BRIDG Overview Clinical Observation Interoperability March 18, 2008

BRIDG Overview

Clinical Observation InteroperabilityMarch 18, 2008

2

BRIDG Background

Stakeholders: HL7, CDISC, NCI/caBIG, FDA

Goals: shared semantics

Domain of Interest: protocol driven research

Project Organization: BAB, THC

3

BRIDG Content

CDISC SDTM – Submission Data Tabulation Model HL7 CDA – Clinical Document Architecture NCI/HL7/CDISC caXChange/LabHub HL7 RPS – Regulated Product Submission CDISC TDM – Trial Design Model NCI PSC – Patient Study Calendar NCI CTOM – Cancer Trial Object Model NCI/? AE – Adverse Events NCI C3PR – Cancer Central Clinical Participant

Registry

4

BRIDG Components

UML (Unified Modeling Language) Static Model: Class diagram, Object diagram

Dynamic Models: Activity diagrams, State diagrams, Sequence diagrams

Abstract Data Types (HL7) Binding to Terminologies (NCI) Mapping to application models Mapping to HL7 RIM

5

Binding to Terminologies

specifies the shared semantics at a comprehensive level

at attribute level to both local and global terminologies occurs in context of run-time instances must remain implementation independent caBIG™ Cancer Data Standards Repository

(caDSR) Enterprise Vocabulary Service (EVS)

6

Backbone – Part 1

Entity Role Participation

class PersonOrganizationView

BiologicEntity

Person

+ name: PN+ initials: ST+ postalAddress: AD+ telecomAddress: SET<TEL>+ educationLevel: CD+ ethnicGroup: SET<CD>+ householdIncome: CD+ maritalStatus: CD+ race: SET<CD>+ adoptedIndicator: BL+ eyeColor: ST- deathIndicator: BL- primaryOccupation: CD- occupationDateRange: IVL<TS>::BiologicEntity+ identifier: SET<II>+ birthOrder: INT+ birthCountry: CD+ deathDate: TS+ sex: CD+ birthDate: TS

Organization

+ identifier: SET<II>+ name: ON+ description: ST+ department: ST+ postalAddress: ST+ telecomAddress: SET<TEL>+ status: CD+ statusDateRange: IVL<TS>

Document

StudyProtocol

+ disease: SET<CD>+ phase: CD+ intent: CD+ populationDescription: ST+ blindedIndicator: BL+ subjectType: CD+ blindingSchema: CD+ multiInstitutionIndicator: BL+ randomizedIndicator: BL+ confidentiality: CD+ monitor: CD::Document+ identifier: SET<II>+ title: ST+ universalResourceLocator: ST+ bibliographicDesignation: ST+ text: ST+ summaryDescription: ST+ synopsis: ST+ type: CD+ subtype: SET<CD>+ revision: ST+ language: CD+ status: CD+ statusDateRange: IVL<TS>

StudyAuthor

Subject

+ state: ST

StudySubject

+ identifier: SET<II>+ confidentialityIndicator: BL+ paymentMethod: CD+ status: CD+ subgroup: CD+ statusDateRange: IVL<TS>+ actualSubjectIndicator: BL

ApplicationSponsor

AssociatedPerson

+ type: CD

ClinicalResearchCoordinator

ClinicalResearchStaff

DocumentAuthor

DocumentReceiv ingOrganization

DocumentReceiv ingPerson

FundingSource

+ identifier: II

HealthCareFacility

+ identifier: II+ postalAddress: AD

CentralLaboratory

HealthCareProv ider

+ identifier: II+ certificateLicenseText: ST

ManufacturerManufacturingSite

PerformingLaboratory

PerformingParty

+ actualPartyIndicator: BL

RegulatedProduct

+ approvalIdentifier: SET<II>+ authorizationType: CD+ approvalStatus: CD

RegulatoryAuthority

+ jurisdiction: CD

StudyCommittee

+ type: CD

StudyCoordinatingCenter

- responsibility: SET<CD>

StudyInvestigator

+ identifier: II+ role: CD+ dateRange: IVL<TS>+ status: CD+ statusDateRange: IVL<TS>+ signatureText: ST

StudySite

+ identifier: II+ role: CD+ accrualStatus: CD+ targetAccrualNumber: INT+ irbApprovalDate: TS+ dateRange: IVL<TS>+ status: CD+ statusDateRange: IVL<TS>

StudySponsor

+ type: CD

OrganizationalStructure

Place

Laboratory

+ identifier: II

Need to add all examples that have been identified through harmonizations.

