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57-492: The Theological Markup Language (ThML) is a "royalty-free" XML -based format created in 1998 by the Christian Classics Ethereal Library (CCEL) to create electronic theological texts. Other formats such as STEP and Logos Library System (LLS) were found unacceptable by CCEL as they are proprietary, prompting the creation of the new language. The ThML format borrowed elements from a somewhat similar format,

114-539: A numeric character reference . Consider the Chinese character "中", whose numeric code in Unicode is hexadecimal 4E2D, or decimal 20,013. A user whose keyboard offers no method for entering this character could still insert it in an XML document encoded either as &#20013; or &#x4e2d; . Similarly, the string "I <3 Jörg" could be encoded for inclusion in an XML document as I &lt;3 J&#xF6;rg . &#0;

171-448: A list of syntax rules provided in the specification. Some key points in the fairly lengthy list include: The definition of an XML document excludes texts that contain violations of well-formedness rules; they are simply not XML. An XML processor that encounters such a violation is required to report such errors and to cease normal processing. This policy, occasionally referred to as " draconian error handling", stands in notable contrast to

228-522: A mechanism whereby an XML processor can reliably, without any prior knowledge, determine which encoding is being used. Encodings other than UTF-8 and UTF-16 are not necessarily recognized by every XML parser (and in some cases not even UTF-16, even though the standard mandates it to also be recognized). XML provides escape facilities for including characters that are problematic to include directly. For example: There are five predefined entities : All permitted Unicode characters may be represented with

285-568: A medicine, based on HL7 Version 3. CCOW , or "Clinical Context Object Workgroup," is a standard protocol designed to enable disparate applications to share user context and patient context in real-time, and at the user-interface level. CCOW implementations typically require a CCOW vault system to manage user security between applications. Fast Healthcare Interoperability Resources is a modern interoperability specification from HL7 International designed to be easier to implement, more open, and more extensible than HL7 versions 2.x or 3.x. It leverages

342-484: A messaging, document exchange, or service approach. SAIF is the framework that is required to rationalize interoperability of other standards. SAIF is an architecture for achieving interoperability, but it is not a whole-solution design for enterprise architecture management. The Arden syntax is a language for encoding medical knowledge. HL7 International adopted and oversees the standard beginning with Arden syntax 2.0. These Medical Logic Modules ( MLMs ) are used in

399-515: A modern web-based suite of API technology, including a HTTP -based RESTful protocol, HTML and Cascading Style Sheets for user interface integration, a choice of JSON or XML for data representation, OAuth for authorization and ATOM for query results. The main purpose of the FHIR standard is to ensure interoperability between different computer systems. It defines the data format and protocol for exchanging medical information, regardless of how it

456-546: A more compact non-XML syntax; the two syntaxes are isomorphic and James Clark 's conversion tool— Trang —can convert between them without loss of information. RELAX NG has a simpler definition and validation framework than XML Schema, making it easier to use and implement. It also has the ability to use datatype framework plug-ins ; a RELAX NG schema author, for example, can require values in an XML document to conform to definitions in XML Schema Datatypes. Schematron

513-450: A number of flexible standards, guidelines, and methodologies by which these healthcare systems can communicate with each other. The standards allow for easier 'interoperability' of healthcare data as it is shared and processed uniformly and consistently by the different systems. This allows clinical and non-clinical data to be shared more easily, theoretically improving patient care and health system performance. HL7 International considers

570-506: A rich datatyping system and allow for more detailed constraints on an XML document's logical structure. XSDs also use an XML-based format, which makes it possible to use ordinary XML tools to help process them. xs:schema element that defines a schema: RELAX NG (Regular Language for XML Next Generation) was initially specified by OASIS and is now a standard (Part 2: Regular-grammar-based validation of ISO/IEC 19757 – DSDL ). RELAX NG schemas may be written in either an XML based syntax or

627-421: A validity error must be able to report it, but may continue normal processing. A DTD is an example of a schema or grammar . Since the initial publication of XML 1.0, there has been substantial work in the area of schema languages for XML. Such schema languages typically constrain the set of elements that may be used in a document, which attributes may be applied to them, the order in which they may appear, and

