		form: • hhmmss[,sss][Z \| ±hh[mm]] or the extended form: • hh:mm:ss[,sss][Z \| ±hh[mm]] or one of the partial forms: • hhmm or hh or the extended form: • hh:mm with an additional optional timezone indicator of: • Z or ±hh[mm] Where: • hh is “00” - “23” (0-filled to two digits) • mm is “00” - “59” (0-filled to two digits) • ss is “00” - “60” (0-filled to two digits) • sss is any numeric string, representing an optional fractional second • Z is a literal meaning UTC (modern replacement for GMT), i.e. timezone +0000 • ±hh[mm], i.e. +hhmm, +hh, -hhmm, -hh indicating the timezone.
Invariants	Hour_valid: valid_hour(hour, minute, second) Minute_valid: not minute_unknown implies valid_minute(minute) Second_valid: not second_unknown implies valid_second(second) Fractional_second_valid: has_fractional_second implies (not second_unknown and valid_fractional_second(fractional_second)) Partial_validity: minute_unknown implies second_unknown

3.4.4 ISO8601_DATE_TIME Class

INTERFACE	ISO8601_DATE_TIME
Purpose	Represents an absolute point in time, specified to the second. Note that this class includes 2 deviations from ISO !8601:2004: • for partial date/times, any part of the date/time up to the month may be missing, not just seconds and minutes as in the standard; • the time !24:00:00 is not allowed, since it would mean the date was really on the next day.
Inherit	ORDERED, TIME_DEFINITIONS
Function	Signature	Meaning

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INTERFACE	ISO8601_DATE_TIME
as_string: String ensure valid_iso8601_date_time(Result)		ISO8601 string for date/time, in format YYYYMMDDThhmmss[,sss][Z \| ±hh[mm]] or in extended format YYYY-MM-DDThh:mm:ss[,sss][Z \| ±hh[mm]] or a partial variant; see valid_iso8601_date_time() below.
year: Integer		year
month: Integerrequire not month_unknown		month in year
day: Integerrequire not day_unknown		day in month
hour: Integerrequire not hour_unknown		hour in day
minute: Integer require not minute_unknown		minute in hour
second: Integerrequire not second_unknown		second in minute
fractional_second: Double require has_fractional_second		fractional seconds
has_fractional_second: Boolean		True if the fractional_second part is signficant (i.e. even if = 0.0).
timezone: ISO8601_TIMEZONE		Timezone; may be Void.
month_unknown: Boolean		Indicates whether month in year is unknown.
day_unknown: Boolean		Indicates whether day in month is unknown.
hour_unknown: Boolean		Indicates whether hour in day is known.
minute_unknown: Boolean		Indicates whether minute in hour is known.
second_unknown: Boolean		Indicates whether minute in hour is known.
is_partial: Boolean		True if this date is partial, i.e. if seconds or more is missing.

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INTERFACE	ISO8601_DATE_TIME
is_decimal_sign_comma: Boolean		True if this time has a decimal part indicated by ‘,’ (comma) rather than ‘.’ (period).
infix ‘<’ (other: like Current): Boolean		Arithmetic comparison with other date/time. True if this date/time is closer to origin than other.
is_extended: Boolean		True if this date/time uses ‘-’, ‘:’ separators.
valid_iso8601_date_time		String is a valid ISO 8601 date-time, i.e.
(s: String): Boolean		takes the form: • YYYYMMDDThhmmss[,sss] [Z \| ±hh[mm]] or the extended form: • YYYY-MM-DDThh:mm:ss[,sss] [Z \| ±hh[mm]] or one of the partial forms: • YYYYMMDDThhmm • YYYYMMDDThh or the equivalent extended forms: • YYYY-MM-DDThh:mm • YYYY-MM-DDThh (meanings as in DV_DATE, DV_TIME) and the values in each field are valid.
Invariants	Year_valid: valid_year(year) Month_valid: valid_month(month) Day_valid: valid_day(year, month, day) Hour_valid: valid_hour(hour, minute, second) Minute_valid: not minute_unknown implies valid_minute(minute) Second_valid: not second_unknown implies valid_second(second) Fractional_second_valid: has_fractional_second implies (not second_unknown and valid_fractional_second(fractional_second)) Partial_validity_year: not month_unknown Partial_validity_month: not month_unknown Partial_validity_day: not day_unknown Partial_validity_hour: not hour_unknown Partial_validity_minute: minute_unknown implies second_unknown

3.4.5 ISO8601_TIMEZONE Class

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INTERFACE	ISO8601_TIMEZONE
Inherit	TIME_DEFINITIONS
Function	Signature	Meaning
as_string: String		ISO8601 timezone string, in format • Z \| ±hh[mm] where: • hh is “00” - “23” (0-filled to two digits) • mm is “00” - “59” (0-filled to two digits) • Z is a literal meaning UTC (modern replacement for GMT), i.e. timezone +0000
hour: Integer		Hour part of timezone - in the range 00 - 13
minute: Integer require not minute_unknown		Minute part of timezone. Generally 00 or 30.
sign: Integer		Direction of timezone expresssed as +1 or -1.
is_gmt: Boolean		True if timezone is UTC, i.e. +0000
minute_unknown: Boolean		Indicates whether minute part known.
Invariants	Min_hour_valid: sign = -1 implies hour > 0 and hour <= Min_timezone_hour Max_hour_valid: sign = 1 implies hour > 0 and hour <= Max_timezone_hour Minute_valid: not minute_unknown implies valid_minute(minute) Sign_valid: sign = 1 or sign = -1

3.4.6 ISO8601_DURATION Class

INTERFACE	ISO8601_DURATION
Purpose	Represents a period of time corresponding to a difference between two time-points.
Inherit	ORDERED, TIME_DEFINITIONS
Function	Signature	Meaning
as_string: String		ISO8601 string for duration, in format • P[nnY][nnM][nnW][nnD][T[nnH][nnM][nnS]]
years: Integer		number of years of nominal 365-day length
months: Integer		number of months of nominal 30 day length
weeks: Integer		number of 7 day weeks

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INTERFACE	ISO8601_DURATION
days: Integer		number of 24 hour days
hours: Integer		number of 60 minute hours
minutes: Integer		number of 60 second minutes
seconds: Integer		number of seconds
fractional_second: Double		fractional seconds
infix ‘<’ (other: like Current): Boolean		Arithmetic comparison with other duration. True if this duration is smaller than other.
valid_iso8601_duration (s: String): Boolean		String is a valid ISO 8601 duration, i.e. takes the form: • P[nnY][nnM][nnW][nnD][T[nnH][nnM][nnS]] Where each nn represents a number of years, months, etc. nnW represents a number of 7day weeks. Note: allowing the W designator in the same expression as other designators is an exception to the published standard, but necessary in clinical information (typically for representing pregnancy duration).
is_decimal_sign_comma: Boolean		True if this time has a decimal part indicated by ‘,’ (comma) rather than ‘.’ (period).
to_seconds: Double		Total number of seconds equivalent (including fractional) of entire duration.
Invariants	years_valid: years >= 0 months_valid: months >= 0 weeks_valid: weeks >= 0 days_valid: days >= 0 hours_valid: hours >= 0 minutes_valid: minutes >= 0 seconds_valid: seconds >= 0 fractional_second_valid: fractional_second >= 0.0 and fractional_second < 1.0

