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XML as a common platform for healthcare communication in Belgium

XML as a common platform for healthcare communication in Belgium. - results & evolution of the KMEHR project -. Tom Fiers Etienne De Clercq Marc Bangels Viviane Van Casteren. KMEHR Kindly Marked up Electronic Healthcare Record.

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XML as a common platform for healthcare communication in Belgium

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  1. XML as a common platform for healthcare communication in Belgium - results & evolution of the KMEHR project - Tom Fiers Etienne De Clercq Marc Bangels Viviane Van Casteren

  2. KMEHRKindly Marked up Electronic Healthcare Record • Limited project, supported by Belgian Ministry of Public Health EMDMI advisory board • Implementation of existing PROREC Belgium EHCR exchange specifications • 2 Goals: • Selection of a suitable interchange format • Implementation of the model using the format

  3. XML: eXtensible Markup Language • Scaled down version of SGML, W3C, 1.0 specification 1998 • extensible • structure (nesting, containers) • validation • style separated from content • Mark Up : well suited for healthcare data • graceful degradation • massive global support & tools

  4. Requirements • transmission of images and binary objects • recursiveness (nesting) • m to n relationships • flexible use of code tables and version support • flexibility and openness • industry acceptance and global support • compatible with International standardisation efforts Problem 1 Drug item 1 Problem 2

  5. Initial Results • Definition of the complete model in XML • Transmission of real life reports using the model • Integration & visualisation in EHCR GP systems • Visualisation using XSL • Creation of a middleware C++ library http://www.users.skynet.be/mb/kmehr.htm

  6. Report

  7. XSL representation

  8. Step 2: Real world Utilisation of XML based KMEHR model • Epidemiological data collection for the Scientific Institute of Public Health (IPH) • 39 General Practitioners • 2 month period • 3 GP packages • +3200 messages

  9. GP - EMR Automatic EMR Extraction Data entry module Conversion to KMEHR- XML format Encryption GP organisation Strip GP Identification IPH

  10. Example EHCRM SRVTYP > * EHCRMID > S > "#A1"+"+"+"A2" ECHRID > * STATUS > * RECEIVER > HP > HPTYP > HPORG > NAME > S > "ISP" SENDER > HP > HPTYP > HPPRO > PNAME > FAMILYNAME > * & UNSTRUCTURED > "#A1" SEHCRMS > EHCRMS > EHCRMS ST_EHCRMS > START > * END > * COMPLETENESS > * GPC PAT > HEIGHT > HIS > 1 HII with DEFITM=TYPE+MEASURE for "#B2" WEIGHT > HIS > 1 HII with DEFITM=TYPE+MEASURE+DATE for "#B3" and"#B4" SMOKING > HIS > 1 HII with DEFITM=TYPE+MEASURE for "#B5" <CODED_STATUS><C><CTBSYS> XML-SQLTYPE="CHAR">ISP</CTBSYS><CTBID> XML-SQLTYPE="CHAR">HITYP</CTBID><CODE> XML-SQLTYPE="CHAR">#Tn_P1_1</CODE><MEANING> XML-SQLTYPE="CHAR">#Tn_P1_1 (1 = oui 2 = non) </MEANING></C></CODED_STATUS></DEFITM></HII>

  11. Message related pilot project conclusions • The KMEHR model is very complete • No problem for highly structured or complex data • XML proves in practice its theoretical advantages • But... • Overhead which burdens messages • Finding the tree in the wood • Complexity: trop c’est trop

  12. Evolution • Telematics Comission Health Care Messages Working Group: Define message format recommendations • Input from existing formats, standards and commonly used file fomats • Input from KMEHR project • Generic concepts of GEHR, CEN • necessity for layered complexity • m x n relations • endless recursivity • code table independence • eg transaction, collection-item, data item

  13. Preliminary Results • Creation of a uniform simple framework for both simple and very complex messages (4 layers of complexity) • Resulting in a number of practical recommendations and examples • To be presented 7/12 : Telematics@health-care.be http://www.health.fgov.be/telematics/symposium/

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