Appendix II - Models and Profiles

In the Interoperability Standards Advisory, a structure to capture necessary data models and profiles associated with interoperability needs is represented. To address public comments that requested a distinct data model section the list below provides a number of sources to which stakeholders can look in order to find the latest applicable data models.  Note that this list is not meant to be exhaustive, and while every effort is made to ensure links are current, links may become outdated as organizations make changes to their websites.

Please note that the ISA serves as an informational resource for available standards, specifications, profiles, etc. that exist to meet the interoperability needs contained within. Stakeholders should ensure and verify that they are adhering to applicable federal, state, and/or local laws or regulations regarding requirements to use a specific standard or specification that may conflict with the information listed in the ISA, as these requirements supersede the ISA.

• HL7 Standards - Section 1: Primary Standards
  • Section 1 Primary standards are the most popular standards integral for system integrations, and interoperability. Most frequently used and in-demand standards are in this category. (This section also includes the Version 2 and Version 3 solution sets, which encompass all standards relative to that version. HL7's primary standards and other select products are licensed at no cost. Additional information can be found at HL7's licensing cost update.)
• HL7 Standards - Section 2: Foundational Standards 
  • Foundational standards define the fundamental tools and building blocks used to build the standards, and the technology infrastructure that implementers of HL7 standards must manage.
• HL7 Standards - Section 3: Clinical and Administrative Domains 
  • Messaging and document standards for clinical specialties and groups are found in this section. These standards are usually implemented once primary standards for the organization are in place.
• HL7 Standards - Section 4: EHR Profiles
  • These standards provide functional models and profiles that enable the constructs for management of electronic health records.
• HL7 Reference Information Model
  • The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large, pictorial representation of the HL7 clinical data (domains) and identifies the life cycle that a message or groups of related messages will carry. It is a shared model between all domains and, as such, is the model from which all domains create their messages. The RIM is an ANSI approved standard.
• IHE Profiles
  • IHE Profiles describe specific solutions to integration problems. A profile documents how standards will be used by each system's Actors to cooperate to address the problem.
• IHE Profiles for Health Information Exchange
  • “IHE Profiles for Health Information Exchange” acts as a comprehensive resource that aggregates the disparate IHE profiles and support tools and points developers directly towards the insights and materials that are relevant to their particular implementations.
• IHE Technical Frameworks
  • The IHE Technical Frameworks are a resource for users, developers and implementers of healthcare imaging and information systems. They define specific implementations of established standards to achieve effective systems integration, facilitate appropriate sharing of medical information and support optimal patient care.
• IHE Document Sharing
  • The IHE Document Sharing is a framework in multiple architectures.
• OMG Healthcare
  • The suite of Object Management Group (OMG) healthcare standards developed in concert with Health Level Seven (HL7), and provide a superstructure allowing for peaceful co-existence of yesterday’s integration strategies while aligning with current industry best-practices, drawing from other vertical market solutions and proven technical approaches.
• X12
  • X12, chartered by the American National Standards Institute, develops and maintains EDI standards and XML schemas which drive business processes globally.
• FHIM
  • Federal Health Information Model program coordinates the efforts of the partner agencies with the development of Electronic Medical Records, information and terminology standards, including the coordination of agency efforts at relevant Standards Development Organizations (SDOs).
• HIMSS - Types of Standards 
  • A wide range of standards exist to drive interoperability of electronic health information. Health data standards can be grouped into four specific categories: transport, vocabulary, content, and privacy/security standards. This site provides links to more information on the specific standards within each category, and additional resources to better understand their implementation and use.
• IEEE 7000-2021 Standard  
  • The IEEE SA platform is open to people and communities from around the world working at every stage of technological development. The IEEE 7000-2021 Standard provides a system engineering standard approach for integrating human and social values into traditional systems engineering and design.
• NCPDP
  • The National Council for Prescription Drug Programs (NCPDP) is a not-for-profit American National Standards Institute (ANSI) Accredited Standards Developer (ASD) consisting of more than 1,500 members representing entities including, but not limited to, claims processors, data management and analysis vendors, federal and state government agencies, insurers, intermediaries, pharmaceutical manufacturers, pharmacies, pharmacy benefit managers, professional services organizations, software and system vendors and other parties interested in electronic standardization within the pharmacy services sector of the healthcare industry. NCPDP provides a forum wherein our diverse membership can develop business solutions, including ANSI-accredited standards and guidance for promoting information exchanges related to medications, supplies and services within the healthcare system.     For over 40 years, NCPDP has been committed to advancing the electronic exchange of information between healthcare stakeholders. The NCPDP Telecommunication Standard is the standard used for eligibility, claims processing, reporting and other functions in the pharmacy services industry, as named in the Health Insurance Portability and Accountability Act (HIPAA). The NCPDP SCRIPT Standard and the Formulary and Benefit Standard are the standards in use in electronic prescribing, as named in the Medicare Modernization Act (MMA).