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Identification Package

4.1 Overview

The rm.support.identification package describes a model of references and identifiers for information entities and is illustrated in FIGURE 5 .

identification

FIGURE 5 rm.support.identification Package

4.1.1 Requirements

Identification of entities both in the real world and in information systems is a non-trivial problem. The needs for identification across systems in a health information environment include the following:

real world identifiers such as social security numbers, veterans affairs ids etc can be recorded as required by health care facilities, enterprise policies, or legislation;
identifiers for informational entities which represent real world entities or processes should be unique;
it should be possible to determine if two identifiers refer to information entities that represent the same real world entity, even if instances of the information entities are maintained in different systems;
versions or changes to real-world entity-linked informational entities (which may create new information instances) should be accounted for in two ways:

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it should be possible to tell if two identifiers refer to distinct versions of the same

informational entity in the same version tree;

it should not be possible to confuse same-named versions of informational entities

maintained in multiple systems which purport to represent the same real world

entity. E.g. there is no guarantee that two systems’ “latest” version of the Person

“Dr Jones” is the same.

Medico-legal use of information relies on previous states of information being

distinguishable from other previous states and the current state.

It should be possible for an entity in one system or service (such as the EHR) to refer to an entity in another system or service in such a way that: -the target of the reference is easily finable within the shared environment, and

the reference does is valid regardless of the physical architecture of servers and applications.

The following subsections describe some of the features and challenges of identification.

Identification of Real World Entities (RWEs)

Real world entities such as people, car engines, invoices, and appointments can all be assigned identifiers. Although many of these are designed to be unique within a jurisdiction, they are often not, due to data entry errors, bad design (ids that are too small or incorporate some non-unique characteristic of the identified entities), bad process (e.g. non-synchronised id issuing points); identity theft (e.g. via theft of documents of proof or hacking). In general, while some real world identifiers (RWIs) are “nearly unique”, none can be guaranteed so. It should also be the case that if two RWE identifiers are equal, they refer to the same RWE, but this is often not the case. For practical purposes, RWIs cannot be regarded as computationally safe for making the inferences described here.

Identification of Informational Entities (IEs)

As soon as information systems are used to record facts about RWEs, the situation becomes more complex because of the intangible nature of information. In particular:

the same RWE can be represented simultaneously on more than one system (‘spatial multiplicity’);
the same RWE may be represented by more than one “version” of the same IE in a system (‘temporal multiplicity’).

At first sight, it appears that there can also be purely informational entities, i.e. IEs which do not refer to any RWE, such as books, online-only documents and software. However, as soon as one considers an example it becomes clear that there is always a notional ‘definitive’ or ‘authoritative’ (i.e. trusted) version of every such entity. These entities can better be understood as ‘virtual RWEs’. Thus it can still be said that multiple IEs may refer to any given RWE.

The underlying reason for the multiplicity of IEs is that ‘reality’ - time and space - in computer systems is not continuous but discrete, and each ‘entity’ is in fact just a snapshot of certain attribute values of a RWE, at a point in time, in a particular system. If identifiers are assigned to IEs without regard to versions or duplicates, then no assertion can be made about the identified RWE when two IE ids are compared.

Identification of Versions

The notion of ‘versioning’ applies only to informational entities, i.e. distinct instances of content each representing a snapshot of some logical entity. Where such instances are stored and managed in versioned containers within a versioning system of some kind, explicit identification of the versions is

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required. The requirements are discussed in detail in the Common IM, change_control package. They can be summarised as follows:

it must be possible to distinguish two versions of the same logical entity, i.e. know from the identifier if they are the same or different versions of the same thing;
it must be possible to distinguish two versions of the same logical entity created in two distinct systems;
it must be possible to tell the relationship between the items in a versioned lineage, from the version identifiers.

Referencing of Informational Entities

Within a distributed information environment, there is a need for entities not connected by direct references in the same memory space to be able to refer to each other. There are two competing requirements:

that the separation of objects in a distributed computing environment not compromise the semantics of the model;
that different types of information can be managed relatively independently; for example EHR and demographic information can be managed by different groups in an organisation or community, each with at least some freedom to change implementation and model details.

4.2 Design

This package models only informational identifiers, i.e. transparent identifiers understood by openEHR or related computational systems. Real World Entity Identifiers such as driver’s license numbers are modelled using the data type DV_IDENTIFIER. This is not to imply that such identifiers are any less systematic or well-managed than the system identifiers defined here, only that from the point of view of openEHR, they have the same status as other informational attributes such as name, address etc of a Person.

A key design decision has been to choose a string representation for all identifiers, with subparts being made available by appropriate functions which perform simple parsing on the string. This ensures that the data representation of identifiers (e.g. in XML) is as small as possible, while not losing object-oriented typing.

4.2.1 Primitive Identifiers

Three kinds of types are defined in this package. The abstract UIDtype and its subtypes correspond to permanent, computationally reliable, primitive identifiers. Such identifiers are regarded as ‘primitive’ because they are treated as having no further internal structure, in the sense that part of such an identifier is not in general meaningful. The three subtypes UUID, ISO_OID and INTERNET_ID all have these properties, and are commonly accepted ways of uniquely identifying entities in computer systems. In openEHR (and generally in health informatics) they are usually used as parts of other identifiers.

A consequence of the string representation approach used in these classes is that to set an attribute of type UID from a string value, as would be done when reading from a database, deserialising from XML or another text form, a piece of code that inspects the string structure has to be used in order to decide which of the subtypes of UID it is. This is a safe thing to do, since all three subtypes have mutually exclusive string patterns, and can easily be distinguished.

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4.2.2 Composite Identifiers

The OBJECT_ID type and its hierarchy of subtypes correspond to composite identifier types whose structure and semantics are defined by openEHR (rather than external organisations), and are the main means of identifying information items in an openEHR system. The abstract type UID_BASED_IDand its two subtypes HIER_OBJECT_IDand OBJECT_VERSION_IDprovide respectively, UID-based identifiers for non-versioned and versioned items. The design of the latter subtype is explained in the openEHR Common IM, change_control package.

The other subtypes, ARCHETYPE_ID and TERMINOLOGY_ID define different kinds of identifier, the former being a multi-axial identifier for archetypes, and the latter being a globally unique single string identifier for terminologies. The ARCHETYPE_ID class explicitly includes archetype version as part of the identifier, while terminology identifier values are assumed to include this, either as part of the name (e.g. as is done in the US National Library of Medicine UMLS identifiers - see http://www.nlm.nih.gov/research/umls/metaa1.html ), or according to the syntax defined in section 4.3.12 below.

Identifying Versions

The OBJECT_VERSION_ID defines the semantics of the scheme used in openEHR for identifying versions, and uses a three-part identifier, consisting of:

object_id: the identifier of the version container, in the form of an UID;

version_tree_id: the location in the version tree, as a 1- or 3-part numeric identifier, where the latter variant expresses branching; this is modelled using the VERSION_TREE_ID type;
creating_system_id: the identifier of the system in which this version was created, or type UID.

