How can CPR benefit from XML?

How can CPR benefit from XML? By Patricio Cobar

Outline • What is CPR? • What is XML? • Benefits of using XML in CPR systems • XML: a language we can all understand • The document hierarchy • Representing the medical record (XML vs. databases) • XML and the CPR architecture • To each his own • Supporting industry standards • Summary • Conclusion

What is CPR? • Computer-based Patient Record. • Electronically maintained information about an individual's lifetime of health status and health care. • CPR systems serve as research facilities in which large quantities of health information is made available while maintaining the confidentiality of patients and providers. • Web-based CPR systems use Internet technologies to accomplish their goals.

What is XML? • eXtensible Markup Language. • Just like HTM, it is used to define how pages appear in web browsers. • Unlike HTML, It provides a context for information, defines what the piece of information actually means. • Allows the use of customized tags. • Supports infinite levels of hierarchal of information.

Context-less <HTML> <BODY> <B> important piece of information: #*^^&)( </B> </BODY> </HTML> Context-sensitive <XML> <important_piece_of_information VALUE=” #*^^&)( “> </important_piece_of_information> </XML> What is XML? (CONTINUED)

XML: a language we can all understand • With XML we can explicitly describe the names of the pieces of data we are collecting. • Easily understood by humans and computers

Easily understood XML file

The Document Hierarchy • XML supports infinite levels of hierarchical information within a document (tree-like representation). • The format of used in medical records is source-oriented. Data are grouped according to the source that generated the data (also tree-like representation).

XML vs. Databases • Databases do not provide the level of detail that XML is able to represent. • The relational database model represents data using entities and relationships. XML employs a document-centric approach. • Representing a medical record using a relational database is more complicated. • Because XML is so widely use, database vendors have built XML facilities into their latest database products.

Sample Medical Record

XML and The CPR Architecture

To Each His Own • CPR systems must be able to produce a different screen for every group accessing the medical record. • eXtensive Style Sheets (XSL) is a feature of XML that we can use to produce different outputs based on the same data

Supporting industry standards • Through the use of Document Type Definitions, XML can help enforce standards. • . By using DTD along with industry standards, we can improve the completeness of the medical record by providing a clear description of the content of the data in the medical record.

Summary • XML gives you a standard and more legible way to represent the medical record than traditional databases. • XML can help healthcare professionals enforce standards and, at the same time, improve the completeness of the medical record. • Facilitate the exchange of medical records.

Conclusion • There is already a place for XML in the CPR architecture, the integration engine. • Sharing this document throughout the enterprise or with external systems presents no problem, the XML medical record contains a standard structure.

References • Pothen, Daniel, and Bambang Parmanto. “XML Furhters CPR Goals.” Journal of AHIMA. October 2000. Available at http://www.ahima.journal.cutting.edge/0010.html • Sokolowsky, Rachel. “XML Makes it mark.” Journal of AHIMA. November 1999. Available at http://www.ahima.journal.cutting.edge/9911.html • Young, Michael. Step by Step XML. Redmon WA.:Microsoft Press, 2000. • Kibbe, David, Bard, Mark R. “How Safe Are Computerized Patient Records?” American Academy of Family Physicians. Available at http://www.aafp.org/fpm/970500fm/lead.html

How can CPR benefit from XML?