MML 4.0(Draft)

1. Introduction

MML has been developed beginning from 1995 as a standard for the exchange of medical data. The initial version used SGML, and XML format was adopted beginning from version 2. Modules have been developed for the use cases in the clinical field, and related tables have been prepared. In 2004, it was harmonized with the HL7 CDA rel1 format as an effort at improving interoperability with international standards.

Beginning from 2007, research has been conducted for harmonizing MML with the ISO13606 standard that is expected to be the next-generation EHR standard. Based on the results of this research, a vital signs module and body temperature chart module were designed in 2013, and an oral and topical prescription module and injection module were released in 2015.

In addition to these results and the dialysis module that was developed by a dialysis SIG, it was decided to modify the language and release it as MML Ver. 4, which changes the schema definition language from DTD, which was used up to Ver. 3, to W3C XML Schema 1.1.

This document and the XML schema are in the development phase, and it is possible that changes will be made to it in the final version.

2. Policy for MML 4.0 revisions

As described above, the largest change in this revision was the change to W3C XML Schema 1.1. This was done to improve convenience for developers because an XML Schema can precisely define the data types and data structures, and because a broad range of related tools are available.

Moreover it was decided to simplify the structure by eliminating the HL7 CDA-related tag information that had become redundant. However it was decided to keep the same namespace and tag names, and to keep the xpath structure that is semantically equivalent in order to reduce the costs involved with the version upgrade.

Shift JIS was the official character code up to Ver. 3, however this has been changed to UTF-8 in Ver. 4. This improves convenience as well as interoperabiltiy with other standards.

It was also decided to officially add the following modules which had previously been considered as Plan B.

Dialysis module
Vital signs module
Body temperature chart module
Prescriptions module
Injections module

The Data Exchange Specification that had been defined in MML 2.3 was eliminated.

3. Intellectual property

All of the copyrights in this specification belong to the MedXML Consortium Non-Profit Organization. Thus, all uses of the specification shall comply with the policies of the MedXML Consortium Non-Profit Organization.

Policy of the MedXML Consortium Non-Profit Organization in relation to products created

In principle, a product that is created by this Consortium shall be made public on the Internet and treated as being in the public domain. Thus, both consortium members and non-members can make use of such products for commercial or academic activities. While using such products, however, the user shall be obligated to report to the Consortium and to clearly indicate that the product of the Consortium is being used in a product, written work, or for other purposes in compliance with copyrights and preferences.

4. Reference documents

MedXML Consortium: http://www.medxml.net/
Hiroyuki Yoshihara, Kazuhiko Ohe, Katsuhiro Ohashi, Ryuichi Yamamoto, Shunji Yamasaki, Yasuyuki Hirose, Kunio Matsui, Teruyoshi Hishiki, Yoshinori Yamashita, Kazushi Minagawa, Hiroshi Koyama: Studies on the standardization of exchange procedures of medical information, 1997., http://www.miyazaki-med.ac.jp/medinfo/SGmeeting/document/mml9702/techcore.html
Hiroyuki Yoshihara, Kazuhiko Ohe, Katsuhiro Ohashi, Ryuichi Yamamoto, Shunji Yamazaki, Yasuyuki Hirose, Kunio Matsui, Teruyoshi Hishiki, Yoshinori Yamashita, Kazush Minagawa: Studies on the standardization of exchange procedures of medical information, http://www.miyazaki-med.ac.jp/medinfo/SGmeeting/document/mml9702/techcore_E.html
Extensible Markup Language (XML) 1.0 W3C Recommendation 10-February-1998, http://www.w3.org/TR/1998/REC-xml-19980210
Namespaces in XML World Wide Web Consortium 14-January-1999, http://www.w3.org/TR/1999/REC-xml-names-19990114/
Date elements and interchange formats - Information interchange - Representation of dates and times, http://www.iso.ch/markete/8601.pdf brief overview of the ISO 8601 standard http://www.cl.cam.ac.uk/~mgk25/iso-time.html
Seagaia Meeting home page: http://www.seagaia.org/
Kenji Araki, Katsuhiro Ohashi, Shunji Yamazaki, Yasuyuki Hirose, Yoshinori Yamashita, Ryuichi Yamamoto, Kazushi Minagawa, Norihiro Sakamoto, and Hiroyuki Yoshihara: Medical Markup Language (MML) for XML-based Hospital Information Interchange, Journal of Medical Systems; Vol.24, No3, 2000
Kenji Araki, Katsuhiro Ohashi, Shunji Yamazaki, Yasuyuki Hirose, Yoshinori Yamashita, Ryuichi Yamamoto, Kazushi Minagawa, Norihiro Sakamoto, and Hiroyuki Yoshihara: Medical Markup Language (MML) Version 2.21 for XML-based Hospital Information Interchange, Journal of Medical Systems; Vol.20(2): 79-85, 2000
HL7: Version 3 Standard: Clinical Document Architecture Framework Release 1.0, 2000
HL7 Modeling & Methodology Committee: Hl7 Version3 Message Development Framework, V3.3, Dec 1999
ANSI/HL7 Standard version 2.4, The Global Healthcare Messaging Standard, Oct 2000
ISO 13606-1:2008, Electronic health record communication — Part 1: Reference model, 2008
ISO 13606-2:2008, Electronic health record communication — Part 2: Archetype interchange specification, 2008
The openEHR Project, http://www.openehr.org/
XML Schema 1.1, World Wide Web Consortium, 2004, http://www.w3.org/XML/Schema

5. Overview of MML structure

MML is composed of 2 blocks: the header block and the body block (Figure 1). The header block defines the content module for each individual use case that is common to all MML instances. It also separately defines the formats that are used in common by all these modules.

Figure 1: MML structure

5.1. MML header block

The MML header is composed of the MML creator information (mmlCi:CreatorInfo), patient ID (masterId), and toc (Table of Contents) information. The SAX parser sees this toc information and recognizes the information in the content modules that are recorded in the MML body block, allowing it to perform the appropriate conditional branching.

5.2. MML body block

The MML body block is composed of multiple item blocks (MmlModuleItem), and each item block contains header information (docInfo) and the content module which expresses the item block contents.

docInfo contains the description date, writer, document type, title, document ID, parent document ID, group ID, access rights, and list of external references.

Each item block contains one of the following modules.

Patient information module
Health insurance information
Diagnosis record information
Lifestyle information
Basic clinical information
Initial-consultation-specific information
Progress course information
Surgery record information
Clinical summary information
Test history information
Report information
Letter of referral
Vital signs
Body temperature chart
Oral and topical prescriptions
Injection record

5.3. MML common format

Information models which are used in common by multiple modules are collected as the following MML common formats.

Address expression format
Telephone number format
ID format
External reference format
Name expression format
Facility information format
Personal information format
Creator information format

However because the table which is used may vary depending on differences in the upper level module, it is necessary to check the explanation of each module when implementing.

6. Basic policy

6.1. Version control of modules and namespace declaration

The version of a module is specified in the numbers at the end of a namespace declaration. For example, if the namespace description for the vital signs module is the following

xmlns:mmlVs="http://www.medxml.net/MML/v4/ContentModule/vitalsign/1.0"

then the version of this vital signs module is 1.0. It is necessary to be aware that the module version and overall MML version are different.

Because it is possible to combine and use multiple items in a MML instance, an instance may be configured which contains multiple items with different creation dates and creators. As a result, it is necessary to indicate the versions of the overall MML instance and the schema which generated each item.

The modules and namespace declarations that are used with MML Version 4.0 are the following.

Structure module of MmlHeader and docInfo

xmlns:mml ="http://www.medxml.net/MML/v4/base/1.0"

Patient information module

xmlns:mmlPi ="http://www.medxml.net/MML/v4/ContentModule/PatientInfo/1.0"

Health insurance information module

xmlns:mmlHi ="http://www.medxml.net/MML/v4/ContentModule/HealthInsurance/1.1"

Diagnosis record information module

xmlns:mmlRd ="http://www.medxml.net/MML/v4/ContentModule/RegisteredDiagnosis/1.0"

Lifestyle information module

xmlns:mmlLs ="http://www.medxml.net/MML/v4/ContentModule/Lifestyle/1.0"

Basic clinical information module

xmlns:mmlBc ="http://www.medxml.net/MML/v4/ContentModule/BaseClinic/1.0"

Initial-consultation specific information module

xmlns:mmlFcl ="http://www.medxml.net/MML/v4/ContentModule/FirstClinic/1.0"

Progress course information module

xmlns:mmlPc ="http://www.medxml.net/MML/v4/ContentModule/ProgressCourse/1.0"

Surgery record information module

xmlns:mmlSg ="http://www.medxml.net/MML/v4/ContentModule/Surgery/1.0"

Clinical summary information module

xmlns:mmlSm ="http://www.medxml.net/MML/v4/ContentModule/Summary/1.0"

Test history information module

xmlns:mmlLb="http://www.medxml.net/MML/v4/ContentModule/Test/1.0"

Report information module

xmlns:mmlRp="http://www.medxml.net/MML/v4/ContentModule/Report/1.0"

Referral module

xmlns:mmlRe="http://www.medxml.net/MML/v4/ContentModule/Referral/1.0"

Vital signs module

xmlns:mmlVs="http://www.medxml.net/MML/v4/ContentModule/VitalSign/1.0"

Body temperature chart module

xmlns:mmlFs="http://www.medxml.net/MML/v4/ContentModule/FlowSheet/1.0"

6.2. Definitions in MML

6.2.1. Type and definition of time

In MML, a variety of times are defined according to the granularity and nature of the information. These are listed below.

createDate (MML basic structure, Mml attribute)
Indicates the time when the MML instance was created. It is expected that this will be input automatically as a time stamp when the MML creation process is executed. Therefore in principle it is unrelated to the time of the information that is recorded in the MML instance. Even if the information dates from 10 years earlier, because the MML instance was created today, the time when the instance was created will be recorded.
start (MML basic structure, scopePeriod attribute)
This is the start date of the period for all of the information recorded in the MML instance. When there are multiple MmlModuleItem, this is the period which includes all of the MmlModuleItem.
end (MML basic structure, scopePeriod attribute)
This is the end date of the period for all of the information recorded in the MML instance. When there are multiple MmlModuleItem, this is the period which includes all of the MmlModuleItem.
confirmDate (MML basic structure)
This is the date when the information recorded in one content was confirmed. Ordinarily this corresponds to the date when the medical record was electronically recorded. During operation, it is preferred that the information confirmation date match the date when the event occurred and the document was recorded. However in cases such as when an event from several days previous is entered late due to operational reasons, the date when the information was entered will be recorded as the confirmDate. With MML, it is necessary to analyze the document information in order to accurately determine the date when an event occurred. Although there are cases when an event date is explicitly recorded as an element in a document, there are also cases when it is necessary to judge from the context or other information. This is unavoidable due to the way that current medical records operate.
start (MML basic structure, confirmDate attribute)
If the description of a content shows information across multiple dates (for example a summary), this records the start date of the period covered by the recorded information. Unlike scopePeriod in (2) above which is the period that covers the entire MML instance, this is the period of the one MmlModuleItem.
end (MML basic structure, confirmDate attribute)
In the same way as above, if the description of a content shows information across multiple dates, this records the end date of the period of the one MmlModuleItem.
mmlHi:startDate (Health insurance information)
This is the date on which the health insurance was issued. Because this date is unrelated to medical events, it is not subject to (2), (3), (5), and (6) above.
mmlHi:expiredDate (Health insurance information)
This is the health insurance expiration date. Because this date also is unrelated to medical events, it is not subject to (2), (3), (5), and (6) above.
mmlRd:startDate (Diagnosis record information)
This date is not the date on which the patient’s symptoms first occurred. It is the start date for use in insurance claims, and because it is unrelated to medical events, it is not subject to (2), (3), (5), and (6) above.
mmlRd:endDate (Diagnosis record information)
This date is not the date on which the patient was treated. It is the end date for use in insurance claims, and because it is unrelated to medical events, it is not subject to (2), (3), (5), and (6) above.
mmlRd:firstEncounterDate (Diagnosis record information)
This is the first visit date, and is the date of the first insurance medical activity. Because this event is unrelated to the symptoms and treatment of the illness itself, this date also is not subject to (2), (3), (5), and (6) above.
mmlSg:date (Surgery record information)
This is the date that surgery was performed (date of event occurrence). It is not the description date. It is recorded as a (4) confirmDate MML basic structure. Because there are cases when the recording is not completed on the surgery date, mmlSg:date and confirmDate may not always be the same.
mmlSm:start (Clinical summary information, mmlSm:serviceHistory attribute)
This is the start date for the period covered by the summary. It is usually the same value as the start attribute of the confirmDate MML basic structure.
mmlSm:end (Clinical summary information, mmlSm:serviceHistory attribute)
This is the end date for the period covered by the summary. It is usually the same value as the end attribute of the confirmDate MML basic structure.

6.2.2. Granularity of elements

Element granularity is frequently a problem. For example whether the patient name is unstructured and handled as a single element, or whether it is divided into elements such as last name and first name. Originally, it is preferable that information be prescribed using a fine-grain data model, however it is also necessary to consider that data will be collected by existing information systems. In order to prevent data degradation caused by mismatching when data is collected from an information system with different granularity, with a number of elements, MML takes the step of allowing elements with different granularity to be selected. Specific examples are shown below.

For the address expression format, an unstructured address (mmlAd:full) and an address with structured format (mmlAd:prefecture, mmlAd:city, mmlAd:town, mmlAd:homeNumber)
For the name expression format, an unstructured name expression (mmlNm:fullname) and a name expression with structured format (mmNm:family, mmlNm:given, mmlNm: middle)
For the diagnosis record information, an unstructured illness name (mmlRd:diagnosis) and a structured illness name format (mmlRd:diagnosisContents)
For the initial-consultation-specific information, a free style expression (mmlFcl:freeNotes), and time and event expressions (mmlFcl:pastHistoryItem)
For the progress course information, a free style expression (mmlPc:FreeExpression) and structured expression (mmlPc:structuredExpression)
For the progress course information–subjective information, a free style expression (mmlPc:freeNotes), and time and event expressions (mmlPc:subjectiveItem)
For the surgery record information, a full expression of a series of surgery procedures (mmlSg:operation) and separated elements expression (mmlSg:operationElement)

However even if the MML instance was generated accurately, the interchangeability between the MML instance and local database schema depends largely on the information granularity of the local database. If there is a mismatch in the granularity, care must be taken in order to prevent data loss. When the granularity of the information in MML is not detailed (not subdivided), it is relatively difficult to achieve correct conversion. If the granularity on the MML side is relatively fine (divided), it is possible to store the information in the local database with tags added to it so that the volume of information is not lost, however this is not practical.

6.2.3. Granularity of documents

In general, a single MML module item (MmlModuleItem, MML basic structure) can contain only one content, and a single content can only be recorded in one MML module. Therefore a single module item can be viewed as a single document. However, the granularity of documents should be defined for each document type.

Patient information
Patient information is cumulative. In most cases, only the latest information is significant. Therefore, multiple meaningful patient information documents seldom appear simultaneously and the granularity of the document is not a matter of concern.
Health insurance information
A combination of available health insurance and public insurance is considered to be one document. For details, refer to the explanation of the element.
Diagnosis record information
One disease is considered to be a single document. Complications of or sequela to the main disease is written to another document. When the description of a disease name is divided into the main disease part and the modifier, the total parts are considered as one document. For details, refer to the explanation of the element.
Lifestyle information
As with patient information, multiple meaningful lifestyle information documents seldom appear simultaneously and the granularity of the document is not a matter of concern.
Basic clinical information
This is the same as patient information.
Initial-consultation-specific information
Information acquired at one first visit (hospitalization) is considered to be a single document. The information may be acquired in stages and divided into several instances. The information acquired at multiple first visits (hospitalization) must not be described in a single document.
Progress course information
This document is equivalent to a progress note; a single description is considered to be a single document. Therefore, not more than one creator exists. Generally, the description date does not cover several dates.
Surgery record information
A series of information items from entry to and exit from the operation room are considered to be a single document. When a patient exits from an operation room once and returns again to the operation room for surgery within a short period of time, such information should be described in two documents. In contrast, if a surgeon, department, or operation method has changed during surgery, such information should be considered as a single document.
Clinical summary information
A summary of the applicable period defined by users is considered to be a single document. For a discharge summary, one hospitalization is considered to be a single document. If a patient has been treated by multiple departments during hospitalization along with a change of the patient department, whether the summary is divided or compiled into a single document is defined by users.

6.2.4. Link of documents using the parentId

Each module item (MmlModuleItem, MML basic structure) is assigned a unique document ID (uid). The "uid" should be "UUID". The "uid" is a required element and the MML processor must affix a "uid" number when it generates an MML instance. It is strongly recommended that the MML processor should somehow store the "uid" locally, when it receives an MML instance.

With MML, the related parent document ID (parentId, MML basic structure) is recorded, and it is possible to associate documents by specifying the document ID.

The following usage is available for specification with parent IDs:

Correction of document (Refer to table MML0008, oldEdition)
If you want to correct or update a generated document, specify the "uid" of the previous document. It is not necessary to physically delete the previous document, but it is preferable that the previous document is invisible in the user interface.
Associating an order with its result (Refer to table MML0008, order)
Specifying one order document from multiple result documents (usually the progress course information module is used for both documents) allows grouping of test results. For associating query with its response (Refer to table MML0008, consult), the same function as the threading control of e-mails is available.
Change of diagnoses (Refer to table MML0008, originalDiagnosis)
Time series changes of diagnoses may be expressed. Diagnosis end (creation of a new diagnosis with the same disease as a previous diagnosis, the outcome of which is "end"), change (creation of a new diagnosis with a different disease name from a previous diagnosis), division (creation of multiple new diagnoses with different disease names from a previous diagnosis), and merge (creation of a new diagnosis from multiple previous diagnoses) may be indicated.
Applicable health insurance for diagnosis (Refer to table MML0008, healthInsurance)
Applicable health insurance for diagnosis may be specified when required by medical accounting.

Note: It is desirable that the MML processor receiving MML instances can search applicable documents with related parent document IDs of MML instances received. However, if there is no guarantee that the receiving MML processor can make a search, the sending MML processor should specify the parent document IDs of only those documents which have already been sent.

6.2.5. Linking documents using the groupId

Group ID (1.2.1.1.3.3. groupId) is used in order to make items such as summaries and letters of referral by combining multiple modules. When data is controlled by the module unit, searching is easier if a group of modules which are completely equivalent and could be linked is controlled with the same document IDs. It is possible to set up an identical ID (that is, groupId) separately from a document ID for multiple modules that are required to be grouped into a single document.

Specifically, following the "uid" (document unique ID) and "parentId" (related parent document ID) elements, the groupId element is added as a subordinate element to the "docId" element within the MML document header (docInfo). Furthermore, the "groupClass" attribute is added, making it possible to classify document types of module groups (such as letters of referral).

6.2.6. Data type

The MML Ver. 4 data type conforms to W3C XML Schema Ver 1.1. Specifically it is as described below. Up to Ver. 3, the timePeriod type was substituted by the xs:duration type.

xs:string

character string

xs:integer

integer number

xs:decimal

decimal number

xs:boolean

true or false

xs:date

date type. Expressed in ISO8601 format (CCYY-MM-DD).

xs:time

time type. Expressed in ISO8601 format (hh:mmLss[Z|(+|-)hh:mm]).

xs:dateTIme

date/time type. Expressed in ISO8601 format (CCYY-MM-DDThh:mm:ss[Z|(+|-)hh:mm]).

xs:duration

period type. Expressed in PnYnMnWnDTnHnMnS format, with weeks (W) added to the ISO8601 format.

xs:token

character string that is used to replace or shrink spaces

6.2.7. Access rights and encryption

Based on a decision by the MML instance creator, it is possible to record access rights for each document (accessRight, MML basic structure). However these access rights are recorded based on a decision by the instance creator at the time when the instance is created, MML does not define how the recorded access rights are to be used by the side receiving the instance. In other words, actual access control is left to the user application.

MML does not define instance encryption. The specific encryption method is selected by the user. However it is possible to record information related to encryption in the encryption information element (encryptInfo, MML basic structure). The recording method is not defined.

One expected method of encryption is to encrypt only the body of the MML instance (MmlBody, MML basic structure) using a public key system, and to record information related to the encryption (the encryption method used) in the encryption information element. If decryption is possible by acquiring the creator's public key from the creator ID in the creator information (mmlCi:CreatorInfo, MML basic structure), then this acts as a digital signature.

Strictly speaking, a MML instance that is wholly or partially encrypted is outside the MML standards, and the MML standards apply only to the decrypted instance.

6.3. Version control of modules and namespaces declaration

With the release of MML Ver. 4, the namespaces declaration which was shared by all the previous versions has been separated into a declaration for each version.

Before Version 4.0, the version of a module was specified in the numbers at the end of a namespaces declaration.

For example, if a test history information namespaces declaration was the following

xmlns:mmlLb="http://www.medxml.net/MML/v4/ContentModule/test/1.0"

then the test history information module version was 1.0 regardless of whether MML Ver. 2.3 or MML Ver. 3.0 was used.

In order to avoid confusion, beginning from Ver. 4 the MML version is recorded as shown below after the "http://www.medxml.net/MML" URL indication.

xmlns:mml="http://www.medxml.net/MML/v4"

The version of each module is added to the end of the URL. When small changes are made to the same MML version, the version number at the end shall be changed.

　xmlns:mmlLb="http://www.medxml.net/MML/v4/ContentModule/test/1.0"

Following is a list of namespaces declarations for each module with MML Ver. 4.

