Applied Mechanics and Materials Online: 2014-01-16 ISSN: 1662-7482, Vols. 496-500, pp 2182-2187 doi:10.4028/www.scientific.net/amm.496-500.2182 2014 Trans Tech Publications, Switzerland Research on Medical Information Cross-regional Integration Scheme Ying Sun 1, a, Jing Chen 1,b and Jian Song 1,c 1 Medical Instrument and Food Engineering College University of Shanghai for Science and Technology, Shanghai, China a yysyysun@163.com, b 122310280@qq.com, c huiyi_shanghai@163.com Keywords: IHE-XDS. ebxml. Medical document Sharing Abstract. Cross-regional medical information sharing is a research hotspot in the field of current regional health informatization. This paper put forward a system architecture based on IHE-XDS (Integrating Healthcare Enterprise-Cross Enterprise Document Sharing) technology framework, meeting the requirements of ebxml (Electronic Business using extensible Markup Language) and distributed access to patient medical documents, and completed the document registration inquiry services and achieved document sharing by studying the mapping relationships between IHE-XDS and ebxml information models. Introduction Cross-regional health informatization is the hotspot and difficulty in the field of current medical informatization. In the construction of regional health information platforms, there are many problems such as disunity of data standards, disunity of medical information sharing flow and so on. With the advances of information technology and the improvement of people's demand for health services, it is urgently needed to achieve the patient's information sharing among hospitals and regions [1]. Therefore, the most important issue we face is how to organize such heterogeneous medical document information for easy search and access. IHE-XDS provides an ebrim-based medical document sharing program within security domain [2,3], using a unified way to describe the properties of medical information documents, providing a solution based on standard description for the medical information document sharing in distributed heterogeneous environments. EbXML Registry EbXML [4] is a set of specifications to support modular electronic commerce framework, which allows businesses in any industry around the world to negotiate and become business partners through the exchange of XML messages. ebxml has defined not only the complete architecture, but also new ways to think about business, recording and storing the information in the ebxml registry / repository for any business to share [5]. EbRIM is one of ISO15000 series of standards developed by OASIS, defining the stored information description specification of document registry, including metadata types, mutual relations and so on. Of which the defined classes mainly include Registry Object, Extrinsic Object, Registry Package, Slot, Classification, Association, External Identifier and so on [6,7]. EbXML registry information model is shown in Fig. 1. All rights reserved. No part of contents of this paper may be reproduced or transmitted in any form or by any means without the written permission of Trans Tech Publications, www.ttp.net. (#69806405, Pennsylvania State University, University Park, USA-18/09/16,01:36:16)
Applied Mechanics and Materials Vols. 496-500 2183 Fig. 1 EbXML Registry Information Model In Fig.1, the Registry Object class is used to provide the metadata of registry objects, Registry Package is used to describe the object collection of Registry Object, Classification is used to classify Registry Object, External Identifier class is used to provide additional identifier information, and Slot is used to add dynamic properties. Cross-Regional Information Integration Solutions IHE-XDS Profile. IHE [8,9] is an integrated framework established by RSNA (Radiology Society of North America) and HIMSS (Healthcare Information Management Systems Society), aiming to promote the medical information system, which provides effective integration scheme guidance for information sharing, helps health care providers effectively and safely create, manage and access to patient medical information, thereby improving medical quality and reducing medical errors [10]. XDS [11-13] is a sub-frame under IHE ITI framework used to promote the inter-agency sharing of patient medical information, and its core design philosophy is: in an application area, a registered document library (based on the ebxml registry / repository architecture) saves the index information of all available document, provides users with a unified query and extraction services [14]. IHE-XDS integrated schematic framework is shown in Fig. 2. Fig. 2 IHE-XDS Integrated Schematic Framework Document source is the producer and publisher of medical information documents. It publishes the medical information documents generated by HIS, RIS and PACS and other systems, submitting medical documents to document repositories; by searching the patient s unique identifier in the document registry, the user forms XML files with the query terms containing the patient s unique identifier, and sends document query request to the document registry; the document registry parses
