ASTM E2436-05(2010)
(Specification)Standard Specification for the Representation of Human Characteristics Data in Healthcare Information Systems (Withdrawn 2017)
Standard Specification for the Representation of Human Characteristics Data in Healthcare Information Systems (Withdrawn 2017)
ABSTRACT
This specification presents the standardized representation for the content and structure of human characteristics data for use in healthcare information systems, and may be extended to apply to characteristics of non-human living things, such as in data systems supporting veterinary medicine. This specification covers the logical representation of human characteristics data for individuals and populations, and the physical representation of human characteristics at the data tier of healthcare information systems. Conversely, the following provisions are outside the scope of this specification: the standardization of policy or regulation concerning the employment of human characteristics data described in this specification; the establishment or standardization of legal constraints over the use of human characteristics in conjunction with healthcare clinical or business processes; and addressing or standardizing personal privacy, medicolegal, and system security provisions associated with documenting human characteristics or storing human characteristics data.
SIGNIFICANCE AND USE
This specification promotes the interoperability of health information systems through enabling a single uniform representation of human characteristics at the data layer of healthcare information systems architecture (See Fig. 1).
It presents a data structure that allows the recording, storage, editing, and retrieval of human characteristics independent of technology and the language, nationality, or culture of persons or organizations involved in healthcare processes.
The intended use of this specification is to promote interoperability at the physical data tier in healthcare information systems, and to enhance the design and development of data subsystems that contain human characteristics data for individuals and populations.
The data structures in this specification can be readily transformed into presentation layer structuresfor example, into XML for presentation in the ASTM Continuity of Care Record or the HL7 standard Clinical Document Architecture, or into standard HL7 2.x messages.
Clinical uses of this data structure include the classification and storage of human characteristics for individuals and populationsfor example, for use in clinical decision support and epidemiology to compare the individual to populations consistent with best clinical and scientific practices.
This specification may be extended for use in veterinary medicine as described in Appendix X1. This extension includes a genus/taxonomy reference and associative entities/tables as cited in ANSI/ADA Specification 1000. This allows the characterization of individual non-human living things, and the inclusion of those of different species into mixed herds.
SCOPE
1.1 This document presents a standardized representation for the content and structure of human characteristics data for use in healthcare information systems.
1.2 This specification may be extended to apply to characteristics of non-human living things, such as in data systems supporting veterinary medicine.
1.3 The following provisions are within the scope of this specification:
1.3.1 Logical representation of human characteristics data for individuals and populations.
1.3.2 Physical representation of human characteristics at the data tier of healthcare information systems.
1.4 The following provisions are outside the scope of this specification:
1.4.1 The standardization of policy or regulation concerning the employment of human characteristics data described in this specification.
1.4.2 The establishment or standardization of legal constraints over the use of human characteristics in conjunction with healthcare clinical or business processes.
1.4.3 Addressing or standardizing personal privacy, medicolegal, and system security provisions associated with documenting human characteristics or storing human characteristics data.
1.5 This standard does not purport ...
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Designation:E2436 −05 (Reapproved 2010) An American National Standard
Standard Specification for the
Representation of Human Characteristics Data in Healthcare
Information Systems
This standard is issued under the fixed designation E2436; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
INTRODUCTION
This document presents a standardized representation for the content and structure of human
characteristics data for use in electronic health records and healthcare information systems generally.
Many of the data available to clinicians, health researchers and educators, and healthcare planners
cannot be easily compared due to the variety in representing human characteristics. This document
standardizes the representation of these characteristics at the data tier of health information systems.
1. Scope responsibility of the user of this standard to establish appro-
priate safety and health practices and determine the applica-
1.1 This document presents a standardized representation
bility of regulatory limitations prior to use.
for the content and structure of human characteristics data for
use in healthcare information systems.
2. Referenced Documents
1.2 This specification may be extended to apply to charac- 2
2.1 ASTM Standards:
teristics of non-human living things, such as in data systems
E1384 Practice for Content and Structure of the Electronic
supporting veterinary medicine.
Health Record (EHR)
1.3 The following provisions are within the scope of this
E1633 SpecificationforCodedValuesUsedintheElectronic
specification: Health Record
1.3.1 Logical representation of human characteristics data
E2145 Practice for Information Modeling
for individuals and populations.
2.2 ANSI Standards
1.3.2 Physical representation of human characteristics at the
ANSI 260.3-1993 Mathematical Signs and Symbols for Use
data tier of healthcare information systems.
in Physical Sciences and Technology (revision and redes-
ignation of ANSI/ASME Y10.20-1990).
1.4 The following provisions are outside the scope of this
ANSI 1320.2-1998 IEEE Standard for Conceptual Model-
specification:
ing Language - Syntax and Semantics for IDEF1X97
1.4.1 Thestandardizationofpolicyorregulationconcerning
(IDEFobject)
the employment of human characteristics data described in this
ANSI/ADA 1000 Standard Data Architecture for the Struc-
specification.
ture and Content of the Electronic Health Record, Febru-
1.4.2 The establishment or standardization of legal con-
ary 2001.
straints over the use of human characteristics in conjunction
2.3 ISO Standards
with healthcare clinical or business processes.