Patient information module

xmlns:mmlPi ="http://www.medxml.net/MML/v4/ContentModule/PatientInfo/1.0"

Health insurance information module

xmlns:mmlHi ="http://www.medxml.net/MML/v4/ContentModule/HealthInsurance/1.1"

Diagnosis record information module

xmlns:mmlRd ="http://www.medxml.net/MML/v4/ContentModule/RegisteredDiagnosis/1.0"

Lifestyle information module

xmlns:mmlLs ="http://www.medxml.net/MML/v4/ContentModule/Lifestyle/1.0"

Basic clinical information module

xmlns:mmlBc ="http://www.medxml.net/MML/v4/ContentModule/BaseClinic/1.0"

Initial-consultation specific information module

xmlns:mmlFcl ="http://www.medxml.net/MML/v4/ContentModule/FirstClinic/1.0"

Progress course information module

xmlns:mmlPc ="http://www.medxml.net/MML/v4/ContentModule/ProgressCourse/1.0"

Surgery record information module

xmlns:mmlSg ="http://www.medxml.net/MML/v4/ContentModule/Surgery/1.0"

Clinical summary information module

xmlns:mmlSm ="http://www.medxml.net/MML/v4/ContentModule/Summary/1.0"

Test history information module

xmlns:mmlLb="http://www.medxml.net/MML/v4/ContentModule/test/1.0"

Report information module

xmlns:mmlRp="http://www.medxml.net/MML/v4/ContentModule/report/1.0"

Referral module

xmlns:mmlRe="http://www.medxml.net/MML/v4/ContentModule/Referral/1.0"

Vital signs module

xmlns:mmlVs="http://www.medxml.net/MML/v4/ContentModule/VitalSign/1.0"

Body temperature chart module

xmlns:mmlFs="http://www.medxml.net/MML/v4/ContentModule/FlowSheet/1.0"

Prescriptions module

xmlns:mmlPs="http://www.medxml.net/MML/v4/ContentModule/Prescription/1.0"

Injection record module

xmlns:mmlInj="http://www.medxml.net/MML/v4/ContentModule/Injection/1.0"

6.4. XHTML

Because MML contains large amounts of information which should be recorded as text, the meaning may not be accurately communicated if the format information is not replaced. Therefore for several elements with data type "string", this defines that XHTML can be used and the format requires only the line break format "<br/>". Other elements are dependent on the processing system, and processing of them is not always necessary. However by leaving additional space for information other than the format in XHTML parts, it has become possible to structure and record in these parts a variety of information which is not defined in MML.

The handling of XHTML parts in Ver. 4 is the same as in past versions, however for future versions, the contents will be carefully examined and consideration given to incorporating as much structuring of the contents as possible.

7. Common format

With MML, components that are frequently reused in different modules are defined as common formats. These components are listed below. For details of each component, refer to the individual component explanations.

7.1. Address expression format

Figure 2. Element structure

Table 1. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlAd:Address
		mmlAd:repCode	string	#REQUIRED	optional
		mmlAd:addressClass	string	#IMPLIED	MML0002
		mmlAd:tableId	string	#IMPLIED
1.1.	mmlAd:full		string	?
1.2.	mmlAd:prefecture		string	?
1.3.	mmlAd:city		string	?
1.4.	mmlAd:town		string	?
1.5.	mmlAd:homeNumber		string	?
1.6.	mmlAd:zip		string	?
1.7.	mmlAd:countryCode		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.1.1. Element explanation

mmlAd:Address (Address expression format)

Description: common format for indicating addresses. Select the full address expression or subdivided address expression using 4 elements (from 1.2. to 1.5.).

Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlAd:repCode

string

#REQUIRED

optional

Expression method

mmlAd:addressClass

string

#IMPLIED

MML0002

Address type code

mmlAd:tableId

string

#IMPLIED

Table name specifying the expression method above

Example: business address expressed alphabetically

<mmlAd:Address mmlAd:repCode = "A" mmlAd:addressClass = "business" mmlAd:tableId = "MML0025">

mmlAd:full

Description: full address
Data type: string
Omission: allowed

mmlAd:prefecture

Description: prefecture
Data type: string
Omission: allowed

mmlAd:city

Description: city, ward, etc.
Data type: string
Omission: allowed

mmlAd:town

Description: town or village
Data type: string
Omission: allowed

mmlAd:homeNumber

Description: remaining address items such as house number, street name, apartment name, room number, etc.
Data type: string
Omission: allowed

mmlAd:zip

Description: zip code
Data type: string
Omission: allowed

mmlAd:countryCode

Description: country code. ISO 3166 A3 code is used.
Data type: string
Omission: allowed

mmlAd:Address (Address expression format), sample instance

For a full address

<mmlAd:Address mmlAd:repCode = "A" mmlAd:addressClass = "business" mmlAd:tableId = "MML0025">
  <mmlAd:full>5200 Kihara, Kiyotake-cho, Miyazaki-gun, Miyazaki-prefecture</mmlAd:full>
  <mmlAd:zip>889-1692</mmlAd:zip>
  <mmlAd:countryCode>JPN</mmlAd:countryCode>
</mmlAd:Address>

For a separated address

<mmlAd:Address mmlAd:repCode = "A" mmlAd:addressClass = "business" mmlAd:tableId = "MML0025">
  <mmlAd:prefecture>Miyazaki</mmlAd:prefecture>
  <mmlAd:city>Miyazaki</mmlAd:city>
  <mmlAd:town>Kiyotake</mmlAd:town>
  <mmlAd:homeNumber>5200 Kihara</mmlAd:homeNumber>
  <mmlAd:zip>889-1692</mmlAd:zip>
  <mmlAd:countryCode>JPN</mmlAd:countryCode>
</mmlAd:Address>

7.2. Telephone number format

Figure 3. Element structure

Table 2. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
2.	mmlPh:Phone
		mmlPh:telEquipType	string	#IMPLIED	MML0003
2.1.	mmlPh:area		string	?
2.2.	mmlPh:city		string	?
2.3.	mmlPh:number		string	?
2.4.	mmlPh:extension		string	?
2.5.	mmlPh:full		string	?
2.6.	mmlPh:country		string	?
2.7.	mmlPh:memo		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.2.1. Element explanation

mmlPh:Phone (Telephone number format)

Description: common format for indicating telephone numbers. Select the separated telephone number expression (from 2.1. to 2.4.) or full telephone number expression (2.5.).
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlPh:telEquipType

string

#IMPLIED

MML0003

Equipment type code

mmlPh:area

Description: area code
Data type: string
Omission: allowed

mmlPh:city

Description: local number
Data type: string
Omission: allowed

mmlPh:number

Description: individual number
Data type: string
Omission: allowed

mmlPh:extension

Description: extension
Data type: string
Omission: allowed

mmlPh:full

Description: full telephone number
Data type: string
Omission: allowed

mmlPh:country

Description: country code
Data type: string
Omission: allowed

mmlPh:memo

Description: describe the time range of calls, etc.
Data type: string
Omission: allowed

mmlPh:Phone (Telephone number format), sample instance

Structured telephone number expression

<mmlPh:Phone mmlPh:telEquipType = "PH">
  <mmlPh:area>0985</mmlPh:area>
  <mmlPh:city>85</mmlPh:city>
  <mmlPh:number>1500</mmlPh:number>
  <mmlPh:extension>2067</mmlPh:extension>
  <mmlPh:country>81</mmlPh:country>
  <mmlPh:memo>daytime</mmlPh:memo>
</mmlPh:Phone>

Unstructured telephone number expression

<mmlPh:Phone mmlPh:telEquipType = "PH">
  <mmlPh:full>0985-85-1500(2067)< /mmlPh:full >
  <mmlPh:country>81</mmlPh:country>
<mmlPh:memo>daytime</mmlPh:memo>

7.3. ID format

Table 3. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
3.	mmlCm:Id		string
		mmlCm:type	string	#REQUIRED	optional
		mmlCm:tableId	string	#REQUIRED
		mmlCm:checkDigit	integer	#IMPLIED
		mmlCm:checkDigitSchema	string	#IMPLIED	MML0001

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.3.1. Element explanation

mmlCm:Id (ID format)

Description: common format for indicating IDs
Data type: string
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlCm:type

string

#REQUIRED

optional

ID type code

mmlCm:tableId

string

#REQUIRED

Table name specifying the ID type code above. In case that the personal ID is unique to a facility, it is possible to enter the facility ID.

mmlCm:checkDigit

integer

#IMPLIED

Check digit

mmlCm:checkDigitSchema

string

#IMPLIED

MML0001

Check digit scheme

Note 1: In principle, the mmlCm:type uses table MML0024 for personal IDs, table MML0027 for facility IDs and table MML0029 for the medical department IDs. The table name used is written in the mmlCm:tableId.

Note 2: Only if the personal ID is unique to a facility, it is possible to enter the facility ID in the mmlCm:tableId and make up a personal ID with the combination of the facility ID and facility unique personal ID.

mmlCm:Id (ID format), sample instance

For a personal ID

<mmlCm:Id mmlCm:type = "facility" mmlCm:checkDigitSchema = "M10" mmlCm:checkDigit = "5"
  mmlCm:tableId = "MML0024">12345</mmlCm:Id>

For a personal ID with the combination of a facility ID and facility unique personal ID

<mmlCm:Id mmlCm:type = "facility" mmlCm:checkDigitSchema = "M10" mmlCm:checkDigit = "5"
  mmlCm:tableId = "JPN452015100001">12345</mmlCm:Id>

For a facility ID

<mmlCm:Id mmlCm:type = "insurance" mmlCm:tableId = " MML0027">12345</mmlCm:Id>

For a medical department ID

<mmlCm:Id mmlCm:type = "medical" mmlCm:tableId = "MML0029">16</mmlCm:Id>

7.4. External reference format

Table 4. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
4.	mmlCm:extRef
		mmlCm:contentType	string	#IMPLIED
		mmlCm:medicalRole	string	#IMPLIED
		mmlCm:title	string	#IMPLIED
		mmlCm:href	string	#REQUIRED

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.4.1. Element explanation

mmlCm:extRef (External reference format)

Description: common format for indicating external references
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlCm:contentType

string

#IMPLIED

Type code of external reference information

mmlCm:medicalRole

string

#IMPLIED

Detail type of external reference information

mmlCm:title

string

#IMPLIED

Title

mmlCm:href

string

#REQUIRED

Regarding images, ECG, and other binary data, it is strongly recommended that the data be a data file that is independent of the MML instance and that a system of external reference from MML be used for reasons including the following: (1) Standards such as HL7 and DICOM exist, (2) Binary data format provides good efficiency for data exchange, (3) These data are most often managed as independent data files. The method of inserting these data into MML instances has not been reviewed sufficiently and the external data reference method is adopted in this specification.

The external reference format follows the description format below.

mmlCm:contentType

The contentType is in compliance with the Content-Type of MIME (RFC 2045, 2046, 2047). In addition to "TEXT/PLAIN", content types such as "IMAGE/DICOM", "APPLICATION/HL72.3-HL7ER2.3", etc. are defined in the MERIT-9 (MEdical Record, Image, Text, - Information eXchange). For details, refer to the CONTENT-TYPE of MERIT-9.

Similarly, images in multiple formats such as "IMAGE/JPEG", "IMAGE/GIF", "IMAGE/TIFF", etc. can be externally referenced.

mmlCm:medicalRole

If external reference files are classified in a user-installed application, files are organized efficiently and reference is made easier. Therefore, medicalRole specifies types for classification of all external files expected in MML. Table MML0033 is used.

mmlCm:title

Enter a short character string that specifically describes the content of an individual external reference file. This can be used as follows:

Example:

Chest X-ray after pleural cavity drainage
Chest CT scan immediately after chemical treatment
Coronary angiography sketch
Literature for similar cases (PDF)

mmlCm:href

Description of relative "uri"s from an MML instance. Since an external reference file is expected to be attached to MML instances in transmission, absolute "uri"s are not used. File names and directory settings are defined by users.

mmlCm:extRef (External reference format ), sample instance

<mml:extRefs>
  <mmlCm:extRef
    mmlCm:contentType = "APPLICATION/HL72.3-HL7ER2.3"
    mmlCm:medicalRole = "prescription"
    mmlCm:title = "Prescription on discharge"
    mmlCm:href = "patient1234/prescription831.HL7"/>
</mml:extRefs>

7.5. Name expression format

Figure 4. Element structure

Table 5. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
5.	mmlNm:Name
		mmlNm:repCode	string	#REQUIRED	optional
		mmlNm:tableId	string	#IMPLIED
5.1.	mmlNm:family		string	?
5.2.	mmlNm:given		string	?
5.3.	mmlNm:middle		string	?
5.4.	mmlNm:fullname		string	?
5.5.	mmlNm:prefix		string	?
5.6.	mmlNm:degree		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.5.1. Element explanation

mmlNm:Name (Name expression format)

Description: common format for indicating names. Select the separated name expression using 3 elements (from 5.1. to 5.3.) or full name expression (5.4.).
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlNm:repCode

string

#REQUIRED

optional

Expression method

mmlNm:tableId

string

#IMPLIED

Table name specifying the expression method

mmlNm:family

Description: family name
Data type: string
Omission: refer to above.

mmlNm:given

Description: given name
Data type: string
Omission: refer to above.

mmlNm:middle

Description: middle name
Data type: string
Omission: allowed

mmlNm:fullname

Description: full name
Data type: string
Omission: refer to above.

mmlNm:prefix

Description: title, prefix, etc.
Data type: string
Omission: allowed

mmlNm:degree

Description: academic degree
Data type: string
Omission: allowed

mmlNm:Name (Name expression format), sample instance

For a name separated into family name and given name

<mmlNm:Name mmlNm:repCode = "A" mmlNm:tableId = "MML0025">
  <mmlNm:family>Araki</mmlNm:family>
  <mmlNm:given>Kenji</mmlNm:given>
  <mmlNm:degree>M.D.</mmlNm:degree>
</mmlNm:Name>

For a full name

<mmlNm:Name mmlNm:repCode = "A" mmlNm:tableId = "MML0025">
 <mmlNm:fullname>Araki Kenji</mmlNm:fullname>
 <mmlNm:degree>M.D.</mmlNm:degree>
</mmlNm:Name>

7.6. Facility information format

Figure 5. Element structure

Table 6. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
6.	mmlFc:Facility
6.1.	mmlFc:name		string	+
		mmlFc:repCode	string	#REQUIRED	optional
		mmlFc:tableId	string	#IMPLIED
6.2.	mmlCm:Id		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.6.1. Element explanation

mmlFc:Facility (Facility information format)

Description:format for indicating facilities

mmlFc:name

Description: facility name
Data type: string
Omission: not allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlFc:repCode

string

#REQUIRED

optional

Expression method

mmlFc:tableId

string

#IMPLIED

Table name specifying the expression method

mmlCm:Id

Description: facility ID. Refer to the MML common format (ID format) for the structure.
Omission: allowed

mmlFc:Facility (Facility information format), sample instance

<mmlFc:Facility>
  <mmlFc:name mmlFc:repCode = "A" mmlFc:tableId = "MML0025">
    New Millenium Medical College Hospital
  </mmlFc:name>
  <mmlCm:Id mmlCm:type = "insurance" mmlCm:checkDigitSchema = "MD10"
    mmlCm:checkDigit = "5" mmlCm:tableId = "MML0027">12345</mmlCm:Id>
</mmlFc:Facility>

7.7. Medical department information format

Figure 6. Element structure

Table 7. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
7.	mmlDp:Department
7.1.	mmlDp:name		string	+
		mmlDp:repCode	string	#REQUIRED	optional
		mmlDp:tableId	string	#IMPLIED
7.2.	mmlCm:Id		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.7.1. Element explanation

mmlDp:Department (Medical department information format)

Description: common format for indicating medical departments

mmlDp:name

Description: medical department name
Data type: string
Omission: not allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlDp:repCode

string

#REQUIRED

optional

Expression method

mmlDp:tableId

string

#IMPLIED

Table name specifying the expression method

mmlCm:Id

Description: medical department ID. Refer to the MML common format (ID format) for the structure.
Omission: allowed

mmlDp:Department (Medical department information format), sample instance

<mmlDp:Department>
  <mmlDp:name mmlDp:repCode = "A" mmlDp:tableId = "MML0025">
    Cardiovascular　Surgery
  </mmlDp:name>
  <mmlCm:Id mmlCm:type = "medical"　 mmlCm:tableId = "MML0029">16</mmlCm:Id>
</mmlDp:Department>

Note: The medical department code of table MML0029 is used in the medical department ID.

7.8. Personal information format

Figure 7. Element structure

Table 8. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
8.	mmlPsi:PersonalizedInfo
8.1.	mmlCm:Id		string
8.2.	mmlPsi:personName
8.2.1.	mmlNm:Name			+
8.3.	mmlFc:Facility			?
8.4.	mmlDp:Department			?
8.5.	mmlPsi:addresses			?
8.5.1.	mmlAd:address			+
8.6.	mmlPsi:emailAddresses			?
8.6.1.	mmlCm:email		string	*
8.7.	mmlPsi:phones			?
8.7.1.	mmlPh:Phone			+

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.8.1. Element explanation

mmlPsi:PersonalizedInfo (Personal information format)

Description: common format for indicating personal information

mmlCm:Id

Description: personal ID. Refer to the MML common format (ID format) for the structure.
Omission: not allowed

mmlPsi:personName

Description: parent element for the input of name information.
Omission: not allowed

mmlNm:Name

Description: name. Refer to the MML common format (Name expression format) for the structure.
Omission: not allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlFc:Facility

Description: facility information. Refer to the MML common format (Facility information format) for the structure.
Omission: allowed

mmlDp:Department

Description: medical department information. Refer to the MML common format (Medical department information format) for the structure.
Omission: allowed

mmlPsi:addresses

Description: parent element for the input of address information.
Omission: allowed

mmlAd:address

Description: address. Refer to the MML common format (Address expression format) for the structure.
Omission: not allowed
Repetition: allowed. If multiple addresses or multiple expression methods are available, the element should be repeated.

mmlPsi:emailAddresses

Description: parent element for the input of e-mail addresses described below.
Omission: allowed

mmlCm:email

Description: e-mail address
Data type: string
Omission: allowed
Repetition: allowed. If multiple e-mail addresses are available, the element should be repeated.
Example:

<mmlPsi:emailAddresses>
  <mmlCm:email>araki@post.medxml.net</mmlCm:email>
</mmlPsi:emailAddresses>

mmlPsi:phones

Description: parent element for the input of telephone numbers described below.
Omission: allowed

mmlPh:Phone

Description: telephone number. Refer to the MML common format (Telephone number format) for the structure.
Omission: not allowed
Repetition: allowed. If multiple telephone numbers are available, the element should be repeated.

mmlPsi:PersonalizedInfo (Personal information format), sample instance

<mmlPsi:PersonalizedInfo>
  <mmlCm:Id mmlCm:type = "facility" mmlCm:checkDigitSchema = "M10"
    mmlCm:checkDigit = "5" mmlCm:tableId = "MML0024">12345</mmlCm:Id>
  <mmlPsi:personName>
    <mmlNm:Name mmlNm:repCode = "A" mmlNm:tableId = "MML0025">
      <mmlNm:family>Araki</mmlNm:family>
      <mmlNm:given>Kenji</mmlNm:given>
      <mmlNm:degree>M.D.</mmlNm:degree>
    </mmlNm:Name>
  </mmlPsi:personName>
  <mmlFc:Facility>
    <mmlFc:name mmlFc:repCode = "A" mmlFc:tableId = "MML0025">
      New Millenium Medical College Hospital
    </mmlFc:name>
    <mmlCm:Id mmlCm:type = "insurance"
      mmlCm:tableId = "MML0027">12345</mmlCm:Id>
  </mmlFc:Facility>
  <mmlDp:Department>
    <mmlDp:name mmlDp:repCode = "A" mmlDp:tableId = "MML0025">
      Cardiovascular Surgery
    </mmlDp:name>
    <mmlCm:Id mmlCm:type = "medical" mmlCm:tableId = "MML0029">16</mmlCm:Id>
  </mmlDp:Department>
  <mmlPsi:addresses>
    <mmlAd:Address mmlAd:repCode = "A" mmlAd:addressClass = "business"
      mmlAd:tableId = "MML0025">
      <mmlAd:full>
        5200 Kihara, Kiyotake-cho, Miyazaki-gun, Miyazaki-prefecture
      </mmlAd:full>
      <mmlAd:zip>889-1692</mmlAd:zip>
      <mmlAd:countryCode>JPN</mmlAd:countryCode>
    </mmlAd:Address>
  </mmlPsi:addresses>
  <mmlPsi:emailAddresses>
    <mmlCm:email>araki@post.medxml.net</mmlCm:email>
  </mmlPsi:emailAddresses>
  <mmlPsi:phones>
    <mmlPh:Phone mmlPh:telEquipType = "PH">
      <mmlPh:area>0985</mmlPh:area>
      <mmlPh:city>85</mmlPh:city>
      <mmlPh:number>1500</mmlPh:number>
      <mmlPh:extension>2067</mmlPh:extension>
      <mmlPh:country>81</mmlPh:country>
      <mmlPh:memo>daytime</mmlPh:memo>
    </mmlPh:Phone>
  </mmlPsi:phones>
</mmlPsi:PersonalizedInfo>

7.9. Creator information format

Figure 8. Element structure

Table 9. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
9.	mmlCi:CreatorInfo
9.1.	mmlPsi:PersonalizedInfo
9.2.	mmlCi:creatorLicense		string	+	optional
		mmlCi:tableId	string	#IMPLIED

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

7.9.1. Element explanation

mmlCi:CreatorInfo (creator information format)

Description: common format which expresses the creator

mmlPsi:PersonalizedInfo

Description: personal information of the creator For the structure, refer to the MML common format (personal information format).
Omission: not allowed

mmlCi:creatorLicense

Description: creator qualification
Data type: string. Enter the value from the table specified by the attribute.
Omission: not allowed
Repetition: allowed. If the person has multiple qualifications, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlCi:tableId

string

#IMPLIED

Name of table which defines creator qualifications

Example:

<mmlCi:creatorLicense mmlCi:tableId = "MML0026">doctor</mmlCi:creatorLicense>

8. Details of MmlHeader format

8.1 MmlHeader

Tags in the MML Ver. 4 MmlHeader all belong to the xmlns:mml = "http://www.medxml.net/MML/v4" Namespace. (Here, this is recorded with xmlns = "http://www.medxml.net/MML/v4" as default.)

