MERIT-9 - A PATIENT INFORMATION EXCHANGE GUIDELINE USING MML, HL7 ANDDICOM

To realize clinical data exchange between healthcare providers, there must be many standards in many layers. Terms and codes should be stand ardized, syntax to wrap the data must be mutually parsable, then trans fer protocol or exchange media should be agreed. Among many standards for the syntax, HL7 and DICOM are most successful. However, everything could not be handled by HL7 solely. DICOM is good for radiology image s, but, other clinical images are already handled by other 'lighter' d ata formats like JPEG, TIFF. So, it is not realistic to use only one s tandard for every area of clinical information. For description of med ical records, especially for narrative information, an standard genera lized mark-up language, document type definition (SGML DTD) for medica l information, called MML (medical markup language) had been created i n Japan. It is already implemented in more than ten healthcare provide rs. However, it is again not realistic to use MML solely for clinical information in various level of detail. Therefore, we proposed a guide line for use of available medical standards to facilitate clinical inf ormation exchange between healthcare providers. It is called MERIT-9 ( MEdical Records, Images, Texts, -Information eXchange). A typical use is HL7 messages, DICOM files, referred from an MML file in a patient r ecord, as external entities. Both MML and MERIT-9 have been research p rojects of Japanese Ministry of Health and Welfare and the purpose is to facilitate clinical data exchanges. They are becoming to be used in technical specifications for new hospital information systems in Japa n. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.