Semantic validation of standard-based electronic health record documents with W3C XML schema.
OBJECTIVE
The goal of this article is to examine whether W3C XML Schema provides a practicable solution for the semantic validation of standard-based electronic health record (EHR) documents. With semantic validation we mean that the EHR documents are checked for conformance with the underlying archetypes and reference model.


METHODS
We describe an approach that allows XML Schemas to be derived from archetypes based on a specific naming convention. The archetype constraints are augmented with additional components of the reference model within the XML Schema representation. A copy of the EHR document that is transformed according to the before-mentioned naming convention is used for the actual validation against the XML Schema.


RESULTS
We tested our approach by semantically validating EHR documents conformant to three different ISO/EN 13606 archetypes respective to three sections of the CDA implementation guide "Continuity of Care Document (CCD)" and an implementation guide for diabetes therapy data. We further developed a tool to automate the different steps of our semantic validation approach.


CONCLUSIONS
For two particular kinds of archetype prescriptions, individual transformations are required for the corresponding EHR documents. Otherwise, a fully generic validation is possible. In general, we consider W3C XML Schema as a practicable solution for the semantic validation of standard-based EHR documents.
Rinner
C
C
Section of Medical Information and Retrieval Systems, Core Unit for Medical Statistics and Informatics, Medical University of Vienna, Spitalgasse 23, Vienna, Austria. christoph.rinner@meduniwien.ac.at
Janzek-Hawlat
S
S
Sibinovic
S
S
Duftschmid
G
G
D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D011381:Programming Languages; D012015:Reference Standards; D012660:Semantics; D012986:Software Validation