an XML framework for medical metadata Marc de Graauw XML Amsterdam 2013 What well cover The problem domain medical procedures and knowledge healthcare IT standards HL7 Snomed ID: 257758
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Slide1
ART DECOR:an XML framework for medical metadata
Marc de Graauw
XML Amsterdam
2013Slide2
What we’ll cover
The problem domain
medical procedures and knowledge
healthcare IT standards (HL7,
Snomed
, ...)
expertise
involved (IT, doctor, terminologist)
The solution
XML data model (DECOR)
XML tooling to edit (ART)
different views and output formats
code
generation
Pros and cons of an all-XML solutionSlide3
A use case
Dutch
colorectal
cancer
screening
entire
population
55+
gets
screened
faeces
samples
collected
,
tested
for
blood
if
suspect,
invitation
for
colonoscopy
gastro-enterologist
performs
colonoscopy
,
submits
findings
to
registry
if
tissue
removed
, sent to
pathologist
pathologist
performs
macro-/
microscopical
analysis,
submits
findings
Other
use
cases
Perinatology
,
Youth
Healthcare (Netherlands)
ELGA elektronische
Gesundheitsakte
(Austria)
QiN
KfH
Datenaustausch in der Nephrologie (Germany)
epSOS
, trans-European
medical
exchange
many
moreSlide4
Koppelingen
HL7 V3 CDA bericht:
Art-decor
, via :
http://decor.nictiz.nl
/
art-decor/
decor-project-
-rivmsp-Slide5
PROBLEM DOMAIN - medicalSlide6Slide7Slide8
Patient
id
Document
id
Medication
Observations
Gastro-enterologistSlide9
PROBLEM DOMAIN - terminologySlide10
Medical terminologies
LOINC
Logical
Observation
Identifiers
Names and CodesLaboratorium Observations
ICD-9, ICD-10
Snomed
Goals:
uniform codes for exchange
enable
analysis /
statisticsSlide11Slide12Slide13
Example valueset
Medical
terms
Snomed
codesSlide14
PROBLEM DOMAIN - ictSlide15
Just enough HL7HL7
version
2 :
currently
used
a lot in
hospitals
HL7v3:Reference Information Model
XML
serialization
XML
Schema
CDA (part
text
, part
structured data)Slow uptake, new developmentsSlide16
0..*
1
0..*
1
RIM
(Reference Information Model)
Backbone
Entity
Participation
Act
Act
Relationship
1
1
0..*
0..*
Referral
Transportation
Supply
Procedure
Condition Node
Consent
Observation
Medication
Act complex
Financial act
Organization
Living Subject
Material
Place
Health Chart
Patient
Guarantor
Healthcare
provider
Insurer
Practitioner
Role
1
0..*Slide17
RIM (Reference Information Model) Slide18
HL7 in the OID treeSlide19
HL7
snippet
for
Gastro-enterelogical
ReportSlide20
The problem domain:
Participants
and
development
cycle
Data SetSlide21
The solution - decorSlide22
DECOR
overviewSlide23
DECOR
dataset
project
name
scenario
copyright
version
info
description
authors
issues
value
sets
identi-fications
rules
concept
group
item
use
case
transaction
actor
code systems
terminology
systems
validation
conditions
constraints
OID
status
assignmentSlide24
Example DECOR fileSlide25
The solution - artSlide26
ART - editorSlide27
ART - editorSlide28
ART demoSlide29
DECOR and ART technology
A DECOR file is an XML file
methodology
developed
by dr. Kai U. Heitmann
basis for
transformations
to other HTML / XMLfine basis for schema(
tron
)
has
its
own
schema (DECOR.xsd)ART is tooling to make DECOR filestooling
developed by Gerrit BoersART is made with XQuery / XFormsopen source products eXist / Orbeon
ART and DECOR are open source (GPL / LGPL)team: Kai, Gerrit, Alexander Henket, Maarten Ligtvoet, MarcSlide30
Healthcare
Terminologists
ICT
Architects
HL7v3
modellers
IT
vendors
Testing
PERI
JGZ
Spoed
e
tc..
Stakeholders
DECOR
XML
WEB INTERFACE
XForms
XQuery
eXist
XML database
ART
toolingSlide31
The solution – outputsSlide32
Stakeholders
ART
DECOR
HTML
X
ML
Outputs
Healthcare
Terminologists
ICT
Architects
HL7v3
modellers
IT
vendors
Testing
dataset
project
scenario
issues
value
sets
identi-fications
rules
CSVSlide33
Care provider viewSlide34
Technical documentationSlide35
XML / CSV resources for implementersSlide36
The solution – code generationSlide37
message
validation
Stakeholders
ART
DECOR
Schematron
Schematron
generation
IT
vendors
Testing
dataset
project
scenario
issues
value
sets
identi-fications
rules
XML
OK ?Slide38Slide39
Schematron / test demoSlide40
Stakeholders
ART
DECOR
XML
specs
UI
generation
IT
vendors
dataset
project
scenario
issues
value
sets
identi-fications
rules
UISlide41Slide42Slide43Slide44
Using xml – pros and consSlide45
Application architectures
A
P
P
DBSlide46
XML as a storage format
A
P
P
DB
X
M
LSlide47
XML as exchange format
A
P
P
DB
A
P
P
DB
A
P
P
X
M
LSlide48
Web
architecture
2013
Con
t
rol
ler
Model
Br
ows
er
View
X
M
L
HTML
CSS
JS
User Interface LogicSlide49
HTML
CSS
JS
non-XML
vs
XML
application
XQuery
eXist
Br
ows
er
XForm
User Interface Logic
XML
HTML
CSS
JS
Django
Post
greSQL
Br
ows
er
Tem
p
la
tes
User Interface LogicSlide50
XML for application: pros and cons
versatile data structure
easy to adapt
easy to generate different outputs
easy to introduce bugs
learning
curve
XQuery: not too hard
XForms
: steeper
harder
to
debug
less tooling, especially server-side
client-side debugging: you see HTML, not
XForm
procedural versus declarative programmingprocedural: here you have an X, multiply by 2 and give it back to medeclarative: if you see an X, multiply it by 2XML all over the place: it’s magic, and sometimes you don’t get it(some) partners have limited XML knowledgeSchematron versus XML Schemaco-occurrence
...error reportingSlide51
Questions ?