title: Clinical professional governance for detailed clinical models.
abstract: This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models. Finally, collections of clinical models do require a repository in which they can be stored, searched, and maintained. Governance of Detailed Clinical Models is required at local, national, and international levels.
authors.affiliation: ICT Innovations in Healthcare, Windesheim, Zwolle.
authors.forename: William
authors.initials: W
authors.lastname: Goossen
authors.forename: Anneke
authors.initials: A
authors.lastname: Goossen-Baremans
mesh_terms: D057286:Electronic Health Records / Q000458:organization & administration*; D063025:Health Information Management / Q000458:organization & administration*; D063005:Health Information Systems / Q000458:organization & administration*; D008490:Medical Informatics / Q000458:organization & administration*; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration*