title: ccML, a new mark-up language to improve ISO/EN 13606-based electronic health record extracts practical edition.
abstract: OBJECTIVE
  The objective of this paper is to introduce a new language called ccML, designed to provide convenient pragmatic information to applications using the ISO/EN13606 reference model (RM), such as electronic health record (EHR) extracts editors. EHR extracts are presently built using the syntactic and semantic information provided in the RM and constrained by archetypes. The ccML extra information enables the automation of the medico-legal context information edition, which is over 70% of the total in an extract, without modifying the RM information.
  
  
  METHODS
  ccML is defined using a W3C XML schema file. Valid ccML files complement the RM with additional pragmatics information. The ccML language grammar is defined using formal language theory as a single-type tree grammar. The new language is tested using an EHR extracts editor application as proof-of-concept system.
  
  
  RESULTS
  Seven ccML PVCodes (predefined value codes) are introduced in this grammar to cope with different realistic EHR edition situations. These seven PVCodes have different interpretation strategies, from direct look up in the ccML file itself, to more complex searches in archetypes or system precomputation.
  
  
  CONCLUSIONS
  The possibility to declare generic types in ccML gives rise to ambiguity during interpretation. The criterion used to overcome ambiguity is that specificity should prevail over generality. The opposite would make the individual specific element declarations useless.
  
  
  CONCLUSIONS
  A new mark-up language ccML is introduced that opens up the possibility of providing applications using the ISO/EN13606 RM with the necessary pragmatics information to be practical and realistic.
authors.affiliation: Telemedicine and Information Society Department, Health Institute 'Carlos III' (ISCIII), Madrid, Spain. ricardo.sanchez@isciii.es
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sánchez-de-Madariaga
authors.forename: Adolfo
authors.initials: A
authors.lastname: Muñoz
authors.forename: Jesús
authors.initials: J
authors.lastname: Cáceres
authors.forename: Roberto
authors.initials: R
authors.lastname: Somolinos
authors.forename: Mario
authors.initials: M
authors.lastname: Pascual
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martínez
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Salvador
authors.forename: José Luis
authors.initials: JL
authors.lastname: Monteagudo
mesh_terms: D057286:Electronic Health Records; D006801:Humans; D008498:Medical Record Linkage; D011381:Programming Languages; D012660:Semantics; D018511:Systems Integration