Device Operator,Technician

Need to add OCL to state thatassociations to PerformingParty are "or".

ResearchOrganization

Distributor

Serv iceDeliveryLocation

+ locationTypeCode: CD

Member

TreatingSite

CooperativeGroup

AdministrativeMemberPI

Class needs to be defined.

AdministrativeMemberCRA

Contact

- postalAddress: AD- telecomAddress: SET<TEL>- primaryIndicator: BL

0..1

scopes / is scoped by

1

0..1

functions as/ isrepresented by

1..*

0..1


0..*

0..1


0..*

0..1


0..*

1plays / is playedby 0..1 0..1


1..*

1

plays / is playedby

0..1

0..*


1

1

functions as / isrepresented by

1..*

1

plays / is playedby

0..1

1

plays / is playedby

0..*

1

plays / is playedby

0..1

1

plays / is playedby «player» 0..*

1

plays / is playedby

0..1

0..*

executes/ isexecuted at

1

1

plays / is playedby

0..1

1

plays/ is playedby

0..1

1

plays / is playedby

0..1

1

plays / is playedby

0..*

0..*

develops / isauthored by

1

1

plays / is playedby

0..1

1

plays / is playedby

0..1

0..*

functions as/ is represented by

1

1


0..*

1..*

is sponsored by /sponsors

1

0..*

is the treatmentlocation for / isassigned to

1

1


0..* 1..*

is conducted by /participates in

1

0..*


1

1

manufactures at /manufactures for

0..*

1


0..*

1plays / is playedby

0..1

1

plays / is playedby

0..*

1

plays / is playedby

0..*

1


1..*

1

contains / contained in0..*

1


0..*

1

contains / contained in

0..*

1

plays / is playedby

0..*

1


1

1


1

1

plays / is playedby

0..*

1plays / is playedby

0..*

1

plays / is playedby

0..1

1

plays / is playedby

0..1

1

scopes / isscoped by

0..*

1

plays / isplayed by

0..*

1

plays / is playedby

0..*

1

operates as /represented by

1..*

1..*


1

0..*

1..*

0..1


1

0..*


1

1

plays / is playedby

0..1

1


0..*

1


0..*

1


1..*

7

class View 8 - Backbone - Part 2

Document

StudyProtocol

Classes to be deleted?::PlannedStudy

Activity ObservationResult

PerformedActiv ity

ScheduledActiv ity

«StudyRelationship»Activ ityRelationship

«StudyRelationship»ObservationResultRelationship

PlannedActiv ity

PerformedObservationResult

«StudyRelationship»DocumentRelationship

PerformedObservation

0..*

associates from /may be thesource for

1

0..1

is used to createa / subject-specificdescription of

0..*

0..1

isoperationalizedby/ is describedby

0..1

1..1

0..*

associates to /may be thetarget for

1

1


0..*0..*

associates from /may be thesource for1

0..*

associates from / maybe the source for

1

0..*

associates to /may be the targetfor

1

0..*

is fulfi l led by / is theinstantiation of

0..1

+disease 1..*

0..1

Name:Package:Version:Author:

View 8 - Backbone - Part 2BRIDG Release 2.0 -- Static Classes1.1BRIDG THC

Backbone – Part 2

Document Activity Result

8

class View 10 - Complete 2 - Classes with Local Attributes

Material

+ identifier: II+ name: ST+ description: ST+ form: CD+ status: CD+ statusDateRange: IVL<TS>

Organization

+ identifier: II+ name: ST+ description: ST+ postalAddress: ST+ telecomAddress: SET<TEL>+ status: CD+ statusDateRange: IVL<TS>

Person

+ name: ST+ initials: ST+ postalAddress: AD+ telecomAddress: SET<TEL>+ birthDate: PQ+ deathDate: PQ+ educationLevel: CD+ ethnicGroup: SET<CD>+ gender: CD+ householdIncome: CD+ maritalStatus: CD+ race: SET<CD>+ adoptedIndicator: BL+ birthOrder: INT+ birthCountry: CD+ eyeColor: ST

