1
Connec ing HL7 wi h so wa e analysis. A model-based app oach.docx
Connec ing HL7 wi h so wa e analysis. A model-based app oach
A. Ma ínez-Ga cía
1
, M.J. Escalona
2
and C.L. Pa a-Calde ón
1
1
Technological Inno a ion G oup, “Vi gen del Rocío” Uni e si y Hospi al, Se ille, Spain
2
Web Enginee ing and Ea ly Tes ing esea ch g oup, Uni e si y o Se ille, Se ille, Spain
Abs ac —HL7 is an in e na ional o ganiza ion ha de ines
s anda ds on heal h in o ma ion sys ems. Mos HL7 domain
in o ma ion models a e designed acco ding o an own g aphic
language. All his domain models a e based in a unique me a-
model. In he las yea s, many esea che s ha e conside ed he
possibili y o using HL7 in he Model D i en Enginee ing
(MDE) con ex . Howe e , we ha e iden i ied a weakness: mos
MDE ools do no suppo HL7 own model language, bu all o
hem suppo UML s anda d model language. The p esen
esea ch a ea aims o connec HL7 wi h so wa e analysis
h ough a model-based app oach.
Keywo ds— HL7, Model D i en Enginee ing, Me amodel,
UML, Model In e change Fo ma .
I.
I
NTRODUCTION
HL7 (Heal h Le el 7) [1] is an in e na ional non-p o i
o ganiza ion ha p omo es and de ines s anda ds associa ed
wi h heal h in o ma ion sys ems. HL7 membe s de elop
s anda ds ela ed o exchange and modeling heal h in o ma-
ion, wi h he objec i e o suppo ing clinical p ac ice, man-
agemen , de elopmen and e alua ion in heal h se ices.
A domain model is a concep ual model ha desc ibes
concep s ela ed o he p oblem domain [2,3]. I copes wi h
concep s linked o he p oblem i sel , ins ead o desc ibing
so wa e sys em concep s.
HL7 de ines di e en domain models o explain each
wo king p oblem o scena io ha has been iden i ied
h oughou he p ocess. These concep ual schemes co e all
a eas ha ange om he necessa y in o ma ion o de ine
sys em messages o clinical documen s hemsel es.
Model D i en Enginee ing (MDE) [2,3] is a new pa a-
digm ha cen e s on models c ea ion and exploi a ion. Us-
ing MDE, we inc ease p oduc i i y since we maximize
compa ibili y among sys ems ( hanks o eu iliza ion), sim-
pli ying he design p ocess. Models ac as sys ems basis.
This way, we can sepa a e applica ions’ concep ual de ini-
ion om echnology whe e hey a e execu ed.
Fo his pu pose, me amodel is a undamen al concep
[2,3] as i desc ibes concep s used in a speci ic model.
The e a e many accep ed no a ions o ep esen me amodels.
In his case, we use UML class diag ams because hey a e
he no a ion used bo h in HL7 and UML.
HL7 has a me amodel, called Model In e change Fo ma
(MIF) [4], om which we can model all HL7 domain mod-
els. HL7 has de eloped i s own g aphic language o model
i s models elemen s. Conside ing he wide ange o en i ies
ha MIF needs o co e o collec all he necessa y concep s
in a gene al heal h sys em, we mus a gue ha MIF is e y
ex ensi e and is p esen ed in such an abs ac way ha ,
al hough i esul s e y in e es ing om he concep ual poin
o iew, i can be di icul o manage.
Keeping in mind ha HL7 models a e modeled in hei
own g aphic language and he ex ension hey p esen o
co e all he necessa y en i ies in a heal h sys em, we hink
ha designing a so wa e solu ion ha should ul ill a HL7
s anda d is no an easy ask o a so wa e enginee . By
con as , so wa e enginee s gene ally know UML and hey
can design solu ions by means o his s anda d. Besides,
he e a e many MDE ools ha , h ough a UML model,
ca y ou a se ies o ac ions au oma ically, such as gene a -
ing code o documen a ion.
The e o e, wo king o connec HL7 wi h so wa e analy-
sis has been ele an o us. Ou long- e m objec i e is ha
so wa e enginee s can design hei solu ions using he
UML me amodel and, in an au oma ic way, he HL7 me a-
model. Consequen ly, we would o e he capabili y o use
s anda d MDE ools ha need he p oblem o be modeled
wi h UML modeling, apa om simpli ying solu ions de-
sign.