Under this scheme, multiple versions in the same container all have the same value for object_id, while their location in the version tree is given by the combination of the version tree identifier and the identifier of the creating system.

The requirements on the third part of the identifier are that it be unique per system, and that it be easy to obtain or generate. It is also helpful if it is a meaningful identifier. The two most practical candidates appear to be GUIDs (which are not meaningful, but are easy to generate) and reverse internet domain identifiers, as recommended in [3] (these are easy to determine if the system has an internet address, and are meaningful and directly processible, however unconnected systems pose a problem). ISO Oids might also be used. All of these identifier types are accommodated via the use of UID.

A full explanation of the version identification scheme and its capabilities is given in the change_control section of the Common IM.

4.2.3 References

All OBJECT_IDs are used as identifier attributes within the thing they identify, in the same way as a database primary key. To refer to an identified object from another object, an instance of the class OBJECT_REF should generally be used, in the same way as a database foreign key. The class OBJECT_REF is provided as a means of distributed referencing, and includes the object namespace (typically !1:1 with some service, such as “terminology”) and type. The general principle of object references is to be able to refer to an object available in a particular namespace or service. Usually they are used to refer to objects in other services, such as a demographic entity from within an EHR, but they may be used to refer to local objects as well. The type may be the concrete type of the referred-to object (e.g. “GP”) or any proper ancestor (e.g. “PARTY”).

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4.3 Class Descriptions

4.3.1 UID Class

CLASS	UID (abstract)
Purpose	Abstract parent of classes representing unique identifiers which identify information entities in a durable way. UIDs only ever identify one IE in time or space and are never re-used.
HL7	The HL7v3 UID Data type.
Attributes	Signature	Meaning
value: String		The value of the id.
Invariant	Value_exists: value /= Void and then not value.empty

4.3.2 ISO_OID Class

CLASS	ISO_OID
Purpose	Model of ISO’s Object Identifier (oid) as defined by the standard ISO/IEC 8824 . Oids are formed from integers separated by dots. Each non-leaf node in an Oid starting from the left corresponds to an assigning authority, and identifies that authority’s namespace, inside which the remaining part of the identifier is locally unique.
HL7	The HL7v3 OID Data type.
Inherit	UID
Functions	Signature	Meaning
Invariant

4.3.3 UUID Class

CLASS	UUID
Purpose	Model of the DCE Universal Unique Identifier or UUID which takes the form of hexadecimal integers separated by hyphens, following the pattern 8-4-4-4-12 as defined by the Open Group, CDE 1.1 Remote Procedure Call specification, Appendix A. Also known as a GUID.
HL7	The HL7v3 UUID Data type.
Inherit	UID

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CLASS	UUID
Functions	Signature	Meaning
Invariant

4.3.4 INTERNET_ID Class

CLASS	INTERNET_ID
Purpose	Model[[BR]of a reverse internet domain, as used to uniquely identify an internet domain. In the form of a dot-separated string in the reverse order of a domain name, specified by IETF RFC 1034 (http://www.ietf.org/rfc/rfc1034.txt).]
Inherit	UID
Functions	Signature	Meaning
Invariant

4.3.4.1 Syntax

According to IETF RFC1034, the syntax of a domain name follows the BNF grammar:

letter: any one of the 52 alphabetic characters A through Z in upper case and a through z in lower case

digit: any one of the ten digits 0 through 9

It can also be expressed using the regular expression:

[a-zA-Z]([a-zA-Z0-9-]*[a-zA-Z0-9])?(\.[a-zA-Z]([a-zA-Z0-9-]*[a-zA-Z0-9]))*

4.3.5 OBJECT_ID Class

CLASS	OBJECT_ID (abstract)
Purpose	Ancestor class of identifiers of informational objects. Ids may be completely meaningless, in which case their only job is to refer to something, or may carry some information to do with the identified object.
Use	Object ids are used inside an object to identify that object. To identify another object in another service, use an OBJECT_REF, or else use a UID for local objects identified by UID. If none of the subtypes is suitable, direct instances of this class may be used.

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CLASS	OBJECT_ID (abstract)
Attributes	Signature	Meaning
value: String		The value of the id in the form defined below.
Invariant	Value_exists: value /= Void and then not value.empty

4.3.6 UID_BASED_ID Class

CLASS	UID_BASED_ID (abstract)
Purpose	Abstract model of UID-based identifiers consisting of a root part and an optional extension; lexical form: root ‘::’ extension
Inherit	OBJECT_ID
Functions	Signature	Meaning
1..1	root: UID	The identifier of the conceptual namespace in which the object exists, within the identification scheme. Returns the part to the left of the first ‘::’ separator, if any, or else the whole string.
1..1	extension: String	Optional local identifier of the object within the context of the root identifier. Returns the part to the right of the first ‘::’ separator if any, or else any empty String.
has_extension: Boolean		True if extension /= Void
Invariant	Root_valid: root /= Void Extension_validity: extension /= Void Has_extension_validity: extension.is_empty xor has_extension

4.3.6.1 Identifier Syntax

The syntax of the value attribute by default follows the following production rules (EBNF):

value: root [ ‘::’ extension ] root: uid -- see UID above extension: string

4.3.7 HIER_OBJECT_ID Class

Concrete type corresponding to hierarchical identifiers of the form defined by UID_BASED_ID.

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CLASS	HIER_OBJECT_ID
HL7	The HL7v3 II Data type.
Inherit	UID_BASED_ID
Functions	Signature	Meaning
Invariant

4.3.8 OBJECT_VERSION_ID Class

CLASS	OBJECT_VERSION_ID
Purpose	Globally unique identifier for one version of a versioned object; lexical form: object_id ‘::’ creating_system_id ‘::’ version_tree_id
Inherit	UID_BASED_ID
Functions	Signature	Meaning
1..1	object_id: UID	Unique identifier for logical object of which this identifier identifies one version; normally the object_id will be the unique identifier of the version container containing the version referred to by this OBJECT_VERSION_ID instance.
1..1	version_tree_id: VERSION_TREE_ID	Tree identifier of this version with respect to other versions in the same version tree, as either 1 or 3 part dot-separated numbers, e.g. “1”, “2.1.4”.
1..1	creating_system_id: UID	Identifier of the system that created the Version corresponding to this Object version id.
is_branch: Boolean		True if this version identifier represents a branch.
Invariants	Object_valid: object_id /= Void Version_tree_id_valid: version_tree_id /= Void creating_system_id_valid: creating_system_id /= Void

4.3.8.1 Identifier Syntax

The string form of an OBJECT_VERSION_ID stored in its value attribute consists of three segments separated by double colons (“::”), i.e. (EBNF):

value: object_id ‘::’ creating_system_id ‘::’ version_tree_id object_id: uid -- see UID below creating_system_id:

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An example is as follows:

