Log in

The Development of Medical Markup Language Version 4 as a Clinical Document Exchange Format for Nationwide EHR Systems

  • Transactional Processing Systems
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

Medical Markup Language (MML) is a standard format for exchange of healthcare data among healthcare providers. Following the last major update (version 3), we developed new modules and discussed the requirements for the next major updates. Subsequently, in 2016 we released MML version 4 and used it to obtain clinical data from healthcare providers for a nationwide electronic health records (EHR) system. In this article we provide an overview of this major update of MML version 4 and discuss its interoperability for clinical data.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. International Organization for Standardization: ISO 8879:1986: Information processing — Text and office systems — Standard Generalized Markup Language (SGML) Geneva: International Organization for Standardization, 1986. http://www.iso.ch/cate/d16387.html

    Google Scholar 

  2. Guo J., Araki K., Tanaka K., Sato J., Suzuki M., Takada A., Suzuki T., Nakashima Y., Yoshihara H.: The Latest MML (Medical Markup Language) Version 2.3 – XML-based standard for medical data exchange/storage. J. Med. Syst. 27 (4): 357, 2003

    Article  CAS  Google Scholar 

  3. Guo J., Takada A., Tanaka K., Sato J., Suzuki M., Suzuki T., Nakashima Y., Araki K., Yoshihara H.: The Development of MML (Medical Markup Language) Version 3.0 as a medical document exchange format for HL7 messages. J. Med. Syst. 28 (6): 523, 2004

    Article  Google Scholar 

  4. Dolin R. H., Alschuler L., Beebe C., Biron P. V., Boyer S. L., Essin D., Kimber E., Lincoln T., Mattison J. E.: The HL7 clinical document architecture. J. Am. Med. Inform. Assoc. 8 (6): 552, 2001

    Article  CAS  Google Scholar 

  5. Takemura T., Araki K., Arita K., Suzuki T., Okamoto K., Kume N., Tomohiro K.T., Takada A., Yoshihara H.: Development of fundamental infrastructure for nationwide EHR in Japan. J. Med. Sys. 36 (4): 2213, 2012

    Article  Google Scholar 

  6. Guo J., Takada A., Tanaka K., Sato J., Suzuki M., Takahashi K., Daimon H., Suzuki T., Nakashima Y., Araki K., Yoshihara H.: CLAIM(Clinical Accounting InforMation) an XML-based data exchange standard for connecting electronic medical record systems to patient accoutning systems. J. Med. Sys. 29 (4): 413, 2005

    Article  Google Scholar 

  7. Schweiger R., Hoelzer S., Heitmann K. U., Dudeck J.: DTDs go XML Schema, tools perspective. Medical Informatics and the Internet in Medicine 26 (4): 297, 2001. https://doi.org/10.1080/14639230110096681

    Article  CAS  PubMed  Google Scholar 

  8. XML Schema Working Group (2015) W3c xml schema. http://www.w3.org/XML/Schema. Accessed Sep 22, 2019

  9. Matsumoto Y. (1993) Ruby programming language. http://www.ruby-lang.org/en/. Accessed Dec 11, 2019

  10. Kimura M., Nakayasu K., Ohshima Y., Fujita N., Nakashima N., Jozaki H., Numano T., Shimizu T., Shimomura M., Sasaki F., Fujiki T., Nakashima T., Toyoda K., Hoshi H., Sakusabe T., Naito Y., Kawaguchi K., Watanabe H., Tani S.: SS-MIX: a ministry project to promote standardized healthcare information exchange. Methods. Inf. Med. 50 (2): 131, 2011

    Article  CAS  Google Scholar 

  11. HL7 (2013) Hl 7 attachment specification: Supplement to consolidated cda templated guide, release 1. http://www.hl7.org/implement/standards/product_brief.cfm?product_id=258. Accessed Sept 30, 2019

  12. Bender D., Sartipi K.: HL 7 FHIR: An agile and RESTful approach to healthcare information exchange.. In: CBMS 2013 - 26 th IEEE international symposium on computer-based medical systems, 2013, pp 326—331

  13. Wyse J. (2014) Why JSON is better than XML. http://blog.cloud-elements.com/json-better-xml. Accessed Sep 30, 2019

  14. Bray T. (2017) The JavaScript Object Notation (JSON) data interchange format. IETF STD 90 internet engineering task force

  15. Zyp K., Court G. (2013) JSON schema: core definitions and terminology. Internet Eng Task Force. http://tools.ietf.org/pdf/draft-zyp-json-schema-04.pdf. Accessed Oct 1, 2019

  16. The openEHR Foundation (1998) The openehr project. http://www.openehr.org/. Accessed Sep 23, 2019

Download references

Acknowledgements

The research and development processes in this article were supported by the MedXML consortium, and funded by the JSPS KAKENHI (Grant number 16K12523)

Funding

This research project was funded by the JSPS KAKENHI (Grant number 16K12523).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shinji Kobayashi.

Ethics declarations

Conflict of interests

The authors declare no conflicts of interest associated with this manuscript.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Transactional Processing Systems

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kobayashi, S., Kume, N., Araki, K. et al. The Development of Medical Markup Language Version 4 as a Clinical Document Exchange Format for Nationwide EHR Systems. J Med Syst 44, 69 (2020). https://doi.org/10.1007/s10916-020-1524-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10916-020-1524-x

Keywords

Navigation