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684-527: A vocabulary to refer to the constructs within an XML document, but does not provide any guidance on how to access this information. A variety of APIs for accessing XML have been developed and used, and some have been standardized. Existing APIs for XML processing tend to fall into these categories: Stream-oriented facilities require less memory and, for certain tasks based on a linear traversal of an XML document, are faster and simpler than other alternatives. Tree-traversal and data-binding APIs typically require

741-616: Is a ANSI certified clinically focused high-level expression language standard curated by Health Level 7. It is designated for clinical knowledge sharing in the domains of electronic clinical quality measurement and clinical decision support . Clinical quality language is being used for a variety of clinical applications including WHO SMART guidelines where it is used for encoding decision logic and performance indicators. The Centers for Medicare & Medicaid Services adopted CQL for clinical quality measure specifications since 2019. CQL allows modular and flexible expression of logic and

798-458: Is a lexical , event-driven API in which a document is read serially and its contents are reported as callbacks to various methods on a handler object of the user's design. SAX is fast and efficient to implement, but difficult to use for extracting information at random from the XML, since it tends to burden the application author with keeping track of what part of the document is being processed. It

855-726: Is a language for making assertions about the presence or absence of patterns in an XML document. It typically uses XPath expressions. Schematron is now a standard (Part 3: Rule-based validation of ISO/IEC 19757 – DSDL ). DSDL (Document Schema Definition Languages) is a multi-part ISO/IEC standard (ISO/IEC 19757) that brings together a comprehensive set of small schema languages, each targeted at specific problems. DSDL includes RELAX NG full and compact syntax, Schematron assertion language, and languages for defining datatypes, character repertoire constraints, renaming and entity expansion, and namespace-based routing of document fragments to different validators. DSDL schema languages do not have

912-570: Is an XML industry data standard. XML is used extensively to underpin various publishing formats. One of the applications of XML is in the transfer of Operational meteorology (OPMET) information based on IWXXM standards. The material in this section is based on the XML Specification . This is not an exhaustive list of all the constructs that appear in XML; it provides an introduction to the key constructs most often encountered in day-to-day use. XML documents consist entirely of characters from

969-507: Is an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. The standard was jointly published with ISO as ISO/HL7 27932. The Continuity of Care Document framework is a US-specific standard for the exchange of medical summaries, based on the Clinical Document Architecture standard. Structured Product Labeling describes the published information that accompanies

1026-498: Is better suited to situations in which certain types of information are always handled the same way, no matter where they occur in the document. Pull parsing treats the document as a series of items read in sequence using the iterator design pattern . This allows for writing of recursive descent parsers in which the structure of the code performing the parsing mirrors the structure of the XML being parsed, and intermediate parsed results can be used and accessed as local variables within

1083-519: Is both human-readable and machine processable. An implementation of CQL was open sourced and published by the National Committee for Quality Assurance in 2023 with the aim of encouraging adoption of the language. A large portion of HL7 messaging is transported by Minimal Lower Layer Protocol (MLLP), also known as Lower Layer Protocol (LLP) or Minimum Layer Protocol (MLP). For transmitting via TCP/IP, header and trailer characters are added to

1140-442: Is not permitted because the null character is one of the control characters excluded from XML, even when using a numeric character reference. An alternative encoding mechanism such as Base64 is needed to represent such characters. Comments may appear anywhere in a document outside other markup. Comments cannot appear before the XML declaration. Comments begin with <!-- and end with --> . For compatibility with SGML ,

1197-562: Is stored in these systems. The HL7 Services-Aware Enterprise Architecture Framework (SAIF) provides consistency between all HL7 artifacts, and enables a standardized approach to Enterprise Architecture (EA) development and implementation, and a way to measure the consistency. SAIF is a way of thinking about producing specifications that explicitly describe the governance, conformance, compliance, and behavioral semantics that are needed to achieve computable semantic working interoperability. The intended information transmission technology might use

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1254-437: Is the default repetition separator. Each segment starts with a 3-character string that identifies the segment type. Each segment of the message contains one specific category of information. Every message has MSH as its first segment, which includes a field that identifies the message type. The message type determines the expected segment types in the message. The segment types used in a particular message type are specified by

1311-450: The .NET Framework , and the DOM traversal API (NodeIterator and TreeWalker). Health Level 7 Health Level Seven , abbreviated to HL7 , is a range of global standards for the transfer of clinical and administrative health data between applications with the aim to improve patient outcomes and health system performance. The HL7 standards focus on the application layer, which is "layer 7" in

