ART DECOR: an XML framework for medical metadata. Marc de Graauw XML Amsterdam 2013

Transcription

1 ART DECOR: an XML framework for medical metadata Marc de Graauw XML Amsterdam 2013

2 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 solution

3 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 more

4 HL7 V3 CDA bericht: Art-decor, via : art-decor/ decor-project--rivmsp- Koppelingen

5 PROBLEM DOMAIN - MEDICAL

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8 Gastroenterologist Patient id Document id Medication Observations

9 PROBLEM DOMAIN - TERMINOLOGY

10 Medical terminologies LOINC Logical Observation Identifiers Names and Codes Laboratorium Observations ICD-9, ICD-10 Snomed Goals: uniform codes for exchange enable analysis / statistics

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13 Example valueset Medical terms Snomed codes

14 PROBLEM DOMAIN - ICT

15 Just enough HL7 HL7 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 developments

16 RIM (Reference Information Model) Backbone Act Relationship 0..* 0..* 1 1 Entity Role Participation Act 1 0..* 0..* 1 0..* 1 Organization Living Subject Material Place Health Chart Patient Guarantor Healthcare provider Insurer Practitioner Referral Transportation Supply Procedure Condition Node Consent Observation Medication Act complex Financial act

17 RIM (Reference Information Model)

18 HL7 in the OID tree

19 HL7 snippet for Gastro-enterelogical Report

20 The problem domain: Participants and development cycle Healthcare IT providers Terminologists Data Set Test / Qualification ICT Architects HL7v3 modellers

21 THE SOLUTION - DECOR

22 DECOR overview

23 DECOR name description project authors version info copyright dataset concept scenario issues value sets group item use case actor transaction status assignment code systems terminology systems identifications OID rules validation constraints conditions

24 Example DECOR file

25 THE SOLUTION - ART

26 ART - editor

27 ART - editor

28 ART demo

29 DECOR and ART technology A DECOR file is an XML file methodology developed by dr. Kai U. Heitmann basis for transformations to other HTML / XML fine basis for schema(tron) has its own schema (DECOR.xsd) ART is tooling to make DECOR files tooling developed by Gerrit Boers ART is made with XQuery / XForms open source products exist / Orbeon ART and DECOR are open source (GPL / LGPL) team: Kai, Gerrit, Alexander Henket, Maarten Ligtvoet, Marc

30 Stakeholders ART tooling DECOR XML Healthcare Terminologists ICT Architects HL7v3 modellers WEB INTERFACE XForms XQuery PERI JGZ Spoed Testing IT vendors exist XML database etc..

31 THE SOLUTION OUTPUTS

32 Outputs DECOR ART Stakeholders project dataset HTML Healthcare Terminologists scenario issues XML ICT Architects HL7v3 value sets modellers identifications CSV Testing rules IT vendors

33 Care provider view

34 Technical documentation

35 XML / CSV resources for implementers

36 THE SOLUTION CODE GENERATION

37 XML OK? Schematron generation DECOR ART Stakeholders project Testing dataset scenario issues Schematron message validation value sets identifications rules IT vendors

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39 Schematron / test demo

40 UI generation DECOR ART Stakeholders project dataset scenario issues XML specs UI value sets identifications rules IT vendors

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44 USING XML PROS AND CONS

45 Application architectures DB A P P

46 XML as a storage format DB A P P X M L

47 XML as exchange format DB A P P A P P DB A P P X M L

48 Web architecture 2013 User Interface Logic Model Con trol ler View Br ows er X HTML M CSS L JS

49 non-xml vs XML application User Interface Logic Post gresql Djan go Tem pla tes HTML CSS JS Br ows er XML User Interface Logic exist XQu ery XForm HTML CSS JS Br ows er

50 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 programming procedural: here you have an X, multiply by 2 and give it back to me declarative: if you see an X, multiply it by 2 XML all over the place: it s magic, and sometimes you don t get it (some) partners have limited XML knowledge Schematron versus XML Schema co-occurrence... error reporting

51 QUESTIONS?