XML Electronic Patient Record

I have specified and helped develop the XML Electronic Patient Record in Oswestry. The technology has subsequently been utilised in acute and primary care extensively in the United Kingdom and is marketed by Graphnet Healthcare Ltd. I have no financial interest in Graphnet.

XML Based Electronic Patient Records

Historical perspective

About a decade ago, the Orthopaedic Hospital decided to use IT to measure how well it performed. The task required recording of clinical activity so that markers of successful or failed care could be retrieved.

Big problems of doing this became apparent immediately:

1. Information needed to be entered into a system to allow searching

2. No spare secretarial resource to input the data

3. A Priori decision required on what might be worth searching for

4. All the useful information was in the form of free text not data

The solution that was chosen was to use a markup language used by the publishing industry known as the Standard Generalizedc Markup Language (SGML). The big advantage of SGML was that it allowed structured text to be viewed by clinicians and processed by search engines in a way that was inpossible with free text. Thus in an operation note a search for Bloggs as surgeon could be performed by querying the <surgeon> element of the note:

<surgeon>Bloggs</surgeon>

This means that potentially very complex queries could be formulated such as find all patients who had a total hip replacement in the last three months where in the first thirty days after surgery the word \"embolus\", \"Thromb*\", \"PE\", \"PVT\" or \"DVT\" occurs and rank the results by consultant in alphabetical order.