1368-504: The Internet . It is a textual data format with strong support via Unicode for different human languages . Although the design of XML focuses on documents, the language is widely used for the representation of arbitrary data structures , such as those used in web services . Several schema systems exist to aid in the definition of XML-based languages, while programmers have developed many application programming interfaces (APIs) to aid

1425-916: The Open Systems Interconnection model . The standards are produced by Health Level Seven International , an international standards organization , and are adopted by other standards issuing bodies such as American National Standards Institute and International Organization for Standardization . There are a range of primary standards that are commonly used across the industry, as well as secondary standards which are less frequently adopted. Health organizations typically have many different computer systems used to process different patient administration or clinical tasks, such as billing, medication management, patient tracking, and documentation. All of these systems should communicate, or "interface", with each other when they receive new information or when they wish to retrieve information. HL7 International specifies

1482-589: The Text Encoding Initiative (TEI). As of September 19, 2006, CCEL had 650 documents in this format. The advantage of using an XML-based format is that a ThML text can be converted into HTML by using an XSLT stylesheet. Also, standard XML tools can convert to PDF and RTF . As of November 8, 2012, the last Document Type Definition of the format, version 1.04, was released on January 20, 2003. XML The design goals of XML emphasize simplicity, generality, and usability across

1539-453: The Unicode repertoire. Except for a small number of specifically excluded control characters , any character defined by Unicode may appear within the content of an XML document. XML includes facilities for identifying the encoding of the Unicode characters that make up the document, and for expressing characters that, for one reason or another, cannot be used directly. Unicode code points in

1596-410: The infoset augmentation facility and attribute defaults. RELAX NG and Schematron intentionally do not provide these. A cluster of specifications closely related to XML have been developed, starting soon after the initial publication of XML 1.0. It is frequently the case that the term "XML" is used to refer to XML together with one or more of these other technologies that have come to be seen as part of

1653-698: The HL7 V3 development methodology. RIM expresses the data content needed in a specific clinical or administrative context and provides an explicit representation of the semantic and lexical connections that exist between the information carried in the fields of HL7 messages. HL7 Development Framework - ISO /HL7 27931 The HL7 Version 3 Development Framework (HDF) is a continuously evolving process that seeks to develop specifications that facilitate interoperability between healthcare systems. The HL7 RIM, vocabulary specifications, and model-driven process of analysis and design combine to make HL7 Version 3 one methodology for

1710-429: The XML core. Some other specifications conceived as part of the "XML Core" have failed to find wide adoption, including XInclude , XLink , and XPointer . The design goals of XML include, "It shall be easy to write programs which process XML documents." Despite this, the XML specification contains almost no information about how programmers might go about doing such processing. The XML Infoset specification provides

1767-549: The XML processor inserts in the DTD itself and in the XML document wherever they are referenced, like character escapes. DTD technology is still used in many applications because of its ubiquity. A newer schema language, described by the W3C as the successor of DTDs, is XML Schema , often referred to by the initialism for XML Schema instances, XSD (XML Schema Definition). XSDs are far more powerful than DTDs in describing XML languages. They use

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1824-512: The aim to support all healthcare workflows. Development of version 3 started around 1995, resulting in an initial standard publication in 2005. The v3 standard, as opposed to version 2, is based on a formal methodology (the HDF) and object-oriented principles. RIM - ISO/HL7 21731 The Reference Information Model (RIM) is the cornerstone of the HL7 Version 3 development process and an essential part of

1881-434: The allowable parent/child relationships. The oldest schema language for XML is the document type definition (DTD), inherited from SGML. DTDs have the following benefits: DTDs have the following limitations: Two peculiar features that distinguish DTDs from other schema types are the syntactic support for embedding a DTD within XML documents and for defining entities , which are arbitrary fragments of text or markup that

1938-617: The analysis of electronic health record architectures and requirements. HL7 specifications draw upon codes and vocabularies from a variety of sources. The V3 vocabulary work ensures that the systems implementing HL7 specifications have an unambiguous understanding of the code sources and code value domains they are using. V3 Messaging The HL7 version 3 messaging standard defines a series of Secure Text messages (called interactions ) to support all healthcare workflows. HL7 v3 messages are based on an XML encoding syntax, as shown in this example: The HL7 Clinical Document Architecture (CDA)