F7C5C7B7-75DB-4b39-9A1E-C0BA9BFDBDEC::87284370-2D4B4e3d-A3F3-F303D2F4F34B::2

4.3.9 VERSION_TREE_ID Class

CLASS	VERSION_TREE_ID
Purpose	Version tree identifier for one version. Lexical form: trunk_version [ ‘.’ branch_number ‘.’ branch_version ]
Attributes	Signature	Meaning
1..1	value: String	String form of this identifier.
Functions	Signature	Meaning
1..1	trunk_version: String	Trunk version number; numbering starts at 1.
0..1	branch_number: String	Number of branch from the trunk point; numbering starts at 1.
0..1	branch_version: String	Version of the branch; numbering starts at 1.
1..1	is_branch: Boolean	True if this version identifier represents a branch, i.e. has branch_number and branch_version parts.
1..1	is_first: Boolean	True if this version identifier corresponds to the first version, i.e. trunk_version = “1”
Invariants	Value_valid: value /= Void and then not value.is_empty Trunk_version_valid: trunk_version /= Void and then trunk_version.is_integer and then trunk_version.as_integer >= 1 Branch_number_valid: branch_number /= Void implies branch_number.is_integer and then branch_number.as_integer >= 1 Branch_version_valid: branch_version /= Void implies branch_version.is_integer and then branch_version.as_integer >= 1 Branch_validity: (branch_number = Void and branch_version = Void ) xor (branch_number /= Void and branch_version /= Void ) Is_branch_validity: is_branch xor branch_number = Void Is_first_validity: not is_first xor trunk_version.is_equal(“1”)

4.3.9.1 Syntax

The format of the value attribute is (EBNF):

value: trunk_version [ ‘.’ branch_number ‘.’ branch_version ] trunk_version: { digit }+ branch_number: { digit }+ branch_version: { digit }+

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4.3.10 ARCHETYPE_ID Class

CLASS	ARCHETYPE_ID
Purpose	Identifier for archetypes. Lexical form: rm_originator ‘-’ rm_name ‘-’ rm_entity ‘.’ concept_name { ‘-’ specialisation }* ‘.v’ number
Inherit	OBJECT_ID
Functions	Signature	Meaning
1..1	qualified_rm_entity: String	Globally qualified reference model entity, e.g. “openehr-composition-OBSERVATION”.
1..1	domain_concept: String	Name of the concept represented by this archetype, including specialisation, e.g. “biochemistry_result-cholesterol”.
1..1	rm_originator: String	Organisation originating the reference model on which this archetype is based, e.g. “openehr”, “cen”, “hl7”.
1..1	rm_name: String	Name of the reference model, e.g. “rim”, “ehr_rm”, “en13606”.
1..1	rm_entity: String	Name of the ontological level within the reference model to which this archetype is targeted, e.g. for openEHR, “folder”, “composition”, “section”, “entry”.
1..1	specialisation: String	Name of specialisation of concept, if this archetype is a specialisation of another archetype, e.g. “cholesterol”.
1..1	version_id: String	Version of this archetype.
Invariant	Qualified_rm_entity_valid: qualified_rm_entity /= Void and then not qualified_rm_entity.is_empty Domain_concept_valid: domain_concept /= Void and then not domain_concept.is_empty Rm_originator_valid: rm_originator /= Void and then not rm_originator.is_empty Rm_name_valid: rm_name /= Void and then not rm_name.is_empty Rm_entity_valid: rm_entity /= Void and then not rm_entity.is_empty Specialisation_valid: specialisation /= Void implies not specialisation.is_empty Version_id_valid: version_id /= Void and then not version_id.is_empty

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4.3.10.1 Archetype ID Syntax

Archetype identifiers are “multi-axial”, meaning that each identifier instance denotes a single archetype within a multi-dimensional space. In this case, the space is essentially a versioned 3-dimensional space, with the dimensions being:

reference model entity, i.e. target of archetype
domain concept
version

As with any multi-axial identifier, the underlying principle of an archetype id is that all parts of the id must be able to be considered immutable. This means that no variable characteristic of an archetype

(e.g. accrediting authority, which might change due to later accreditation by another authority, or may be multiple) can be included in its identifier. The syntax of an ARCHETYPE_ID is as follows (EBNF):

archetype_id: qualified_rm_entity ‘.’ domain_concept ‘.’ version_id

qualified_rm_entity: rm_originator ‘-’ rm_name ‘-’ rm_entity rm_originator: V_NAME rm_name: V_NAME rm_entity: V_NAME

domain_concept: concept_name { ‘-’ specialisation }* concept_name: V_NAME specialisation: V_NAME

version_id: ‘v’ V_NUMBER

NUMBER: [0-9]* NAME: [a-z][a-z0-9()/%$#&]*

The field meanings are as follows:

rm_originator: id of organisation originating the reference model on which this archetype is based;

rm_name: id of the reference model on which the archetype is based;

rm_entity: ontological level in the reference model;

domain_concept: the domain concept name, including any specialisations;

version_id: numeric version identifier;

Examples of archetype identifiers include:

openehr-composition-SECTION.physical_examination.v2 • openehr-composition-SECTION.physical_examination-prenatal.v1

hl7-rim-act.progress_note.v1 • openehr-composition-OBSERVATION.progress_note-naturopathy.v2

Archetypes can also be identified by other means, such as ISO oids.

4.3.11 TEMPLATE_ID Class

Identifier for templates. Lexical form to be determined.

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CLASS	TEMPLATE_ID
Inherit	OBJECT_ID
Functions	Signature	Meaning
Invariant

4.3.12 TERMINOLOGY_ID Class

CLASS	TERMINOLOGY_ID
Purpose	Identifier for terminologies such accessed via a terminology query service. In this class, the value attribute identifies the Terminology in the terminology service, e.g. “SNOMED-CT”. A terminology is assumed to be in a particular language, which must be explicitly specified. The value if the id attribute is the precise terminology id identifier, including actual release (i.e. actual “version”), local modifications etc; e.g. “ICPC2”. Lexical form: name [ ‘(’ version ‘)’ ]
Inherit	OBJECT_ID
Functions	Signature	Meaning
1..1	name: String	Return the terminology id (which includes the “version” in some cases). Distinct names correspond to distinct (i.e. non-compatible) terminologies. Thus the names “ICD10AM” and “ICD10” refer to distinct terminologies.
1..1	version_id: String	Version of this terminology, if versioning supported, else the empty string.
Invariants	Name_valid: name /= Void and then not name.is_empty Version_id_valid: version_id /= Void

4.3.12.1 Identifier Syntax

The syntax of the value attribute is as follows:

name [ ‘(’ version ‘)’ ]

Examples of terminology identifiers include:

“snomed-ct”
“ICD9(1999)”

Versions should only be needed for those terminologies which break the rule that the thing being identified with a code loses or changes its meaning over versions of the terminology. This should not be the case for well known modern terminologies and ontologies, particularly those designed since the publication of Cimino’s ‘desiderata’ [1] of which the principle of “concept permanance” is appli-

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cable here - “A concept's meaning cannot change and it cannot be deleted from the vocabulary”. However, there maybe older terminologies, or specialised terminologies which may not have obeyed these rules, but which are still used; version ids should always be used for these.