8.1.1. MmlHeader

Description: header information

8.1.2. mmlCi:CreatorInfo

Description: identification information of creators. Refer to the MML common format (Creator information format) for the structure.
Omission: not allowed

8.1.3. masterId

Description: patient master ID.
Omission: not allowed

8.1.4. mmlCm:Id

Description: refer to the MML common format (ID format) for the structure.
Omission: not allowed

8.1.5. toc

Description: table of contents. The "toc" check in the header is performed by the system, making it possible to identify what kind of data is contained. Although redundant, this was continued with Ver. 4 because it is effective in SAX system processing.
Omission: not allowed

8.1.6. tocItem

Description: all DTDs used in this MML document are listed. Although redundant, this was continued with Ver. 4 because it is effective in SAX system processing.
Data type: string
Omission: not allowed
Repetition: allowed. The element should be repeated the number of times of used DTD types.

8.1.7. scopePeriod

Description: period covered by entire MML documents
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

start

date

#IMPLIED

Start date

end

date

#IMPLIED

End date

hasOtherInfo

boolean

#IMPLIED

Whether or not there is information before/after the specified period. true: Yes, false: No

isExtract

boolean

#IMPLIED

Whether or not information is extracted. true: Yes, false: No

extractPolicy

string

#IMPLIED

MML0004

Policy of extraction

For the period covered by the entire MML indicated by "start" and "end", the value of "hasOtherInfo" should be "true" if patient’s clinical information extends beyond the period. If all patient information held by the sending facility within the period is described in an MML instance, the value of "isExtract" should be "false"; if any extraction is carried out, the value should be "true". Furthermore, in the latter case, the extraction policy should be given in "extractPolicy". This is to clarify whether all or partial patient information is received at the reception side of the MML instance. If it is assumed that all information is received despite the fact that only partial information is received, a serious mistake in medical treatment may occur.

8.1.8. encryptInfo

Description: encryption information such as electronic signature. The description method is not specified in particular. Refer to the "Access rights and encryption" section in the basic policy.
Data type: string
Omission: allowed

9. Details of docInfo structure

9.1. What is docInfo?

As described in the overview, docInfo is recorded at the start of each MmlModuleItem, and records the creator, range of access rights, and other information related to that item.

9.1.1. docInfo

Description: individual document header information
Omission: usually not allowed, with few exceptions. Omission is allowed only when there is no query specifying modules or no modules are applicable to a given query.
Attribute: it is necessary to set up attributes so that the type and version of the module used will become obvious only with the reference of the document header.

Attribute name

Data type

Omission

Table

Remarks

contentModuleType

string

#IMPLIED

MML0005

Document type code

moduleVersion

uri

#IMPLIED

The URIs of DTDs of used modules are described.

9.1.2. securityLevel

Description: types of access rights. The access rights selected at the time of creation of an MML instance by the MML instance creator should be entered. The actual access control is subject to the application (and its manager) receiving the instance.
Omission: not allowed

9.1.3. accessRight

Description: access right
Omission: not allowed
Repetition: allowed. The element should be repeated the number of times access rights are set up. At least, it is essential to set up an access right for creators so that they will not be rejected from making a reference.

If multiple accessRight elements exist, the accessRight elements are mutually under the "OR" condition. When more than two subordinate elements of a facility, medical department, occupation, or person exist to a single accessRight element, the condition is "AND". If nothing meets this "AND" condition, the access right is not accepted.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

permit

string

#REQUIRED

MML0034

Rights of reference
none: no access permissible
read: reference permissible
write: reference and correction permissible
delete: reference and deletion permissible
all: reference, correction, and deletion permissible

startDate

date

#IMPLIED

Start date of an access right

endDate

date

#IMPLIED

End date of an access right

In order to specify explicitly that no reference is permissible, set none for the permit attribute.

Answers to a deletion request for deletion-permissible documents are not specifically defined in MML. When it is important to keep the correction history of a medical record, it is an assumable way during implementation to keep the document invisible to normal accesses rather than carrying out physical deletion.

9.1.4. mmlSc:facility

Description: facility. Set up access rights in the facility unit.
Omission: allowed

9.1.5. mmlSc:facilityName

Description: facility name
Data type: string
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of facilities for which access rights are set.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSc:facilityCode

string

#REQUIRED

MML0035

Facility access right definition

mmlSc:tableId

string

#IMPLIED

Table name used for the facility access right definition. Enter MML0035 as described above.

mmlSc:facilityId

string

#IMPLIED

Facility code

mmlSc:facilityIdType

string

#IMPLIED

MML0027

Facility code master name

Meanings of each value in the facility access right definition are as follows:

all

All accessing facilities are permissible.

creator

The same facilities as those of creators are permissible.

experience

Facilities that have the experience of medical cares to a described person (patient) are permissible.
The method of selecting a facility that has the experience of medical cares is subject to each application.

individual

Facilities with facility IDs that are individually specified are permissible. Permissible facilities are specified in the + mmlSc:facilityId and mmlSc:facilityIdType.

9.1.6. mmlSc:department

Description: medical department
Omission: allowed

9.1.7. mmlSc:departmentName

Description: medical department name
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of departments for which access rights are set.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSc:departmentCode

string

#REQUIRED

MML0028

Medical department code

mmlSc:tableId

string

#IMPLIED

Table name of the medical department code. Enter MML0028.

9.1.8. mmlSc:license

Description: occupation
Omission: allowed

9.1.9. mmlSc:licenseName

Description: occupation name
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of occupations for which access rights are set.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSc:licenseCode

string

#REQUIRED

MML0026

Occupation code

mmlSc:tableId

string

#IMPLIED

Table name of the occupation code. Enter MML0026.

9.1.10. mmlSc:person

Description: person
Omission: allowed

9.1.11. mmlSc:personName

Description: person's name
Data type: string
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of people for which access rights are set.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSc:personCode

string

#REQUIRED

MML0036

Personal access right definition

mmlSc:tableId

string

#IMPLIED

Table name used for the personal access right definition. Enter MML0036.

mmlSc:personId

string

#IMPLIED

Personal ID

mmlSc:personIdType

string

#IMPLIED

Personal ID master name

Meanings of each value in the personal access right definition are as follows:

all

All accessing people are permissible.

creator

Creators are permissible.

patient

Described persons (patients) themselves are permissible.

individual

Persons with personal IDs that are individually specified are permissible.
Permissible persons are specified in the mmlSc:personId and mmlSc:personIdType.

Example: Description of securityLevel (type of access right)

Case to set up an access right of reference, correction, and deletion from October 1, 2001 to December 31, 2001 for doctors at the internal medicine department, Miyazaki Medical College Hospital.

<securityLevel>
  <accessRight
    permit="all"
    startDate="2001-10-01"
    endDate="2001-12-31">
    <mmlSc:facility>
      <mmlSc:facilityName
        mmlSc:facilityCode="individual"
        mmlSc:tableId="MML0035"
        mmlSc:facilityId="JPN453010100003"
        mmlSc:facilityIdType="JMARI">
        Miyazaki Medical College Hospital
      </mmlSc:facilityName>
    </mmlSc:facility>
    <mmlSc:department>
      <mmlSc:departmentName
      mmlSc:departmentCode="01"
      mmlSc:tableId="MML0028"/>
    </mmlSc:department>
    <mmlSc:license>
      <mmlSc:licenseName
        mmlSc:licenseCode="doctor"
        mmlSc:tableId="MML0026"/>
    </mmlSc:license>
  </accessRight>
</securityLevel>

Case to set up an open-ended access right of all for the creator’s facility and an access right of reference from October 1, 2001 to December 31, 2001 for a patient Taro Kanja.

<securityLevel>
  <accessRight permit="all">
    <mmlSc:facility>
      <mmlSc:facilityName
        mmlSc:facilityCode="creator"
        mmlSc:tableId="MML0035">
       Creator’s facility 
      </mmlSc:facilityName>
    </mmlSc:facility>
  </accessRight>
  <accessRight
    permit="read"
    startDate="2001-10-01"
    endDate="2001-12-31">
    <mmlSc:person>
      <mmlSc:personName
        mmlSc:personCode="patient"
        mmlSc:tableId="MML0036"
        mmlSc:personId="4500001234"
        mmlSc:personIdType="dolphinUserid_2001-10-03">
        Taro Kanja 
      </mmlSc:personName>
    </mmlSc:person>
  </accessRight>
</securityLevel>

9.1.12. title

Description: document title
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

generationPurpose

string

#IMPLIED

MML0007

Document type in detail

9.1.13. docId

Description: document ID information
Omission: not allowed

9.1.14. uid

Description: document unique ID. The format of unique numbers should be UUID. (UUID is a format that includes hyphens.) It is strongly recommended that the MML processor should somehow locally store the uid when it receives an MML instance.
Data type: string
Omission: not allowed
Example:

<uid>0aae5960-667c-11d3-9751-00105a6792e7</uid>

9.1.15. parentId

Description: related parent document ID. For usage, refer to the "Link of documents" section in the basic policy.
Data type: string
Omission: allowed
Repetition: allowed. If multiple parent documents are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

relation

string

#IMPLIED

MML0008

Document relation type

Example: When a document is a revised document(new edition) of a parent document

<parentId relation = "oldEdition">0aae5960-667c-11d3-9751-00105a6792e8</parentId>

9.1.16. groupId

Description: group ID. For usage, refer to the "Link of documents using the groupId" section in the basic policy.
Data type: string
Omission: allowed
Repetition: allowed. If a document belongs to multiple groups, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

groupClass

string

#IMPLIED

MML0007

Module group type

9.1.17. confirmDate

Description: date and time when the electronic storage of a medical chart is confirmed
Data type: dateTime ISO8610. Format: CCYY-MM-DDThh:mm:ss
Omission: not allowed
Attribute: when time series information is one document, specify the start/end dates and times in the following attributes. Note that scopePeriod represents the period covered by an entire MML document and that in contrast, this represents the period of one <MmlModuleItem>.

Attribute name

Data type

Omission

Table

Remarks

start

dateTime

#IMPLIED

Start date and time for time series information

end

dateTime

#IMPLIED

End date and time for time series information

firstConfirmDate

dateTime

#IMPLIED

The first confirmed date when a correction has been made.

eventDate

dateTime

#IMPLIED

Date and time of a described medical event

9.1.18. mmlCi:CreatorInfo

Description: creator information of individual document. Refer to the MML common format (Creator information format) for the structure.
Omission: not allowed

9.1.19. extRefs

Description: list of all external link information described in the content. The list of external reference files can be obtained without analyzing the content.
Omission: not allowed

9.1.20. mmlCm:extRef

Description: external link information. Refer to the MML common format (External reference format) for the structure.
Omission: allowed
Repetition: allowed. The element should be repeated the same number of times as the number of external link information.

10. Details of MML content modules

　With MML, the modules listed below that were designed for each use case are recorded in MmlItem as a single unit. For details, refer to the document and schema.

10.1. Patient information module

Figure 9. Element structure

10.1.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlPi= "http://www.medxml.net/MML/v4/ContentModule/PatientInfo/1.0"

Table 10. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlPi:PatientModule
1.1.	mmlPi:uniqueInfo
1.1.1.	mmlPi:masterId
1.1.1.1.	mmlCm:Id		string
1.1.2.	mmlPi:otherId			*
		mmlPi:type	string	#REQUIRED	MML0009
1.1.2.1.	mmlCm:Id		string
1.2.	mmlPi:personName
1.2.1.	mmlNm:Name			+
1.3.	mmlPi:birthday		date
1.4.	mmlPi:sex		string		MML0010
1.5.	mmlPi:nationality		string	?
		mmlPi:subtype	string	#IMPLIED
1.6.	mmlPi:race		string	?
		mmlPi:raceCode	string	#IMPLIED
		mmlPi:raceCodeId	string	#IMPLIED
1.7.	mmlPi:marital		string	?	MML0011
1.8.	mmlPi:addresses			?
1.8.1.	mmlAd:Address			*
1.9.	mmlPi:emailAddresses			?
1.9.1.	mmlCm:email		string	*
1.10.	mmlPi:phones			?
1.10.1.	mmlPh:Phone			*
1.11.	mmlPi:accountNumber		string	?
1.12.	mmlPi:socialIdentification		string	?
1.13.	mmlPi:death		boolean	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.1.2. Element explanation

mmlPi:PatientModule

Description: patient information

mmlPi:uniqueInfo

Description: ID information
Omission: not allowed

mmlPi:masterId

Description: master ID. This must be identical to the masterId of an MmlHeader.
Omission: not allowed

mmlCm:Id

Description: refer to the MML common format (ID format) for the structure.
Omission: not allowed

mmlPi:otherId

Description: other IDs. IDs of a representative, emergency contact person, etc. are described.
Omission: allowed
Repetition: allowed. The element should be repeated if multiple other IDs are available.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlPi:type

string

#REQUIRED

MML0009

Other ID Type

mmlCm:Id

Description: refer to the MML common format (ID format) for the structure.
Omission: not allowed

mmlPi:personName

Description: name information
Omission: not allowed

mmlNm:Name

Description: refer to the MML common format (Name expression format) for the structure.
Omission: not allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlPi:birthday

Description: birth date/year
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example:

<mmlPi:birthday>1958-10-21</mmlPi:birthday>

mmlPi:sex

Description: Sex. Use table MML0010.
Data type: string
Omission: not allowed

mmlPi:nationality

Description: nationality code. ISO 3166 A3 code is used. Enter JPN for Japan.
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlPi:subtype

string

#IMPLIED

Second nationality code. Use ISO 3166 A3 code.

Example: the first nationality is Japan and the second nationality is the USA.

<mmlPi:nationality mmlPi:subtype = "USA">JPN</mmlPi:nationality>

mmlPi:race

Description: race, ethnic group
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlPi:raceCode

string

#IMPLIED

Race code

mmlPi:raceCodeId

string

#IMPLIED

Enter the name of a used table

mmlPi:marital

Description: marital status. Use table MML0011.
Data type: string
Omission: allowed

mmlPi:addresses

Description: parent element for the input of addresses described below.
Omission: allowed

mmlAd:Address

Description: address. Refer to the MML common format (Address expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple addresses or multiple expression methods are available, the element should be repeated.

mmlPi:emailAddresses

Description: parent element for the input of e-mail addresses described below.
Omission: allowed

mmlCm:email

Description: e-mail address
Data type: string
Omission: allowed
Repetition: allowed. If multiple e-mail addresses are available, the element should be repeated.

mmlPi:phones

Description: parent element for the input of telephone numbers described below.
Omission: allowed

mmlPh:Phone

mmlPi:accountNumber

Description: account number
Data type: string
Omission: allowed

mmlPi:socialIdentification

Description: social security number
Data type: string
Omission: allowed

mmlPi:death

Description: death flag. true: death, false: alive
Data type: boolean
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlPi:date

date/dateTime

#IMPLIED

Date and time of death. The datatypes should be either date or dateTime.

Example: died on September 1,1999

<mmlPi:death mmlPi:date="1999-09-01">true</mmlPi:death>

Example: died at 6:15 on September 1, 1999

<mmlPi:death mmlPi:date="1999-09-01T06:15">true</mmlPi:death>

10.2. Insurance information module

Figure 10. Element structure

10.2.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlHi= "http://www.medxml.net/MML/v4/ContentModule/HealthInsurance/1.1"

Table 11. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlHi:HealthInsuranceModule
		mmlHi:countryType	string	#IMPLIED
1.1.	mmlHi:insuranceClass		string	?
		mmlHi:ClassCode	string	#REQUIRED
		mmlHi:tableId	string	#REQUIRED	MML0031
1.2.	mmlHi:insuranceNumber		string
1.3.	mmlHi:clientId
1.3.1.	mmlHi:group		string
1.3.2.	mmlHi:number		string
1.4.	mmlHi:familyClass		boolean
1.5.	mmlHi:clientInfo			?
1.5.1.	mmlHi:personName			?
1.5.1.1.	mmlNm:Name			*
1.5.2.	mmlHi:addresses			?
1.5.2.1.	mmlAd:Address			*
1.5.3.	mmlHi:phones			?
1.5.3.1.	mmlPh:Phone			*
1.6.	mmlHi:continuedDiseases			?
1.6.1.	mmlHi:diseases		string	+
1.7.	mmlHi:startDate		date
1.8.	mmlHi:expiredDate		date
1.9.	mmlHi:paymentInRatio		decimal	?
1.10.	mmlHi:paymentOutRatio		decimal	?
1.11.	mmlHi:insuredInfo			?
1.11.1.	mmlHi:facility			?
1.11.1.1.	mmlFc:Facility			?
1.11.2.	mmlHi:addresses			?
1.11.2.1.	mmlAd:Address			*
1.11.3.	mmlHi:phones			?
1.11.3.1.	mmlPh:Phone			*
1.12.	mmlHi:workInfo			?
1.12.1.	mmlHi:facility			?
1.12.1.1.	mmlFc:Facility			?
1.12.2.	mmlHi:addresses			?
1.12.2.1.	mmlAd:Address			*
1.12.3.	mmlHi:phones			?
1.12.3.1.	mmlPh:Phone			*
1.13.	mmlHi:publicInsurance			?
1.13.1.	mmlHi:publicInsuranceItem			+
		mmlHi:priority	string	#REQUIRED
1.13.1.1.	mmlHi:providerName		string	?
1.13.1.2.	mmlHi:provider		string
1.13.1.3.	mmlHi:recipient		string
1.13.1.4.	mmlHi:startDate		date
1.13.1.5.	mmlHi:expiredDate		date
1.13.1.6.	mmlHi:paymentRatio		decimal	?
		mmlHi:ratioType	string	#REQUIRED	MML0032

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.2.2. Element explanation

mmlHi:HealthInsuranceModule

Description: combination of available health insurance and public insurance.
Omission: not allowed
Repetition: allowed. If multiple combinations are available, MmlModuleItem should be repeated.

For example, if the following 3 insurance types are used;

1． National health insurance only

2． National health insurance and public insurance (tuberculosis)

3． Continued social insurance

3 items of information should be described separately by repeating the <MmlModuleItem> 3 times.

Attribute: the following attribute is provided to indicate that this module is unique to Japan.

Attribute name

Data type

Omission

Remarks

MmlHi:countryType

string

#IMPLIED

Country type. Enter JPN for Japan.

Example:

<mmlHi:HealthInsuranceModule mmlHi:countryType = "JPN">

mmlHi:insuranceClass

Description: health insurance class. In principle, table MML0031 is used, but in case there is a need of expanding the table specifically to users due to local public insurance, etc. use another table and enter the name of the new table.
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

mmlHi:ClassCode

string

#REQUIRED

mmlHi:tableId

string

#REQUIRED

MML0031

Example:

<mmlHi:insuranceClass mmlHi:ClassCode="00" mmlHi:tableId="MML0031">National health insurance</mmlHi:insuranceClass>

mmlHi:insuranceNumber

Description: health insurance number
Data type: string
Omission: not allowed
Example: <mmlHi:insuranceNumber>8001</mmlHi:insuranceNumber>

mmlHi:clientId

Description: information of an insured person
Omission: not allowed

mmlHi:group

Description: insured person symbol
Data type: string
Omission: not allowed

mmlHi:number

Description: insured person number
Data type: string
Omission: not allowed
Example:

<mmlHi:clientId>
  <mmlHi:group>Miyaichi Miheshi</mmlHi:group>
  <mmlHi:number>421</mmlHi:number>
</mmlHi:clientId>

mmlHi:familyClass

Description: indication of an insured person or family member. true: insured person, false: family
Data type: boolean
Omission: not allowed
Example: a case of an insured person

<mmlHi:familyClass>true</mmlHi:familyClass>

Example: a case of a family member

<mmlHi:familyClass>false</mmlHi:familyClass>

mmlHi:clientInfo

Description: information of an insured person
Omission: allowed

mmlHi:personName

Description: parent element for the input of insured person's names described below.
Omission: allowed

mmlNm:Name

Description: name. Refer to the MML common format (Name expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHi:addresses

Description: parent element for the input of insured person's addresses described below.
Omission: allowed

mmlAd:Address

mmlHi:phones

Description: parent element for the input of insured person's telephone numbers described below.
Omission: allowed

mmlPh:Phone

Description: telephone number. Refer to the MML common format (Telephone number format) for the structure.
Omission: allowed
Repetition: allowed. If multiple telephone numbers are available, the element should be repeated.

mmlHi:continuedDiseases

Description: continued disease information
Omission: allowed

mmlHi:diseases

Description: name of an applicable continued disease
Data type: string
Omission: not allowed
Repetition: allowed. If multiple continued diseases are available, the element should be repeated.
Example: Diabetes mellitus and hypertension

<mmlHi:continuedDiseases>
  <mmlHi:diseases>diabetes mellitus</mmlHi:diseases>
  <mmlHi:diseases>hypertension</mmlHi:diseases>
</mmlHi:continuedDiseases>

mmlHi:startDate

Description: start date (issue date)
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example:

<mmlHi:startDate>1995-04-01</mmlHi:startDate>

mmlHi:expiredDate

Description: expiration date
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example:

<mmlHi:expiredDate>1999-09-30</mmlHi:expiredDate>

mmlHi:paymentInRatio

Description: insured person's payment ratio for an inpatient care. 0[.0][0]_1[.0][0] (Example: "0.3" for 30% payment)
Data type: decimal
Omission: allowed
Example: 20% of payment ratio

<mmlHi:paymentInRatio>0.2</mmlHi:paymentInRatio>

mmlHi:paymentOutRatio

Description: insured person's payment ratio for an outpatient care. 0[.0][0]_1[.0][0] (Example: "0.3" for 30% payment)
Data type: decimal
Omission: allowed
Example: 20% of payment ratio

<mmlHi:paymentOutRatio>0.2</mmlHi:paymentOutRatio>

mmlHi:insuredInfo

Description: insurer's information
Omission: allowed

mmlHi:facility

Description: parent element for the input of insurer's information described below.
Omission: allowed

mmlFc:Facility

Description: facility information. Refer to the MML common format (Facility information format) for the structure.
Omission: allowed

mmlHi:addresses

Description: parent element for the input of insurer’s addresses described below.
Omission: allowed

mmlAd:Address

mmlHi:phones

Description: parent element for the input of insurer's telephone numbers described below.
Omission: allowed

mmlPh:Phone

mmlHi:workInfo

Description: place of business information of an insured person.
Omission: allowed

mmlHi:facility

Description: parent element for the input of place of business information described below.
Omission: allowed

mmlFc:Facility

Description: facility information. Refer to the MML common format (Facility information format) for the structure.
Omission: allowed

mmlHi:addresses

Description: parent element for the input of addresses of place of business described below.
Omission: allowed

mmlAd:Address

mmlHi:phones

Description: parent element for the input of telephone numbers of place of business described below.
Omission: allowed

mmlPh:Phone

mmlHi:publicInsurance

Description: medical information covered by public insurance
Omission: allowed

mmlHi:publicInsuranceItem

Description: public insurance item
Omission: not allowed
Repetition: allowed. If multiple types of public insurance are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHi:priority

string

#REQUIRED

Priority of multiple public insurances
Enter integers starting from 1

Example:

<mmlHi:publicInsuranceItem mmlHi:priority = "1">

mmlHi:providerName

Description: public insurance name
Data type: string
Omission: allowed

mmlHi:provider

Description: provider number
Data type: string
Omission: not allowed

mmlHi:recipient

Description: recipient number
Data type: string
Omission: not allowed

mmlHi:startDate

Description: start date
Data type: date
Omission: not allowed

mmlHi:expireDate

Description: expiration date
Data type: date
Omission: not allowed

mmlHi:paymentRatio

Description: payment ratio or amount
Data type: decimal
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlHi:ratioType

String

#REQUIRED

MML0032

Payment amount or ratio is described.

