Standards for detailed clinical models as the basis for medical data exchange and decision support.
BACKGROUND
Detailed clinical models are necessary to exchange medical data between heterogeneous computer systems and to maintain consistency in a longitudinal electronic medical record system. At Intermountain Health Care (IHC), we have a history of designing detailed clinical models. The purpose of this paper is to share our experience and the lessons we have learned over the last 5 years.


METHODS
IHC's newest model is implemented using eXtensible Markup Language (XML) Schema as the formalism, and conforms to the Health Level Seven (HL7) version 3 data types. The centerpiece of the new strategy is the Clinical Event Model, which is a flexible name-value pair data structure that is tightly linked to a coded terminology.


CONCLUSIONS
We describe IHC's third-generation strategy for representing and implementing detailed clinical models, and discuss the reasons for this design.
Coyle
Joseph F
JF
Intermountain Health Care, and Department of Medical Informatics, University of Untah, Salt Lake City, UT, USA.
Mori
Angelo Rossi
AR
Huff
Stanley M
SM
D020000:Decision Support Systems, Clinical / Q000592:standards*; D006801:Humans; D008490:Medical Informatics; D008498:Medical Record Linkage / Q000379:methods*; D016347:Medical Records Systems, Computerized / Q000592:standards*; D017146:Models, Organizational; D011381:Programming Languages; D018511:Systems Integration