The Detailed Clinical Model Library is a suite of logical models that underpins the national My Health Record system.
Each Detailed Clinical Model (DCM) and Structured Content Specification (SCS) is designed to be a shared basis for data interpretation. It specifies rigorous business and technical definitions of data that systems may need to share. It is intended to be a logical specification of the data to be persisted within or communicated between systems. It is also the foundation for the compliance, conformance and declaration process. Our CDA Implementation Guides are guides to the implementation of HL7™ CDA R2® messages based upon these DCMs and SCSs.
The logical model in the Australian context
The national logical model is a complex model, rich with information that is used across our specification library. In this model, the green, yellow and red circles represent different data types or common information components. The blue circles represent specifications – for example Event Summary and Shared Health Summary. Both specifications have links to almost all of the data types and/or information components. This shows the common link between specifications and the importance of understanding how change, even changes that may appear small and isolated, can have a ripple effect across our national logical model and may also impact other specifications.
Figure 1: Detailed Clinical Model Library
Below is our high-level national logical model which provides an overview of the complex relationships between our 20+ specifications.
Figure 2: Detailed Clinical Model Library - Zoomed to Higher Level
Each DCM specifies the data components required for any use of a clinical concept; for instance, an entry in a medical record such as a procedure or imaging test. As such, they are maximal data sets. DCMs are building blocks, which are trimmed to size for use in the construction of SCSs.
Each SCS describes a template of a structured document. It specifies the data for a single type of clinical document or information exchange, such as a discharge summary. It is assembled using DCMs that have been constrained to eliminate data components not relevant to the particular context. For example, the procedure section in a discharge summary uses only some of the data components required in a specialist report.
The Australian Digital Health Agency has provided the following clinical document specifications that apply to the information described above:
The Australian Digital Health Agency is actively engaging with the healthcare community to develop computable clinical content definitions known as detailed clinical models (DCMs).