This a icle, lays he ounda ion o his esea ch a ea ha
we ha e jus begun and is mo i a ed by ou p e ious expe-
iences, such as he Di aya Specialized A en ion p ojec
[5,6]. In ha p ojec , we ca ied ou a p ac ical expe ience in
he MDE con ex , consis ing in applying NDT (Na iga ion-
al De elopmen Techniques) Web Enginee ing me hodolo-
gy [7,8] when pe o ming he equi emen s and he analysis
phases in a la ge-scale Web sys em ha aimed o suppo
he heal h in o ma ion sys ems in Andalusia. This expe-
ience concluded ha MDE could educe he de elopmen
ime, as well as de ec s possible e o s o inconsis encies in
he ea ly phases.
The main a ge o he esea ch p esen ed in his pape is
o use he HL7 me amodel in he MDE con ex .
Figu e 1 illus a es he gene al p ocess ha we aim o
each h ough his esea ch.
2
Connec ing HL7 wi h so wa e analysis. A model-based app oach.docx
F
ig. 1 Solu ion using he HL7 me amodel in he MDE con ex
Seconda y goals:
• To p opose a solu ion using he bene i s o UML gene -
al p oposed s anda d, he s anda ds p oposed by HL7,
and MDE exis ing ools, o he so wa e enginee s
wo king in he heal hca e a ea.
• To acqui e a mo e comple e knowledge bo h o HL7
and UML me amodels.
• To ake ad an age o he po en ial o he exis ing ools
ha wo k wi h he new domain models exploi a ion pa-
adigm: MDE.
This pape is s uc u ed in he ollowing way: A e his
in oduc ion, Sec ion II e iews and p esen s p e ious expe-
iences. Then, Sec ions III and IV explain he me hod and
esul s, espec i ely. Finally, Sec ion V p o ides a discus-
sion and Sec ion VI s a es inal conclusions.
II.
P
REVIOUS EXPERIENCES
Some membe s o he HL7 communi y ha e conside ed
he need o using a modeling s anda d ins ead o he model-
ing language ha de ines he domain models gene a ed om
MIF.
P e ious expe iences ha e s udied he connec ion be-
ween HL7 2.X and UML s uc u es [9]. One o he i s
s eps o use HL7 in MDE con ex consis s in implemen ing
MIF in a compu e -wo kable language. The e a e expe-
iences o implemen a ion in compu e -wo kable languages
o speci ic domain model, o example HL7 3, bu hey do
no co e he HL7 me amodel comple ely [10].
A esea ch eam o he Poly echnic Uni e si y o Ca alu-
ña has conduc ed an expe ience in his same line. They
iden i ied di icul ies as a esul o he use o HL7 modeling
language, and p oposed ansla ing HL7 domain models in o
he UML nomencla u e. They e en implemen ed HL7 3
domain model ans o ma ions o UML models [11]. The
obs acle hey may ace is ha he global HL7 communi y
may no ind i con enien o abandon he o iginal MIF and,
consequen ly, hey may ejec he p oposal.
No p e ious s udies ha in end o use HL7 in he MDE
con ex making a co espondence be ween i s me amodel
elemen s and UML me amodel elemen s ha e been ound,
wi h he aim ha he so wa e enginee can use UML di ec -
ly (being able o ge help om all exis ing UML ools in he
MDE con ex ) and wo k au oma ically on he HL7 me amo-
del.
III.
M
ATERIALS AND METHODS
We a e wo king o each a solu ion in he MDE con ex
e alua ing he possibili y o associa ing bo h me amodels,
UML and HL7.
To ge his goal, i s ly we ha e concep ually analyzed
UML and HL7 me amodels and secondly, we ha e s udied
heo e ically he co espondence be ween hei elemen s.
Below, able 1 shows he esul o his co espondence
s udy.
T
able 1 Co espondence be ween bo h me amodels
HL7 Me amo-
del Diag am
HL7 Me amodel Elemen UML Me amodel
Elemen
In o ma ion Model
Class Class
A ibu e P ope y
S uc u al_a ibu e Di ec co espon-
dence no ound
Associa ion Associa ion
Composi e_agg ega ion Di ec co espon-
dence no ound
Gene aliza ion_ ela ionship Gene aliza ion
S a e S a e
Da a ypes and
Vocabula y domain
Da a_ ype Type
Da a_ ype_ca ego y Di ec co espon-
dence no ound
A ibu e_ ype TypedElemen
Vocabula y_concep Di ec co espon-
dence no ound
Domain_ e sion Di ec co espon-
dence no ound
Code_sys em Di ec co espon-
dence no ound
Coded_ e m Di ec co espon-
dence no ound
Concep _ ela ionship
Di ec co espon-
dence no ound
3
Connec ing HL7 wi h so wa e analysis. A model-based app oach.docx
Use cases and
In e ac ion
Ac o Ac o
Use_case UseCase
Use_case_ ela ionship Di ec edRela ion-
ship
S o yboa d Di ec co espon-
dence no ound
In e ac ion In e ac ion
Applica ion_ ole Di ec co espon-
dence no ound
Messages design
Design_in o ma ion_model Di ec co espon-
dence no ound
DIM_class_ ow Di ec co espon-
dence no ound
DIM_a ibu e_ ow Di ec co espon-
dence no ound
DIM_ ela ionship_ ow Di ec co espon-
dence no ound
DIM_s a e_ ow Di ec co espon-
dence no ound
Hie a chic-
al_message_desc ip ion
Di ec co espon-
dence no ound
HMD_class_ ow Di ec co espon-
dence no ound
HMD_a ibu e_ ow Di ec co espon-
dence no ound
HMD_ ela ionship_ ow Di ec co espon-
dence no ound
Message_ ype Di ec co espon-
dence no ound
As expec ed, he e a e many elemen s in he HL7 me a-
model ha we could no iden i y wi h UML (app oxima ely
65% agains 35% ha we could iden i y).
