Revision of the access right definition

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

accessRight

This is the access right element. It is repeated the number of times access rights are set up. At least, it is essential to set up an access right for creators so that they will not be prevented from making a reference. One attribute in the element is “permit”( right of reference). The “permit” attribute can hold values of “none” (no access permissible), “read” (reference permissible), “write” (reference and correction permissible), “delete” (reference and deletion permissible), and “all” (reference, correction, and deletion permissible). The other available attributes are “mmlSc:startDate” (start date) and “mmlSc:endDate” (end date).

The following four elements are subordinate to this element:

mmlSc:facility

To set up access rights in the facility unit.

mmlSc:department

To set up access rights in the medical department unit.

mmlSc:licence

To set up access rights in the occupation unit.

mmlSc:person

To set up access rights in the individual person unit.

Establishment of group ID

Group ID was established in order to make items such as summaries and letters of referral by combining multiple modules. In order to associate different modules, Version 2.21 was equipped with related parent document ID (parentId) tags, used in document revisions to correlate with documents that existed before the revisions were carried out. It was pointed out, however, that when the data was controlled by the module unit during implementation of the MML, searching would have been easier if a group of modules which were completely equivalent and could be linked was controlled with the same document ID. Given this background, it became possible to set up an identical ID (that is, groupId) separately from a document ID for multiple modules that are required to be grouped into a document.

Specifically, following the “uid” (document unique ID) and “parentId” (related parent document ID) elements the “groupId” element was added as a subordinate element to the “docId” element within the MML document header (docInfo). Furthermore, the “groupClass” attribute was added, making it possible to classify document types of module groups (such as letters of referral).

Revision of the health insurance module

Since the MML health insurance module was also used for linking electronic medical chart and clinical systems, it was necessary to add information items with greater detail. As for Version 2.21, personal identification information, such as the name of the person insured, was entered in the patient information module. But if the patient himself/herself was not the person insured, it became necessary to enter information on the insured person; thus, this latter information was added to the health insurance module. Moreover, since the patient’s share of bills may differ depending on whether the patient is an inpatient or outpatient, it became possible to differentiate between these two cases. Health insurance class (legal codes and designations), insurer’s information (such as the name of place of business), and detailed public insurance information were also added.

Referral module

For letters of referral, the use of the existing clinical summary information module was examined. However, because of the lack of certain kinds of information, such as the purpose of referral, a new referral module was created.

Report information module

This module was added for writing general-purpose reports, not limited solely to radiation-related reports. The module was aimed at radiological tests, physiological tests, and pathologic cytological diagnoses and tests, with a simple structure being selected rather than a detailed structure for each individual test.

The specific structure contains the root element (mmlRp:ReportModule) in the module and the subordinate elements of report header information (test performance date/time, report date/time, report status, report class, report subclass, internal organ, requester information, and performer information) and report body information (chief complaint, test purpose, test diagnosis, test note, external reference, test comment, test comment name, and test free comment).

Test history information module

This module was added to give structure to laboratory test results. Targeted tests are laboratory (specimen) tests, including endocrine load tests and urinary sediments. Bacilli culture tests, histopathological tests, and cytological diagnoses are not targeted. In normal operations, a single module corresponds to a single request slip (or a single test set). For test item codes, it is possible to include both the facility’s unique code and JLAC10 code (Japanese Society of Laboratory Medicine).

The specific structure contains the root element (mmlLb:TestModule) in the module and the subordinate elements of test history header information (mmlLb:information) and laboratory test result information (mmlLb:laboTest), the latter being repeated by the specimen unit. The test history header information includes the request ID, sampling date/time, registration date/time, report date/time, report status, set name, requesting facility, requesting medical department, requesting ward, test requester, test performing facility, test performer, report comment, report comment name, and report free comment. On the other hand, the laboratory test result information includes specimen information (specimen material, specimen comment, specimen comment name, 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, “numerical” value, upper limit value, lower limit value, normal range “in characters”, abnormal value flag, unit, external reference information, external reference, item comment, item comment name, and item free comment). The item information is repeated only the same number of times as the number of items.

Addition of tables

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

MML0031 Insurance class (type of insurance)

MML0032 Pay ratio type (payment type code)

MML0033 Medical role

MML0034 Access approval classification

MML0035 Facility access right definition

MML0036 Personal access right definition