Sjabloon:HCIM BasicElements Include

Basic elements

A number of data elements are implicitly present in each information model and are therefore not explicitly specified in the HCIM. These are concepts that are of a more technical nature, often have little or no clinical relevance, but for the sake of clarity and readability of the data are necessary. The basic elements at each HCIM are:

• Subject: The person to whom the information relates. Often this will be the patient, but for example, in small children it may be information about the parent or caregiver.
• Source of information: The person who provided the information and ensures the correctness of it. This is not always a healthcare professional who enters the data in the information system, but it may also be the patient or another person, such as a parent, caretaker or guardian.
• Author: The person who has recorded the information. Depending on the information system in which the data is recorded, this may be the patient, a contact person or the healthcare professional.
• Identification number: The number that identifies the instantiation of the HCIM (worldwide) uniquely. The number is composed of an identification of the issuer organization and a unique number assigned by this organization
• DateTime : The date and possibly the time at which the event relates to the information. This is the medically relevant date and time.

A more detailed explanation of the basic elements can be found in Architecture Document Volume 1, paragraph 3.8 .