This is mainly because UML is a gene al s anda d and
HL7 is a speci ic s anda d (heal hca e) ha de ines speci ic
elemen s o heal h needs.
I is necessa y o seek a solu ion using all HL7 me amo-
del concep ual ichness in ou MDE solu ion. Fo his pu -
pose, we sugges he use o UML ex ensibili y mechanisms.
These ex ensibili y mechanisms enable UML o be p e-
sen ed as an open s anda d ha can model aspec s no p e-
iously co e ed in i s p incipal and gene al speci ica ion,
allowing us o b oaden he no a ion and seman ics o his
s anda d.
Once heo e ical ounda ions ha e been laid, we will use
model ans o ma ion echniques in he MDE con ex , by
ensu ing ha he esul s o hese ans o ma ions a e consis-
en wi h sou ce models. This ac will educe e o and
e o s, o hese echniques allow au oma ing models con-
s uc ion and ex gene a ion.
IV.
R
ESULTS
This esea ch a ea is cu en ly being add essed on a PhD
hesis wo k. E en hough he p esen wo k is s ill in i s ea ly
s ages, i has al eady p e ious expe iences, such as he Di-
aya Specialized A en ion p ojec men ioned a o e, which
cons i u es he i s p e ious expe ience on his esea ch
opic.
The sho - e m objec i e deals wi h designing a solu ion
in he MDE con ex o connec bo h me amodels, UML and
HL7, bu ocusing on equi emen s and analysis le els.
We would also like o es hese esul s in he NDT me-
hodology con ex [7,8]. This me hodology, de eloped
mainly in he so wa e p ojec s con ex , has been applied in
biosani a y ields ela ed o HL7 and o e s a sui able
amewo k o ocus he p ac ical assessmen o ou esul s.
In addi ion, we will execu e a p oo o concep in his line in
he con ex o OncoIn es p ojec (code PI-0116-2012) by
designing i s scena io based on he EHR unc ional model,
clinical esea ch p o ile o HL7 [12], and he e o e acco d-
ing o he HL7 me amodel unde lying o any model.
V.
D
ISCUSSION
HL7 in ol es many s anda ds de elopmen lines and
wo king g oups ocused on di e en objec i es. Each HL7
subg oup conduc s he wo k based on a domain model. All
hese domain models a e based on he same me amodel.
We ind i in e es ing o lead ou wo k o hese lines be-
low, once he co espondence be ween UML and HL7 me-
amodels has been s udied and he ans o ma ion be ween
models has been implemen ed:
• To design he so wa e sys ems models by means o he
UML s anda d and ob ain he HL7 co espondence au-
oma ically. The lea ning cu e o so wa e enginee s,
who would like o design hese sys ems in acco dance
wi h HL7, would be sho e as hey would model di ec -
ly in UML. Mos so wa e enginee s know UML, since
i is he mos commonly used concep ual model lan-
guage.
• To use UML-based ools. The e a e lo s o UML-based
ools, bo h in open-sou ce and p i a e ma ke s ha al-
low designing a sys em wi h UML. Addi ionally, he e
a e lo s o ools ha can use UML diag ams o make
easie so wa e enginee s wo k, such as NDT [7,8].
• To align, in a simple way, he concep s used in HL7
models wi h a sys em o concep s in a heal h scena io:
ISO 13940. S udying he co espondence be ween con-
cep s used in he HL7 me amodel is he only equisi e
o align all HL7 models wi h a s anda d sys em o con-
cep s, since all HL7 models a e based on he same me-
amodel.