CentralLaboratory

PerformingLaboratory

Activity

+ category: CD+ subcategory: CD+ codedDescription: CD+ textDescription: ST+ reason: SET<CD>+ status: CD+ statusDateRange: IVL<TS>+ comment: ST

Document

+ identifier: SET<II>+ title: ST+ detailedDescription: ST+ summaryDescription: ST+ synopsis: ST+ type: CD+ subtype: SET<CD>+ revision: ST+ language: CD+ status: CD+ statusDateRange: IVL<TS>

Participant

+ identifier: SET<II>+ confidentialityIndicator: BL+ paymentMethod: CD

Assessment

+ evaluationDate: TS+ codedInterpretation: CD+ textInterpretation: ST+ baselineIndicator: BL+ comment: ST

ObservationResult

+ reportedDate: TS+ codedResult: CD+ numericResult: PQ+ textResult: ST+ targetSite: CD+ confidentiality: CD+ uncertainty: CD+ baselineIndicator: BL+ comment: ST

PerformedActivity

+ actualDateRange: IVL<TS>+ actualDuration: PQ+ effectiveDateRange: IVL<TS>+ effectiveDuration: PQ+ missedIndicator: BL+ missedReason: ST

ScheduledActivity

+ scheduledDateRange: IVL<TS>+ scheduledDuration: PQ+ scheduledRangeOfRepetitions: ST

SubmissionUnitRelationship

SubmissionUnit

+ receiptDate: TS+ type: CD+ status: CD+ statusDateRange: IVL<TS>

Submission

+ receiptDate: TS+ type: CD+ regulatoryAssessment: CD+ assessmentDateRange: IVL<TS>

Application

+ identifier: II+ type: CD

ReviewableUnit

ApplicationSponsor

RegulatedIndustry

+ registrationNumber: II

PerformedAdministrativeActivity

+ name: CD+ varianceReason: ST

DocumentRelationship

AdverseEventData

HealthCareSite

+ identifier: II+ postalAddress: AD

Specimen

+ identifier: II+ accessionNumber: ST+ type: CD+ condition: ST

PerformedSpecimenCollection

+ method: CD+ fastingStatusIndicator: BL

AssessmentRelationship

ObservationResultRelationship

PerformedProcedure

+ method: CD+ targetSite: CD+ name: CD

StudySite

+ identifier: II+ role: CD+ accrualStatus: CD+ targetAccrualNumber: INT+ irbApprovalDate: TS+ dateRange: IVL<TS>+ status: CD+ statusDateRange: IVL<TS>

HealthCareProvider

+ identifier: II+ certificateLicenseText: ST

StudySubject

+ identifier: SET<II>+ subgroup: CD+ status: CD+ statusDateRange: IVL<TS>+ state: ST+ actualSubjectIndicator: BL

PerformedSubstanceAdministration

+ dose: PQ+ doseFrequency: CD+ doseRegimen: ST+ doseDescription: ST+ doseForm: CD+ doseTotal: PQ+ doseModificationType: ST+ doseChangeType: CD+ doseChangeReason: ST+ routeOfAdministration: CD+ locationOfDoseAdministration: CD+ treatment: CD+ treatmentVehicle: CD+ treatmentVehicleVolume: PQ+ treatmentModifiedText: ST+ substanceUseStartRelativeToReference: CD+ substanceUseEndRelativeToReference: CD

PerformedClinicalResult

+ name: CD+ numericPrecision: INT+ referenceTextList: CD+ referenceRangeLow: REAL+ referenceRangeHigh: REAL+ referenceRangeComment: ST+ reportedResultStatus: CD+ asCollectedIndicator: BL+ normalRangeComparison: CD

StudyInvestigator

+ identifier: II+ role: CD+ dateRange: IVL<TS>+ status: CD+ statusDateRange: IVL<TS>+ signatureText: ST

PlannedStudy

+ targetAccrual: INT+ plannedSubjectParticipationDuration: ST+ plannedSubjectInterventionDuration: ST PerformedStudy

+ actualAccrualNumber: INT+ referenceDateRange: IVL<TS>

StudyProtocol

+ disease: CD+ phase: CD+ intent: CD+ populationDescription: ST+ blindedIndicator: BL+ subjectType: CD+ blindingSchema: CD+ multiInstitutionIndicator: BL+ randomizedIndicator: BL+ confidentiality: CD+ monitor: CD