2184 Frontiers of Manufacturing and Design Science IV query terms, searches the qualifying documents in the document repository, and feed them back to the user in the file form of XML; the user parses the XML file contents, gets the required metadata information including inspection time, hospital name, summary, etc., extracts the corresponding documents from the document repository.the document sharing flow is shown in Fig. 3. Fig. 3 Document Sharing Flow Document Registration Data Model and Registry Information Model Mapping. The core of IHE XDS achieving inter-agency medical information sharing is the affair communication between roles, which submits the documents to the document repository for storage through the document source, and registers the document metadata in the document repository. IHE XDS document registration data model is shown in Fig. 4. Fig. 4 IHE XDS Document Registration Data Model XDS metadata is the entity for the information exchange between the roles of IHE XDS, as the registration / storage concept in ebxml specifications is similar to the registry / repository in XDS, so the XDS Document Entry metadata, XDS Submission Set metadata and XDS Folder metadata in the XDS are mapped with the classes in the ebxml to complete the registration of medical documents and achieve document sharing. XDS document entry is the information entity for the management of the document registry, which contains the metadata sets and document links describing XDS documents, to the maximizing the description of the characteristics of medical information documents, and each medical information document should correspond to a XDS document entry object, and each document entry has a
Applied Mechanics and Materials Vols. 496-500 2185 universally unique ID (EntryUUID), each document also contains a universally unique ID (uniqueid). XDS Document Entry corresponds to the ExtrisicObject class in registry information models that describe the properties and characteristics of metadata information, correspond with the submitted documents, providing a transparent registration of registry content. The management of registries toward document entries are identified by the ExtrinsicObject.id: <ExtrinsicObject id="document01" mimetype="text/xml" objecttype="urn:uuid:7edca82f-054d-4 7f2-a032-9b2a5b5186c1"> </ExtrinsicObject> XDS Submission Set is the submission unit of medical information documents, each information document submission / registration must be placed in an XDS Submission Set. Registry Package divides XDS metadata into Submission Set metadata and XDS Folder metadata according to the internal classification rules. XDSSubmissionSet.uniqueId is the universally unique ID used to identify the instances of document submission set, and each time of a medical institution submitting a request shall correspond to a document submission set, generating a permanent record for a new XDS document, and the submissiontime shall record the document submission time, while generating permanent records for the existing XDS documents associated with the same events: <RegistryPackage id="submissionset01"> <Slot name="submissiontime"> <Value>20121225235050</Value></Slot> <LocalizedString value="xdssubmissionset.uniqueid"/> </RegistryPackage> XDS folder is used to group XDS documents for multiple document sources under different conditions and organize the interrelated documents in a folder, enable users to quickly find all XDS document entries in the same folder. Finding the corresponding folder location through XDSFolder.uniqueId, the registered patient can be found through the XDSFolder.patientId: <RegistryPackage id="folder"> <LocalizedStringvalue="XDSFolder.uniqueId"> <ExternalIdentifier id="urn:uuid:2876acb1-e84c-9fe4-d356-f98d6e8afd82" identificationscheme="urn:uuid:f64ffdf0-4b97-4e06-b79f-a52b38ec2f8a" registryobject="folder" value="$patientid"> <LocalizedString value="xdsfolder.patientid"/> </ExternalIdentifier> </RegistryPackage> XDS Document Query Service Implementation. XDS document query service is initiated by the document user to a document registry, and after the physical memory address of the required documents is returned, the user may issue document retrieval requests to the document repository. The document user s query request is encapsulated in an AdhocQueryRequest object is sent to the document registry by adding it to the SOAP message. Taking a XDS document as an example, to set the returned query result class as LeafClass (a list of returned objects), to seek XDSDocumentUniqueId corresponding to XDS document from the Slot class based on the keyword "uniqueid07", and then get the value of the sub-node corresponding to the XDSDocumentUniqueId by searching ExternalIdentifier, and finally, to form metadata document according to the format sequence, and return it to the document user. The flow of a user submitting a query document is shown in Fig.5.
2186 Frontiers of Manufacturing and Design Science IV Fig. 5 User Submitting a Query Document Search the corresponding record with uniqueid07 as XDSDumentEntryUniqueId in the registry, as shown in Fig.6. Fig. 6 Search the Corresponding Record in the Registry After a successful search, return the query result status to the client via SOAP message, as shown in Fig.7. Fig. 7 Query Result Status Discussion and Conclusions The paper mainly studied the process of mapping the XDS Framework Data Model with ebxml information model by applying ebrim technical specifications on the XDS framework, so as to achieve XDS document registration and query. The paper has achieved XDS document sharing with the ebxml registration model, and in the further studies, automated reasoning within delineated areas should be further realized on the basis of the semantic representation, so as to provide the more convenient application ways for cross-regional sharing. References [1] Mendez-Rangel, J., Lozano-Garzon, C. A network design methodology proposal for E-health in rural areas of developing countries. Telematics and Information Systems (EATIS), 2012 6th Euro American Conference on Publication Year: 2012 :1-7 [2] Noumeir, R., Sharing Medical Records: The XDS Architecture and Communication Infrastructure IT Professional, IEEE Journals & Magazines, 2011, Vol.13 (4) : 46-52 [3] Rinner C, Kohler M, Hübner-Bloder G, Saboor S, Ammenwerth E, Duftschmid G. Archetype based search in an IHE XDS environment, Stud Health Technol Inform, 2012;180:631-5
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