1995-598: The base language for communication protocols such as SOAP and XMPP . It is one of the message exchange formats used in the Asynchronous JavaScript and XML (AJAX) programming technique. Many industry data standards, such as Health Level 7 , OpenTravel Alliance , FpML , MISMO , and National Information Exchange Model are based on XML and the rich features of the XML schema specification. In publishing, Darwin Information Typing Architecture

2052-401: The behavior of programs that process HTML , which are designed to produce a reasonable result even in the presence of severe markup errors. XML's policy in this area has been criticized as a violation of Postel's law ("Be conservative in what you send; be liberal in what you accept"). The XML specification defines a valid XML document as a well-formed XML document which also conforms to

2109-423: The case of C1 characters, this restriction is a backwards incompatibility; it was introduced to allow common encoding errors to be detected. The code point U+0000 (Null) is the only character that is not permitted in any XML 1.1 document. The Unicode character set can be encoded into bytes for storage or transmission in a variety of different ways, called "encodings". Unicode itself defines encodings that cover

2166-480: The clinical setting as they can contain sufficient knowledge to make single medical decisions. They can produce alerts, diagnoses, and interpretations along with quality assurance function and administrative support. An MLM must run on a computer that meets the minimum system requirements and has the correct program installed. Then, the MLM can give advice for when and where it is needed. Clinical Quality Language (CQL)

2223-429: The data structure and contain metadata . What is within the tags is data, encoded in the way the XML standard specifies. An additional XML schema (XSD) defines the necessary metadata for interpreting and validating XML. (This is also referred to as the canonical schema.) An XML document that adheres to basic XML rules is "well-formed"; one that adheres to its schema is "valid." IETF RFC 7303 (which supersedes

2280-549: The development of consensus-based standards for healthcare information systems interoperability . The HDF is the most current edition of the HL7 V3 development methodology. The HDF not only documents messaging, but also the processes, tools, actors, rules, and artifacts relevant to the development of all HL7 standard specifications. Eventually, the HDF will encompass all of the HL7 standard specifications, including any new standards resulting from

2337-442: The direct use of almost any Unicode character in element names, attributes, comments, character data, and processing instructions (other than the ones that have special symbolic meaning in XML itself, such as the less-than sign, "<"). The following is a well-formed XML document including Chinese , Armenian and Cyrillic characters: The XML specification defines an XML document as a well-formed text, meaning that it satisfies

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2394-516: The entire repertoire; well-known ones include UTF-8 (which the XML standard recommends using, without a BOM ) and UTF-16 . There are many other text encodings that predate Unicode, such as ASCII and various ISO/IEC 8859 ; their character repertoires are in every case subsets of the Unicode character set. XML allows the use of any of the Unicode-defined encodings and any other encodings whose characters also appear in Unicode. XML also provides

2451-498: The following ranges are valid in XML 1.0 documents: XML 1.1 extends the set of allowed characters to include all the above, plus the remaining characters in the range U+0001–U+001F. At the same time, however, it restricts the use of C0 and C1 control characters other than U+0009 (Horizontal Tab), U+000A (Line Feed), U+000D (Carriage Return), and U+0085 (Next Line) by requiring them to be written in escaped form (for example U+0001 must be written as &#x01; or its equivalent). In

2508-440: The following standards to be its primary standards – those standards that are most commonly used and implemented: Other HL7 standards/methodologies include: The HL7 version 2 standard (also known as Pipehat) has the aim to support hospital workflows. It was originally created in 1989. HL7 version 2 defines a series of electronic messages to support administrative, logistical, financial as well as clinical processes. Since 1987

2565-685: The functions performing the parsing, or passed down (as function parameters) into lower-level functions, or returned (as function return values) to higher-level functions. Examples of pull parsers include Data::Edit::Xml in Perl , StAX in the Java programming language, XMLPullParser in Smalltalk , XMLReader in PHP , ElementTree.iterparse in Python , SmartXML in Red , System.Xml.XmlReader in