ManufacturedMaterial

+ lotNumberText: ST+ stabilityDate: TS+ expirationDate: TS

StudyAgent

+ leadAgentIndicator: BL

«StudyRelationship»ActivityRelationship

TherapeuticAgent

+ identifier: II+ indIndicator: BL

PlannedArmSoA

+ referenceTimePoint: ST

ScheduledStudySoA

PlannedSoACell

+ plannedTiming: BRIDGRelative<TS>

PlannedStudySegmentStudyCellRule

ScheduledSoACell

+ scheduledTiming: IVL<TS>+ note: ST

PlannedEpochRule

ConcomitantAgent

PlannedObservationResult

StudyAuthor

BiologicMaterial

PlannedArm

+ name: ST+ description: ST+ targetAccrual: INT+ randomizationWeight: ST

PlannedEpoch

+ name: ST+ description: ST+ type: CD+ firstEpochIndicator: BL

PlannedStudySegment

+ name: ST+ description: ST+ firstStudySegmentIndicator: BL+ plannedDuration: PQ

PlannedActivityStudySegmentRule

PlannedStudyCell

+ name: ST+ blindedDescription: ST

StudySponsor

+ type: CDFundingSource

+ identifier: II

ask RPS team if identifier and type are needed for application sponsor -- review mapping document

AdministrativeActivity.nameEnrollmentRegistrationOff StudyInformed Consent

ObservationResultAssessmentRelationship

AECausalAssessment

AEIdentification

PerformedObservationResult

AssessmentPerformedActivityRelationship

These AE classes are work-in-progress and may change in R 2.0

Laboratory

+ identifier: II

PlannedActivity

+ plannedDuration: BRIDGRelative<TS>+ additionalDurationDescription: ST+ plannedRangeOfRepetitions: ST+ contingentIndicator: BL+ actualIndicator: BL+ inStudySegmentPlannedActivityType: CD

AdverseEvent

+ seriousness: CD+ grade/severity: CD+ expected/unexpected: CD+ hospitalizationRequired: BL

Analysis

Work in progressAssessor

+ type: CD

AssociatedPerson

+ type: CD

ClinicalResearchCoordinator

Container

+ type: CD

ClinicalInterpretation

+ toxicityTerm: CD+ abnormalIndicator: BL+ toxicityGrade: CD+ clinicallySignificantIndicator: BL+ severity: CD

PerformedMedicalHistoryResult

+ name: CD+ nameModifiedText: ST+ description: ST+ occurrenceDateRange: IVL<TS>+ endRelativeToReference: CD+ startRelativeToReference: CD

PerformingParty

+ actualPartyIndicator: BL

PlannedSubstanceAdministration

+ dose: PQ+ doseFrequency: CD+ doseRegimen: ST+ doseDescription: ST+ doseForm: CD+ doseTotal: PQ+ routeOfAdministration: CD+ locationOfDoseAdministration: CD+ treatment: CD+ treatmentVehicle: CD+ treatmentVehicleAmount: PQ

ProtocolDeviation

+ name: CD+ description: ST+ category: CD+ dateRange: IVL<TS>

PerformedStudyAgentTransfer

+ quantity: PQ+ originalQuantity: PQ

StudyCommittee

+ type: CD

StudyObective

+ description: ST+ primaryIndicator: BL

Needs defined.

Needs defined.

Class and attributes need defined.

Needs defined.

Class and attribute needs defined.

Needs definition.

Needs defined.

NonTherapeuticAgent

DocumentFrameDocumentStructure

DocumentStructureRelationship

DocumentContent

PlannedStudySoA

PlannedSubjectStudyEncounter

+ name: ST+ type: CD+ plannedTiming: BRIDGRelative<TS>

PlannedSubjectStudyEncounterRule

ScheduledSubjectStudyEncounterRule

ScheduledSubjectStudyEncounter

+ name: ST+ type: CD+ scheduledTiming: IVL<TS>

ScheduledArmSoA


ScheduledArm

+ name: ST+ description: ST+ randomizationWeight: ST

PerformedStudySoA

PerformedArmSoA


PerformedArm

+ name: ST+ description: ST+ randomizationWeight: ST

PerformedSubjectStudyEncounter

+ name: ST+ type: CD+ performedTiming: IVL<TS>

PerformedSubjectStudyEncounterRule

PerformedSoACell

+ performedTiming: IVL<TS>

DefinedStudySegment

DefinedActivityStudySegmentRule

PerformedActivityStudySegmentRule

ScheduledStudyCell


ScheduledEpoch

+ name: ST+ description: ST+ type: CD+ firstEpochIndicator: BL+ scheduledStartDate: TS