Example:
In case payment type is "fixed" and that the amount is 10,000 yen,

<mmlHi:paymentRatio mmlHi:ratioType="fix">10000</ mmlHi:paymentRatio>

In case payment type is "ratio" and that the ratio is 5 %,

<mmlHi:paymentRatio mmlHi:ratioType="ratio">0.05</ mmlHi:paymentRatio>

Example:

<mmlHi:publicInsurance>
  <mmlHi:publicInsuranceItem mmlHi:priority = "1">
    <mmlHi:providerName>Public insurance</mmlHi:providerName>
    <mmlHi:provider>15450034</mmlHi:provider>
    <mmlHi:recipient>0009043</mmlHi:recipient>
    <mmlHi:startDate>1997-09-30</mmlHi:startDate>
    <mmlHi:expiredDate>1999-09-30</mmlHi:expiredDate>
    <mmlHi:paymentRatio mmlHi:ratioType="fix">10000</mmlHi:paymentRatio>
  </mmlHi:publicInsuranceItem>
</mmlHi:publicInsurance>

10.3. Diagnosis record information module

Figure 11. Element structure

10.3.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlRd= "http://www.medxml.net/MML/v4/ContentModule/RegisteredDiagnosis/1.0"

Table 12. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlRd:RegisteredDiagnosisModule
1.1.	mmlRd:diagnosis		string
		mmlRd:code	string	#IMPLIED
		mmlRd:system	string	#IMPLIED
1.2.	mmlRd:diagnosisContents			?
1.2.1.	mmlRd:dxItem			+
1.2.2.	mmlRd:name		string
		mmlRd:code	string	#IMPLIED
		mmlRd:system	string	#IMPLIED
1.3.	mmlRd:categories			?
1.3.1.	mmlRd:category		string	+	optional
		mmlRd:tableId	string	#REQUIRED
1.4.	mmlRd:startDate		date	?
1.5.	mmlRd:endDate		date	?
1.6.	mmlRd:outcome		string	?	MML0016
1.7.	mmlRd:firstEncounterDate		date	?
1.8.	mmlRd:relatedHealthInsurance			?
		mmlRd:uid	string	#IMPLIED

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.3.2. Element explanation

mmlRd:RegisteredDiagnosisModule

Description: diagnosis record information. Enter only one disease name in one module. If there are multiple diseases, MmlModuleItem should be repeated. Select either to enter a full disease name including modifiers or enter a name divided into a main disease part and modifiers.

mmlRd:diagnosis

Description: disease name. A full name including modifiers is stored.
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlRd:code

string

#IMPLIED

Disease code

mmlRd:system

string

#IMPLIED

Disease code system name

Example: a case of colon carcinoid (ICD10 code: C189-.006)

<mmlRd:diagnosis mmlRd:code = " C189-.006" mmlRd:system = "ICD10">colon carcinoid</mmlRd:diagnosis>

mmlRd:diagnosisContents

Description: a disease name divided into the main disease and modifiers is stored. Select either one of the above or this method.
Omission: allowed

mmlRd:dxItem

Description: element for repetition
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of elements.

mmlRd:name

Description: disease element name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlRd:code

string

#IMPLIED

Disease code

Example: a case that paroxysmal atrial fibrillation is described, separated into paroxysmal and atrial fibrillation.

<mmlRd:diagnosisContents>
  <mmlRd:dxItem >
    <mmlRd:name mmlRd:code=" I48--.004" mmlRd:system="ICD10">
      atrial fibrillation
    </mmlRd:name>
  </mmlRd:dxItem>
  <mmlRd:dxItem >
    <mmlRd:name>paroxysmal</mmlRd:name>
  </mmlRd:dxItem>
</mmlRd:diagnosisContents>

mmlRd:categories

Description: category of diagnosis
Omission: allowed

mmlRd:category

Description: category name. Use tables from MML0012 to MML0015. Specific operation methods of each category is defined by users.
Data type: string
Omission: not allowed
Repetition: allowed. If multiple categories are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

Example: when the diagnosis is a main diagnosis, academic diagnosis, pathological diagnosis and confirmed diagnosis

<mmlRd:categories>
  <mmlRd:category mmlRd:tableId = "MML0012">mainDiagnosis</mmlRd:category>
  <mmlRd:category mmlRd:tableId = "MML0013">academicDiagnosis</mmlRd:category>
  <mmlRd:category mmlRd:tableId = "MML0014">pathologicalDiagnosis</mmlRd:category>
  <mmlRd:category mmlRd:tableId = "MML0015">confirmedDiagnosis</mmlRd:category>
</mmlRd:categories>

mmlRd:startDate

Description: start date of a disease
Data type: date. Format: CCYY-MM-DD
Omission: allowed

mmlRd:endDate

Description: end date of a disease
Data type: date. Format: CCYY-MM-DD
Omission: allowed

mmlRd:outcome

Description: outcome. Use table MML0016.
Data type: string
Omission: allowed

mmlRd:firstEncounterDate

Description: first visit date
Data type: date. Format: CCYY-MM-DD
Omission: allowed

mmlRd:relatedHealthInsurance

Description: related health insurance information. This is an empty tag. Enter the document uid of related health insurance information in the attribute. This element is used only when the mmlRd:RegisteredDiagnosisModule is used in the mmlSg:SurgeryModule or mmlSm:SummaryModule. When the mmlRd:RegisteredDiagnosisModule is used as a single MML content, enter the document uid of related health insurance information in the parentId (docInfo module).
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlRd:uid

string

#IMPLIED

Enter the uid of the mmlHi:HealthInsuranceModule of the health insurance related to a disease.

Example:

<mmlRd:relatedHealthInsurance mmlRd:uid = "0aae5960-667c-11d3-9751-00105a6792e8"/>

10.4. Lifestyle information module

Figure 12. Element structure

10.4.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlLs= "http://www.medxml.net/MML/v4/ContentModule/Lifestyle/1.0"

Table 13. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlLs:LifestyleModule
1.1.	mmlLs:occupation		string
1.2.	mmlLs:tobacco		string
1.3.	mmlLs:alcohol		string
1.4.	mmlLs:other		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.4.2. Element explanation

mmlLs:LifestyleModule

Description: lifestyle information

mmlLs:occupation

Description: occupation
Data type: string
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlLs:tobacco

Description: smoking history
Data type: string
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlLs:alcohol

Description: history of alcohol use
Data type: string
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlLs:other

Description: other lifestyles. Religion, sports history, etc.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

10.5. Basic clinical information module

Figure 13. Element structure

10.5.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlBc= "http://www.medxml.net/MML/v4/ContentModule/BaseClinic/1.0"

Table 14. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlBc:BaseClinicModule
1.1.	mmlBc:allergy			?
1.1.1.	mmlBc:allergyItem			+
1.1.1.1.	mmlBc:factor		string
1.1.1.2.	mmlBc:severity		string	?	MML0017
1.1.1.3.	mmlBc:identifiedDate		string	?
1.1.1.4.	mmlBc:memo		string	?
1.2.	mmlBc:bloodtype			?
1.2.1.	mmlBc:abo		string		MML0018
1.2.2.	mmlBc:rh		string	?	MML0019
1.2.3.	mmlBc:others			?
1.2.3.1.	mmlBc:other			*
1.2.3.1.1.	mmlBc:typeName		string
1.2.3.1.2.	mmlBc:typeJudgement		string
1.2.3.1.3.	mmlBc:description		string	?
1.2.4.	mmlBc:memo		string	?
1.3.	mmlBc:infection			?
1.3.1.	mmlBc:infectionItem			+
1.3.1.1.	mmlBc:factor		string
1.3.1.2.	mmlBc:examValue		string
1.3.1.3.	mmlBc:identifiedDate		string	?
1.3.1.4.	mmlBc:memo		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.5.2. Element explanation

mmlBc:BaseClinicModule

Description: basic clinical information

mmlBc:allergy

Description: allergy information
Omission: allowed

mmlBc:allergyItem

Description: element for repetition
Omission: not allowed
Repetition: allowed. If there are multiple allergy items, the element should be repeated.

mmlBc:factor

Description: cause of allergy
Data type: string
Omission: not allowed

mmlBc:severity

Description: severity of allergic response. Use table MML0017.
Data type: string
Omission: allowed

mmlBc:identifiedDate

Description: identified date of allergy. The description method is not specified in particular. Expressions such as "childhood" or "approx. 20 years ago" may be acceptable.
Data type: string
Omission: allowed

mmlBc:memo

Description: allergy memo. Enter information not provided in the elements above such as special remarks or comments.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

Example: the patient has been slightly allergic to crabs for approx. 20 years, but not allergic to shrimps.

<mmlBc:allergyItem>
  <mmlBc:factor>crab</mmlBc:factor>
  <mmlBc:severity>mild</mmlBc:severity>
  <mmlBc:identifiedDate>since almost 20 years ago</mmlBc:identifiedDate>
  <mmlBc:memo>no reaction to shrimp</mmlBc:memo>
</mmlBc:allergyItem>

Example: a case that there are no special remarks relating to allergy.

<mmlBc:allergyItem>
  <mmlBc:factor>nothing</mmlBc:factor>
  <mmlBc:memo>non-contributory </mmlBc:memo>
</mmlBc:allergyItem>

mmlBc:bloodtype

Description: blood type information
Omission: allowed

mmlBc:abo

Description: ABO blood type. Use table MML0018.
Data type: string
Omission: not allowed

mmlBc:rh

Description: Rho (D) blood type. Use table MML0019.
Data type: string
Omission: allowed

mmlBc:others

Description: other blood type information
Omission: allowed

mmlBc:other

Description: other blood type
Omission: allowed
Repetition: allowed. If multiple other blood types are available, the element should be repeated.

mmlBc:typeName

Description: blood type name
Data type: string
Omission: not allowed

mmlBc:typeJudgement

Description: method of blood typing
Data type: string
Omission: not allowed

mmlBc:description

Description: note on blood type
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

Example:

<mmlBc:other>
  <mmlBc:typeName>MNS blood type</mmlBc:typeName>
  <mmlBc:typeJudgement>MN</mmlBc:typeJudgement>
  <mmlBc:description>examination at 2 years ago </mmlBc:description>
</mmlBc:other>

mmlBc:memo

Description: memo
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlBc:infection

Description: infection information
Omission: allowed

mmlBc:infectionItem

Description: element for repetition
Omission: not allowed
Repetition: allowed. If there are multiple factors of infection, the element should be repeated.

mmlBc:factor

Description: infection factor name
Data type: string
Omission: not allowed

mmlBc:examValue

Description: test result of infection factor
Data type: string
Omission: not allowed

mmlBc:identifiedDate

Description: identified date of infection factor. The description method is not specified in particular.
Data type: string
Omission: allowed

mmlBc:memo

Description: memo for infection factor
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

10.6. Initial-consultation-specific information module

Figure 14. Element structure

10.6.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlFcl= "http://www.medxml.net/MML/v4/ContentModule/FirstClinic/1.0"

Table 15. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlFcl:FirstClinicModule
1.1.	mmlFcl:familyHistory			?
1.1.1.	mmlFcl:familyHistoryItem			+
1.1.1.1.	mmlFcl:relation		string		MML0020
1.1.1.2.	mmlRd:RegisteredDiagnosisModule
1.1.1.3.	mmlFcl:age		duration	?
1.1.1.4.	mmlFcl:memo		string	?
1.2.	mmlFcl:childhood			?
1.2.1.	mmlFcl:birthInfo			?
1.2.1.1.	mmlFc:Facility			?
1.2.1.2.	mmlFcl:deliveryWeeks		duration	?
1.2.1.3.	mmlFcl:deliveryMethod		string	?
1.2.1.4.	mmlFcl:bodyWeight		decimal	?
		mmlFcl:unit	string	#REQUIRED
1.2.1.5.	mmlFcl:bodyHeight		decimal	?
		mmlFcl:unit	string	#REQUIRED
1.2.1.6.	mmlFcl:chestCircumference		decimal	?
		mmlFcl:unit	string	#REQUIRED
1.2.1.7.	mmlFcl:headCircumference		decimal	?
		mmlFcl:unit	string	#REQUIRED
1.2.1.8.	mmlFcl:memo		string	?
1.2.2.	mmlFcl:vaccination			?
1.2.2.1.	mmlFcl:vaccinationItem			+
1.2.2.1.1.	mmlFcl:vaccine		string
1.2.2.1.2.	mmlFcl:injected		boolean
1.2.2.1.3.	mmlFcl:age		duration	?
1.2.2.1.4.	mmlFcl:memo		string	?
1.3.	mlFcl:pastHistory			?
1.3.1.	mmlFcl:freeNotes		string
1.3.2.	mmlFcl:pastHistoryItem			*
1.3.2.1.	mmlFcl:timeExpression		string
1.3.2.2.	mmlFcl:eventExpression		string	*
1.4.	mmlFcl:chiefComplaints		string	?
1.5.	mmlFcl:presentIllnessNotes		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.6.2. Element explanation

mmlFcl:FirstClinicModule

Description: initial-consultation-specific information

mmlFcl:familyHistory

Description: family history information
Omission: allowed

mmlFcl:familyHistoryItem

Description: element for repetition
Omission: not allowed
Repetition: allowed. If there are multiple family members to be described, the element should be repeated. Furthermore, if a family member has multiple diseases, the element should also be repeated.

mmlFcl:relation

Description: relation code. Use table MML0020.
Data type: string
Omission: not allowed
Example: mother-in-law (If the relation is "in-law", put "InLaw" at the end.)

<mmlFcl:relation>motherInLaw</mmlFcl:relation>

mmlRd:RegisteredDiagnosisModule

Description: diagnosis information. Refer to the MML module (Diagnosis record information) for the structure.
Omission: not allowed
Example: died of gastric cancer on August 25,1989

<mmlRd:RegisteredDiagnosisModule>
  <mmlRd:diagnosis mmlRd:code="C169-.007" mmlRd:system="ICD10">gastric cancer</mmlRd:diagnosis>
  <mmlRd:endDate>1989-08-25</mmlRd:endDate>
  <mmlRd:outcome>died</mmlRd:outcome>
</mmlRd:RegisteredDiagnosisModule>

mmlFcl:age

Description: age of a family member at disease onset
Data type: duration. Format: PnYnMnWnDTnHnMnS
Normally PnY is acceptable except for infant.
Omission: allowed
Example: at the age of 40

<mmlFcl:age>P40Y</mmlFcl:age>

Example: 1 year and 3 months after birth

<mmlFcl:age>P1Y3M</mmlFcl:age>

Example: 3 months after birth

<mmlFcl:age>P3M</mmlFcl:age>

mmlFcl:memo

Description: memo
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlFcl:childhood

Description: childhood information
Omission: allowed

mmlFcl:birthInfo

Description: birth information
Omission: allowed

mmlFc:Facility

Description: birth facility. Refer to the MML common format (Facility information format) for the structure.
Omission: allowed

mmlFcl:deliveryWeeks

Description: delivery weeks
Data type: duration. Format: PnW
Omission: allowed
Example: 40 weeks

<mmlFcl:deliveryWeeks>P40W</mmlFcl:deliveryWeeks>

mmlFcl:deliveryMethod

Description: delivery method. The description method is not specified in particular.
Data type: string
Omission: allowed
Example: cesarean section

<mmlFcl:deliveryMethod>cesarean section</mmlFcl:deliveryMethod>

mmlFcl:bodyWeight

Description: body weight at birth
Data type: decimal
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlFcl:unit

string

#REQUIRED

Unit: g or kg

Example: 3,270 gram

<mmlFcl:bodyWeight mmlFcl:unit="g">3270</mmlFcl:bodyWeight>

mmlFcl:bodyHeight

Description: body height at birth
Data type: decimal
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlFcl:unit

string

#REQUIRED

Unit: cm or m

mmlFcl:chestCircumference

Description: chest circumference at birth
Data type: decimal
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlFcl:unit

string

#REQUIRED

Unit: cm

mmlFcl:headCircumference

Description: head circumference at birth
Data type: decimal
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlFcl:unit

string

#REQUIRED

Unit: cm

mmlFcl:memo

Description: memo at birth
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlFcl:vaccination

Description: vaccination information
Omission: allowed

mmlFcl:vaccinationItem

Description: element for repetition
Omission: not allowed
Repetition: allowed. If multiple vaccination records are available, the element should be repeated.

mmlFcl:vaccine

Description: vaccine name
Data type: string
Omission: not allowed

mmlFcl:injected

Description: vaccination status. true: Vaccinated, false: Not vaccinated
Data type: boolean
Omission: not allowed

mmlFcl:age

Description: age at vaccination
Data type: duration. Format: PnYnMnWnDTnHnMnS
Normally, PnYnM is acceptable.
Omission: allowed

mmlFcl:memo

Description: memo at vaccination
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example: polio injection twice; at 6 months and 1 year and 6 months old.

<mmlFcl:vaccination>
  <mmlFcl:vaccinationItem>
    <mmlFcl:vaccine>polio</mmlFcl:vaccine>
    <mmlFcl:injected>true</mmlFcl:injected>
    <mmlFcl:age>P6M</mmlFcl:age>
    <mmlFcl:memo>first administration</mmlFcl:memo>
  </mmlFcl:vaccinationItem>
  <mmlFcl:vaccinationItem>
    <mmlFcl:vaccine>polio</mmlFcl:vaccine>
    <mmlFcl:injected>true</mmlFcl:injected>
    <mmlFcl:age>P1Y6M</mmlFcl:age>
    <mmlFcl:memo>second administration</mmlFcl:memo>
  </mmlFcl:vaccinationItem>
</mmlFcl:vaccination>

mmlFcl:pastHistory

Description: past history information. Select either the free style expression (mmlFcl:freeNotes) or time and event expressions (mmlFcl:timeExpression and mmlFcl:eventExpression).
Omission: allowed

mmlFcl:freeNotes

Description: free style expression
Data type: string
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlFcl:pastHistoryItem

Description: element for repetition
Omission: allowed
Repetition: allowed. If multiple past history items are available, the element should be repeated.

mmlFcl:timeExpression

Description: time expression. The expression format is not defined in particular.
Data type: string
Omission: not allowed

mmlFcl:eventExpression

Description: corresponding event expression to time expression.
Data type: string
Omission: allowed
Repetition: allowed. If there are multiple event expressions for one time expression, the element should be repeated.
Document layout: use of XHTML is allowed.
Example: for past history information in the free style expression

<mmlFcl:pastHistory>
  <mmlFcl:freeNotes>
    Appendectomy (6 years old), hypertension (5 years ago)
  </mmlFcl:freeNotes>
</mmlFcl:pastHistory>

Example: for past history information in the time and event expressions

<mmlFcl:pastHistory>
  <mmlFcl:pastHistoryItem>
    <mmlFcl:timeExpression>6 years old</mmlFcl:timeExpression>
    <mmlFcl:eventExpression>appendectomy</mmlFcl:eventExpression>
  </mmlFcl:pastHistoryItem>
  <mmlFcl:pastHistoryItem>
    <mmlFcl:timeExpression>5 years ago (1994)</mmlFcl:timeExpression>
    <mmlFcl:eventExpression>hypertension</mmlFcl:eventExpression>
  </mmlFcl:pastHistoryItem>
</mmlFcl:pastHistory>

mmlFcl:chiefComplaints

Description: chief complaint
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlFcl:presentIllnessNotes

Description: present illness in free style expression
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

10.7. Progress course information module

Figure 15. Element structure

10.7.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlPc= "http://www.medxml.net/MML/v4/ContentModule/ProgressCourse/1.0"

Table 16. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlPc:ProgressCourseModule
1.1.	mmlPc:FreeExpression		string
1.1.1.	mmlCm:extRef			*
1.2.	mmlPc:structuredExpression
1.2.1.	mmlPc:problemItem			*
1.2.1.1.	mmlPc:problem		string	?
		mmlPc:dxUid	string	#IMPLIED
1.2.1.2.	mmlPc:subjective			?
1.2.1.2.1.	mmlPc:freeNotes		string
1.2.1.2.2.	mmlPc:subjectiveItem			*
1.2.1.2.2.1.	mmlPc:timeExpression		string
1.2.1.2.2.2.	mmlPc:eventExpression		string	+
1.2.1.3.	mmlPc:objective			?
1.2.1.3.1.	mmlPc:objectiveNotes		string	?
1.2.1.3.2.	mmlPc:physicalExam			?
1.2.1.3.2.1.	mmlPc:physicalExamItem			+
1.2.1.3.2.1.1.	mmlPc:title		string
1.2.1.3.2.1.2.	mmlPc:result		string
1.2.1.3.2.1.3.	mmlPc:interpretation		string	?
1.2.1.3.2.1.4.	mmlPc:referenceInfo			?
1.2.1.3.2.1.4.1.	mmlCm:extRef			*
1.2.1.3.3.	mmlPc:testResult		string	?
1.2.1.3.3.1.	mmlCm:extRef			*
1.2.1.3.4.	mmlPc:rxRecord		string	?
1.2.1.3.4.1.	mmlPs:PrescriptionModule			?
1.2.1.3.4.2.	mmlInj:InjectionModule			*
1.2.1.3.4.2.	mmlCm:extRef			*
1.2.1.3.5.	mmlPc:txRecord		string	?
1.2.1.3.5.1.	mmlCm:extRef			*
1.2.1.4.	mmlPc:assessment			?
1.2.1.4.1.	mmlPc:assessmentItem		string	+
1.2.1.5.	mmlPc:plan			?
1.2.1.5.1.	mmlPc:testOrder		string	?
1.2.1.5.1.1.	mmlCm:extRef			*
1.2.1.5.2.	mmlPc:rxOrder		string	?
1.2.1.5.2.1	mmlPs:PrescriptionModule			?
1.2.1.5.2.2	mmlInj:InjectionModule			?
1.2.1.5.2.3.	mmlCm:extRef			*
1.2.1.5.3.	mmlPc:txOrder		string	?
1.2.1.5.3.1.	mmlCm:extRef			*
1.2.1.5.4.	mmlPc:planNotes		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.7.2. Element explanation

mmlPc:ProgressCourseModule

Description: progress course information. Select either the mmlPc:FreeExpression or mmlPc: structured Expression.

mmlPc:FreeExpression

Description: progress course in free style expression. This can be present together with the mmlCm:extRef.
Data type: string
Omission: if the mmlPc:structuredExpression is selected, omission is allowed.
Document layout: use of XHTML is allowed.

mmlCm:extRef

Description: refer to the MML common format (External reference format) for the structure.
Omission: allowed
Repetition: allowed. If multiple external references are available, the element should be repeated.

mmlPc:structuredExpression

Description: structured expression of progress course
Omission: if the mmlPc:FreeExpression is selected, omission is allowed.

mmlPc:problemItem

Description: problem information
Omission: allowed
Repetition: allowed. If there are multiple problems, the element should be repeated.

mmlPc:problem

Description: problem name
Data type: string
Omission: allowed
Attribute: enter the uid of a related diagnosis in the attribute.