ISO 639 Codesfortherepresentationofnamesoflanguages
1.4.3 Addressing or standardizing personal privacy,
ISO 2955 Representation of SI Units
medicolegal, and system security provisions associated with
ISO 5218 Representation of the Human Sexes
documenting human characteristics or storing human charac-
ISO 8601 Representation of Dates
teristics data.
2.4 Other Standards and Documents
1.5 This standard does not purport to address all of the
American Heritage Dictionary
safety concerns, if any, associated with its use. It is the
ANSI/ADA Specification 1000 Implementation Guide
HL7 2.x reference values.
This specification is under the jurisdiction of ASTM Committee E31 on
Healthcare Informatics and is the direct responsibility of Subcommittee E31.25 on
Healthcare Data Management, Security, Confidentiality, and Privacy. For referenced ASTM standards, visit the ASTM website, www.astm.org, or
Current edition approved June 1, 2010. Published September 2010. Originally contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
approved in 2005. Last previous edition approved in 2005 as E2436–05. DOI: Standards volume information, refer to the standard’s Document Summary page on
10.1520/E2436-05R10. the ASTM website.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E2436−05 (2010)
National Institute of Standards and Technology, Federal 3.3.4 Logical Data Model, n—A graphical and textual
Information Processing Standards Publications 184 Inte- representation of the data properties that describes a business
grated Definition for Information Modeling (IDEFIX), 23 function, process, or organization, consisting and all the
December 1993. relationships that exist among them.
3.3.5 Metadata, n—Data about data, or information about
3. Terminology
information, generally comprising a structured set of descrip-
3.1 Acronyms:
tive elements about any definable entity.
3.3.6 Physical Data Model, n—A graphical and textual
ADA = American Dental Association
representation of the structural properties that are implemented
ANSI = American National Standards Institute
CCR = ASTM standard Continuity of Care Record
or able to be implemented in a database, consisting of tables,
HL7 = Health Level Seven
columns and rows, and all the relationships that exist among
IDEF = Integrated Definition language
these.
ISO = International Standards Organization
3.3.7 Table, n—The basic unit of storage in a relational
LDM = Logical data model
database management system; in the physical data model
LOINC = Logical Observation Identifiers Names and Codes
analogous to the entity of the logical data model.
PDM = Physical data model
XML = Extensible Markup Language
4. Reference Data Model
3.2 Definitions:
4.1 This specification is based upon the ANSI/ADA Speci-
3.2.1 Ethnicity, n—characteristics of a group of people
fication 1000 reference data model and expands upon data
sharing a common and distinctive racial, national, religious,
structures found in the “Individual Characteristics” and “Popu-
linguistic, or cultural heritage.
lation Characteristics” subject areas.
American Heritage Dictionary
4.1.1 The Individual Characteristics subject area of this
3.2.2 Language, n—A system of arbitrary signals, such as
specification has been extended to include two additional
voice sounds, gestures, or written symbols, including its rules
entities/tables.
for combining its components, such as words, as used by a
4.1.1.1 Living Arrangement to allow the characterization
nation, people, or other distinct community for communication
and textual description of the residential life patterns and
of thoughts and feelings.
interpersonal life-dependencies of a patient or related indi-
American Heritage Dictionary
vidual.
4.1.1.2 Individual Physical Characteristics to allow docu-
3.2.3 LivingArrangement, n—Thesettingorenvironmentin
mentation of administrative characteristics (e.g. height, eye
which an individual lives, such as family setting, as may have
color, hair color, etc.) not otherwise documented in this model.
impact on the individual’s health and course of care.
4.1.2 Inthisspecification,severalattributesaredeletedfrom
3.2.4 Physical characteristic, n—a group of characteristics
the Individual entity that are not relevant to personal
previously used by convention as a means to describe an
characteristics, and this entity is extended by adding reported
individual, e.g. by hair color, eye color, build, etc.
and derived dates of birth and death.
3.2.5 Race, n—A local geographic or global human popu-
4.1.3 The following entities in theANSI/ADASpecification
lation distinguished as a more or less distinct group by
1000 Individual Characteristics subject area are not referenced
genetically transmitted physical characteristics.
in this specification:
American Heritage Dictionary
4.1.3.1 Individual Object is employed inANSI/ADASpeci-
3.2.6 Religion, n—A personal or institutionalized system
fication 1000 to carry object data descriptive of an individual
grounded in such belief and worship. A set of beliefs, values, such as an identification image or biometric data. This data is
and practices based on the teachings of a spiritual leader.
not considered as characteristics within the context of this
American Heritage Dictionary specification.
4.1.3.2 Individual Taxonomy associative entity is not used
3.2.7 Sex Characteristic, n—Preferred term to more com-
in human health information systems. Where this specification
pletely classify the multiple human sex characteristics. The
isextendedtorepresentthecharacteristicsofnon-humanliving
term “Sex” is preferred as the biologically correct term rather
things, the taxonomy or genus reference and associative
than the grammatical term “gender.”
entities may be employed.
