1. How can CPR benefit from XML? By Patricio Cobar

2. 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

3. 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.

4. 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.

5. 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)

6. 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

7. Easily understood XML file

8. 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).

9. 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.

10. Sample Medical Record

11. XML and The CPR Architecture

12. 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

13. 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.

14. 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.

15. 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.

16. 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