Structuring of medical documents with XML

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standardize the structure of the documents as proposed by. HL7 CDA [2]. The presented framework based on open source software components and the tamino ...
MEDINFO 2004 M. Fieschi et al. (Eds) Amsterdam: IOS Press © 2004 IMIA. All rights reserved

Structuring of medical documents with XML: enhancing retrieval and presentation of pathology reports Martin Boeker, Christoph Jentzsch and Rüdiger Klar Department of Medical Informatics, Freiburg University Hospital, Germany

XML technologies can enhance and simplify the structuring and presentation of medical documents. Here, we investigate the storage, retrieval and presentation of medical documents with a XML web publishing framework. The pathology reports of a legacy department system were exported as HL7 messages and after transformation to XML stored in a XML database. Database results on XQuery request were transformed server-side by an XML presentation framework to HTML and displayed by standard web browser on the client.

Pathology department system Hl7

Apache : web server

HL7 -> XML transformation

Tomcat : servlet container

XML XQuery XML database tamino

XML

Cocoon: XML presentation

client

HTML

web browser

HTML

Figure 1 – basic components and dataflow

Objectives Results & Discussion

Semi structured narrative texts are an important part of medical records which are characterized by high individual specific expressiveness combined with limited retrieval and presentation possibilities. XML allows to markup semi structured data in a flexible manner and is suited for communication of documents over standard web technologies [1]. These characteristics are employed in structuring pathology reports of a legacy system to enhance retrieval and presentation. The general appropriateness of XML and related technologies to store, retrieve and present high amounts of medical documents has to be evaluated.

XML technologies are appropriate to structure clinical documents and build a system of transformation, storage, retrieval and presentation layers. The XML document type definition (DTD, XSD) fundamentally depends on the available structure information of the original documents but can easily be augmented with additional XML structures once accessible (e.g. by data extraction methods). The relative high flexibility of XML applications enables the stepwise development of electronic patient records. Further development is directed to enhance the structure of documents by enlarging the number of available details and to standardize the structure of the documents as proposed by HL7 CDA [2]. The presented framework based on open source software components and the tamino XML database enables to enhance the retrieval and presentation of medical documents by automatic structuring them with XML. Its scope of application is the narrative and semi structured textual data of considerable importance in medicine.

Methods A large number of semi-structured textual pathology reports of the Pathology Department of the Freiburg University Hospital was exported as HL7 v2.3 messages over an existing HL7 interface from a legacy department system. The HL7 messages were transformed in several steps to a XML representation which best suited the needs to represent pathology data using all possible structure information of the original message. The XML instances were persistently stored in the native XML database Tamino (Software AG, Darmstadt, Germany).

References [1] Lovis C, Baud RH, and Planche P. Power of expression in the electronic patient record: structured data or narrative text? Int J Med Inf, 58-59: 101–110 (2000)

Retrieval and presentation is controlled by the Cocoon XML presentation framework (Apache Software Foundation, open source software). XQuery requests are built from clients HTML request and directed to the XML database. Resulting XML is flexible transformed to HTML. The processing of HTML to XQuery is mediated by extensible server pages (XSP) and of XML to HTML by extensible stylesheet transformation (XSLT).

[2] Heitmann KU, Schweiger R & Dudeck J. Discharge and referral data exchange using global standards – the SCIPHOX project in Germany. Int J Med Inf, 70:195–203 (2003).

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