4.3.13 GENERIC_ID Class

CLASS	GENERIC_ID
Purpose	Generic identifier type for identifiers whose format is othterwise unknown to openEHR. Includes an attribute for naming the identification scheme (which may well be local).
Inherit	OBJECT_ID
attributes	Signature	Meaning
1..1	scheme: String	Name of the scheme to which this identifier conforms. Ideally this name will be recognisable globally but realistically it may be a local ad hoc scheme whose name is not controlled or standardised in any way.
Invariants	Scheme_valid: scheme /= Void and then not scheme.is_empty

4.3.14 OBJECT_REF Class

CLASS	OBJECT_REF
Purpose	Class describing a reference to another object, which may exist locally or be maintained outside the current namespace, e.g. in another service. Services are usually external, e.g. available in a LAN (including on the same host) or the internet via Corba, SOAP, or some other distributed protocol. However, in small systems they may be part of the same executable as the data containing the Id.
Attributes	Signature	Meaning
1..1	id: OBJECT_ID	Globally unique id of an object, regardless of where it is stored.
1..1	namespace: String	Namespace to which this identifier belongs in the local system context (and possibly in any other openEHR compliant environment) e.g. “terminology”, “demographic”. These names are not yet standardised. Legal values for the namespace are “local” \| “unknown” \| “[a-zAZ][a-zA-Z0-9_-:/&+?]*”

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CLASS	OBJECT_REF
1..1	type: String	Name of the class (concrete or abstract) of object to which this identifier type refers, e.g. “PARTY”, “PERSON”, “GUIDELINE” etc. These class names are from the relevant reference model. The type name “ANY” can be used to indicate that any type is accepted (e.g. if the type is unknown).
Invariant	Id_exists: id /= Void Namespace_exists: namespace /= Void and then not namespace.is_empty Type_exists: type /= Void and then not type.is_empty

4.3.15 ACCESS_GROUP_REF Class

CLASS	ACCESS_GROUP_REF
Purpose	Reference to access group in an access control service.
Inherit	OBJECT_REF
Functions	Signature	Meaning
Invariant	Type_validity: type.is_equal(“ACCESS_GROUP”)

4.3.16 PARTY_REF Class

CLASS	PARTY_REF
Purpose	Identifier for parties in a demographic or identity service. There are typically a number of subtypes of the PARTY class, including PERSON, ORGANISATION, etc. Abstract supertypes are allowed if the referenced object is of a type not known by the current implementation of this class (in other words, if the demographic model is changed by the addition of a new PARTY or ACTOR subtypes, valid PARTY_REFs can still be constructed to them).
Inherit	OBJECT_REF
Functions	Signature Meaning Type_validity: type.is_equal(“PERSON”) or type.is_equal(“ORGANISATION”) or type.is_equal(“GROUP”) or type.is_equal(“AGENT”)or type.is_equal(“ROLE”) or type.is_equal(“PARTY”) or type.is_equal(“ACTOR”)
Invariant

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4.3.17 LOCATABLE_REF Class

CLASS	LOCATABLE_REF
Purpose	Reference to a LOCATABLE instance inside the top-level content structure inside a VERSION<T>; the path attribute is applied to the object that VERSION.data points to.
Inherit	OBJECT_REF
Attributes	Signature	Meaning
1..1 (redefined)	id: OBJECT_VERSION_ID	The identifier of the Version.
0..1	path: String	The path to an instance in question, as an absolute path with respect to the object found at VERSION.data. An empty path means that the object referred to by id being specified.
Functions	Signature	Meaning
1..1	as_uri: String	A URI form of the reference, created by concatenating the following: “ehr://” + id.value + “/” + path
Invariant	Path_valid: path /= Void implies not path.is_empty

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Terminology Package

5.1 Overview

This section describes the terminology package, which contains classes for accessing terminologies and code sets, including the openEHR Support Terminology, from within instances of classes defined in the reference model. The classes shown here would normally be inherited via the classes EXTERNAL_ENVIRONMENT_ACCESS and OPENEHR_DEFINITIONS, although the exact details of how this is done may vary depending on implementation language.

5.2 Service Interface

5.2.1 Code Sets

In any case, code sets needed within the openEHR models themselves (e.g. for attributes whose value is a language code) are not referred to directly by an external name such as “ISO_639-1”, but via an internal constant, in this case, the constant Code_set_id_languages, whose value is defined to be “languages”. These constants are defined in the class OPENEHR_CODE_SET_IDENTIFIERS in FIGURE

The mapping between the internal identifiers and external names should be done in configuration files. The service function TERMINOLOGY_SERVICE.code_set_for_id() is used to retrieve code sets on the basis of a constant. The current mapping and external identifiers assumed in openEHR is defined in the openEHR Support Terminology document. This use of indirection is employed to ensure that the obsoleting and superseding of code-sets does not directly affect openEHR software.

For code sets not mapped to internally used constants, i.e. code sets not required in the openEHR model itself, but otherwise known in the terminology service, the function TERMINOLOGY_SERVICE.code_set() can be used to retrieve these code sets by their external identifier.

5.2.2 Terminologies

Terminologies, including the openEHR Support Terminology are accessed via the TERMINOLOGY_SERVICEfunctions terminology() and terminology_identifiers(), where the argument includes “openehr”, “centc251” (for CEN TC/251codes) and names from the US NLM terminologies list (see below). The openEHR Terminology supports groups, and the set of groups required by the reference model is defined in the class OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS. These groups correspond to coded attributes found in the openEHR Reference Model.

5.2.3 Terms and Codes in the openEHR Reference Model

True coded attributes in the Reference Model (i.e. attributes of type DV_CODED_TEXT), such as FEEDER_AUDIT.change_type are defined by an invariant in the enclosing class, such as the following:

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terminology

OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS

const Terminology_id_openehr: String is “openehr” const Group_id_audit_change_type: String is “audit change type” const Group_id_attestation_reason: String is “attestation reason” const Group_id_composition_category: String is “composition category” const Group_id_event_math_function: String is “event math function” const Group_id_instruction_states: String is “instruction states” const Group_id_instruction_transitions: String is “instruction transitions” const Group_id_null_flavours: String is “null flavours” const Group_id_property: String is “property” const Group_id_participation_function: String is “participation function” const Group_id_participation_mode: String is “participation mode” const Group_id_setting: String is “setting” const Group_id_term_mapping_purpose: String is “term mapping purpose” const Group_id_subject_relationship: String is “subject relationship” const Group_id_version_lifecycle_state: String is “version lifecycle state”

valid_group_id(an_id: String): Boolean

TERMINOLOGY_SERVICE

OPENEHR_CODE_SET_IDENTIFIERS

const Code_set_id_character_sets: String is “character sets” const Code_set_id_compression_algorithms: String is “compression algorithms” const Code_set_id_countries: String is “countries” const Code_set_id_integrity_check_algorithms: String is “integrity check algorithms” const Code_set_id_languages: String is “languages” const Code_set_id_media_types: String is “media types” const Code_set_id_normal_statuses: String is “normal statuses”

valid_code_set_id(an_id: String): Boolean

CODE_SET_ACCESS <<interface>>

id: Stringall_codes: Set<CODE_PHRASE> has_lang (...): Boolean has_code (...): Boolean terminology (name: String): TERMINOLOGY_ACCESS code_set (name: String): CODE_SET_ACCESS code_set_for_id (id: String): CODE_SET_ACCESS has_terminology (name: String): Boolean has_code_set (name: String): Boolean terminology_identifiers: List<String>openehr_code_sets: Hash<String, String> code_set_identifiers: List<String>

TERMINOLOGY_ACCESS <<interface>>

id: Stringall_codes: Set<CODE_PHRASE> codes_for_group_id (...): Set<CODE_PHRASE> codes_for_group_name (...): Set<CODE_PHRASE> has_code_for_group_id (...): Boolean rubric_for_code (...): String

FIGURE 6 rm.support.terminology Package

Support Information Model Terminology Package Rev 1.6.0

Change_type_valid:terminology(Terminology_id_openehr).has_code_for_group_id (Group_id_audit_change_type, change_type.defining_code)

This is a formal way of saying that the attribute change_type must have a value such that its defining_code (its CODE_PHRASE) is in the set of CODE_PHRASEs in the openEHR Terminology which are in the group whose indentifier is Group_id_audit_change_type.

