Executive Summary What is XML? Extensible Markup Language (XML) is a markup language that transmits and store data. XML encodes structured documents in machine-readable form. XML documents contain constructs that define the content and structure of a message within the document. International Organization for Standardization (ISO) certifies XML (ISO-8879) as an application profile of Standard Generalized Markup Language (SGML). In contrast with Hyper Text Markup Language (HTML), XML transmit and store the data while HTML displays the data.
XML needs a software or language to be converted into readable format such as an Extensible Stylesheet Language Transformations (XSLT). XSLT is used to transform XML documents into web pages or office documents. One major goal of XML is to emphasize simplicity of communication over the Internet. In the field of Healthcare Information Technology (HIT), Health Level Seven (HL7) is the widely used language when communicating medical information. In 2005, HL7 v3. 0 was published to address the many problems of inherent in v2. x. HL7 v3. addresses issues such as lack of consistent application model, lack of formal methodologies, lack of well-defined application and user roles, and lack of precision in standards. HL7 v3. 0 seeks to support different types of healthcare workflows to allow seamless communication between different systems such as an EHR or CPOE. HL7 v3. 0 messaging standards are based on an XML encoding syntax. HL7 v3. 0 is not backward compatible with v2. x messaging standards. HL7 v2. x needs conversion software to be compatible with v3. 0. Progress Data Direct is a company that provides conversion software between different HL7 versions.
XML and HL7 History ISO-SGML was first introduced in 1986 as a standard for representing texts in electronic form. In 1998, XML v1. 0 was defined as a standard for representing arbitrary messages in a document. In 1987, HL7, Incorporated was founded which introduced a standard language for exchanging medical information. XML v2. 0 and HL7 v3. 0 are both new and in the infant maturity stage. Basically, XML and HL7 were evolving in the same timeline displayed below (HL7, 2010). XML and HL7 Evolution ISO-SGMLW3C-XML v1. 0XML v1. 1 198619982004 ———————————————————————————————————————————————- ( 1987 1989199419972005 HL7 HL7 v2. 0ANSI-HL7HL7 v2. 3HL7 v3. 0 HL7 Usage (Corepoint Health, 2010) [pic] HL7 v3. 0 and XML Challenges ? Small number of volunteers ? Lack of vendor participation ? Standard still in infancy HL7 v3. 0 and XML Benefits ? Internationalization – standard language is adaptable to most countries. ? Consistent Data Model ? New and Precise Data Standard XML Components There are four major constructs of an XML document (W3C, 2010). Declaration – is the main header of an XML document. The declaration section informs the machine reading that the contents are in XML form. For example, ? Attribute – is a syntax element used to represent attributes that are associated with its parent element. An XML attribute consists of a name and value pair tags. For example, HDL ? Element – is a component of an XML document that has a start and end tags. An element may contain sub-parts such as child elements. ? Tag – are constructs that begins with a less than sign “”. For example, . Strategic Goals and Coordination
Last December, the President’s Council of Advisors on Science and Technology (PCAST) released a report entitled “Designing a Digital Future: Federally Funded Research and Development in Networking and Information Technology,” which explains a universal language standard set forth that can be used for system interoperability. The standard is an XML variant that can be built on top of existing CPOE or EHR systems (Holdren, & Lander, 2010). Data tagging techniques can allow a system to control a patient’s information to the smallest detail which could have a potential benefit in disseminating information between different healthcare entities.
The data tagging feature will be most beneficial when it comes to privacy control. The integrity of CPOE systems need to adhere to government standards or third party accreditations to increase adaptation among healthcare users. A single error in a CPOE system can have devastating effects to a large population of users. Interoperability Goals • Increase Quality of Care • Patient Engagement • Accurate Clinical Research (de-identified) • Improved Knowledge Base • New Medicine Tools • Increased Administrative Efficiency (billing) Summary
The ability to store, document, and exchange medical encounters in electronic form could reduce the disintegration of major clinical decisions. Healthcare professionals are faced daily with fragmented information when making or researching clinical decisions. Communication standards are needed to exchange medical information across multiple entities such as the adoption of an XML-based HL7. Healthcare Information Technology (HIT) has the promise to improve healthcare quality, cost, and access through standardization communication. References Corepoint Health, . (2010).
The hl7 evolution. Retrieved from http://www. corepointhealth. com/sites/default/files/whitepapers/hl7-history-v2-v3. pdf Health Level 7, HL7. (2010). V3 messaging standard. Retrieved from http://www. hl7. org/implement/standards/v3messages. cfm Holdren, J. P. , & Lander, E. Executive Office of the President, President’s Council of Advisors on Science and Technology. (2010). Realizing the full potential of health information technology to improve healthcare for americans: the path forward,Washington, DC: Networking and Information Technology Research and Development .
Retrieved from http://www. whitehouse. gov/sites/default/files/microsites/ostp/pcast-nitrd-report-2010. pdf World Wide Web Consortium, W3C. (2010). Xml technology. Retrieved from http://www. w3. org/standards/xml/ Video Raising Healthcare Quality and Lowering Costs through HIT (Eric Lander, PCAST 10 minutes) http://www. youtube. com/watch? v=NpZBF7FKk2M&feature=player_detailpage#t=1170s Presentation http://prezi. com/vi1uxwdh7ok_/xml/ Suggested Question What does XML stand for? Answer: Extensible Markup Language ———————– 8