Attribute name

Data type

Omission

Remarks

mmlPc:dxUid

string

#IMPLIED

Enter the uid of the related mmlRd:RegisteredDiagnosisModule.

Document layout: use of XHTML is allowed.

mmlPc:subjective

Description: sbj information. Select either the free style expression (mmlPc:freeNotes) or time and event expressions (mmlPc:timeExpression and mmlPc:eventExpression).
Omission: allowed

mmlPc:freeNotes

Description: free style expression
Data type: string
Omission: when the combination of the mmlPc:timeExpression and mmlPc:eventExpression is selected, omission is allowed.
Document layout: use of XHTML is allowed.
Example:

<mmlPc:freeNotes>
  25-Aug-1999. AM.:Palpitation was felt early in the morning.
  25-Aug-1999. PM.: no palpitations.
</mmlPc:freeNotes>

mmlPc:subjectiveItem

Description: element for repetition
Omission: if the mmlPc:freeNotes is selected, omission is allowed.
Repetition: allowed. If multiple pairs of time expression (1.2.1.2.2.1.) and event expression (1.2.1.2.2.2.) are available, this element should be repeated.

mmlPc:timeExpression

Description: time expression. The expression format is not defined in particular. (Example: recently, since several years ago, childhood, etc.)
Data type: string
Omission: not allowed

mmlPc:eventExpression

Description: corresponding event expression to time expression.
Data type: string
Omission: not allowed
Repetition: allowed. If there are multiple event expressions for one time expression, the element should be repeated.
Document layout: use of XHTML is allowed.
Example: when the same content as in the mmlPc:freeNotes is structured.

<mmlPc:subjectiveItem>
  <mmlPc:timeExpression>
    25-Aug-1999. AM.
  </mmlPc:timeExpression>
  <mmlPc:eventExpression>
    Palpitation was felt early in the morning.
  </mmlPc:eventExpression>
</mmlPc:subjectiveItem>
<mmlPc:subjectiveItem>
  <mmlPc:timeExpression>
    25-Aug-1999. PM.
  </mmlPc:timeExpression>
  <mmlPc:eventExpression>
    No palpitations.
  </mmlPc:eventExpression>
</mmlPc:subjectiveItem>

mmlPc:objective

Description: Obj information
Omission: allowed

mmlPc:objectiveNotes

Description: objective information in free style expression
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlPc:physicalExam

Description: physical examination information
Omission: allowed

mmlPc:physicalExamItem

Description: physical examination items
Omission: not allowed
Repetition: allowed. If multiple combinations of the following elements (from 1.2.1.3.2.1.1. to 1.2.1.3.2.1.4.1.) are available, this element should be repeated.

mmlPc:title

Description: item name of physical examination
Data type: string
Omission: not allowed

mmlPc:result

Description: result of physical examination
Data type: string
Omission: not allowed

mmlPc:interpretation

Description: interpretation of physical examination result
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlPc:referenceInfo

Description: external reference information
Omission: allowed

mmlCm:extRef

mmlPc:testResult

Description: test result. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlPc:rxRecord

Description: prescription record. This can be present together with the mmlInj:InjectionModule and mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlInj:InjectionModule

Description: refer to the injection record module for the structure.
Omission: allowed
Repetition: allowed. If there are multiple cases, the element should be repeated.

mmlCm:extRef

mmlPc:txRecord

Description: treatment record. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlPc:assessment

Description: assessment information
Omission: allowed

mmlPc:assessmentItem

Description: assessment item
Data type: string
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of individual assessments.
Document layout: use of XHTML is allowed.

mmlPc:plan

Description: treatment plan information
Omission: allowed

mmlPc:testOrder

Description: test order. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlPc:rxOrder

Description: prescription order. This can be present together with the mmlPs:PrescriptionModule and mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlPs:PrescriptionModule

Description: refer to the prescription module for the structure.
Omission: allowed
Repetition: allowed. If there are multiple cases, the element should be repeated.

mmlCm:extRef

mmlPc:txOrder

Description: treatment order. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlPc:planNotes

Description: treatment plan in free style expression
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

10.8. Surgery record information module

Figure 16. Element structure

10.8.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlSg= "http://www.medxml.net/MML/v4/ContentModule/Surgery/1.0"

Table 17. Element list
	Elements	Attribute	Datatypes	Occurence	TableId
1.	mmlSg:SurgeryModule
1.1.	mmlSg:surgeryItem			+
1.1.1.	mmlSg:surgicalInfo
		mmlSg:type	string	#IMPLIED	MML0021
1.1.1.1.	mmlSg:date		date
1.1.1.2.	mmlSg:startTime		time	?
1.1.1.3.	mmlSg:duration		duration	?
1.1.1.4.	mmlSg:surgicalDepartment			?
1.1.1.4.1.	mmlDp:Department
1.1.1.5.	mmlSg:patientDepartment			?
1.1.1.5.1.	mmlDp:Department
1.1.2.	mmlSg:surgicalDiagnosis
1.1.2.1.	mmlRd:RegisteredDiagnosisModule			+
1.1.3.	mmlSg:surgicalProcedure
1.1.3.1.	mmlSg:procedureItem			+
1.1.3.1.1.	mmlSg:operation		string
		mmlSg:code	string	#IMPLIED
		mmlSg:system	string	#IMPLIED
1.1.3.1.2.	mmlSg:operationElement			?
1.1.3.1.2.1.	mmlSg:operationElementItem			+
1.1.3.1.2.1.1.	mmlSg:title		string
		mmlSg:code	string	#IMPLIED
		mmlSg:system	string	#IMPLIED
1.1.3.1.3.	mmlSg:procedureMemo		string	?
1.1.4.	mmlSg:surgicalStaffs
1.1.4.1.	mmlSg:staff			+
		mmlSg:staffClass	string	#IMPLIED	MML0022
		mmlSg:superiority	integer	#IMPLIED
1.1.4.1.1.	mmlSg:staffInfo
1.1.4.1.1.1.	mmlPsi:PersonalizedInfo
1.1.5.	mmlSg:anesthesiaProcedure			?
1.1.5.1.	mmlSg:title		string	+
		mmlSg:code	string	#IMPLIED
		mmlSg:system	string	#IMPLIED
1.1.6.	mmlSg:anesthesiologists			?
1.1.6.1.	mmlSg:staff			*
		mmlSg:staffClass	string	#IMPLIED	MML0023
		mmlSg:superiority	integer	#IMPLIED
1.1.6.1.1.	mmlSg:staffInfo
1.1.6.1.1.1.	mmlPsi:PersonalizedInfo
1.1.7.	mmlSg:anesthesiaDuration		duration	?
1.1.8.	mmlSg:operativeNotes		string	?
1.1.9.	mmlSg:referenceInfo			?
1.1.9.1.	mmlCm:extRef			+
1.1.10.	mmlSg:memo		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.8.2. Element explanation

mmlSg:SurgeryModule

Description: surgery record information. Attention should be paid to the granularity of surgeries and element repetition. For the description of different surgeries with apparently different dates, <MmlModuleItem> should be repeated. A series of operations performed almost at the same time should be described in one mmlSg:SurgeryModule. If multiple surgical procedures are performed in a series of operation, the mmlSg:surgeryItem should be repeated.

mmlSg:surgeryItem

Description: element for the input of an individual surgery in a series of operation
Omission: not allowed
Repetition: allowed. If multiple surgeries are performed in a series of operation, the element should be repeated. (Example: if surgeries of lobectomy and aorta replacement with a synthetic graft due to abdominal aortic aneurysm are performed at the same time, each surgical procedure is described in a different mmlSg:surgeryItem.)

mmlSg:surgicalInfo

Description: surgery header information
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSg:type

string

#IMPLIED

MML0021

Surgery type code

Example: a case of an elective surgery

<mmlSg:surgicalInfo mmlSg:type = " elective ">

mmlSg:date

Description: surgery date
Data type: date. Format: CCYY-MM-DD
Omission: not allowed

mmlSg:startTime

Description: surgery start time
Data type: time. Format: hh:mm:ss
Normally, time can be shortened to hours and minutes (hh:mm).
Omission: allowed
Example:

<mmlSg:startTime>08:30</mmlSg:startTime>

mmlSg:duration

Description: surgery duration
Data type: duration. Format: PnYnMnDTnHnMnS
Normally, the PTnHnM form is used.
Omission: allowed
Example: duration of 5 hours and 25 minutes

<mmlSg:duration>PT5H25M</mmlSg:duration>

mmlSg:surgicalDepartment

Description: surgery operating department information
Omission: allowed

mmlDp:Department

Description: surgery operating department. Refer to the MML common format for the structure.
Omission: not allowed ===== mmlSg:patientDepartment
Description: patient department information. Since the patient department may be different from the surgery-operating department, the patient department information can be entered here.
Omission: allowed

mmlDp:Department

Description: department to which a patient belonged at the time of surgery. Refer to the MML common format for the structure.
Omission: not allowed
Example: when the patient belongs to the internal medicine (ID 01).

<mmlDp:Department>
  <mmlDp:name mmlDp:repCode = "A" mmlDp:tableId = "MML0025">
    Internal medicine
  </mmlDp:name>
  <mmlCm:Id mmlCm:type = "medical" mmlCm:tableId = "MML0029">01</mmlCm:Id>
</mmlDp:Department>

mmlSg:surgicalDiagnosis

Description: surgical diagnosis information Considering diagnoses particular to surgeries, such as Classification of Carcinoma, surgical diagnosis information can be entered separately from the mmlRd:RegisteredDiagnosisModule. However, the structure should be the same.
Omission: not allowed

mmlRd:RegisteredDiagnosisModule

Description: refer to the aforementioned explanation for the structure.
Omission: not allowed
Repetition: allowed. If multiple diagnoses are available, the element should be repeated.
Example: a case of upper right lung cancer

<mmlSg:surgicalDiagnosis>
  <mmlRd:RegisteredDiagnosisModule>
    <mmlRd:diagnosisContents>
      <mmlRd:dxItem >
        <mmlRd:name mmlRd:code = " C349-.007" mmlRd:system = "ICD10">
          Lung cancer
        </mmlRd:name>
      </mmlRd:dxItem>
      <mmlRd:dxItem>
        <mmlRd:name>right</mmlRd:name>
      </mmlRd:dxItem>
      <mmlRd:dxItem >
        <mmlRd:name>upper lobe</mmlRd:name>
      </mmlRd:dxItem>
    </mmlRd:diagnosisContents>
    <mmlRd:categories>
      <mmlRd:category mmlRd:tableId = "MML0012">mainDiagnosis</mmlRd:category>
      <mmlRd:category mmlRd:tableId = "MML0013">academicDiagnosis</mmlRd:category>
      <mmlRd:category mmlRd:tableId = "MML0014">operativeDiagnosis</mmlRd:category>
      <mmlRd:category mmlRd:tableId = "MML0015">confirmedDiagnosis</mmlRd:category>
    </mmlRd:categories>
  </mmlRd:RegisteredDiagnosisModule>
</mmlSg:surgicalDiagnosis>

mmlSg:surgicalProcedure

Description: surgery header information
Omission: not allowed

mmlSg:procedureItem

Description: element for repetition of surgical procedures. Select either the full expression of the entire procedures including modifiers or separated element expression of surgical procedures in one mmlSg:procedureItem.
Omission: not allowed
Repetition: allowed. If multiple procedures are used for a surgery, the element should be repeated. (Example: coronary bypass grafting and cardio-pulmonary bypass)

mmlSg:operation

Description: surgical procedure. Full expression of the entire procedure including modifiers.
Data type: string
Omission: if the separated expression of elements is selected, omission is allowed.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSg:code

string

#IMPLIED

Surgical procedure code

mmlSg:system

string

#IMPLIED

Surgical procedure code system name

Example: coronary bypass grafting and cardio-pulmonary bypass

 <mmlSg:surgicalProcedure>
   <mmlSg:procedureItem>
     <mmlSg:operation>coronary artery bypass grafting</mmlSg:operation>
   </mmlSg:procedureItem>
   <mmlSg:procedureItem>
     <mmlSg:operation>cardio-pulmonary bypass</mmlSg:operation>
 </mmlSg:procedureItem>
</mmlSg:surgicalProcedure>

mmlSg:operationElement

Description: separated expression of surgical elements
Example: right mastectomy is separated into right and mastectomy.
Example: coronary artery 3 vessel bypass grafting is separated into coronary artery bypass grafting and 3 vessel bypass grafting.
Omission: if the full expression including modifiers is selected, omission is allowed.

mmlSg:operationElementItem

Description: element for repetition of surgical elements.
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of elements.

mmlSg:title

Description: title of a separated operation element
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSg:code

string

#IMPLIED

Surgical procedure code

mmlSg:system

string

#IMPLIED

Surgical procedure code system name

mmlSg:procedureMemo

Description: memo for surgical procedures
Data type: string
Omission: allowed
Example: procedures of coronary artery bypass grafting, 3 vessel bypass and cardio-pulmonary bypass, retrograde blood cardioplegia (no blood transfusion)

<mmlSg:surgicalProcedure>
  <mmlSg:procedureItem>
    <mmlSg:operationElement>
      <mmlSg:operationElementItem>
        <mmlSg:title> coronary artery bypass grafting </mmlSg:title>
      </mmlSg:operationElementItem>
      <mmlSg:operationElementItem>
        <mmlSg:title>3 vessels (LIMA to LAD, SVGs to #9, #12) </mmlSg:title>
      </mmlSg:operationElementItem>
    </mmlSg:operationElement>
  </mmlSg:procedureItem>
  <mmlSg:procedureItem>
    <mmlSg:operationElement>
      <mmlSg:operationElementItem>
        <mmlSg:title> cardio-pulmonary bypass</mmlSg:title>
      </mmlSg:operationElementItem>
      <mmlSg:operationElementItem>
        <mmlSg:title> retrograde blood cardioplegia</mmlSg:title>
      </mmlSg:operationElementItem>
    </mmlSg:operationElement>
    <mmlSg:procedureMemo>no blood transfusion </mmlSg:procedureMemo>
  </mmlSg:procedureItem>
</mmlSg:surgicalProcedure>

mmlSg:surgicalStaffs

Description: surgery staff information except anesthesia staff
Omission: allowed

mmlSg:staff

Description: element for repetition
Omission: not allowed
Repetition: allowed. The element should be repeated the same number of times as the number of staff.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSg:staffClass

string

#IMPLIED

MML0022

Classification of surgery staff

mmlSg:superiority

integer

#IMPLIED

Superiority

Superiority means ranking such as "First" or "Second" assistant. It should be specified with an integer. + Example: a case of the first assistant

<mmlSg:staff mmlSg:superiority = "1" mmlSg:staffClass = " assistant">

mmlSg:staffInfo

Description: surgery staff ID information
Omission: not allowed

mmlPsi:PersonalizedInfo

Description: personal identification information. Refer to the aforementioned mmlPsi:PersonalizedInfo.
Omission: not allowed

mmlSg:anesthesiaProcedure

Description: anesthesia procedure information
Omission: allowed

mmlSg:title

Description: anesthesia procedure title
Data type: string
Omission: not allowed
Repetition: allowed. If multiple anesthesia procedures are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSg:code

string

#IMPLIED

Anesthesia procedure code

mmlSg:system

string

#IMPLIED

Anesthesia procedure code system name

Example: general anesthesia, endotracheal intubation and G+O+Ethrane anesthesia

<mmlSg:anesthesiaProcedure>
  <mmlSg:title>general anesthesia</mmlSg:title>
  <mmlSg:title>tracheal intubation </mmlSg:title>
  <mmlSg:title>G+O+Ethrane</mmlSg:title>
</mmlSg:anesthesiaProcedure>

mmlSg:anesthesiologists

Description: anesthesiologist information
Omission: not allowed

mmlSg:staff

Description: anesthesiologist
Omission: allowed
Repetition: allowed. If multiple anesthesiologists are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSg:staffClass

string

#IMPLIED

MML0023

Classification of anesthesiologists

mmlSg:superiority

integer

#IMPLIED

Superiority

mmlSg:staffInfo

Description: anesthesiologist ID information
Omission: not allowed

mmlPsi:PersonalizedInfo

Description: personal identification information. Refer to the aforementioned mmlPsi:PersonalizedInfo.
Omission: not allowed

mmlSg:anesthesiaDuration

Description: anesthesia duration
Data type: duration. Format: PnYnMnDTnHnMnS
Normally, the PTnHnM form is used.
Omission: allowed
Example: duration of 6 hours and 25 minutes

<mmlSg:anesthesiaDuration> PT6H25M </mmlSg:anesthesiaDuration>

mmlSg:operativeNotes

Description: free note of operation record
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlSg:referenceInfo

Description: external references of illustrations and photos used for operation record.
Omission: allowed

mmlCm:extRef

Description: refer to the MML common format (External reference format) for the structure.
Omission: not allowed
Repetition: allowed. If multiple external references are available, the element should be repeated the number of times.
Example: surgical record figure (Fig. 1: Skin incision) <mmlSg:referenceInfo> <mmlCm:extRef mmlCm:contentType = "image/gif" mmlCm:medicalRole = " surgicalFigure " mmlCm:title = "Fig1. Skin incision" mmlCm:href = "patient001/surgicalFigure001.gif"/> </mmlSg:referenceInfo>

mmlSg:memo

Description: memo for surgery
Data type: string
Omission: allowed

10.9. Clinical summary information module

Figure 17. Element structure

10.9.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlSm= "http://www.medxml.net/MML/v4/ContentModule/Summaryr/1.0"

Table 18. Element list
	Elements	Attribute	Datatypes	Occurence	Table
1.	mmlSm:SummaryModule
1.1.	mmlSm:serviceHistory
		mmlSm:start	date	#IMPLIED
		mmlSm:end	date	#IMPLIED
1.1.1.	mmlSm:outPatient			?
1.1.1.1.	mmlSm:outPatientItem			*
1.1.1.1.1.	mmlSm:date		date
1.1.1.1.2.	mmlSm:outPatientCondition		string	?
		mmlSm:first	boolean	#IMPLIED
		mmlSm:emergency	boolean	#IMPLIED
1.1.1.1.3.	mmlSm:staffs			?
1.1.1.1.3.1.	mmlSm:staffInfo			+
1.1.1.1.3.1.1.	mmlPsi:PersonalizedInfo
1.1.1.1.3.1.2.	mmlCi:creatorLicense			+
1.1.2.	mmlSm:inPatient			?
1.1.2.1.	mmlSm:inPatientItem			*
1.1.2.1.1.	mmlSm:admission
1.1.2.1.1.1.	mmlSm:date		date
1.1.2.1.1.2.	mmlSm:admissionCondition		string	?
		mmlSm:emergency	boolean	#IMPLIED
1.1.2.1.1.3.	mmlSm:referFrom			?
1.1.2.1.1.3.1.	mmlPsi:PersonalizedInfo
1.1.2.1.2.	mmlSm:discharge
1.1.2.1.2.1.	mmlSm:date		date
1.1.2.1.2.2.	mmlSm:dischargeCondition		string	?
		mmlSm:outcome	string	#IMPLIED	MML0016
1.1.2.1.2.3.	mmlSm:referTo			?
1.1.2.1.2.3.1.	mmlPsi:PersonalizedInfo
1.1.2.1.3.	mmlSm:staffs			?
1.1.2.1.3.1.	mmlSm:staffInfo			+
1.1.2.1.3.1.1.	mmlPsi:PersonalizedInfo
1.1.2.1.3.1.2.	mmlCi:creatorLicense			+
1.2.	mmlRd:RegisteredDiagnosisModule			*
1.3.	mmlSm:deathInfo			?
		mmlSm:date	date/dateTime	#IMPLIED
		mmlSm:autopsy	boolean	#IMPLIED
1.4.	mmlSg:SurgeryModule			*
1.5.	mmlSm:chiefComplaints		string	?
1.6.	mmlSm:patientProfile		string	?
1.7.	mmlSm:history		string	?
1.8.	mmlSm:physicalExam		string	?
1.8.1.	mmlCm:extRef			*
1.9.	mmlSm:clinicalCourse			?
1.9.1.	mmlSm:clinicalRecord		string	+
		mmlSm:date	date/dateTime	#IMPLIED
1.9.1.1.	mmlCm:extRef			*
1.9.1.2.	mmlSm:relatedDoc		string	*
		mmlSm:relation	string	#IMPLIED	MML0008
1.10.	mmlSm:dischargeFindings		string	?
1.10.1.	mmlCm:extRef			*
1.11.	mmlSm:medication		string	?
1.11.1.	mmlPs:PrescriptionModule			*
1.11.2.	mmlCm:extRef			*
1.12.	mmlSm:testResults			?
1.12.1.	mmlSm:testResult		string	+
		mmlSm:date	date/dateTime	#IMPLIED
1.12.1.1.	mmlCm:extRef			*
1.13.	mmlSm:plan		string	?
1.13.1.	mmlCm:extRef			*
1.14.	mmlSm:remarks		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.9.2. Management

The clinical summary information groups various items of information (progress course, patient information, diagnosis, surgery, etc.). The following methods are available for the creation of a group.