A similar invariant is used for attributes of type CODE_PHRASE, which come from a code_set. The following invariant appears in the class ENTRY (rm.composition.content.entry package):

Language_valid: media_type /= Void and then code_set(Code_set_languages).has_code(language)

5.3 Identifiers

In openEHR, the identifier of a terminology or code set is found in the terminology_id attribute of the class CODE_PHRASE (Data Types Information Model, text package).

5.3.1 Code Set Identifiers

Internal code set identifiers (such as “languages”) used in openEHR are defined in the class OPENEHR_CODE_SET_IDENTIFIERS; assumed external identifiers (such as “ISO_639-1”) for code sets used by the openEHR Reference Model are defined in the openEHR Support Terminology document.

5.3.2 Terminology Identifiers

Valid identifiers that can be used for this attribute for terminologies include but are not limited to the following:

“openehr”
“centc251”
an identifier value from the first column of the US National Library or Medicine (NLM) UMLS terminology identifiers table below, in either of two forms:

-as is, e.g. “ICD10AM_2000”, “ICPC93”; -with any trailing section starting with an underscore removed, e.g. “ICD10AM”.

Other identification schemes are used in some standards, such as ISO Oids. These are not specified for direct use in openEHR for various reasons:

they are not currently used by the NLM, and no definitive published list of terminology identifiers is available;
ISO Oids are long identifiers and may significantly increase the size of persisted information due to the ubiquity of coded terms;
determing the identity of the terminology in data always requires a request to a service containing the Oid / name mapping;
there is a safety factor in having human readable terminology identifiers in the data.

The use of Oid-based or other terminology identification schemes is not however incompatible with openEHR; all that is required is a terminology identifier / name mapping service or table.

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The following table is a snapshot of the US National Library of Medicine UMLS terminology identifiers list. A definitive up-to-date list may be found on the NLM website at http://www.nlm.nih.gov/research/umls/metaa1.html .

UMLS 2003 Terminology Identifiers
Identifier	Description
AIR93	AI/RHEUM,1993
ALT2000	Alternative Billing Concepts, 2000
AOD2000	Alcohol and Other Drug Thesaurus, 2000
BI98	Beth Israel Vocabulary, 1.0
BRMP2002	Portuguese translation of the Medical Subject Headings, 2002
BRMS2002	Spanish translation of the Medical Subject Headings, 2002
CCPSS99	Canonical Clinical Problem Statement System, 1999
CCS99	Clinical Classifications Software, 1999
CDT4	Current Dental Terminology(CDT), 4
COSTAR_89-95	COSTAR, 1989-1995
CPM93	Medical Entities Dictionary, 1993
CPT01SP	Physicians' Current Procedural Terminology, Spanish Translation, 2001
CPT2003	Physicians' Current Procedural Terminology, 2003
CSP2002	CRISP Thesaurus, 2002
CST95	COSTART, 1995
DDB00	Diseases Database, 2000
DMD2003	German translation of the Medical Subject Headings, 2003
DMDICD10_1995	German translation of ICD10, 1995
DMDUMD_1996	German translation of UMDNS, 1996
DSM3R_1987	DSM-III-R, 1987
DSM4_1994	DSM-IV, 1994
DUT2001	Dutch Translation of the Medical Subject Headings, 2001
DXP94	DXplain, 1994
FIN2003	Finnish translations of the Medical Subject Headings, 2003
HCDT4	HCPCS Version of Current Dental Terminology(CDT), 4
HCPCS03	Healthcare Common Procedure Coding System, 2003
HCPT03	HCPCS Version of Current Procedural Terminology(CPT), 2003
HHC96	Home Health Care Classification, 1996
HL7_1998-2002	Health Level Seven Vocabulary, 1998-2002
HLREL_1998	ICPC2E-ICD10 relationships from Dr. Henk Lamberts, 1998
HPC99	Health Product Comparison System, 1999
ICD10AE_1998	ICD10, American English Equivalents, 1998
ICD10AMAE_2000	International Statistical Classification of Diseases and Related Health Problems, Australian Modification, Americanized English Equivalents, 2000
ICD10AM_2000	International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification, January 2000 Release
ICD10_1998	ICD10, 1998

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Support Information Model Terminology Package Rev 1.6.0

UMLS 2003 Terminology Identifiers
Identifier	Description
ICD9CM_2003	ICD-9-CM, 2003
ICPC2AE_1998	International Classification of Primary Care, Americanized English Equivalents, 2E, 1998
ICPC2E_1998	International Classification of Primary Care 2nd Edition, Electronic, 2E, 1998
ICPC2P_2000	International Classification of Primary Care, Version2-Plus, 2000
ICPC93	International Classification of Primary Care, 1993
ICPCBAQ_1993	ICPC, Basque Translation, 1993
ICPCDAN_1993	ICPC, Danish Translation, 1993
ICPCDUT_1993	ICPC, Dutch Translation, 1993
ICPCFIN_1993	ICPC, Finnish Translation, 1993
ICPCFRE_1993	ICPC, French Translation, 1993
ICPCGER_1993	ICPC, German Translation, 1993
ICPCHEB_1993	ICPC, Hebrew Translation, 1993
ICPCHUN_1993	ICPC, Hungarian Translation, 1993
ICPCITA_1993	ICPC, Italian Translation, 1993
ICPCNOR_1993	ICPC, Norwegian Translation, 1993
ICPCPAE_2000	International Classification of Primary Care ,Version2-Plus, Americanized English Equivalents, 2000
ICPCPOR_1993	ICPC, Portuguese Translation, 1993
ICPCSPA_1993	ICPC, Spanish Translation, 1993
ICPCSWE_1993	ICPC, Swedish Translation, 1993
INS2002	French translation of the Medical Subject Headings, 2002
ITA2003	Italian translation of Medical Subject Headings, 2003
JABL99	Online Congenital Multiple Anomaly/ Mental Retardation Syndromes, 1999
LCH90	Library of Congress Subject Headings, 1990
LNC205	LOINC, 2.05
LOINC	LOINC
MCM92	McMaster University Epidemiology Terms, 1992
MDDB99	MasterDrug DataBase, 1999
MDR51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), 5.1
MDRAE51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), American English Equivalents, 5.1
MDREA51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), American English, with expanded abbreviations, 5.1
MDREX51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), with expanded abbreviations, 5.1
MDRPOR51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), 5.1, Portuguese Edition