3.3 Definitions:The following information modeling and
4.1.4 Associated Individual and Pair Bond Status are em-
technology terms are used in this document:
ployedinANSI/ADASpecification1000toallowtheconstruc-
3.3.1 Attribute, n—In a logical data model, an identifiable
tion of complex networks of interpersonal relationships, such
characteristic or data element of an entity.
as in an extended family or patterns of epidemiological
3.3.2 Column, n—In a database, a vertical space or dimen-
contacts.This specification does not address such relationships
sion in a database table that represents a particular domain of
as these concepts are subsequently covered in a separate
data and hold values for a particular attribute; in the physical
standard.
data model analogous to the attribute of the logical data model.
3.3.3 Entity, n—In a logical data model, a distinguishable
These modifications and extensions are under consideration for inclusion in the
object about which data is kept. next scheduled revision of ANSI/ADA Specification 1000.
E2436−05 (2010)
4.2 Both Logical and Physical Data Models are presented in populations—for example, for use in clinical decision support
Annex A1. and epidemiology to compare the individual to populations
4.2.1 Annex A1 illustrates the logical data model normal- consistent with best clinical and scientific practices.
izedtotheThirdNormalForm.Atthislevel,thedatastructures
5.3 This specification may be extended for use in veterinary
demonstrate the ability to connect the type of name element,
medicine as described in Appendix X1. This extension in-
such as family name, with its text value.
cludes a genus/taxonomy reference and associative entities/
4.2.2 Annex A1.6 illustrates a generic physical data model
tables as cited in ANSI/ADA Specification 1000. This allows
using Oracle 9.x datatypes.
thecharacterizationofindividualnon-humanlivingthings,and
4.3 The models illustrated in this document are presented in the inclusion of those of different species into mixed herds.
the ANSI standard IDEF1X data modeling notation.
6. Specification
4.4 Where the ANSI/ADA Specification 1000 data models
6.1 The logical data structure of a person’s characteristics is
have been enhanced, mixed case data names are employed to
composed of an association of reference entities with that
easily identify these changes.
person’s identifying entity, with the component attributes
reflecting the specific characteristics of the subject person. The
5. Significance and Use
structure and content of these associative entities varies with
5.1 This specification promotes the interoperability of
individuals and frequently over time. The physical structure
health information systems through enabling a single uniform
and content of these characteristics, along with reference data
representation of human characteristics at the data layer of
sources, are specified in Fig. A1.2.
healthcare information systems architecture (See Fig. 1).
It presents a data structure that allows the recording, storage, 6.2 Ageisaderivedvaluecalculatedusingthereporteddate
of birth; therefore, the individual’s age does not require data
editing, and retrieval of human characteristics independent of
technology and the language, nationality, or culture of persons storage as a separate item.
or organizations involved in healthcare processes.
6.3 The data structure in this specification provides a
5.1.1 The intended use of this specification is to promote
framework for recording or storing human characteristics data:
interoperability at the physical data tier in healthcare informa-
this specification does not mandate or require that any specific
tion systems, and to enhance the design and development of
human characteristic be obtained, recorded or stored in an
data subsystems that contain human characteristics data for
information system.
individuals and populations.
5.1.2 The data structures in this specification can be readily 7. Compliance
transformed into presentation layer structures—for example,
7.1 To be compliant with this specification, designers,
into XML for presentation in the ASTM Continuity of Care
developers, and vendors of healthcare applications and infor-
Record or the HL7 standard Clinical Document Architecture,
mationsystemsshalluseaphysicaldatastructurederivedfrom
or into standard HL7 2.x messages.
the generic physical data model presented in this specification.
5.2 Clinical uses of this data structure include the classifi- Physical data names and characteristics must be retained to
cation and storage of human characteristics for individuals and promote data interoperability.
FIG. 1Where This Specification Applies to System Architecture
E2436−05 (2010)
7.2 System designers and developers may adjust this ge- HL7 or LOINC, or the draft ASTM reference data for ANSI/
nericdatastructure,forexample,denormalize,forperformance ADA Specification 1000. Users should weigh the benefits of
and storage considerations as appropriate to their specific
usingthesereferencedataforinternaluseagainsttheimpacton
database management system.
achieving data interoperability across systems.
7.3 Systemdesigners,developers,andvendorsshouldtrans-
7.6 All database entries of these data must record the date
form these characteristics data for human interaction at the
and time of the observation (date-time stamp).
system presentation tier as appropriate to the ASTM CCR or
7.7 System designers, developers and vendors may extend
HL7 CDA standards.
the data structure beyond the representation in this specifica-
7.4 Systemdesigners,developers,andvendorsshouldtrans-
tion by including additional characteristics tables and data
form these characteristics data at the system presentation tier
elements.
for messaging between systems as appropriate to healthcare
7.7.1 ASTM Committee E31 should be notified of any
messaging standards, for example, HL7 2.x, ASTM, ANSI
X12N, NCPDP, etc. extension to these data structures for consideration in future
evolution of this standard.
7.5 System de
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