ScheduledEpochRule

ScheduledStudySegmentStudyCellRule

ScheduledStudySegment

+ name: ST+ description: ST+ firstStudySegmentIndicator: BL

ScheduledActivityStudySegmentRule

PerformedStudyCell


PerformedEpoch

+ name: ST+ description: ST+ type: CD+ firstEpochIndicator: BL

PerformedEpochRule

PerformedStudySegment

+ name: ST+ description: ST+ firstStudySegmentIndicator: BL

PerformedStudySegmentStudyCellRule

DefinedActivity

DefinedSubstanceAdministration

DefinedProcedure

DefinedSpecimenCollection

DefinedObservation DefinedAdministrativeActivity

DefinedStudyAgentTransfer

PlannedSpecimenCollection


PlannedProcedure

+ name: CD+ method: CD+ targetSite: CD

PlannedObservation


PlannedAdministrativeActivity

+ name: CD

PlannedStudyAgentTransfer


ScheduledObservation


ScheduledProcedure

+ name: CD+ targetSite: CD+ method: CD

ScheduledSpecimenCollection


ScheduledStudyAgentTransfer


ScheduledAdministrativeActivity

+ name: CD

ScheduledSubstanceAdministration

+ dose: PQ+ doseFrequency: CD+ doseRegimen: ST+ doseDescription: ST+ doseForm: CD+ doseTotal: PQ+ routeOfAdministration: CD+ locationOfDoseAdministration: CD+ treatment: CD+ treatmentVehicle: CD+ treatmentVehicleAmount: PQ

StudyRelationship

+ description: ST+ type: CD+ inversionIndicator: BL+ contextControl: CD+ contextConductionIndicator: BL+ sequenceNumber: INT+ priorityNumber: INT+ split: CD+ pauseQuantity: PQ+ checkpoint: CD+ join: CD+ negationIndicator: BL+ conjunction: CD+ separableIndicator: BL+ subset: CS+ evaluableExpression: CD+ comment: ST

ClinicalResearchStaff DocumentAuthor

HL7 RIM Entity

HL7 RIM Role

HL7 RIM Participation

HL7 RIM Act

HL7 RIM ActRelationship

Placeholder

Draft

Data Type

DefinedEpoch

PerformedObservation

+ name: CD+ nameModifiedText: ST+ targetSite: CD+ method: CD+ bodyPosition: CD

PerformedSubjectMilestone

+ informedConsentSignatureText: ST+ informedConsentDate: TS+ registrationDate: TS+ offStudyDate: TS+ offStudyReason: CD+ studyReferenceDateRange: IVL<TS>

