SGML: HL7 Healthcare Initiative

SGML: HL7 Healthcare Initiative

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Date: Fri, 29 Nov 96 05:37:28 CST
From: (Paul Grosso)
Message-Id: <>
Subject: HL7 Healthcare initiative

. . . here is a summary from Dan Essin on the SGML initiative in Healthcare.

[Daniel Essin is Director of Medical Informatics at LA County Hospital and
the University of Southern California Medical Center.]

From: "Daniel Essin, MD" <>

Synopsis of the SGML initiative in Healthcare:

HL7 (healthcare ISO level 7 application standard) is a long-established
standard for the message oriented transfer of event-driven information
between healthcare systems. This means that HL7 is used to notify the lab
that a patient was moved or that a test was ordered and to notify the
pharmacy that a medication was ordered. The application system that will do
the work often sends a reciprocal message upon completion to notify other
systems of the "results". To date most of the messages (with the exception
of lab results) are administrative in nature. The current standard
assumptions assumes that all communicating systems are owned or controlled
by the same entity and that changes will happen slowly enough to code and
test them.

HL7 messages use a form of "markup" in that they are composed of delimited
strings and define the delimiter set at the beginning of each message.

Interface engines are frequently used to mediate the communications and to
route, filter and translate various messages.

Certain types of information are not handled well by existing HL7. They
include complex clinical reports with significant included detail and
inquiries that may return sets of such reports.

As institutions branch out into new, distributed relationships as a part of
mananged care, more dynamic and self-defining interchange schemes would be

A number of us in healthcare have concluded that SGML would provide a good
solution to all of these problems - structuring complex information laden
documents, facilitating more ad hoc transfers of information and providing a
more flexible means of transmitting large and/or complex result sets.

In order to accomplish this there the healthcare information systems vendors
and users will advice on DTD design and tool sets to help them incorporate
SGML into existing and planned systems.

Daniel Essin, MD                                 
Director of Medical Informatics, LAC+USC Medical Center    fax   (818) 358-8724
USC School of Medicine                                     voice (213)-226-3188