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Terminology Package Support Information Model Rev 1.6.0

UMLS 2003 Terminology Identifiers
Identifier	Description
MDRSPA51	Medical Dictionary for Regulatory Activities Terminology (MedDRA), 5.1, Spanish Edition
MIM93	Online Mendelian Inheritance in Man, 1993
MMSL01	Multum MediSource Lexicon, 2001
MMX01	Micromedex DRUGDEX, 2001-08
MSH2003_2002_10_24	Medical Subject Headings, 2002_10_24
MTH	UMLS Metathesaurus
MTHCH03	Metathesaurus CPT Hierarchical Terms, 2003
MTHHH03	Metathesaurus HCPCS Hierarchical Terms, 2003
MTHICD9_2003	Metathesaurus additional entry terms for ICD-9-CM, 2003
MTHMST2001	Metathesaurus Version of Minimal Standard Terminology Digestive Endoscopy, 2001
MTHMSTFRE_2001	Metathesaurus Version of Minimal Standard Terminology Digestive Endoscopy, French Translation, 2001
MTHMSTITA_2001	Metathesaurus Version of Minimal Standard Terminology Digestive Endoscopy, Italian Translation, 2001
NAN99	Classification of Nursing Diagnoses, 1999
NCBI2001	NCBI Taxonomy, 2001
NCI2001a	NCI Thesaurus, 2001a
NCISEER_1999	NCISEER ICD Neoplasm Code Mappings, 1999
NDDF01	FirstDataBank National Drug DataFile, 2001-07
NEU99	Neuronames Brain Hierarchy, 1999
NIC99	Nursing Interventions Classification, 1999
NOC97	Nursing Outcomes Classification, 1997
OMIM97	OMIM, Online Mendelian Inheritance in Man, 1997
OMS94	Omaha System, 1994
PCDS97	Patient Care Data Set, 1997
PDQ2002	Physician Data Query, 2002
PPAC98	Pharmacy Practice Activity Classification , 1998
PSY2001	Thesaurus of Psychological Index Terms, 2001
QMR96	Quick Medical Reference (QMR), 1996
RAM99	QMR clinically related terms from Randolph A. Miller, 1999
RCD99	Clinical Terms Version 3 (CTV3) (Read Codes), 1999
RCDAE_1999	Read thesaurus, American English Equivalents, 1999
RCDSA_1999	Read thesaurus Americanized Synthesized Terms, 1999
RCDSY_1999	Read thesaurus, Synthesized Terms, 1999
RUS2003	Russian Translation of MeSH, 2003
RXNORM_03AA	RXNORM Project, META2003AA
SNM2	SNOMED-2, 2
SNMI98	SNOMED International, 1998

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Support Information Model Terminology Package Rev 1.6.0

UMLS 2003 Terminology Identifiers
Identifier	Description
SNOMED-CT	SNOMED International Clinical Terms, 2002
SPN02	Standard Product Nomenclature, 2002
SRC	Metathesaurus Source Terminology Names
ULT93	UltraSTAR, 1993
UMD2003	UMDNS: product category thesaurus, 2003
UMLS	UMLS: National Library of Medicine, USA
UWDA155	University of Washington Digital Anatomist, 1.5.5
VANDF01	Veterans Health Administration National Drug File, 2001
WHO97	WHO Adverse Reaction Terminology, 1997
WHOFRE_1997	WHOART, French Translation, 1997
WHOGER_1997	WHOART, German Translation, 1997
WHOPOR_1997	WHOART, Portuguese Translation, 1997
WHOSPA_1997	WHOART, Spanish Translation, 1997

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Terminology Package Support Information Model Rev 1.6.0

5.4 Class Definitions

5.4.1 TERMINOLOGY_SERVICE Class

CLASS	TERMINOLOGY_SERVICE
Purpose	Defines an object providing proxy access to a terminology service.
Inherit	OPENEHR_CODE_SET_IDENTIFIERS, OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS
Functions	Signature	Meaning
terminology (name: String):		Return an interface to the terminology
TERMINOLOGY_ACCESS		named name. Allowable names include
require		• “openehr”
name /= Void and then has_terminology (name) ensure Result /= Void		• “centc251” • any name from are taken from the US NLM UMLS meta-data list at http://www.nlm.nih.gov/research/umls/metaa1.html
code_set (name: String): CODE_SET_ACCESS require name /= Void and then has_code_set (name) ensure Result /= Void		Return an interface to the code_set identified by the external identifier name (e.g. “ISO_639-1”).
code_set_for_id(id: String): CODE_SET_ACCESS require id /= Void and then valid_code_set_id (id) ensure Result /= Void has_terminology (name: String): Boolean require name /= Void and then not name.is_empty		Return an interface to the code_set identified internally in openEHR by id. True if terminology named name known by this service. Allowable names include • “openehr” • “centc251” • any name from are taken from the US NLM UMLS meta-data list at http://www.nlm.nih.gov/research/umls/metaa1.html

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Support Information Model Terminology Package Rev 1.6.0

CLASS	TERMINOLOGY_SERVICE
has_code_set (name: String): Boolean require name /= Void and then not name.is_empty		True if code_set linked to internal name (e.g. “languages”) is available.
terminology_identifiers: List<String>		Set of all terminology identifiers known in the terminology service. Values from the US NLM UMLS meta-data list at http://www.nlm.nih.gov/research/umls/metaa1.html
code_set_identifiers: List<String>		Set of all code set identifiers known in the terminology service.
openehr_code_sets: Hash<String, String>		Set of all code sets identifiers for which there is an internal openEHR name; returned as a Hash of ids keyed by internal name.
Invariants

5.4.2 TERMINOLOGY_ACCESS Class

CLASS	TERMINOLOGY_ACCESS
Purpose	Defines an object providing proxy access to a terminology.
Functions	Signature	Meaning
id: String		Identification of this Terminology
all_codes: Set<CODE_PHRASE>		Return all codes known in this terminology
codes_for_group_id (group_id: String): Set<CODE_PHRASE>		Return all codes under grouper ‘group_id’ from this terminology
has_code_for_group_id (group_id: String; a_code: CODE_PHRASE): Boolean codes_for_group_name (name, lang: String): Set<CODE_PHRASE>		True if ‘a_code’ is known in group ‘group_id’ in the openEHR terminology. Return all codes under grouper whose name in ‘lang’ is ‘name’ from this terminology

rubric_for_code (code, lang: String): String		Return all rubric of code ‘code’ in language ‘lang’.
Invariants	id_exists: id /= Void and then not id.is_empty

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Terminology Package Support Information Model Rev 1.6.0

5.4.3 CODE_SET_ACCESS Class

CLASS	CODE_SET_ACCESS
Purpose	Defines an object providing proxy access to a code_set.
Functions	Signature	Meaning
id: String		External identifier of this code set
all_codes: Set<CODE_PHRASE>		Return all codes known in this code set
has_lang (a_lang: CODE_PHRASE): Boolean		True if code set knows about ‘a_lang’
has_code (a_code: CODE_PHRASE): Boolean		True if code set knows about ‘a_code’
Invariants	Id_valid: id /= Void and then not id.is_empty

