ASTM_E_2183_-_02.pdf

Designation:E 2183 02An American National StandardStandard Guide forXML DTD Design,Architecture and Implementation1This standard is issued under the fixed designation E 2183;the number immediately following the designation indicates the year oforiginal adoption or,in the case of revision,the year of last revision.A number in parentheses indicates the year of last reapproval.Asuperscript epsilon(e)indicates an editorial change since the last revision or reapproval.1.Scope1.1 Recently,there has been widespread use of the Internetby the health care industry to represent information.Much ofthe success of the Internet can be attributed to the World WideWeb(WWW)and its browsing system,which make it possibleto navigate the Internet by pointing and clicking.Web pages,electronic documents located on the Internet,are published toa computer screen by a browser.These pages are developedusing HyperText Markup Language(HTML).1.1.1 The next generation of the WWW and web pages hasarrived with the specification of eXtensible Markup Language(XML).Just like HTML,XML can define how pages appear inweb browser.Additionally XML provides a context for infor-mation.While HTML tells the browser what a page shouldlook like,XML defines what the piece of information actuallymeans.Both HTML and XML are markup languages;that is,they insert markup,or additional information,into text.Themarkup is known as a tag.For example,HTML marks up texton a page by inserting a tag when the text should bebolded and by inserting a tag around the first heading ofa web page.In HTML,there is no way to distinguish betweena medical record number or an telephone number because theyare both tagged for bold.XML,on the other hand,markseach item with special tags so that computers can tell thedifference.With XML,humans and computers can tell thedifference between a tag and or a from a.1.1.2 The names of the tags and the rules for using them arecontained in the DTD or Document Type Definition(DTD).The DTD describes the structure of the document and definesthe names of tags it contains.Additionally,the DTD declaresthe order in which the tags occur and how often the tags canappear;that is,the DTD defines the hierarchy of the tags.ADTD for a prescription might contain structural elements forthe medication prescribed,the dosage,the form,the quantity,and so forth.1.2 This guide provides a compendium of information forthe use of E 2183 XML DTDs within health care.This guidedescribes design considerations,the architecture of the DTDs,and implementing systems using the E 2183 DTDs.1.3 This guide refers to and makes use of recommendationsfrom the World Wide Web consortium,the W3C(http:/www.w3.org).1.4 This standard does not purport to address all of thesafety concerns,if any,associated with its use.It is theresponsibility of the user of this standard to establish appro-priate safety and health practices and determine the applica-bility of regulatory requirements prior to use.2.Referenced Documents2.1 ASTM Standards:E 1239 Guide for Description of Reservation/Registration-Admission,Discharge,Transfer(R-ADT)Systems forElectronic Health Record(EHR)Systems2E 1384 Guide for Content and Structure of the ElectronicHealth Record(EHR)2E 1633 Specification for Coded Values Used in the Elec-tronic Health Record2E 2182 Specification for Clinical XML DTDs in Health-care22.2W3C World Wide Web Consortium Recommendations,(http:/www.w3.org)XML 1.0 Recommendation,http:/www.w3.org/TR/REC-xmlXHTML Basic Recommendation,http:/www.w3.org/TR/xhtml-basicXML Linking(Xlink)1.0Recommendation,http:/www.w3.org/TR/xlinkXML Namespaces Recommendation,http:/www.w3.org/TR/REC-xml-namesXPointer,http:/www.w3.org/TR/xptrXSLT,http:/www.w3.org/TR/xslt2.3HL7 Standards,(http:/www.HL7.org)Informative Document:Using XML as an Alternative Mes-sage Syntax for HL7 Version 2.3.x1This guide is under the jurisdiction of ASTM Committee E31 on HealthcareInformatics and is the direct responsibility of Subcommittee E31.28 on ElectronicHealthcare Records.Current edition approved Jan 10,2002.Published March 2002.2Annual Book of ASTM Standards,Vol 14.01.1Copyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959,United States.Clinical Document Architecture:Level 12.4IETF Specifications,(http:/www.ietf.org)RFC 2396:Uniform Resource Indentifiers(URI),http:/ietf.org/rfc/rfc23963.Terminology3.1 Definitions:3.1.1 clinical document,ndefined in terms of the nativeXML and hypertext architecture.The Document Type Defini-tion(DTD)is the base method of defining the structure of aclinical document.XML schema languages such as the W3CXML Schema Language and the OASIS RELAXNG Schemalanguage provide alternative methods of defining clinicaldocument structures.3.1.2 clinical document architecture(CDA),nthe HL7CDA is a document markup standard for the structure andsemantics of exchanged clinical documents.A clinical docu-ment is a documentation of observations and other serviceswith the following characteristic