Method 1:

Information on diagnoses and surgeries can be entered in the mmlSm:SummaryModule, not in external references or links.

Method 2:

The mmlSm:SummaryModule and related modules (patient information, diagnosis, surgery, etc.) can be compiled into a single MML instance with repetition of <paragraph>s, not using an external reference or link. In this case, enter "summary" in the extractPolicy (an attribute of the scopePeriod in the docInfo module) to define the data as a general summary.

Method 3:

Use the link function between documents using the MML groupId. More specifically, enter the same uid in the groupId of the related modules (patient information, diagnosis, surgery, etc.) including the mmlSm:SummaryModule. It is not necessary to compile the data into a single MML instance. Specify the appropriate document type in the groupClass attribute of the groupId.

Method 3 is most recommended. The reasons for this are firstly that diagnosis or surgery information entered in the mmlSm:SummaryModule via method 1 is difficult to search or reuse and that, secondly, in the case of method 2 it is difficult to control information in the module unit. In method 3, since diagnosis or surgery information is considered to be an independent module, it is easy to carry out a search or make use of the information; links will not be lost even when the information is controlled in the module unit because of the existence of the groupId.

10.9.3. Element explanation

mmlSm:SummaryModule

Description: clinical summary information

mmlSm:serviceHistory

Description: period information. This module is not necessarily limited to one admission to hospital. Multiple admissions to hospital, visits to outpatient clinic, and the combinations of both may also be included.
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSm:start

date

#IMPLIED

Start date of a summary period

mmlSm:end

date

#IMPLIED

End date of a summary period

Normally, the values of attributes above will be the same as those of the "start" and "end" attributes of the docInfo module, .confirmDate.

Example:

<mmlSm:serviceHistory mmlSm:start = "1999-08-25" mmlSm:end = "1999-08-31">

Example: summary of one year

<mmlSm:serviceHistory mmlSm:start = "1998-01-01" mmlSm:end = "1998-12-31">

mmlSm:outPatient

Description: outpatient history information
Omission: allowed

mmlSm:outPatientItem

Description: individual outpatient history item
Omission: allowed
Repetition: allowed. If there are multiple visits as outpatients, the element should be repeated.

mmlSm:date

Description: outpatient visit date
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example: visit to outpatient clinic on August 25.

<mmlSm:date>1999-08-25</mmlSm:date>

mmlSm:outPatientCondition

Description: condition at an outpatient visit
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSm:first

boolean

#IMPLIED

Indication of the first time visit. true: First time visit, false: Revisit

mmlSm:emergency

boolean

#IMPLIED

Indication of an emergency visit. true: Emergency, false: Normal

Example: for the first and emergency visit

<mmlSm:outPatientCondition mmlSm:first = "true" mmlSm:emergency = "true">
  10A.M.the patient was put into the ambulance on a stretcher and driven to our hospital.
</mmlSm:outPatientCondition>

mmlSm:staffs

Description: information on staff for a patient
Omission: allowed

mmlSm:staffInfo

Description: staff for an outpatient
Omission: not allowed
Repetition: allowed. If multiple members of staff are available, the element should be repeated.

mmlPsi:PersonalizedInfo

Description: personal information. Refer to the MML common format for the structure.
Omission: not allowed

mmlCi:creatorLicense

Description: staff license
Data type: string
Omission: not allowed
Repetition: allowed. If multiple licenses are available, the element should be repeated.

mmlSm:inPatient

Description: inpatient history information
Omission: not allowed

mmlSm:inPatientItem

Description: individual inpatient history item. Multiple admissions to hospital, ward transfer and change of department in one admission to hospital may be described by repetition.
Omission: allowed
Repetition: allowed. If there are multiple admissions, the element should be repeated.

mlSm:admission

Description: admission to hospital
Omission: not allowed

mmlSm:date

Description: admission (or transfer) date
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example: admission on August 27,1999

<mmlSm:date>1999-8-27</mmlSm:date>

mmlSm:admissionCondition

Description: condition at time of admission to hospital
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSm:emergency

boolean

#IMPLIED

Indication of an emergency admission. true: Emergency, false: Normal

Example: emergency admission by ambulance

<mmlSm:admissionCondition mmlSm:emergency = "true">
  Emergency admission by ambulance
</mmlSm:admissionCondition>

mmlSm:referFrom

Description: referring physician information
Omission: allowed

mmlPsi:PersonalizedInfo

Description: refer to the MML common format for the structure.
Omission: not allowed
Example: referring from Yoko Ono M.D., Internal Medicine, New Millennium Medical College

<mmlSm:referFrom>
  <mmlPsi:PersonalizedInfo>
    <mmlCm:Id mmlCm:type="facility" mmlCm:tableId="MML0024">
      23234567
    </mmlCm:Id>
    <mmlPsi:personName>
      <mmlNm:Name mmlNm:repCode = "A" mmlNm:tableId = "MML0025">
        <mmlNm:family>Ono</mmlNm:family>
        <mmlNm:given>Yoko</mmlNm:given>
        <mmlNm:degree>M.D.</mmlNm:degree>
      </mmlNm:Name>
    </mmlPsi:personName>
    <mmlFc:Facility>
      <mmlFc:name mmlFc:repCode="A" mmlFc:tableId="MML0025">
        New Millenium Medical College Hospital</mmlFc:name>
      <mmlCm:Id mmlCm:type="insurance" mmlCm:tableId="MML0027">
        801.006.3
      </mmlCm:Id>
    </mmlFc:Facility>
    <mmlDp:Department>
      <mmlDp:name mmlDp:repCode="A" mmlDp:tableId="MML0025">
        Internal medicine
      </mmlDp:name>
      <mmlCm:Id mmlCm:type="medical" mmlCm:tableId="MML0029">01</mmlCm:Id>
    </mmlDp:Department>
  </mmlPsi:PersonalizedInfo>
</mmlSm:referFrom>

mmlSm:discharge

Description: discharge from hospital
Omission: not allowed

mmlSm:date

Description: discharge (or transfer) date
Data type: date. Format: CCYY-MM-DD
Omission: not allowed
Example: discharge on August 31,1999

<mmlSm:date>1999-08-31</mmlSm:date>

mmlSm:dischargeCondition

Description: condition at time of discharge from hospital
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSm:outcome

string

#IMPLIED

MML0016

Outcome at time of discharge

Example: a case that the patient is transferred to the chronic hospital on the 4th post operative day.

<mmlSm:dischargeCondition mmlSm:outcome="transferChronic">
  4 P.O.D, the patient was transferred to the chronic hospital.
</mmlSm:dischargeCondition>

mmlSm:referTo

Description: consulted physician information
Omission: not allowed

mmlPsi:PersonalizedInfo

Description: refer to the MML common format for the structure.
Omission: not allowed
Example: referring to Fujiko Tanaka M.D., Cardiology, New Millennium Heisei Hospital

<mmlSm:referTo>
  <mmlPsi:PersonalizedInfo>
    <mmlCm:Id mmlCm:type="facility" mmlCm:tableId="MML0024">
      55234567</mmlCm:Id>
    <mmlPsi:personName>
      <mmlNm:Name mmlNm:repCode="A" mmlNm:tableId="MML0025">
        <mmlNm:family>Tanaka</mmlNm:family>
        <mmlNm:given>Fujiko</mmlNm:given>
        <mmlNm:degree>M.D.</mmlNm:degree>
      </mmlNm:Name>
    </mmlPsi:personName>
    <mmlFc:Facility>
      <mmlFc:name mmlFc:repCode="A" mmlFc:tableId="MML0025">
        New Millenium Heisei Hospital
      </mmlFc:name>
      <mmlCm:Id mmlCm:type="insurance" mmlCm:tableId="MML0027">
        2354678
      </mmlCm:Id>
    </mmlFc:Facility>
    <mmlDp:Department>
      <mmlDp:name mmlDp:repCode="A" mmlDp:tableId="MML0025">
        Cardiology
      </mmlDp:name>
      <mmlCm:Id mmlCm:type="medical" mmlCm:tableId="MML0029">08</mmlCm:Id>
    </mmlDp:Department>
  </mmlPsi:PersonalizedInfo>
</mmlSm:referTo>

mmlSm:staffs

Description: information on staff for a patient
Omission: allowed

mmlSm:staffInfo

Description: staff for an inpatient
Omission: not allowed
Repetition: allowed. If multiple members of staff are available, the element should be repeated.

mmlPsi:PersonalizedInfo

Description: refer to the MML common format for the structure.
Omission: not allowed

mmlCi:creatorLicense

Description: staff license
Data type: string
Omission: not allowed
Repetition: allowed. If multiple licenses are available, the element should be repeated.
Example: the doctor in charge of the patient at the time of admission is Kenji Araki M.D., Cardiovascular surgery, New Millennium Medical College Hospital.

<mmlSm:staffInfo>
  <mmlPsi:PersonalizedInfo>
    <mmlCm:Id mmlCm:type="facility" mmlCm:tableId="MML0024">
      23456789
    </mmlCm:Id>
    <mmlPsi:personName>
      <mmlNm:Name mmlNm:repCode="A" mmlNm:tableId="MML0025">
        <mmlNm:family>Araki</mmlNm:family>
        <mmlNm:given>Kenji</mmlNm:given>
        <mmlNm:degree>M.D.</mmlNm:degree>
      </mmlNm:Name>
    </mmlPsi:personName>
    <mmlFc:Facility>
      <mmlFc:name mmlFc:repCode="A" mmlFc:tableId="MML0025">
        New Millenium Medical College Hospital
      </mmlFc:name>
      <mmlCm:Id mmlCm:type="insurance" mmlCm:tableId="MML0027">801.006.3</mmlCm:Id>
    </mmlFc:Facility>
    <mmlDp:Department>
      <mmlDp:name mmlDp:repCode="A" mmlDp:tableId="MML0025">
        Cardiovascular surgery
      </mmlDp:name>
      <mmlCm:Id mmlCm:type="medical" mmlCm:tableId="MML0029">16</mmlCm:Id>
    </mmlDp:Department>
  </mmlPsi:PersonalizedInfo>
  <mmlCi:creatorLicense mmlCi:tableId="MML0026">doctor</mmlCi:creatorLicense>
</mmlSm:staffInfo>

mmlRd:RegisteredDiagnosisModule

Description: diagnosis record information in a summary. Refer to the aforementioned explanation for the structure.

Refer to the management section above. Use this element in method 1. In methods 2 and 3, this element is omitted.

Omission: allowed
Repetition: allowed. If multiple diagnoses are available, the element should be repeated.

mmlSm:deathInfo

Description: death related information
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSm:date

date/dateTime

#IMPLIED

Date and time of death

mmlSm:autopsy

boolean

#IMPLIED

Whether or not autopsy was performed true: autopsy performed, false: no autopsy

Example: died of gastric cancer on August 31,1999. Autopsy performed.

<mmlSm:deathInfo mmlSm:date="1999-08-31" mmlSm:autopsy="true">
  The patient died of gastric cancer.
</mmlSm:deathInfo>

mmlSg:SurgeryModule

Description: surgery record information in a summary. Refer to the aforementioned explanation for the structure.

Refer to the management section above. Use this element in method 1. In methods 2 and 3, this element is omitted.

Omission: allowed
Repetition: allowed. If multiple surgeries are performed, the element should be repeated.

mmlSm:chiefComplaints

Description: chief complaint
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

<mmlSm:chiefComplaints>Severe chest pain</mmlSm:chiefComplaints>

mmlSm:patientProfile

Description: patient profile
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

<mmlSm:patientProfile>
  The patient is a 40-year-old married forester.
</mmlSm:patientProfile>

10.9.4. mmlSm:history

Description: history before admission
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

<mmlSm:history>
  On a background of good health, the patient noted the onset of chest pain and dyspnea on Aug 25,1999. At 10 A.M., he was put into the ambulance on a stretcher and driven to our hospital
  On arrival, the symptoms subsided and he went home without any medication. Two days ago (Aug 27), he felt intractable chest pain and was referred to the department of cardiovascular surgery under the diagnosis of unstable angina pectoris.
</mmlSm:history>

mmlSm:physicalExam

Description: physical findings at time of admission
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

<mmlSm:physicalExam>
  Physical findings were essentially normal except for the blood pressure which was 160/100. Heart sounds were clear and rhythm was regular without audible murmurs or friction sounds.
</mmlSm:physicalExam>

mmlCm:extRef

mmlSm:clinicalCourse

Description: clinical course and treatment
Omission: allowed

mmlSm:clinicalRecord

Description: clinical record. This can be present together with the mmlCm:extRef and mmlSm:relatedDoc.
Data type: string
Omission: not allowed
Repetition: allowed. The element should be repeated the corresponding number of times to dates or items.
Document layout: use of XHTML is allowed.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlSm:date

date/dateTime

#IMPLIED

Date and time of an event occurrence

mmlCm:extRef

mmlSm:relatedDoc

Description: enter the uid of the MmlModuleItem in an MML document related to this clinical record.
Data type: string
Omission: allowed
Repetition: allowed. If multiple related documents are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlSm:relatedDoc

string

#IMPLIED

MML0008

Document relation type

Example:

<mmlSm:clinicalCourse>
  <mmlSm:clinicalRecord mmlSm:date="1999-08-27">
    Emergency coronary angiography was carried out.
    <mmlCm:extRef mmlCm:contentType="image/jpeg"
      mmlCm:medicalRole="angioGraphy "
      mmlCm:title = "Preoperative coronary angiography"
      mmlCm:href = "patient001/surgicalFigure003.jpg"/>
    Three vessels (LAD, #9, #12) were involved.
    ＜mmlSm:relatedDoc mmlSm:relation=" detail"＞
      11D1AC5400A0C94A814796045F768ED5
    ＜/mmlSm:relatedDoc＞
  </mmlSm:clinicalRecord>
</mmlSm:clinicalCourse>

mmlSm:dischargeFindings

Description: findings at time of discharge. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

<mmlSm:dischargeFindings>
  Symptoms free, no wound infection.
</mmlSm:dischargeFindings>

mmlSm:medication

Description: prescription at time of discharge. This can be present together with the mmlPs:PrescriptionModule and mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlPs:PrescriptionModule

Description: refer to the content module mmlPs:PrescriptionModule for the structure.
Omission: allowed
Example:

<mmlSm:medication>
 Prescription on discharge
 <mmlPs:PrescriptionModule>
   <mmlPs:medication>
     <mmlPs:batchNo>1</mmlPs:batchNo>
     <mmlPs:medicine>
       <mmlPs:name>Predinisolone tab. 5mg</mmlPs:name>
       <mmlPs:code system="YJ">61222033</mmlPs:code>
     </mmlPs:medicine>
     <mmlPs:dose>4</mmlPs:dose>
     <mmlPs:doseUnit>Tablets</mmlPs:doseUnit>
     <mmlPs:frequencyPerDay>1</mmlPs:frequencyPerDay>
     <mmlPs:startDate>2015-05-13</mmlPs:startDate>
     <mmlPs:duration>P14D</mmlPs:duration>
     <mmlPs:instruction>Oral once/day before breakfast</mmlPs:instruction>
   </mmlPs:medication>
 </mmlPs:PrescriptionModule>
</mmlSm:medication>

mmlCm:extRef

<mmlSm:medication>
  Prescription on discharge
  <mmlCm:extRef
    mmlCm:contentType="APPLICATION/HL72.3-HL7ER2.3"
    mmlCm:medicalRole="prescription"
    mmlCm:title="Prescription on discharge"
    mmlCm:href="patient1234/prescription003.HL7"/>
</mmlSm:medication>

mmlSm:testResults

Description: test result at time of discharge
Omission: allowed

mmlSm:testResult

Description: individual test result. This can be present together with the mmlCm:extRef.
Data type: string
Omission: not allowed
Repetition: allowed. If multiple tests are available, the element should be repeated.
Document layout: use of XHTML is allowed.

mmlCm:extRef

<mmlSm:testResults>
  <mmlSm:testResult mmlSm:date=" 1999-08-31">
    Labo findings on discharge
    <mmlCm:extRef mmlCm:contentType="APPLICATION/HL72.3-HL7ER2.3"
      mmlCm:medicalRole="laboratoryTest"
      mmlCm:title = "Blood chemistry data on discharge"
      mmlCm:href = "patient1234/prescription004.HL7"/>
  </mmlSm:testResult>
  <mmlSm:testResult mmlSm:date=" 1999-08-31">
    ECG on discharge. No ST change and new Q wave was observed.
    <mmlCm:extRef mmlCm:contentType="image/gif"
      mmlCm:medicalRole="ecg"
      mmlCm:title="ECG on discharge"
      mmlCm:href="patient1234/exam004.gif"/>
  </mmlSm:testResult>
</mmlSm:testResults>

mmlSm:plan

Description: treatment plan after discharge. This can be present together with the mmlCm:extRef.
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

<mmlSm:plan>
  Rehabilitation program and wound care will continue in the chronic hospital.
</mmlSm:plan>

mmlSm:remarks

Description: remarks for a patient
Data type: string
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

---
 <mmlSm:remarks>
   Patient education: good. Appointment in outpatient department in 2 weeks.
 </mmlSm:remarks>
---

10.10. Test history information module

10.10.1. Purpose and target

The purpose of this MML module is to provide laboratory test result information. In normal operations, a single module corresponds to a single request slip (or single test set). Targeted tests include laboratory (specimen) tests, as well as endocrine load tests and urinary sediment. Bacilli culture tests, histopathological tests, and cytological diagnoses are not targeted.

10.10.2. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlLb="http://www.medxml.net/MML/v4/ContentModule/test/1.0"

10.10.3. Specification of the document header information (docInfo) specific to this module

docInfo

The test value from table MML0005 should be entered in the contentModuleType attribute.

title

Apparently, there is no necessity for a document title of the test history information module, but, since it cannot be omitted, some sort of document title must be entered. One assumable example is that of using the set name in the module as a title.

For the generationPurpose attribute, the "reportTest" (test history report) value from table MML0007 must be entered.

confirmDate

This is the module creation date. It should match the report date/time in the module.

mmlCi:CreatorInfo

The document creator in the test history information module is not the test requester but the representative of the facility that performed the test. Thus, assumably it may correspond to the test performing laboratory or test performer in the module.

extRefs

The mmlCm:extRef element in the test history information module is described. The element should be repeated only the same number of times as the number of external link information items.

content

Only a single test history information module should be entered in a single content.