0..*

executes/ isexecuted at

1

0..*is the treatmentlocation for / isassigned to 1

1..*

1

0..*


1

0..*


1

1..*

performs at /facility for

0..*

1..*

is sponsoredby / sponsors

1

1functions as /is representedby

0..*

0..*


11


0..*

1

plays / isplayed by

0..1

0..*associates from /may be thesource for 1

0..*

performs / isperformed at

1

1

functions as /representedby

1..*

1..*

1

1..*

1

1

is used as / isfulfilled by

0..*

0..*

isadministeredduring / uses

0..1

1..*

facility for /performs at 0..*

1..*

1

0..*

includes / isincluded in

1..*

0..*associates to /may be thetarget for

1

1

associates from /may becontained by

0..*

0..*


1

0..*


1

0..*

participatesas / isfulfilled by

1

0..1


1..*

0..*

may be thecontainer of /associates to

1

0..*

isoperationalizedby / is describedby

1

1 may report /is reportedby

0..*

1

associates a submissionunit to / is associated to asubmission unit via

1..*

0..*

is fulfilled by /is theinstantiation of

0..1

0..*

1

0..*


1

0..*

identifiesevents for /has

1

0..*


1

1..*

is conductedby /participatesin

1

1

functions as/ isrepresented by 0..*

1..*

1

1


0..*

1

submits / issubmittedby

1

0..*

is associated to asubmission via /associates asubmission to

1

1..*

1

0..*


1

1..*

is collected during/ results in

0..1

1

plays / isplayed by

0..1

1

plays / isplayed by

0..1

1

may be the source for/ associates from

0..*

1..*

associates to / is acomponent of

1

1

plays / isplayed by

0..*

1

is fulfilled by / isthe fulfillment of

0..1

1

is used to create a/ subject-specificdescription of

0..*

1 0..*

1 0..*

0..*

1

1


0..*

1

plays / isplayed by

0..1

1

plays/ isplayedby 0..1

1

plays / isplayed by

0..1

1..*

1

1 0..1

1..*

1

1..*

contains / iscontained in

1

1..* 1

1

1

0..1isadministeredduring / uses

1..*

1

is used as / isfulfilled by

0..*

1

plays / isplayed by

0..1

0..*

is evaluating / isa research topicin

1

0..*

develops / isauthored by

1

1..*

1

0..*


11..*

0..*

1

results in / is theresult of

0..*

1 0..*

1..*

is comprised of /associates from

1

0..*

may be the target for /associates to

1

0..1

is operationalized by/is described by

0..1

0..1

is used to create a/ subject-specificdescription of

0..*

0..* 1

1 0..*

1


0..*

0..*

may be thetarget for /associatesto

1

1..*

0..1

0..*


1

1..*


1

1..*


1

1..*

is comprised of /is a componentof

0..1

1..*

is a component of/ is comprised of

1

0..*

may be thesource for /associatesfrom

1

1 0..1

0..*

may be thetarget for /associatesto

1

1..*

is a division of /is divided into

1

1

contains theactivities for / isdescribed by

1

0..*


1

0..*

may be thesource for /associatesfrom

1

0..*


1

1..*


1

1..*


11..*


1

1


0..*

1

contains theactivities for / isdescribed by

1

1


0..*

1..*

0..1

0..*


1

1

contains theactivities for /is describedby

1

1..*


0..1

1

results in / is theresult of 0..*

1..*


0..1

0..*


1

1

1..*

1 1..*

1

0..*

1..*1

0..*

1

1..*

1

0..*

associates from /may becontained by 1

0..*


1

0..*


1

1

is collected in /results in

1..*

0..*


1

0..*


1

0..1

is collectedduring / resultsin

1..*

1..*

is a division of /is divided into

1

1..*

1

1..*

1

1..*

1

1..*

0..1

0..1

is collected in /results in

1..*

1..*


1

1

plays / isplayed by

0..*

1

authorizes / isauthorized by

0..*

1

changes handsduring /involves

0..*

0..1

identifies the timeslot for /is planned within

1

1

plays / is playedby

0..1 1


1..*

1

is authored by /authors

1..*

0..*


1

0..1


1..*1

plays / isplayed by

0..1

0..1


0..*

0..1


0..*

0..1


0..*

0..1


1..*

1

plays / isplayed by

0..1

0..1

is the originator of /is reported by

0..*

1..*

has participation of /participates in

0..1

identifies thetimeslot for / isperformedwithin

1

1

operates as /representedby 1..*

0..1

is the originatorof / is reportedby

0..*

1

is produced by /may produce

0..*

0..1


1..*

1

plays / isplayed by

0..1

1 1

1


0..*

0..1

identifies the timeslot for / isscheduled within

10..1

participates in / isperformed for

0..*

1

authorizes / isauthorized by

0..*

1

manages / ismanaged by

0..*

Name:Package:Version:Author:

View 10 - Complete 2 - Classes with Local AttributesBRIDG Release 1.1 -- Static Classes1.1BRIDG THC

BRIDG – Close Up

Labs

Vitals

Meds

9

SDTM Implementation Guide

10

SDTM Mapping

11

HL7 RIM

12

HL7 Mapping

BRIDG attributes may map to Class Attribute Data Type Vocabulary (for structural codes, e.g.,

participation type)

May require several iterations Changes to RIM Changes to BRIDG

13

Eligibility Criteria

ASPIRE – Agreement on Standardized Protocol Inclusion Requirements for Eligibility, Joyce Niland, City of Hope

HL7 CRFQ – Clinical Research Filtered Query, Charlie Mead, BAH

14

Questions

http://bridgmodel.org

Documents

BRIDG Overview Clinical Observation Interoperability March 18, 2008