title: Standards for detailed clinical models as the basis for medical data exchange and decision support.
abstract: 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.
authors.affiliation: Intermountain Health Care, and Department of Medical Informatics, University of Untah, Salt Lake City, UT, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Coyle
authors.forename: Angelo Rossi
authors.initials: AR
authors.lastname: Mori
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Huff
mesh_terms: 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