Federal Health Information Model (FHIM) Project Overview


Background

The Federal Health Information Model is a project under a larger program called the Federal Health Interoperability Modeling and Standards (FHIMS), which is an initiative of the Federal Health Architecture (FHA). Briefly, the United States federal government has established a Federal Enterprise Architecture(FEA), which provides guidance to federal agencies on how they should develop their enterprise architectures. The methodology used by FEA, the Federal Segment Architecture Methodology (FSAM) recognizes that some "lines of businesses" in which the federal government is engaged cross agency boundaries. The healthcare line of business is one such case. As a result, the FHA was established as a partnership of over 20 departments and agencies to coordinate Healthcare Information Technology (sometimes called Healthcare IT, or HIT) activities among those partners. The FHA is managed by the Office of the National Coordinator for Health IT (ONC). The FHA has served as a forum by which the partner agencies have collaborated on several important initiatives, including the Nationwide Health Information Network.

The FHIMS program is intended to coordinate the efforts of the partner agencies with respect to information and terminology standards, including the coordination of agency efforts at relevant Standards Development Organizations (SDOs) such as Health Level Seven (HL7), the National Council for Prescription Drug Programs (NCPDP), Integrating the Healthcare Enterprise (IHE), and others. Many of the partner agencies are already active in some of these SDOs, in which case the FHIMS program can help agencies speak with a single voice at the SDOs while also reducing redundant participation. For those agencies that do not yet have a presence in a particular SDO, this program provides a mechanism for agencies to delegate issues to another agency. For example, if the Department of Veterans Affairs (VA) is active in the Organization for the Advancement of Structured Information Standards (OASIS), and the Indian Health Service (IHS) is not, the FHIMS program provides an opportunity for IHS to learn of relevant OASIS activities, and for IHS to request the VA representatives to OASIS to champion a particular issue.

Another FHIMS initiative is the Federal Health Terminology Model project, which coordinates partner agency efforts to develop healthcare terminology models (i.e., new content), and to enumerate "value sets" that can be associated with the Information Model. The Terminology Model is closely related to the Information Model, as they are each describing the same real-world concepts from two different angles. The Information Modeling team will work very closely with the Terminology Modeling team to identify those concepts which should be enumerated in a value set, to define that value set, and to define the members of the value set.

FHIM

The FHIM project seeks to develop a common Logical Information Model or Computationally Independent Model (CIM), depending on what jargon one wishes to use, for use by the partner agencies. This model describes the information of importance to the agencies at a level of detail that is precise enough for business or clinical experts, but does not include implementation-platform specific details. For example, the FHIM might define a particular data element as a "string"; an implementation model targeting an Oracle database could be derived from the FHIM in which that data element might be defined as a VARCHAR(20).

The primary purpose of the FHIM is to provide a basis for the Information Architecture aspect of the partner agencies' Enterprise Architecture. Information which is common among partner agencies is defined in the FHIM - agencies would extend the FHIM with agency-specific requirements. Initially, we are concentrating on those data that are required for information exchange, especially those defined by the Health IT Standards Panel (HITSP) and/or required to achieve Meaningful Use of EHR criteria.

The FHIM was initially populated by existing models provided by the partner agencies, including the VHA Health Information Model, the BRIDG model, Structured Product Label, Common Product Model, Integrated Case Safety Report, and the Public Health Information Model Unfallversicherung Tarife. The FHIM is expressed in Unified Modeling Language (UML), and is organized by "domains", which are semi-arbitrary groupings of related information. For example, the FHIM contains a Laboratory domain and a Pharmacy domain. The organization by domain also facilitates the management of the modeling efforts, as the work is broken into manageable parts. As each domain is analyzed, relevant content from SDOs such as HL7 are also studied. Among the goals of the project is that an implementation compliant with the FHIM would also be compliant to - or be easily mapped to - the appropriate industry standard. Since the members of the FHIM project are also active in the various SDOs, it is anticipated that any changes needed to the standards can be communicated to the SDO by team members.

One of the barriers to the uptake of healthcare industry standards is that there are multiple standards which sometimes overlap or have gaps between them. These standards are very different from one another, and several have been developed without the benefit of an overarching model to ensure consistency within the standards. A secondary goal of the FHIM project is to provide a single model that covers the concepts of the differing standards in such a way that the concepts could be mapped to the original standards. This effort could be used to "harmonize" the standards themselves through agency participation directly in the SDOs or in collaborative efforts such as the SDO Coordinating Organization (SCO).

The FHIM capitalizes on advanced use of Model Driven Architecture (MDA) techniques, which allows us to generate from the FHIM other models that are more suited for particular purposes. This model-to-model transformation is critical to the FHIM's success. The FHIM model is a Computationally Independent Model (CIM) expressed in the Unified Modeling Language (UML). This CIM can be transformed into a Platform Specific Model (PSM) through a transformation process. Often, some additional information is needed in order to inform the transformation. This information can be stored in a UML Profile. While it is commonly understood that a UML model can be converted to source code such as Java, we've discovered that one can target multiple platforms with a single model with a judicious use of UML Profiles. An important insight is that HL7 Version 3 or NIEM can be considered a "platform" for the purposes of artifact generation.
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Additional contributors are welcome. Anyone wishing to participate or contribute, see the telecon and meeting schedules and/or contact one of the persons listed at the bottom of this page.


Models, Source Code, and other Artifacts

We have set up a project space under the auspices of Open Health Tools (OHT). This allows us to use the version control system hosted by OHT. Please contact Galen Mulrooney for access. Please see www.fhims.org for more details.

Teleconference Information

When: Every Friday afternoon at 2:30 Eastern
Where:
Live Meetings will be set up as needed