Table 19. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
1.	mmlLb:TestModule
1.1.	mmlLb:information
		mmlLb:registId	string	#REQUIRED
		mmlLb:sampleTime	dateTime	#IMPLIED
		mmlLb:registTime	dateTime	#REQUIRED
		mmlLb:reportTime	dateTime	#REQUIRED
1.1.1.	mmlLb:reportStatus		string
		mmlLb:statusCode	string	#REQUIRED	mmlLb0001
		mmlLb:statusCodeId	string	#REQUIRED
1.1.2.	mmlLb:set		string	?
		mmlLb:setCode	string	#IMPLIED	Specified by users
		mmlLb:setCodeId	string	#IMPLIED
1.1.3.	mmlLb:facility		string
		mmlLb:facilityCode	string	#REQUIRED
		mmlLb:facilityCodeId	string	#REQUIRED	MML0027
1.1.4.	mmlLb:department		string	?
		mmlLb:depCode	string	#IMPLIED	MML0028
		mmlLb:depCodeId	string	#IMPLIED
1.1.5.	mmlLb:ward		string	?
		mmlLb:wardCode	string	#IMPLIED	Specified by users
		mmlLb:wardCodeId	string	#IMPLIED
1.1.6.	mmlLb:client		string	?
		mmlLb:clientCode	string	#IMPLIED	Specified by users
		mmlLb:clientCodeId	string	#IMPLIED
1.1.7.	mmlLb:laboratoryCenter		string
		mmlLb:centerCode	string	#REQUIRED	Specified by users
		mmlLb:centerCodeId	string	#REQUIRED
1.1.8.	mmlLb:technician		string	?
		mmlLb:techCode	string	#IMPLIED	Specified by users
		mmlLb:techCodeId	string	#IMPLIED
1.1.9.	mmlLb:repMemo		string	*
		mmlLb:repCodeName	string	#IMPLIED
		mmlLb:repCode	string	#IMPLIED	Specified by users
		mmlLb:repCodeId	string	#IMPLIED
1.1.10.	mmlLb:repMemoF		string	?
1.2.	mmlLb:laboTest			+
1.2.1.	mmlLb:specimen
1.2.1.1.	mmlLb:specimenName		string
		mmlLb:spCode	string	#REQUIRED	Specified by users
		mmlLb:spCodeId	string	#REQUIRED
1.2.1.2.	mmlLb:spcMemo		string	*
		mmlLb:smCodeName	string	#IMPLIED
		mmlLb:smCode	string	#IMPLIED	Specified by users
		mmlLb:smCodeId	string	#IMPLIED
1.2.1.3.	mmlLb:spcMemoF		string	?
1.2.2.	mmlLb:item			+
1.2.2.1.	mmlLb:itemName		string
		mmlLb:itCode	string	#REQUIRED	Specified by users
		mmlLb:itCodeId	string	#REQUIRED
		mmlLb:Acode	string	#IMPLIED	JLAC10
		mmlLb:Icode	string	#IMPLIED	JLAC10
		mmlLb:Scode	string	#IMPLIED	JLAC10
		mmlLb:Mcode	string	#IMPLIED	LAC10
		mmlLb:Rcode	string	#IMPLIED	JLAC10
1.2.2.2.	mmlLb:value		string
1.2.2.3.	mmlLb:numValue		decimal	?
		mmlLb:up	decimal	#IMPLIED
		mmlLb:low	decimal	#IMPLIED
		mmlLb:normal	string	#IMPLIED
		mmlLb:out	string	#IMPLIED	mmlLb0002
1.2.2.4.	mmlLb:unit		string	?
		mmlLb:uCode	string	#IMPLIED	Specified by users
		mmlLb:uCodeId	string	#IMPLIED
1.2.2.5.	mmlLb:referenceInfo			?
1.2.2.5.1.	mmlCm:extRef			*
1.2.2.6.	mmlLb:itemMemo		string	*
		mmlLb:imCodeName	string	#IMPLIED
		mmlLb:imCode	string	#IMPLIED	Specified by users
		mmlLb:imCodeId	string	#IMPLIED
1.2.2.7.	mmlLb:itemMemoF		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.10.4. Element explanation

mmlLb:TestModule

Description: test history information module

mmlLb:information

Description: test history header information
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:registId

string

#REQUIRED

Request ID
The same request ID is used for a test progress report and a final report that are created from the same test request.

mmlLb:sampleTime

dateTime

#IMPLIED

Sampling date/time

mmlLb:registTime

dateTime

#REQUIRED

Registration date/time

mmlLb:reportTime

dateTime

#REQUIRED

Report date/time

mmlLb:reportStatus

Description: report status
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:statusCode

string

#REQUIRED

mmlLb0001

mid: test in progress final: final report

mmlLb:statusCodeId

string

#REQUIRED

Enter mmlLb0001

mmlLb:set

Description: set name
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:setCode

string

#IMPLIED

Specified by users

mmlLb:setCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:facility

Description: requesting facility
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:facilityCode

string

#REQUIRED

mmlLb:facilityCodeId

string

#REQUIRED

MML0027

Enter the name of a used code system

mmlLb:department

Description: requesting medical department
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:depCode

string

#IMPLIED

MML0028

mmlLb:depCodeId

string

#IMPLIED

MML0028と入力

mmlLb:ward

Description: requesting ward
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:wardCode

string

#IMPLIED

Specified by users

mmlLb:wardCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:client

Description: test requester
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:clientCode

string

#IMPLIED

Specified by users

mmlLb:clientCodeId

string

#IMPLIED

Enter the name of a used code system

mmlLb:laboratoryCenter

Description: test-performing laboratory
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:centerCode

string

#REQUIRED

Specified by users

mmlLb:centerCodeId

string

#REQUIRED

Enter the name of a used table

mmlLb:technician

Description: test performer
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:techCode

string

#IMPLIED

Specified by users

mmlLb:techCodeId

string

#IMPLIED

Enter the name of a used code system

mmlLb:repMemo

Description: report comment
Repetition: allowed. If there are multiple report comments, the element should be repeated the number of times.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:repCodeName

string

#IMPLIED

mmlLb:repCode

string

#IMPLIED

Specified by users

mmlLb:repCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:repMemoF

Description: report free comment

mmlLb:laboTest

Description: laboratory test result information
Repetition: allowed. In principle, if there are multiple specimen materials, the element should be repeated the number of times.

mmlLb:specimen

Description: specimen information

mmlLb:specimenName

Description: specimen material
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:spCode

string

#REQUIRED

Specified by users

mmlLb:spCodeId

string

#REQUIRED

Enter the name of a used table

mmlLb:spcMemo

Description: specimen comment
Repetition: allowed. If there are multiple specimen comments, the element should be repeated the number of times.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:smCodeName

string

#IMPLIED

Specimen comment name

mmlLb:smCode

string

#IMPLIED

Specified by users

mmlLb:smCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:spcMemoF

Description: specimen free comment

mmlLb:item

Description: item information
Repetition: allowed. If there are multiple items, the element should be repeated the number of times.

mmlLb:itemName

Description: item name
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:itCode

string

#REQUIRED

Specified by users

Facility's unique code

mmlLb:itCodeId

string

#REQUIRED

Name of a facility's unique code system
Enter the name of a used table

mmlLb:Acode

string

#IMPLIED

JLAC10

Analyzed item code of JLAC10

mmlLb:Icode

string

#IMPLIED

JLAC10

Identification code of JLAC10

mmlLb:Scode

string

#IMPLIED

JLAC10

Material code of JLAC10

mmlLb:Mcode

string

#IMPLIED

JLAC10

Measurement method code of JLAC10

mmlLb:Rcode

string

#IMPLIED

JLAC10

Result identification code of JLAC10

mmlLb:value

Description: value in character strings for display-purpose. This is a required element.

mmlLb:numValue

Description: value (numerical value). This element is specified only for numerical value data.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:up

decimal

#IMPLIED

Upper limit value

mmlLb:low

decimal

#IMPLIED

Lower limit value

mmlLb:normal

string

#IMPLIED

Normal range shown in character strings. Example: "negative"

mmlLb:out

string

#IMPLIED

mmlLb0002

Abnormal values graph
H: above upper limit
N: within standard range
L: below lower limit
A: abnormal

mmlLb:unit

Description: unit
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:uCode

string

#IMPLIED

Specified by users

mmlLb:uCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:referenceInfo

Description: external reference information

mmlCm:extRef

Description: external reference. When a figure or graph is attached, the MML common format (External reference format) is used.
Repetition: allowed. If multiple external references are available, the element should be repeated the number of times.

mmlLb:itemMemo

Description: item comment
Repetition: allowed. If there are multiple item comments, the element should be repeated the number of times.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlLb:imCodeName

string

#IMPLIED

Item comment name

mmlLb:imCode

string

#IMPLIED

Specified by users

mmlLb:imCodeId

string

#IMPLIED

Enter the name of a used table

mmlLb:itemMemoF

Description: item free comment

10.11. Report information module

10.11.1. Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlRp="http://www.medxml.net/MML/v4/ContentModule/report/1.0"

10.11.2. Specification of the document header information (docInfo) specific to this module

docInfo

The "report" value from table MML0005 is specified in the contentModuleType attribute.

title

A title that indicates the content of the report should be entered.

In the generationPurpose attribute, select and enter a suitable value from MML0007 table’s "report", "reportRadiology" "reportPathology", etc.

confirmDate

This is the module creation date. It should match the report date/time in the module.

mmlCi:CreatorInfo

The document creator in the report information module is not the test requester but the person who writes the report.

extRefs

The mmlCm:extRef element in the report information module is described. The element should be repeated only the same number of times as the number of external link information items.

content

Only a single report information module should be entered in a single content.

Table 20. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
1.	mmlRp:ReportModule
1.1.	mmlRp:information
		mmlRp:performTime	dateTime	#REQUIRED
		mmlRp:reportTime	dateTime	#REQUIRED
1.1.1.	mmlRp:reportStatus		string
		mmlRp:statusCode	string	#REQUIRED	mmlLb0001
		mmlRp:statusCodeId	string	#REQUIRED
1.1.2.	mmlRp:testClass		string
		mmlRp:testClassCode	string	#REQUIRED	MML0033
		mmlRp:testClassCodeId	string	#REQUIRED
1.1.3.	mmlRp:testSubclass		string	?
		mmlRp:testSubclassCode	string	#IMPLIED	Specified by users
		mmlRp:testSubclassCodeId	string	#IMPLIED
1.1.4.	mmlRp:organ		string	?
1.1.5.	mmlRp:consultFrom			?
1.1.5.1.	mmlRp:conFacility		string	?
		mmlRp:facilityCode	string	#IMPLIED
		mmlRp:facilityCodeId	string	#IMPLIED	MML0027
1.1.5.2.	mmlRp:conDepartment		string	?
		mmlRp:depCode	string	#IMPLIED	MML0028
		mmlRp:depCodeId	string	#IMPLIED
1.1.5.3.	mmlRp:conWard		string	?
		mmlRp:wardCode	string	#IMPLIED	Specified by users
		mmlRp:wardCodeId	string	#IMPLIED
1.1.5.4.	mmlRp:client		string	?
		mmlRp:clientCode	string	#IMPLIED	Specified by users
		mmlRp:clientCodeId	string	#IMPLIED
1.1.6.	mmlRp:perfom
1.1.6.1.	mmlRp:pFacility		string
		mmlRp:facilityCode	string	#REQUIRED
		mmlRp:facilityCodeId	string	#REQUIRED	MML0027
1.1.6.2.	mmlRp:pDepartment		string	?
		mmlRp:depCode	string	#IMPLIED	MML0028
		mmlRp:depCodeId	string	#IMPLIED
1.1.6.3.	mmlRp:pWard		string	?
		mmlRp:wardCode	string	#IMPLIED	Specified by users
		mmlRp:wardCodeId	string	#IMPLIED
1.1.6.4.	mmlRp:performer		string
		mmlRp:performerCode	string	#REQUIRED	Specified by users
		mmlRp:performerCodeId	string	#REQUIRED
1.1.6.5.	mmlRp:supervisor		string	?
		mmlRp:supervisorCode	string	#IMPLIED	Specified by users
		mmlRp:supervisorCodeId	string	#IMPLIED
1.2.	mmlRp:reportBody
1.2.1.	mmlRp:chiefComplaints		string	?
1.2.2.	mmlRp:testPurpose		string	?
1.2.3.	mmlRp:testDx		string	?
1.2.4.	mmlRp:testNotes		string	?
		mmlCm:extRef		*
1.2.5.	mmlRp:testMemo		string	*
		mmlRp:tmCodeName	string	#IMPLIED
		mmlRp:tmCode	string	#IMPLIED	Specified by users
		mmlRp:tmCodeId	string	#IMPLIED
1.2.6.	mmlRp:testMemoF		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.11.3. Element explanation

mmlRp:ReportModule

Description: report information module

mmlRp:information

Description: report header information
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:performTime

dateTime

#REQUIRED

Test performance date/time

mmlRp:reportTime

mmlRp:reportStatus

Description: report status
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:statusCode

string

#REQUIRED

mmlLb0001

mid: test in progress
final: final report

mmlRp:statusCodeId

string

#REQUIRED

Enter mmlLb0001

mmlRp:testClass

Description: report class
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:testClassCode

string

#REQUIRED

MML0033

mmlRp:testClassCodeId

string

#REQUIRED

MML0033

1.1.3.mmlRp:testSubclass

Description: report subclass. A detailed class that cannot be covered by the report class is entered. When using codes, use an original table defined by users. + Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:testSubclassCode

string

#IMPLIED

Specified by users

mmlRp:testSubclassCodeId

mmlRp:organ

Description: internal organ. This is an internal organ targeted at for testing. Codes are not particularly used.

mmlRp:consultFrom

Description: requester information

mmlRp:conFacility

Description: requesting facility
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:facilityCode

string

#IMPLIED

Facility code

mmlRp:facilityCodeId

string

#IMPLIED

MML0027

mmlRp:conDepartment

Description: requesting medical department
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:depCode

string

#IMPLIED

MML0028

mmlRp:depCodeId

string

#IMPLIED

Enter MML0028

mmlRp:conWard

Description: requesting ward
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:wardCode

string

#IMPLIED

Specified by users

mmlRp:wardCodeId

string

#IMPLIED

Enter the name of a used table

mmlRp:client

Description: test requester
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:clientCode

string

#IMPLIED

Specified by users

mmlRp:clientCodeId

string

#IMPLIED

Enter the name of a used table

mmlRp:perform

Description: performer information

mmlRp:pFacility

Description: performing facility

Attribute name

Data type

Omission

Table

Remarks

mmlRp:facilityCode

string

#REQUIRED

mmlRp:facilityCodeId

string

#REQUIRED

MML0027

mmlRp:pDepartment

Description: performing medical department
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:depCode

string

#IMPLIED

MML0028

mmlRp:depCodeId

string

#IMPLIED

Enter MML0028

mmlRp:pWard

Description: performing ward
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:wardCode

string

#IMPLIED

Specified by users

mmlRp:wardCodeId

string

#IMPLIED

Enter the name of a used table

mmlRp:performer

Description: performer
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:performerCode

string

#REQUIRED

Specified by users

mmlRp:performerCodeId

string

#REQUIRED

Enter the name of a used table

mmlRp:supervisor

Description: supervisor

Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:supervisorCode

string

#IMPLIED

Specified by users

mmlRp:supervisorCodeId

string

#IMPLIED

Enter the name of a used table

mmlRp:reportBody

Description: report body information

mmlRp:chiefComplaints

Description: chief complaint
Document layout: use of XHTML is allowed.

mmlRp:testPurpose

Description: test purpose
Document layout: use of XHTML is allowed.

mmlRp:testDx

Description: test diagnosis. Within this element, diagnoses are written in text (XHTML can be used). If structured diagnoses information is required, create the required number of diagnosis record information modules and link the documents by the groupId.
Document layout: use of XHTML is allowed.

mmlRp:testNotes

Description: test notes. This can be present together with text data (#PCDATA) and the mmlCm:extRef.
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlRp:testMemo

Description: test comment
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlRp:tmCodeName

string

#IMPLIED

Test comment name

mmlRp:tmCode

string

#IMPLIED

Specified by users

mmlRp:tmCodeId

mmlRp:testMemoF

Description: test free comment

10.12. Referral module

10.12.1. Introduction

The referral module is described as mmlRe:ReferralModule. The elements contained in this module are in a generally unstructured, flat form.

10.12.2. Overview

The referral module specifies a data exchange method for linking hospitals and local clinics, based on letters of referral. A letter of referral contains a simple summary of the patient history, progress of treatment, and other information, and is created for the purpose of handing over treatment to another physician. Although they are issued by each medical institution, for insurance treatment only those which satisfy the format prescribed for "clinical information offering forms" can be calculated as "clinical information offering forms". This referral module covers all the items required by the clinical information offering forms for insurance treatment.

In this module only, patient information which is introduced separately from docinfo is included as mmlPi:PatientModule.

It had been recommended that images, test results, prescriptions, and other items that may be attached to a letter of referral use the external reference format mmlCm:extRef element to refer to files that are external from the perspective of the MML instance. For test results, it is possible to standardize the mmlRe:testResults with XML by using the test history information module. For prescriptions mmlRe:medication, it is possible to standardize the expressions using XML by using the mmlPs that was expanded with MML Ver. 4.

Similarly, for the creator of a letter of referral, the mmlCi:CreatorInfo in the MML common format (Creator information format) is used to match the creator information in the referral module instance with the actual creator of the letter. The mmlPsi:PersonalizedInfo in the MML common format (Personal information format) is used for the medical institution and department of the doctor who creates the letter of referral.

Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlRe="http://www.medxml.net/MML/v4/ContentModule/Referral/1.0"

Specification of the document header information (docInfo) specific to this module

docInfo

The "referral" value from table MML0005 is specified in the contentModuleType attribute.

title

A title that indicates the content of the referral letter should be entered.

For the generationPurpose attribute, the "consult" value from table MML0007 must be specified.

confirmDate

This is the referral module creation date.

mmlCi:CreatorInfo

The document creator in the referral module is the writer of a letter of referral. The persons who introduces the patient (mmlRe:referFrom) and writes the letter (mmlCi:CreatorInfo) may not be the same due to the use of a substitute writer, for instance.

extRefs

The mmlCm:extRef element in the referral module is described. The element should be repeated only the same number of times as the number of external link information items.

content

Only a single referral module should be entered in a single content.

Table 21. Element list
	Elements	Datatypes	Occurrence
1	mmmRe:ReferralModule
1.1.	mmlPi:PatientModule
1.2.	mmlRe:occupation	string	?
1.3.	mmlRe:referFrom
1.3.1	mmlPsi:PersonalizedInfo
1.4.	mmlRe:title	string
1.5.	mmlRe:greeting	string	?
1.6.	mmlRe:chiefComplaints	string
1.7.	mmlRe:clinicalDiagnosis	string	?
1.8.	mmlRe:pastHistory	string	?
1.8.1.	mmlCm:extRef		*
1.9.	mmlRe:familyHistory	string	?
1.9.1.	mmlCm:extRef		*
1.10.	mmlRe:presentIllness	string
1.10.1.	mmlCm:extRef		*
1.11.	mmlRe:testResults	string	?
1.11.1.	mmlCm:extRef		*
1.12.	mmlSm:clinicalCourse		?
1.13.	mmlRe:medication	string	?
1.13.1.	mmlPs:PrescriptionModule	string	?
1.13.2.	mmlInj:InjectionModule	string	?
1.13.3.	mmlCm:extRef		*
1.14.	mmlRe:referPurpose	string
1.15.	mmlRe:remarks	string	?
1.15.1.	mmlCm:extRef		*
1.16.	mmlRe:referToFacility
1.16.1.	mmlFc:Facility
1.16.2.	mmlDp:Department		?
1.17.	mmlRe:referToPerson		?
1.17.1.	mmlPsi:PersonalizedInfo
1.18.	mmlRe:referToUnknownName	string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.12.3. Element explanation

mmlRe:ReferralModule

Description: referral module. A single act of a creation of a referral letter by a single doctor is described in a single module.

Omission: not allowed

mmlPi:PatientModule

Description: patient information, such as name, birth date/year, address, and telephone number. Refer to the MML module (Patient information module) for the structure.
Omission: not allowed

mmlRe:occupation

Description: occupation
Omission: allowed
Document layout: use of XHTML is allowed.

mmlRe:referFrom

Description: parent element for the input of information on a person who introduces a patient.
Omission: not allowed

mmlPsi:PersonalizedInfo

Description: person who introduces a patient. Refer to the mmlPsi:PersonalizedInfo in the MML common format (Personal information format) for the structure.
Omission: not allowed ===== mmlRe:title
Description: title of a letter, such as letters of referral, clinical information offering forms, etc.
Omission: not allowed

10.12.4. mmlRe:greeting

Description: greetings
Omission: allowed
Document layout: use of XHTML is allowed.
Example:

<mmlRe:greeting>
 Dear Doctor: Thank you for the professional medical care services that you provide to patients.<xhtml:br/>
 At this time, I would like to refer the following patient to you.<xhtml:br/>
 I sincerely appreciate your taking time from your busy schedule to examine this patient. 
</mmlRe:greeting>

mmlRe:chiefComplaints

Description: chief complaint
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlRe:clinicalDiagnosis

Description: diagnosis. Within this element, diagnoses are written in an unstructured form using XHTML. If a structured diagnosis is required, a diagnosis record information module is created separately and linked with the referral module by the groupId.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlRe:pastHistory

Description: past history. This can be present together with text data (#PCDATA) and the mmlCm:extRef.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlRe:familyHistory

Description: family history. This can be present together with text data and the mmlCm:extRef.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

Description: external reference. When a figure or table is attached, the MML common format (External reference format) is used.
Repetition: allowed. If multiple external references are available, the element should be repeated the number of times.

mmlRe:presentIllness

Description: progress of condition. This can be present together with text data and the mmlCm:extRef.
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlRe:testResults

Description: test result. This can be present together with text data and the mmlCm:extRef.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

Description: external reference. When a figure, graph, or table is attached, the MML common format (External reference format) is used.
Repetition: allowed. If multiple external references are available, the element should be repeated the number of times.

mmlSm:clinicalCourse

Description: progress of treatment. Refer to the mmlSm:clinicalCourse of the MML module (Clinical summary information module) for the structure.
Omission: allowed

mmlRe:medication

Description: current prescription. This can be present together with text data and the mmlCm:extRef.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlPs:PrescriptionModule

Description: refer to the content module mmlPs:PrescriptionModule for the structure.
Omission: allowed
Example:

<mmlSm:medication>
 Prescription on discharge
 <mmlPs:PrescriptionModule>
   <mmlPs:medication>
     <mmlPs:batchNo>1</mmlPs:batchNo>
     <mmlPs:medicine>
       <mmlPs:name>Predinisolone tab. 5mg</mmlPs:name>
       <mmlPs:code system="YJ">61222033</mmlPs:code>
     </mmlPs:medicine>
     <mmlPs:dose>4</mmlPs:dose>
     <mmlPs:doseUnit>Tablets</mmlPs:doseUnit>
     <mmlPs:frequencyPerDay>1</mmlPs:frequencyPerDay>
     <mmlPs:startDate>2015-05-13</mmlPs:startDate>
     <mmlPs:duration>P14D</mmlPs:duration>
     <mmlPs:instruction>Oral once/day before breakfast</mmlPs:instruction>
   </mmlPs:medication>
 </mmlPs:PrescriptionModule>
</mmlSm:medication>

mmlInj:InjectionModule

Description: refer to the content module mmlInj:InjectionModule for the structure.
Omission: allowed

mmlCm:extRef

Description: external reference. When a figure, file, or table is attached, the MML common format (External reference format) is used.
Repetition: allowed. If multiple external references are available, the element should be repeated the number of times.

mmlRe:referPurpose

Description: purpose of referral
Omission: not allowed
Document layout: use of XHTML is allowed.

mmlRe:remarks

Description: remarks. This can be present together with text data (#PCDATA) and the mmlCm:extRef.
Omission: allowed
Document layout: use of XHTML is allowed.

mmlCm:extRef

mmlRe:referToFacility

Description: consulted medical institution name. A parent element for the input of facility information.
Omission: not allowed

mmlFc:Facility

Description: consulted medical institution. Refer to the mmlFc:Facility in the MML common format (Facility information format) for the structure.
Omission: not allowed

mmlDp:Department

Description: consulted medical department. Refer to the mmlDp:Department in the MML common format (Medical department information format) for the structure.
Omission: allowed

mmlRe:referToPerson

Description: consulted doctor's name. A parent element for the input of name information.
Omission: allowed

mmlPsi:PersonalizedInfo

Description: consulted doctor. Refer to the mmlPsi:PersonalizedInfo in the MML common format (Personal information format) for the structure.

mmlRe:referToUnknownName

Description: unspecified consulted doctor
Omission: allowed

Author: Shinji KOBAYASHI :Email: skoba@moss.gr.jp :toc: right :toclevels: 2 :pagenums: :numberd: :sectnums: :imagesdir: ./figures :linkcss:

10.13. Vital signs module

10.13.1. Purpose and target

When creating the body temperature chart module, it was decided to make it separate because the module which records the vital signs is highly universal and is also highly independent in terms of the treatment concept.

