| Detailed clinical models (DCMs) are the basis for retaining computable meaning when data are exchanged between heterogeneous computer systems. DCMs are also the basis for shared computable meaning when clinical data are referenced in decision support logic, and they provide a basis for data consistency in a longitudinal electronic medical record. Intermountain Healthcare has a long history in the design and evolution of these models, beginning with PAL (PTXT Application Language) and then the Clinical Event Model, which was developed in partnership with 3M. After the partnership between Intermountain and 3M dissolved, Intermountain decided to design a next-generation architecture for DCMs. The aim of this research is to develop a detailed clinical model architecture that meets the needs of Intermountain Healthcare and other healthcare organizations.;The approach was as follows: 1. An updated version of the Clinical Event Model was created using XML Schema as a formalism to describe models. 2. In response to problems with XML Schema, The Clinical Element Model was designed and created using Clinical Element Modeling Language as a formalism to describe models. 3. To verify that our model met the needs of Intermountain Healthcare and others, a desiderata for Detailed Clinical Models was developed. 4. The Clinical Element Model is then critiqued using the desiderata as a guide, and suggestions for further refinements to the Clinical Element Model are described. |