5.4.4 OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS Class

CLASS	OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS
Purpose	List of identifiers for groups in the openEHR terminology.
Constants	Signature	Meaning
Terminology_id: Stringis “openehr”		Name of openEHR’s own terminology
Group_id_audit_change_type: String is “audit change type”
Group_id_attestation_reason: String is “attestation reason”
Group_id_composition_category: Stringis “composition category”
Group_id_event_math_function: String is “event math function”
Group_id_instruction_states: Stringis “instruction states”
Group_id_instruction_transitions: String is “instruction transitions”
Group_id_null_flavours: String is “null flavours”

Date of Issue:08 Apr 2007 Page 58 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model Terminology Package Rev 1.6.0

CLASS	OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS
Group_id_property: Stringis “property”
Group_id_participation_function: Stringis “participation function”
Group_id_participation_mode: String is “participation mode”
Group_id_subject_relationship: String is “subject relationship”
Group_id_setting: String is “setting”
Group_id_term_mapping_purpose: String is “term mapping purpose”
Group_id_version_lifecycle_state: Stringis “version lifecycle state”
Functions	Signature	Meaning
valid_terminology_group_id (an_id: String): Boolean		Validity function to test if an identifier is in the set defined by this class.
Invariants

5.4.5 OPENEHR_CODE_SET_IDENTIFIERS Class

CLASS	OPENEHR_CODE_SET_IDENTIFIERS
Purpose	List of identifiers for code sets in the openEHR terminology.
Constants	Signature	Meaning
Code_set_id_character_sets: String is “character sets”
Code_set_id_compression_algorithms: Stringis “compression algorithms”
Code_set_id_countries: String is “countries”
Code_set_id_integrity_check_algorithms: Stringis “integrity check algorithms”
Code_set_id_languages: String is “languages”

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Terminology Package Support Information Model Rev 1.6.0

CLASS	OPENEHR_CODE_SET_IDENTIFIERS
Code_set_id_media_types: String is “media types”
Code_set_id_normal_statuses: String is “normal statuses”
Functions	Signature	Meaning
valid_code_set_id (an_id: String): Boolean		Validity function to test if an identifier is in the set defined by this class.
Invariants

Date of Issue:08 Apr 2007 Page 60 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model Measurement Package Rev 1.6.0

Measurement Package

6.1 Overview

The Measurement package defines a minimum of semantics relating to quantitative measurement, units, and conversion, enabling the Quantity package of the openEHR Data Types Information Model to be correctly expressed. As for the Terminology package, a simple service interface is assumed, which provides useful functions to other parts of the reference model. The definitions underlying measurement and units come from a variety of sources, including:

CEN ENV 12435, Medical Informatics - Expression of results of measurements in health sciences (see http://www.centc251.org );
the Unified Code for Units of Measure (UCUM), developed by Gunther Schadow and Clement J. McDonald of The Regenstrief Institute (available in HL7v3 ballot materials; http://www.hl7.org).

These of course rest in turn upon a vast amount of literature and standards, mainly from ISO on the subject of scientific measurement.

6.2 Service Interface

A simple measurement data service interface is defined according to FIGURE 7 , enabling quantitative semantics to be used formally from within the Reference Model. Note that this service as currently defined in no way seeks to properly model the semantics of units, conversions etc - it provides only the minimum functions required by the openEHR Reference Model.

measurement

MEASUREMENT_SERVICE

is_valid_units_string (units: String): Boolean units_equivalent (units1, units2: String): Boolean

FIGURE 7 rm.support.measurement Package
6.2.1	Class Definitions
6.2.1.1	MEASUREMENT_SERVICE Class

CLASS	MEASUREMENT_SERVICE
Purpose Functions	Defines an object providing proxy access to a measurement information service. Signature Meaning
is_valid_units_string (units: String): Boolean require units /= Void True if the units string ‘units’ is a valid string according to the HL7 UCUM specification.

Editors:{T Beale, S Heard}, {D Kalra, D Lloyd} Page 61 of 67 Date of Issue:08 Apr 2007

Measurement Package Support Information Model Rev 1.6.0

CLASS	MEASUREMENT_SERVICE
units_equivalent (units1, units2: String): Boolean require units1 /= Void and then is_valid_units_string(units1) units2 /= Void and then is_valid_units_string(units2)		True if two units strings correspond to the same measured property.
Invariants

Date of Issue:08 Apr 2007 Page 62 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model Definition Package Rev 1.6.0

Definition Package

7.1 Overview

The definitionpackage, illustrated in FIGURE 8, defines symbolic definitions used by the openEHR models. Only a small number are currently defined.

definition

BASIC_DEFINITIONS

CR: Character is ‘\015’ LF: Character is ‘\012’

OPENEHR_DEFINITIONS

FIGURE 8 rm.support.definition Package
7.2	Class Definitions
7.2.1	OPENEHR_DEFINITIONS Class

CLASS	OPENEHR_DEFINITIONS
Purpose	Inheritance class to provide access to constants defined in other packages.
Inherit	BASIC_DEFINITIONS
Attributes	Signature	Meaning
Invariants

7.2.2 BASIC_DEFINITIONS Class

CLASS	BASIC_DEFINITIONS
Purpose	Defines globally used constant values.
Attributes	Signature	Meaning
CR: Character is ‘\015’		Carriage return character
LF: Character is ‘\012’		Linefeed character
Invariants

Editors:{T Beale, S Heard}, {D Kalra, D Lloyd} Page 63 of 67 Date of Issue:08 Apr 2007

Definition Package Support Information Model Rev 1.6.0

Date of Issue:08 Apr 2007 Page 64 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model References Rev 1.6.0

A References

A.1	General
1	Cimino J J. Desiderata for Controlled Medical vocabularies in the Twenty-First Century. IMIA
WG6 Conference, Jacksonville, Florida, Jan 19-22, 1997.

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References Support Information Model Rev 1.6.0

Date of Issue:08 Apr 2007 Page 66 of 67 Editors:{T Beale, S Heard}, {D Kalra, D Lloyd}

Support Information Model

Rev 1.6.0

END OF DOCUMENT

Editors:{T Beale, S Heard}, {D Kalra, D Lloyd} Page 67 of 67 Date of Issue:08 Apr 2007

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© 2003-2007 The openEHR Foundation.

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Acknowledgements

Table of Contents

​5.4.4 OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS Class..58

Introduction

1.1 Purpose

1.2 Related Documents

1.3 Status

1.4 Peer review

1.5 Conformance

Support Package

2.1 Overview

definition

Assumed Types

3.1 Overview

3.2 Inbuilt Primitive Types

Octet

3.3 Assumed Library Types

String

3.3.1.1 UNICODE

3.3.2 Aggregate Type

3.4 Date/Time Types

Deviations from the published standard include the following:

Identification Package

4.1 Overview

4.1.1 Requirements

4.2 Design

4.2.1 Primitive Identifiers

4.2.2 Composite Identifiers

4.2.3 References

4.3.6.1 Identifier Syntax

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5.4.4 OPENEHR_TERMINOLOGY_GROUP_IDENTIFIERS Class..58