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The section includes information about CBIIT internal initiatives and other standards that affect Semantic Infrastructure 2.0.

Office of the National Coordinator and National Health Standards

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The Health Level Seven International Standards Development Organization (HL7) is an international community, working together towards a common goal of improving patient care through technology. HL7 interoperability protocols include messaging standards, decision support standards, clinical document standards, Electronic Health Record (EHR) functional requirements, drug product labeling standards, and more. Many of these protocols are specifically called out in the meaningful use final rules for the HITECH Act.

In addition, HL7 defines Electronic Health Record (EHR) and Personal Health Record (PHR) functional requirements, which provide a reference list of functions that may be present in an EHR. The function list is described from a user perspective with the intent to enable consistent expression of system functionality. In 2009, the HL7 EHR-System Functional Model became an internationally recognized ISO standard (PDF of press release on the HL7 site), setting the stage to achieve common functionality of EHRs globally.

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The Clinical Document Architecture, a V3-based standard, provides an exchange model for clinical documents (such as discharge summaries and progress notes) - and brings the healthcare industry closer to the realization of an electronic medical record. CDA leverages the use of XML, the HL7 Reference Information Model (RIM) and coded vocabularies. RIM is the basis for the Clinical Document Architecture standard being adopted internationally.

Common Message Element Types (CMETs) are standardized model fragments intended to be building blocks that individual content domains can "include" in their designs. These blocks reduce the effort to produce a domain-specific design and assure that similar content across multiple domains is consistently represented.

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The CDISC SHARE project is attempting to map CDISC standards (for example, Study Data Tabulation Model (SDTM) and Clinical Data Acquisition Standards Harmonization (CDASH) to Biomedical Research Integrated Domain Group (BRIDG) concepts and then have these concepts reused by CDISC participants (for example care delivery organizations, pharmaceutical companies), who create their own local concepts. BRIDG already incorporates a number of CDISC standards (for example, STDMSDTM) and is working to harmonize other CDISC standards.

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SAIF should be regarded as an adjunct to any EAF (Enterprise Architecture Framework) which focuses on Working Interoperability (WI). It is a framework which brings from service-oriented architecture (SOA) practice, two critical constructs which significantly enhance the path to WI, that is:

1. Separation of concerns (static versus behavioral semantics)
2. Formal notion of contracts

SAIF is interoperability paradigm neutral (documents, messages, open enough to be implemented for all or one or a few types of interoperability paradigms (messages, documents, or services).

Intended usea of SAIF include enterprise interoperability projects including those building large-scale integrated health IT infrastructures at the national level.

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• Initiative 1. Distributed, federated metadata repositories and model repositories and operations
• Initiative 2. Automated generation of metadata from line-of-business artifacts
• Initiative 3. Rules management and contracts support (behavioral semantics)
• Initiative 4. Semantics support for W3C service oriented architecture resources
• Initiative 5. HL7 Common Terminology Services 2 (CTS 2)/ Object Management Group Model Interchange Format (OMG and HL7 Model Interchange Format (MIF)) compliant federated terminology services
• Initiative 6. Controlled biomedical terminology, ontology and metadata content
• Initiative 7. Assessment of semantic unification of compositional and derivational models

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World Wide Web Consortium (W3C) Recommendations

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SWRL (Semantic Web Rule Language) is a proposal for a Semantic Web rules-language, combining sublanguages of the OWL Web Ontology Language (OWL DL and Lite) with those of the Rule Markup Language (Unary/Binary Datalog).