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Introduction to “XHL” The Interoperable Computer Data Standard

Introduction to “XHL” The Interoperable Computer Data Standard. HITSP Foundations Committee December 19, 2007. Agenda. What is “ XHL ” ? How is it related to XML & XBRL? What are advantages of “ XHL ” ? Does XHL comply with Executive Order 13410? What are next steps for HITSP?.

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Introduction to “XHL” The Interoperable Computer Data Standard

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  1. Introduction to “XHL”The Interoperable Computer Data Standard HITSP Foundations Committee December 19, 2007

  2. Agenda • What is “XHL” ? • How is it related to XML & XBRL? • What are advantages of “XHL”? • Does XHL comply with Executive Order 13410? • What are next steps for HITSP?

  3. What is “XHL” ? • Extensible Healthcare Language (XHL) • Extensible Markup Language (XML) • Extensible Business Reporting Language (XBRL) • XML is generic; like ice cream, - XBRL and XHL are flavors of XML - Other flavors; intelligence & law enforcement, global logistics, etc.

  4. What is “XHL”? XHL is a Healthcare Taxonomy (semantic interoperability) + XBRL processing technology for computer formatting, coding & linking journal level data

  5. XML was the Breakthrough • Put metadata on HTML documents to make them exchangeable and viewable on the Internet • Introduced in 1998 and made Internet possible • Global corporations recognized limits and started to work to make their documents information on XML documents interoperable - Internally - Externally

  6. Original 1998 XML Concepts Useful • Metadata - data to identify an HTML document (makes XML a general mark up language) • Schema - a set of rules to which an XML document must conform to be 'valid' according to that schema (an index) • Extensions-a suffix to a computer file (add your own tags to customize or detail the schema) • Style Sheets - pre-defined method of displaying information (IRS 1040 Form) • Instance Documents-completed style sheets (your completed 1040) on a computer.

  7. XBRL Delivers on Promise of XML • 30 companies grew to 500 global companies (www.xbrl.org) • XBRL introduced in 2004 • Data Standard for XML to manage data in an enterprise • Requires metadata on all journal entry data • Makes information data centric, not application centric

  8. Global Adoption of XBRL • Accepted standard for financial reporting in the world • United State lags in technology - Broadband - Cellular Phones - HDTV - XBRL • SEC will mandate in 2008; Shanghai and Shenzhen Stock Exchanges using for 4 years • All U.S. banks using since 2005 for Call Report

  9. Two Parts Make-up XHL… XBRL Data Formatting Technology Financial Taxonomy XHL Data Formatting Technology Healthcare Taxonomy

  10. XML Schemas & XHL Taxonomy • Schema is like a topic index of a library • XML schema extension tags are like - Locations of book shelves - Book titles • Taxonomy is like the Dewey Decimal System - All books have defined context - All libraries use identical defined context

  11. Diagnostic A A Clinical B B Laboratory C C Pharmacy D D Digital Imaging E E Billing & Claims F F Existing Medical Standards Separate Computer Software Data Protocols* Individual Computer Applications Standard Semantic Medical Definitions * Some semantic medical standards have no software data protocol. Other medical standards have data protocols that can be converted into Extensible Markup Language (XML) that permits transmission and viewing, but not integration or interoperability

  12. New Standards: HITSP Harmonization + Computer Data Interoperability XHL is a Healthcare Taxonomy (semantic interoperability) + Proven processing technology for computer formatting, coding & linking journal level data

  13. XHL Reformats Legacy Systems Data XHL Formatted Data Convert Convert XML Formatted Data MUMPS Formatted Data

  14. XHL Permits Interoperable EHR EHR in XHL Formatted Data Convert Convert Clinic/Hospital A (XML Formatted Data) Clinic/Hospital B (MUMPS Formatted Data)

  15. Interactive EHR Possible Today EHR in XBRL Formatted Data Convert Convert Clinic/Hospital B (MUMPS Formatted Data) Clinic/Hospital A (XML Formatted Data) Clinical Laboratory Prescriptions

  16. Advantages of XHL • Interoperability of legacy computer systems • Electronic audit trail of ERH & Consents at the journal entry level • De-identification through redaction & encryption • Data electronically linked to external references

  17. Advantages of XHL (cont.) • Enhanced analysis of longitudinal laboratory data - PSA 1.0-4.0 conventional normative range - Newer data suggest 28% annual rate of change is key - Automatic regression analysis test results can be e-mailed • Designed for mapping to all existing software • Upgrading XML software straight forward • Meets mandate of Executive Order 13410

  18. Executive Order 13410August 22, 2006 Sec 2 (c) : "Interoperability" means the ability to communicate and exchange dataaccurately, effectively, securely and consistently with different information technology systems, software applications, and networks in various settings, and exchange data such that clinical or operational purpose and meaning of the dataare preserved and unaltered.” (emphasis added)

  19. General Accounting Office DefinitionMay 8, 2007 “ Interoperability is the ability of two or more systems or components to exchange information and to use the information that has been exchanged.” “Unlike legacy systems, the modernized systems are to be based on computable data: that is the data are to be in a format that a computer application can act on, for example, to provide alerts to clinicians (of such things as drug allergies) or to plot graphs of changes in vital signs such as blood pressure” GAO-7-852T

  20. XHL Meets E.O. 13410 Mandate • XHL provides “computable data” • A software application with XHL mapping and processing capabilities can accept data from any computer’s software, format it into XHL data, transmit and reformat it into the receiving computer’s software data protocol, where it can then be used without additional operations.

  21. Next Steps for HITSP • Continue harmonizing semantic standards, e.g. - SNOMED - X12 - HL7 • New Foundations Sub-Committee on Interoperable Data Standard - Identify all possible standards - Benchmark standards against 13410 - Recommend “recognized interoperability standard” - Recommend to Foundations Committee - Recommend to HITSP Panel - HITSP Panel recommends to HHS

  22. HITSP XHL XBRL Formatting Technology Healthcare Taxonomy Today Diverse Computer Data Standards Semantic Standards (SMOMED, X12, HL7,etc.)

  23. Next Steps Outside of HITSP • HHS “accepts” interoperability data standard for Federal Healthcare • HHS “recognizes” interoperability data standard for all public and private healthcare • Healthcare taxonomy to be developed - Possible OASIS sponsorship - Regular taxonomy updating as HITSP proceeds; - Version 1.0, 2.0, etc. to reflect HITSP progress - Development and maintenance funding TBD

  24. Additional Information See HITSP web site for additional information in Foundations Committee Interoperability White Paper, December 19, 2007. Contact R.T. McNamar at rtmcnamar@e-certus.com

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