Version 2.3: Background of the revision

MML Version 2.21 was officially announced on November 1, 1999, at which time full-scale implementation tests were performed, special interest groups (SIGs) were created in specialized fields, and standards were developed. As the implementation advanced, the existence of insufficient information and functions in Version 2.21 was pointed out. This situation led to the release of the current MML Version 2.3. A summary of the revision is provided hereinafter.

Revision of access right definition

The structure of the document access right definition in MML Version 2.21 was reexamined. Specifically, the following elements were added/corrected, making it possible to set up facilities, departments, occupations, and personal IDs that can be referred to in documents.

accessRight

Access right element. The number of preset access rights is repeated. At a minimum, it is necessary to set up an access right for the person who makes an entry so that that person will not be prevented from making reference. One attribute that is held is “permit” (right of reference). The attribute “permit” can have values for “none” (no access permissible), “read” (reference permissible), “write” (reference and correction permissible), “delete” (reference and deletion permissible), and “all” (reference, correction, and deletion permissible). Other available attributes include “mmlSc:startDate” (start date) and “mmlSc:endDate” (end date).

Subordinate to these elements are the four elements described below.

mmlSc:facility

Sets up access rights according to facility units.

mmlSc:department

Sets up access rights according to departmental units.

mmlSc:licence

Sets up access rights according to licensed occupation units.

mmlSc:person

Sets up access rights according to individual personal units.

 

Establishment of group ID

Group IDs were established in order to construct items such as summaries and letters of referral by combining multiple modules. In order to interconnect different modules, Version 2.21 is equipped with a related parent document ID (parentId) tag, which is used during document revision for correlation with the document that existed before revision. It was pointed out, however, that when information is controlled in module units with MML implementation, searching is easier if completely equivalently arranged module groups are controlled with the same document ID. Given this background, it became possible to set up an identical ID (that is, a groupId) separately from the document ID for multiple modules requiring arrangement as a document.

Specifically, the element “groupId” is added as well as “uid” (document unique ID) and “parentId” (related parent document ID), as a subordinate element, to the “docId” in the MML document header (docInfo). Furthermore, “groupClass” can be set up as an attribute, making it possible to set up classes of module group documents (such as letters of referral).

Revision of health insurance module

The MML health insurance module is also used for linking electronic medical charts and clinical systems as the addition of more detailed information items was sought. Personal identification information, such as the name of the person insured, was entered by means of the patient information module in Version 2.21. But if the patient is not the insured himself or herself, it becomes necessary to enter information on the insured; thus, information on the insured was added to the health insurance module. Moreover, since the patient’s share of the bill may differ depending on whether the patient is an inpatient or outpatient, the two cases were differentiated. Health insurance classifications (legal codes and designations), information on the insured (such as place of business), and detailed government funding information were also added.

Letter of referral module

For the letter of referral, the use of the existing clinical summary information module was examined. But because of the existence of insufficient information items, such as the purpose of referral, a referral module was newly established.

Report module

A module was added for writing general-purpose reports, without being limited to that of radiation. The module was aimed at radiological tests, physiological tests, and pathologic cytological diagnosis and test, with a simple structure being selected rather than a detailed structure for each individual test.

The specific structure includes a root element (mmlRp:ReportModule) as a module; then subordinate to that are report header information (test performance date/time, report date/time, report status, report class, report subclass, internal organ, requester information, and performer information) and the report text (chief complaints, test purpose, test diagnosis, test notes, external reference, test comment, test comment designation, and test free comment).

 

Test history information module

A module was added for giving structure to the results of laboratory tests. Targeted tests include laboratory (specimen) tests, as well as endocrine load tests and urinary sediment. Bacilliculture tests, histopathologic tests, and cytological diagnoses are not targeted. With normal operation, a single module corresponds to a single request slip (or single test set). For the test item code, it is possible to include both the facility’s unique code and JLAC10 code (Japanese Society of Laboratory Medicine).

The specific structure includes a root element (mmlLb:TestModule) as a module; then subordinate to that are test history header information (mmlLb:information) and laboratory test result information (mmlLb:laboTest), the latter of which includes specimen unit repetition. Test history header information includes the request ID, sampling date/time, registration date/time, report date/time, report status, set name, request facility, request department, request ward, requester, test-performing facility, test performer, report comment, report comment designation, and report free comment. Furthermore, the laboratory test result information includes specimen information (specimen material, specimen comment, specimen comment designation, and specimen free comment) and item information (item name, facility’s unique code, facility’s unique code system name, analyzed item code, identification code, material code, measurement method code, result identification code, value, value “numerical value,” upper limit, lower limit, standard value “character,” abnormal value flag, unit, external reference information, external reference, item comment, item comment designation, and item free comment). For item information, only the number of items is repeated.

Addition of tables

Along with the revision and addition of the aforementioned modules and correction of the access right definition, the following tables were added:

MML0031 Insurance Class (insurance class)

MML0032 Pay ratio type (share method code)

MML0033 Medical Role

MML0034 Access approval classification

MML0035 Facility access right definition

MML0036 Personal access right definition