is an agile and open standards-based framework for implementing computable semantic interoperability in healthcare.

Please note that MLHIM has been replaced with the information domain agnostic, Shareable, Structured, Semantic Model (S3Model). This site remains as the academic foundation for S3Model.

This capability is required in order to advance the usage of clinical (and other) decision support services (CDSS) and Big Data analysis across data coming from multiple points. These points of data creation are increasing every day as a result of more institutions bringing new digital capabilities to more functions, in addition to the plethora of new devices arriving in the personal healthcare marketplace.
MLHIM is not a standard in the historical sense of the term. The standards development process is far from agile; healthcare is too dynamic to wait for the 20th century standards processes. In addition, healthcare is too broad for a top-down, one-size-fits-all solution for information interoperability. MLHIM is based on widely used standards for data exchange and expression on the semantic web.
MLHIM can be implemented as the information model for applications ranging from mobile apps to enterprise suites. MLHIM is also use- ful to enhance semantic interoperability of existing systems and healthcare IT interfaces such as those based on HL7 messaging.
MLHIM specifically addresses the need to communicate syntactically sound data with the intended semantics. The larger picture of information exchange is already handled by other formal and de facto standards.
We have a growing list of peer-reviewed material on our website as well as invited presentations, educational material on SlideShare and YouTube.

Multi-Level Information modeling (MLHIM is pronounced muh-leem) is an approach to programming computer systems that need to transmit data with unambiguous, shared meaning between different implementations. It advocates the use of an abstract framework embodying all the standards and specifications of the data to be transmitted. Although this framework will often be human-readable, user-friendly interfaces that represent the data accurately, such as for a GUI, should also be defined.

Do you know why interoperability is hard?

With traditional software design approaches, the semantics are locked up in the application code and database schema. Having access to the semantics of the data is essential for clinical and epidemiological decision support.

MLHIM is first a concept. Based on this concept are frameworks, applications and tools used to develop health care applications and the governance of knowledge artifacts using a multi-level information model. MLHIM is an implementation independent model. The reference implementation is expressed in XML Schema Language v1.1

t is multi-level in regards to a reference model that is developed in software with the conceptual knowledge models implemented using XML schemas that express constraints on the reference model.

The XML schemas can then be easily shared between systems so that the semantic context is made available to the data in any conforming application. These XML schema knowledge models can be aggregated in order to form queries, messages, screen forms, reports, etc.

It is important, in the context of the current global world of health informatics, to describe what MLHIM *IS NOT*.

MLHIM is not an EMR/EHR specification. MLHIM is not a messaging specification.

MLHIM is the foundation of these and other healthcare IT applications. It is the foundation that provides the capability for full semantic interoperability via open standards and open specifications.

Technical documentation for the reference implementation is online here. We also have an example Concept Constraint Definition (CCD) documented here with links back to the reference model. This should help you understand how the restriction based interoperability works.

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