The following topics provide general information about the Health Level-Seven Context Management Architecture (CMA). They are designed to help familiarize developers with the concepts and standards created by the Clinical Context Object Workgroup (CCOW) committee within the HL7 group.

The CCOW architecture defines methods, concepts and procedures to facilitate interoperability and synchronization in clinically significant ways. The goal is to create visually integrated healthcare applications on end-user devices (i.e. personal computers that serve as clinical desktops).

More detailed technical specifications and the latest version of the “CCOW” Standard is available on line at the HL7 Bookstore:

Advantages of CCOW

Conceptual Model

The goal of HL7 CCOW is to provide mechanisms for developing standards that create a unified view of information held in disparate healthcare applications on clinical workstations. Creating a common context that applications can share accomplishes these goals. Examples of contexts are patient, user, clinical encounter etc. These common contexts become the context identification for a session. As a result, when a clinician signs on to an application within a group of applications connected within a CCOW environment, all of the other applications within the group simultaneously execute the sign-on. Similarly, when the clinician selects a patient, all the applications in the CCOW environment populate the patient selection. This eliminates the need to log on to multiple applications and creates a combined view of the patient information -- enabling a visually integrated user interface.

The following list describes some of the primary concepts of the CCOW Context Management Architecture.

CCOW leverages existing investments. Health care providers can realize the benefits of a single sign-on, patient-focused information system without re-investing in new technologies.


Context Management Architecture
Component Architecture
Context Organization and Data Definitions
Context Transactions
Context Actions
Context Agents
Context Session Management
Common Links and Synchronization
Operations for Secure Links
Establishing a Chain of Trust
User Link Theory of Operation
Patient Link Theory of Operation
Authentication Repository
Subject and Item Data Format
Subject Data Definition Constraints
Custom Subjects
Custom Subject and Item Naming Conventions
Repeating Data Item Values
User Identity Subjects
Patient Identity Subjects
DICOM Study Identity Subjects
Encounter Identity Subjects
Observation Request Identity Subjects
View Subjects
Certificate Annotation Subjects
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