2622-510: The message to identify the beginning and ending of the message because TCP/IP is a continuous stream of bytes. Hybrid Lower Layer Protocol (HLLP) is a variation of MLLP that includes a checksum to help verify message integrity. Amongst other software vendors, MLLP is supported by Microsoft, Oracle, Cleo . MLLP contains no inherent security or encryption but relies on lower layer protocols such as Transport Layer Security (TLS) or IPsec for safeguarding Protected health information outside of

2679-550: The older RFC 3023 ), provides rules for the construction of media types for use in XML message. It defines three media types: application/xml ( text/xml is an alias), application/xml-external-parsed-entity ( text/xml-external-parsed-entity is an alias) and application/xml-dtd . They are used for transmitting raw XML files without exposing their internal semantics . RFC 7303 further recommends that XML-based languages be given media types ending in +xml , for example, image/svg+xml for SVG . Further guidelines for

2736-449: The processing of XML data. The main purpose of XML is serialization , i.e. storing, transmitting, and reconstructing arbitrary data. For two disparate systems to exchange information, they need to agree upon a file format. XML standardizes this process. It is therefore analogous to a lingua franca for representing information. As a markup language , XML labels, categorizes, and structurally organizes information. XML tags represent

2793-487: The rules of a Document Type Definition (DTD). In addition to being well formed, an XML document may be valid . This means that it contains a reference to a Document Type Definition (DTD), and that its elements and attributes are declared in that DTD and follow the grammatical rules for them that the DTD specifies. XML processors are classified as validating or non-validating depending on whether or not they check XML documents for validity. A processor that discovers

2850-483: The segment for additional patient information. HL7 v2.x has allowed for the interoperability between the plethora of digital health systems, from Patient Administration Systems, to Electronic Health Records, and specialised Laboratory and Radiology Information Systems. Currently, the HL7 v2.x messaging standard is supported by every major health informatics vendor in the United States. The HL7 version 3 standard has

2907-644: The segment grammar notation used in the HL7 standards. The following is an example of an admission message. MSH is the header segment, PID the Patient Identity, PV1 is the Patient Visit information, etc. The 5th field in the PID segment is the patient's name, in the order, family name, given name, second name (or their initials), suffix, etc. Depending on the HL7 V2.x standard version, more fields are available in

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2964-477: The standard has been updated regularly, resulting in more than ten iterations. The v2.x standards are backward compatible , meaning a message based on version 2.3 will be understood by an application that supports version 2.6. HL7 v2.x messages use a non- XML encoding syntax based on segments ( lines ) and one-character delimiters . Segments have composites ( fields ) separated by the composite delimiter. A composite can have sub-composites (components) separated by

3021-469: The string "--" (double-hyphen) is not allowed inside comments; this means comments cannot be nested. The ampersand has no special significance within comments, so entity and character references are not recognized as such, and there is no way to represent characters outside the character set of the document encoding. An example of a valid comment: <!--no need to escape <code> & such in comments--> XML 1.0 (Fifth Edition) and XML 1.1 support

3078-436: The sub-composite delimiter, and sub-composites can have sub-sub-composites (subcomponents) separated by the sub-sub-composite delimiter. The default delimiters are carriage return for the segment separator, vertical bar or pipe ( | ) for the field separator, caret ( ^ ) for the component separator, ampersand ( & ) for the subcomponent separator, and number sign (#) for the default truncation separator. The tilde ( ~ )

3135-522: The use of XML in a networked context appear in RFC 3470 , also known as IETF BCP 70, a document covering many aspects of designing and deploying an XML-based language. XML has come into common use for the interchange of data over the Internet. Hundreds of document formats using XML syntax have been developed, including RSS , Atom , Office Open XML , OpenDocument , SVG , COLLADA , and XHTML . XML also provides

3192-472: The use of much more memory, but are often found more convenient for use by programmers; some include declarative retrieval of document components via the use of XPath expressions. XSLT is designed for declarative description of XML document transformations, and has been widely implemented both in server-side packages and Web browsers. XQuery overlaps XSLT in its functionality, but is designed more for searching of large XML databases . Simple API for XML (SAX)

3249-426: The vendor support of XML Schemas yet, and are to some extent a grassroots reaction of industrial publishers to the lack of utility of XML Schemas for publishing . Some schema languages not only describe the structure of a particular XML format but also offer limited facilities to influence processing of individual XML files that conform to this format. DTDs and XSDs both have this ability; they can for instance provide

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