4
Connec ing HL7 wi h so wa e analysis. A model-based app oach.docx
• To ce i y he compliance o HL7 domain models wi h
UML in o ma ion sys ems designed models. Once
UML models ha e been au oma ically ans o med in o
HL7 models, a ool ha epo s on e o s ound will be
designed. Thanks o Model- o-Model ans o ma ion
(M2M), we will be able o alida e models, as we will
speci y he me amodel wi h which he sou ce model
mus comply. I may be in e es ing o HL7 o ha e a
ool ha can alida e a UML equi emen model, which
should include he sys em equi emen s o HL7 unc-
ional model, in o de o ini ia e a alida ion p ocess o
he exis ing sys ems.
Mo eo e , ou esea ch mus ace up a challenge: We ex-
pec ha so wa e enginee s can design sys ems using
UML, and align hem au oma ically wi h HL7 me amodel.
Ne e heless, i aises he ollowing ques ion: Wha would
happen, i we wan ed hem o be aligned wi h a speci ic
HL7 model as, o example, RIM? We will ha e o ind a
solu ion o his challenge, and we may ge i by aligning
wi h HL7 De elopmen F amewo k (HDF).
VI.
C
ONCLUSIONS
Domain models p oposed by HL7 s anda ds a e e y in-
e es ing om a concep ual poin o iew despi e hey a e
e y complex. Fo his eason, so wa e enginee s who y
o design sys ems based on hese s anda ds may ind some
di icul ies when handling hem, oge he wi h a long lea n-
ing cu e.
Using HL7 s anda d in he MDE con ex emains an un-
explo ed a ea, om which many bene i s can be ob ained as
well as many esea ch a eas p o iding so wa e enginee s,
who y o design heal h in o ma ion sys ems wi h a solid
suppo .
A
CKNOWLEDGMENT
This esea ch p ojec has been suppo ed by he Tempos
p ojec (code TIN2010-20057-C03-02), he NDTQ-
F amewo k (code TIC-5789), he “Ca los III” Heal h Ins i-
u e wi hin he call S a egic Help in Heal h (PITeS p ojec ,
code PI09/90518) and RETICS Inno a ion in Heal hca e
Technology call (code RD09/0077/00025).
R
EFERENCES
1. HL7 o icial web page a h p://www.hl7.o g/
2. Schmid DC (2006) Model-D i en Enginee ing. IEEE Compu e
39(2):25-31 DOI 10.1109/MC.2006.58
3. Van De S ae en R, Mens T, Van Baelen S (2009) Challenges in
Model-D i en So wa e Enginee ing. Models in So wa e Enginee -
ing 5421:35-47 DOI 10.1007/978-3-642-01648-6_4
4. Sp onk R, Ringholm C (2010) The HL7 MIF - Model In e change
Fo ma . A h p://www. ingholm.com/docs/03060_en_HL7_MIF.h m
5. Escalona MJ, Pa a CL, Nie o J (2007)Di aya P ojec . The powe o
me amodels in eal expe iences wi h Web Enginee ing, P oceedings
o XI In e na ional Cong ess on P ojec Enginee ing (AEIPRO), Lu-
go, Spain, 2007, pp 167
6. Escalona MJ, Pa a CL, Ma ín FM, Nie o J, Lle gó A, Pé ez F (2008)
A P ac ical Example F om Model-D i en Web Reque imen s. In o -
ma ion Sys em De elopmen . Challenges in P ac ice, Theo y and
Educa ion 1:157-168
7. Escalona MJ, A agón G (2008) NDT a Model-D i en App oach o
Web Requi emen s. IEEE T ansac ions on So wa e Enginee ing
34:377-390 DOI 10.1109/TSE.2008.27
8. IWT2 Resea ch G oup a www.iw 2.o g
9. Oemig F, Blobel B (2011) A o mal analysis o HL7 e sion 2.x. S ud
Heal h Technol In o m 169:704-708 DOI 10.3233/978-1-60750-806-
9-704
10. Bán ai B, Ul ich B, Tö ök Z, Na a ajan R, I eland T (2009) Imple-
men ing an HL7 e sion 3 modeling ool om an Eco e model. S ud
Heal h Technol In o m 150:157-161 DOI 10.3233/978-1-60750-044-
5-157
11. O iz D, Villegas A, Sancho MR, Oli e A, Vilal a J (2011) Au oma ic
ans o ma ion o HL7 3 in o ma ion models in o equi alen UML
models. HL7 Spain Technical Repo .
12. HL7 EHR Clinical Resea ch Func ional P o ile (CRFP), Release 1 a
h p://www.hl7.o g/implemen /s anda ds/p oduc _b ie .c m?p oduc _i
d=16
Au ho : Alicia Ma ínez-Ga cía
Ins i u e: “Vi gen del Rocío” Uni e si y Hospi al
S ee : Manuel Siu o A enue
Ci y: Se ille
Coun y: Spain
Email: alicia.ma inez.ex s@jun adeandalucia.es