 Last updated on May 8, 2001
I. Objectives of HeMX The Hemodialysis Medical Record Exchange Format (HeMX) is designed to structure and describe medical records, including data on dialysis therapy, as a format for exchanging information and data both online and offline. Sharing hemodialysis data with multiple medical institutions by means of HeMX will allow rapid, accurate exchange, collection, and analysis of data. HeMX will enhance efficient collection of statistical data from multiple institutions involved in hemodialysis. However, the current HeMX version 1.0 has the following limitations: - Applies only to data on hemodialysis.
- Not applicable to information on inpatient/outpatient care (e.g., examination, prescription, surgery) or health insurance.
- Not applicable to information on peritoneal dialysis or plasma exchange.
II. Samples of HeMX data HeMX samples of orders for and records of hemodialysis are available for free download. The samples can be seen directly through Internet Explorer 5.0 and Netscape 6.0, or newer. Since other browsers do not support XML files, HTML files are also available for download. These samples show how easy it is to review, print, and analyze HeMX data. | To see a sample of hemodialysis orders, click here: XML or HTML. | To see a sample of hemodialysis records, click here: XML or HTML |
III. Structure of HeMX Language
HeMX uses Extensible Markup Language (XML) because this language has the following advantages:
- Information can be described in various formats
- Allows semantic structured description
- Is independent of type of computer (i.e., highly universal)
- Allows database creation
- Is compatible with other languages for medical description (e.g., MML, MERIT-9)
- Is readable
Since HeMX is described with XML, it can be installed easily as a subset of other medical exchange protocols. It is very flexible in displaying data, which allows displaying on host computers and a wide variety of terminals, including mobile terminals. HeMX data do not need any data processing to create an XML database of, for example, dialysis patients in multiple institutions. IV. Structure and sections
HeMX consists of headers and a body. Each header includes institution identification codes and patient identification codes. The body consists of the following sections:
A. HD History Section
sp(a section regarding the history of hemodialysis therapy)
B. HD Order Section
sp(a section regarding orders for hemodialysis therapy)
C. HD Progress Section
sp(a section regarding hemodialysis records)
D. HD Test Result Section
sp(a section regarding laboratory test results)
V. Detailed discussion of structure
| 1. HD History Section | 1. Information on the initiation of hemodialysis (e.g., underlying disease, date of initiation, medical institution where hemodialysis was initiated) | sp | | 2. Blood access information | sp | | 2. HD Order Section | 1. Basic orders (e.g., schedules, basic orders for each session) | 1. Continued orders (active orders)1. Continued orders (active orders) | | 2. Altered orders (alteration orders) and a record of previous orders | | 2. Daily orders (e.g., orders for one session only, records of such orders including specification of amount of water to be removed). | Each order block includes the following information:
(1) Date
(2) Time
(3) Method
(4) Dry weight (basic order only)
(5) Target weight (daily order only)
(6) Target amount of water to be removed (daily order only)
(7) Water removal plan (daily order only)
(8) Weight correction
(9) Blood flow rate
(10) Dialyzer
(11) Dialysate
(12) Dialysate flow rate
(13) Dialysate temperature
(14) Puncture needle
(15) Oral medication
(16) Intravenous medication
(17) Comments | | 3. HD Progress Section | The following information is included for each session:
| (1) Method | | (2) Dry weight | | (3) Pretreatment weight | | (4) Posttreatment weight | | (5) Total amount of water removed | | (6) Weight correction | | (7) Dialyzer | | (8) Dialysate | | (9) Puncture needle | | (10) Hemodialysis device | | (11) Monitor records | | (e.g., duration, results for monitored items as described in the right column, monitoring personnel, monitor) | | (12) Oral medication | | (13) Intravenous medication | | (14) Comments |
| Monitored items
Comments
Objective items
Subjective items
Systolic blood pressure
Diastolic blood pressure
Heart rate
Body temperature
Blood flow rate
Venous pressure
Dialysate flow rate
Water removal rate
Dialysate pressure
Dialysate temperature
Dialysate sodium level
Dialysate potassium level
Dialysate calcium level
Management
| | 4. HD Test Result Section | 1. Date | sp | | 2. Condition | sp | | 3. Time (after the initiation of dialysis) | sp | | 4. Test group | (1) Test name
(2) Results
(3) Comments
(4) External reference |
VI. Document type definition (DTD) Download HeMX.dtd by clicking the right mouse button and selecting "Save" from the menu. VII. Code table for HeMX See the code table. VIII. Others
A. Elements and attributes
BizTalk framework guidelines (http://biztalk.org/)
Camel Case style
*Upper Camel Case: Each word begins with an upper case letter. This style is used for reusable elements (sections).
*Lower Camel Case: Each word begins with a lower case letter. This style is used for usual elements and attributes. B. Character code set
Shifted JIS code C. Datatype
The HeMX datatypes comply with XML schema datatypes (http://www.w3.org/1999/05/06-xmlschema-2/). The following types are used.
1. String: Character string
2. dateTime: ISO 8601. A combination of calendar date and local time of the day. Extended format.
Format: CCYY-MM-DDThh:mm:ss
(e.g., 1999-08-08T10:20:30) 3. Date: ISO 8601. Calendar date. Extended format.
Format: CCYY-MM-DD
(eg, 1999-08-19) 4. timePeriod: ISO 8601. Time period. Basic format.
Format: PnYnMnDTnHnMnS
(e.g., PT4H0M0S)
Dialysis Data Computerization Subcommittee Working Group
Scientific Committee, Japanese Society for Dialysis Therapy
References
1. Design of a data format (HeMX) for exchanging medical information on hemodialysis. Journal of Japanese Society for Dialysis Therapy 33 (9): 1273-1282, 2000. For more information, contact us at kfusmed2@med.tmd.ac.jp. |