This module is used for measurement of body temperature, pulse, blood pressure, SpO2 and other vital signs. It contains a list of only those items necessary to record the series of vital signs measured at any event during the course of hospital rounds or outpatient treatment. Although the relationships between the items are not indicated, systolic blood pressure and diastolic blood pressure that are stored in a single instance are considered to have been measured at the same time (Figure 1).

Namespaces declaration

Namespaces declaration of this module is as follows.

xmlns:mmlVs="http://www.medxml.net/MML/v4/ContentModule/VitalSign/1.0"

Element list

Elements

Attribute

Datatypes

Occurrence

Table id

mmlVs:VitalSignModule

1.1

mmlVs:context

1.1.1

mmlVs:facility

string

mmlVs:facilityCode

string

#REQUIRED

mmlVs:facilityCodeId

string

#REQUIRED

MML0027

1.1.2

mmlVs:department

string

mmlVs:depCode

string

#IMPLIED

MML0028

mmlVs:depCodeId

string

#IMPLIED

1.1.3

mmlVs:ward

string

mmlVs:wardCode

string

#IMPLIED

Specified by users

mmlVs:wardCodeId

string

#IMPLIED

1.1.4

mmlVs:observer

string

mmlVs:obsCode

string

#IMPLIED

Specified by users

mmlVs:obsCodeId

string

#IMPLIED

1.2

mmlVs:item

1.2.1

mmlVs:itemName

string

mmlVs01

1.2.2

mmlVs:value

string

1.2.3

mmlVs:numValue

decimal

1.2.4

mmlVs:unit

string

mmlVs02

1.2.5

mmlVs:itemMemo

string

1.3

mmlVs:observedTime

dateTime

1.4

mmlVs:protocol

1.4.1

mmlVs:procedure

string

1.4.2

mmlVs:device

string

1.4.3

mmlVs:position

string

mmlVs03

1.4.4

mmlVs:bodyLocation

string

1.4.5

mmlVs:protMemo

string

1.5

mmlVs:vsMemo

string

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.13.2. Element explanation

mmlVs:VitalSignModule

Description: vital signs record module

mmlVs:context

Description: vital signs header information
Omission: omission is allowed when used with embedded in the body temperature chart module or other module, and information is duplicated.

mmlVs:facility

Description: facility which measured and recorded the vital signs
Omission: omission is not allowed when this VitalSignModule is used independently. Omission is permitted when it is used in combination with the FlowSheetModule or other module.
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlVs:facilityCode

string

#REQUIRED

mmlVs:facilityCodeId

string

#REQUIRED

MML0027

Enter the name of a used code system

mmlVs:department

Description: division or medical department which measured and recorded the vital signs
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlVs:depCode

string

#IMPLIED

MML0028

mmlVs:depCodeId

string

#IMPLIED

Enter MML0028

mmlVs:ward

Description: ward or location where the vital signs were measured and recorded
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlVs:wardCode

string

#IMPLIED

Specified by users

mmlVs:wardCodeId

string

#IMPLIED

Enter the name of a used table

mmlVs:observer

Description: person who measured the vital signs
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlVs:observerCode

string

#IMPLIED

Specified by users

mmlVs:observerCodeId

string

#IMPLIED

Enter the code system that was used.

10.13.3. mmlPi:PatientModule

Description: patient information, such as name, birth date/year, address, and telephone number. Use the MML patient information module.
Omission: not allowed

mmlVs:item

Description: item information
Repetition: 1 or more repetitions allowed. If there are multiple items, the element should be repeated the same number of times.

mmlVs:itemName

Description: item name
Data type: string
Omission: not allowed
Table: mmlVs01

mmlVs:value

Description: vital signs value expressed by a character string
Data type: string
Omission: allowed. Either this or numValue is used.

mmlVs:numValue

Description: vital signs value expressed by a numeric value
Data type: decimal
Omission: allowed. Either this or value is used.

mmlVs:unit

Description: vital sign units
Data type: string
Omission: allowed
Table: mmlVs02

mmlVs:itemMemo

Description: item comment
Data type: string
Repetition: 0 or more repetitions are allowed. If there are multiple item comments, the element should be repeated the number of times.

mmlVs:observedTime

Description: time during which vital signs were observed
Data type: dateTime
Omission: not allowed

mmlVs:protocol

Description: parent element that records the vital signs measurement procedures
Repetition: not allowed.
Omission: allowed

1.4.1 mmlVs:procedure

Description: procedures for measuring vital signs. Measurement methods, load test type, etc.
Data type: string
Omission: allowed

mmlVs:device

Description: equipment and devices used for vital sign measurement. Stethoscope, mercury column sphygmomanometer, mechanical sphygmomanometer, intraarterial probe, etc.
Data type: string
Omission: allowed

mmlVs:bodyLocation

Description: body location where vital signs were measured. Right upper arm, left lower leg, etc.
Data type: string
Omission: allowed

mmlVs:position

Description: posture when vital signs were measured
Data type: string
Omission: allowed
Table: mmlVs03

mmlVs:protMemo

Description: comments related to vital sign measurement methods
Data type: string
Omission: allowed

mmlVs:vsMemo

Description: vital sign record comments
Data type: string
Omission: allowed

10.14. Body temperature chart module (draft)

10.14.1. Purpose and target

This is used for recording a chart of body temperatures that were recorded during daily nursing or other care.

This module, together with the vital signs module, handles information related to dietary intake and excretion. The expected use case is various information that is recorded in the body temperature chart.

As shown in the figure, information related to vital signs, dietary intake, and excretion is repeatedly recorded.

10.14.2. Namespace declaration

Namespace declaration of this module is as follows.

xmlns:mmlFs="http://www.medxml.net/MML/v4/ContentModule/FlowSheet/1.0"

10.14.3. Specification of the document header information (docInfo) specific to this module

docInfo

The "flowsheet" value from table MML005 is specified in the contentModuleType attribute.

title

The primary use case intended for this module is as a body temperature chart that is recorded each day at a hospital, nursing care facility, or other facility. Therefore, although it is prepared based on a report title of "body temperature chart", it is expected that it will be used as the "fever type chart", "body temperature chart", "temperature list", or other title which is customarily used at the hospital.

For the generationPurpose attribute, the "flowsheet" value (body temperature chart) from table MML0007 must be specified.

confirmDate

This is the module creation date, and indicates the time that the overall report was made.

mmlCi:CreatorInfo

In the body temperature chart module, there are cases when information observed by multiple persons with different job types may be entered into a single report. The final writer or representative is recorded as the creator information.

Table 22. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
1	mmlFs:FlowSheetModule
1.1	mmlFs:context
1.1.1	mmlFs:facility		string
		mmlFs:facilityCode	string	#REQUIRED
		mmlFs:facilityCodeId	string	#REQUIRED	MML0027
1.1.2	mmlFs:department		string	?
		mmlFs:depCode	string	#IMPLIED	MML0028
		mmlFs:depCodeId	string	#IMPLIED
1.1.3	mmlFs:ward		string	?
		mmlFs:wardCode	string	#IMPLIED	Specified by users
		mmlFs:wardCodeId	string	#IMPLIED
1.1.4	mmlFs:observer		string	?
		mmlFs:obsCode	string	#IMPLIED	Specified by users
		mmlFs:obsCodeId	string	#IMPLIED
1.2	mmlVs:VitalSignModule			*
1.3	mmlFs:intake			*
1.3.1	mmlFs:intakeType		string		mmlFs01
1.3.2	mmlFs:intakeVolume		decimal	?
1.3.3	mmlFs:intakeUnit		string	?	mmlFs02
1.3.4	mmlFs:intakePathway		string	?
1.3.5	mmlFs:intakeStartTime		dateTime	?
1.3.6	mmlFs:intakeEndTime		dateTime	?
1.3.7	mmlFs:intakeMemo		string	?
1.4	mmlFs:bodilyOutput			*
1.4.1	mmlFs:boType		string		mmlFs03
1.4.2	mmlFs:boVolume		decimal	?
1.4.3	mmlFs:boUnit		string	?	mmlFs04
1.4.4	mmlFs:boStatus		string	?
1.4.5	mmlFs:boColor		string	?
1.4.6	mmlFs:boPathway		string	?
1.4.7	mmlFs:boStartTime		dateTime	?
1.4.8	mmlFs:boEndTime		dateTime	?
1.4.9	mmlFs:boMemo		string	?
1.4.10	mmlFs:boFrequency			*
1.4.10.1	mmlFs:bofTimes		decimal	?
1.4.10.2	mmlFs:bofPeriodStartTime		dateTime	?
1.4.10.3	mmlFs:bofPeriodEndTime		dateTime	?
1.4.10.4	mmlFs:bofMemo		string	?
1.5	mmlFs:fsMemo		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.14.4. Element explanation

mmlFs:FlowSheetModule

Description: body temperature chart module

mmlFs:context

Description: parent element which expresses the body temperature chart module header
Omission: not allowed

mmlFs:facility

Description: facility which recorded the body temperature chart
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlFs:facilityCode

string

#REQUIRED

mmlFs:facilityCodeId

string

#REQUIRED

MML0027

Enter the name of a used code system

mmlFs:department

Description: division which recorded the body temperature chart
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlFs:depCode

string

#IMPLIED

MML0028

mmlFs:depCodeId

string

#IMPLIED

Enter MML0028

mmlFs:ward

Description: ward or place where the body temperature chart was recorded
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlFs:wardCode

string

#IMPLIED

Specified by users

mmlFs:wardCodeId

string

#IMPLIED

Enter the name of a used table

mmlFs:observer

Description: observer of body temperature chart information
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlFs:obsCode

string

#IMPLIED

Specified by users

mmlFs:obsCodeId

string

#IMPLIED

Enter the name of a used table

mmlVs:VitalSignModule

Description: vital sign information
Repetition: allowed. The element should be repeated the same number of times as the series of measured vital signs. (Example: systolic blood pressure, diastolic blood pressure, pulse, body temperature, SpO2 measured during rounds)

mmlFs:intake

Description: parent element related to food, water, and other dietary intake conditions
Repetition: 0 or more repetitions are allowed.

mmlFs:intakeType

Description: types of foods and drinks consumed. Examples: breakfast (main), lunch (sub), water, tube-feeding nutritive food, etc.
Omission: not allowed
Data type: string
Table: mmlFs01

mmlFs:intakeVolume

Description: amounts of foods and drinks consumed.
Omission: allowed
Data type: decimal

10.14.5. mmlFs:intakeUnit

Description: units of foods and drinks consumed. / 10, ml, g, kcal, etc.
Omission: allowed
Data type: string
Table: mmlFs02

mmlFs:intakePathway

Description: intake route. Oral intake, feeding tube, IVH management, etc.
Omission: allowed
Data type: string

mmlFs:intakeStartTime

Description: intake start time. Records the time when observation was started. If records are kept without classifying them as start or end, then enter the time here.
Omission: allowed
Data type: dateTime

mmlFs:intakeEndTime

Description: intake end time
Omission: allowed
Data type: dateTime

mmlFs:intakeMemo

Description: comments, memos concerning intake conditions
Omission: allowed
Data type: string

mmlFs:bodilyOutput

Description: parent element for recording bodily excretions. In addition to urine and feces, this includes chest fluid, abdominal fluid, bodily fluids, bile, and other excretions.
Repetitions: 0 or more

mmlFs:boType

Description: type of discharge
Omission: not allowed
Data type: string
Table: mmlFs03

mmlFs:boVolume

Description: volume of discharge
Omission: allowed
Data type: decimal

mmlFs:boUnit

Description: units for volume of discharge
Omission: allowed
Data type: string
Table: mmlFs04

mmlFs:boStatus

Description: conditions of discharge. Soft stools, diarrhea, cloudy, etc. If volumes are indicated as "large", "medium", "small", or other terms which cannot be quantified, they are recorded here.
Omission: allowed
Data type: string

mmlFs:boColor

Description: color of discharge. Yellow, brown, etc.
Omission: allowed
Data type: string

mmlFs:pathway

Description: route of discharge, catheter or drain, colostomy, etc.
Omission: allowed
Data type: string

mmlFs:boStartTime

Description: discharge start time. Records the time when observation was started. If records are kept without classifying them as start or end, then enter the time here.
Omission: allowed
Data type: dateTime

mmlFs:boEndTime

Description: discharge end time
Omission: allowed
Data type: dateTime

mmlFs:boMemo

Description: comments, memos concerning intake conditions. 3rd day of constipation, reduced bleeding, etc.
Omission: allowed
Data type: string

mmlFs:boFrequency

Description: parent element that expresses the number of discharges within a certain time period
Repetition: 0 or more repetitions are allowed.

mmlFs:bofTimes

Description: number of observed discharges within a certain time period
Omission: allowed
Data type: decimal

mmlFs:bofPeriodStartTime

Description: time when observation was started
Omission: allowed
Data type: dateTime

mmlFs:bofPeriodEndTime

Description: time when observation was ended
Omission: allowed
Data type: dateTime

mmlFs:bofMemo

Description: frequency expressions that are not quantified. Frequent, oliguria, etc.
Omission: allowed
Data type: string

mmlFs:fsMemo

Description: comments, memos concerning body temperature charts. Other information recorded in the body temperature chart.
Omission: allowed
Data type: string

10.15. Prescriptions module (draft)

10.15.1. Purpose and target

This is used to record the prescriptions issued by a physician. It is expected to be used primarily as a clinical record, summary, and part of letters of referral.

This module is intended for accurate recording of the prescriptions issued by a physician. In MML up to Ver. 3, prescriptions were recorded and used by the clinical record module and modules that use claims. However because there were problems with granularity and model accuracy, it was decided to design a new module.

For the method of recording prescriptions, a guideline was issued by the Ministry of Health, Labour and Welfare in 2013 recommending that prescription formats be based on the amount per dose rather than the amount per day. As of 2015, this format is not in widespread use and prescriptions continue to be issued using the customary basis of daily amounts.

However because in terms of the data, it is more convenient to record prescriptions using per-dose amounts, this module is based on per-dose prescriptions.

This module covers prescriptions that are indicated by a physician, and does not cover the results of dispensation by the pharmacy or the results of use. The prescription data that is used for insurance billing is expressed by claims.

10.15.2. Namespace declaration

Namespace declaration of this module is as follows.

 xmlns:mmlPs="http://www.medxml.net/MML/v4/ContentModule/Prescription/1.0" 
Specification of the document header information (docInfo) specific to this module

docInfo

The "prescription" value from table MML005 is specified in the contentModuleType attribute.

title

It is expected that the title of this module will be "Prescriptions".

For the generationPurpose attribute, the "prescription" value from table MML0007 must be specified. This is the date that the confirmDate module was created. It is considered to be the prescription issue date.

mmlCi:CreatorInfo

The physician which issued the prescription is recorded as the creator information in the prescription module.

Table 23. Element list
	Elements	Attribute	Datatypes	Occurrence
1	mmlPs:PrescriptionModule
1.1	mmlPs:issuedTo		string	?
1.2	mmlPs:medication			+
1.2.1	mmlPs:medicine
1.2.1.1	mmlPs:name		string
1.2.1.2	mmlPs:code		string	*
		mmlPs:system	string	#REQUIRED
1.2.2	mmlPs:dose		decimal
1.2.3	mmlPs:doseUnit		string
1.2.4	mmlPs:frequencyPerDay		decimal
1.2.5	mmlPs:startDate		date	?
1.2.6	mmlPs:duration		decimal	?
1.2.7	mmlPs:instruction		string	?
1.2.8	mmlPs:PRN		boolean	?
1.2.9	mmlPs:route		string	?
1.2.10	mmlPs:form		string	?
1.2.11	mmlPs:batchNo		decimal	?
1.2.12	mmlPs:brandSubstitutionPermitted		boolean	?
1.2.13	mmlPs:longTerm		boolean	?
1.2.14	mmlPs:additionalInstruction		string	?
1.3	mmlPs:narcoticPrescriptionLicenseNumber		string	?
1.4	mmlPs:comment		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.15.3. Element explanation

mmlPs:PrescriptionModule

Description: prescriptions module

mmlPs:issuedTo

Description: classification as hospital external or internal prescription. Record "external" for a hospital external prescription and "internal" for a hospital internal prescription.
Omission: allowed
Repetition: not allowed

mmlPs:medication

Description: combination of medications, doses, and methods recorded in the prescription
Omission: not allowed
Repetition: 1 or more

mmlPs:medicine

Description: set consisting of medicine name and corresponding code
Omission: not allowed

mmlPs:name

Description: medicine name
Omission: not allowed

mmlPs:code

Description: medicine code
Repetition: 0 or more
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlPs:system

string

Not allowed

Enter the name of a used code system

mmlPs:dose

Description: dose
Omission: not allowed
Data type: decimal

mmlPs:doseUnit

Description: dose units
Omission: not allowed
Data type: string

mmlPs:frequencyPerDay

Description: frequency of medication per day
Omission: allowed
Data type: decimal
Explanation: omission is allowed in cases such as topical medications where only the total amount is recorded

mmlPs:startDate

Description: medication start date
Omission: allowed
Data type: date
Explanation: medication start date

mmlPs:duration

Description: medication period (number of days)
Omission: allowed
Data type: decimal
Explanation: omission is allowed in cases such as topical medications where only the total amount is recorded

mmlPs:instruction

Description: use instruction
Omission: allowed
Data type: string
Explanation:

mmlPs:PRN

Description: single use instruction
Omission: allowed
Data type: boolean
Explanation: true if a single-use prescription, false if not

mmlPs:route

Description: route of administration
Omission: allowed
Data type: string
Explanation: records the injection route, such as oral, topical, or suppository.

mmlPs:form

Description: medication form
Omission: allowed
Data type: string
Explanation: records the form, such as pill, powder, or liquid.

mmlPs:batchNo

Description: batch number
Omission: allowed
Data type: decimal
Explanation: records the batch number. This allows multiple medications which have the same method of use to be collected in a single batch unit.

mmlPs:brandSubtitutionPermitted

Description: permit substitution by generic drug
Omission: allowed
Data type: boolean
Explanation: true if use of generic drug is permitted, false if not permitted. Considered true if omitted.

mmlPs:longTerm

Description: permit long-term use
Omission: allowed
Data type: boolean
Explanation: true if long-term use is permitted, false if not permitted.

mmlPs:additionalInstruction

Description: additional instructions, comments
Omission: allowed
Data type: string
Explanation: additional instructions related to the method and dose. Record as necessary.

mmlPs:narcoticPrescriptionLicenseNumber

Description: narcotic prescription license number
Omission: allowed
Data type: string
Explanation: when issuing a prescription for a narcotic, it is necessary to record the narcotic prescription license number and patient address.

mmlPs:comment

Description: comment
Omission: allowed
Data type: string
Explanation: other comments concerning the prescription

10.16. Injection record module (draft)

10.16.1. Purpose and target

This is used to record the injections that were performed.

This module is intended for recording the injections that were clinically carried out. Because injections are frequently changed during the course of treatment, it was decided to make this a record of the injections that were finally carried out rather than injection instructions (injection prescriptions). In MML up to Ver. 3, descriptions related to injections were recorded and used by the clinical record module and modules that use claims. However because there were problems with granularity and model accuracy, it was decided to design a new module.

This record covers the results of injection execution, and does not cover the the results of dispensation by the pharmacy or the results of use.

10.16.2. Namespace declaration

Namespace declaration of this module is as follows.

xmlns:mmlInj="http://www.medxml.net/MML/v4/ContentModule/Injection/1.0"

10.16.3. Specification of the document header information (docInfo) specific to this module

docInfo

For the contentModuleType attribute, the "injection" value from table MML005 must be specified.

title

It is expected that the title of this module will be "injection record".

For the generationPurpose attribute, the "injection" value from table MML0007 must be specified.

confirmDate

This is the module creation date and matches the date/time of the injection record (last) in the module.

mmlCi:CreatorInfo

Although injections are actually administered by medical practitioners, including nurses, this module is recorded with the physician who was recorded for the prescription as the representative staff for the injection.

Table 24. Element list
	Elements	Attribute	Datatypes	Occurrence
1	mmlInj:InjectionModule
1.1	mmlInj:medication			+
1.1.1	mmlInj:medicine
1.1.1.1	mmlInj:name		string
1.1.1.2	mmlInj:code		string	*
		mmlInj:system	string
1.1.2	mmlInj:dose		decimal
1.1.3	mmlInj:doseUnit		string
1.1.4	mmlInj:startDateTime		dateTime	?
1.1.5	mmlInj:endDateTime		dateTime	?
1.1.6	mmlInj:instruction		string	?
1.1.7	mmlInj:route		string	?
1.1.8	mmlInj:site		string	?
1.1.9	mmlInj:deliveryMethod		string	?
1.1.10	mmlInj:batchNo		decimal	?
1.1.11	mmlInj:additionalInstruction		string	?
1.2	mmlInj:narcoticPrescriptionLicenseNumber		string	?
1.3	mmlInj:comment		string	?

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.16.4. Element explanation

mmlInj:InjectionModule

Description: injection record module

mmlInj:medication

Description: combination of injected medications, doses, and methods
Omission: not allowed
Repetition: 1 or more

mmlInj:medicine

Description: set consisting of medicine name and corresponding code
Omission: not allowed

mmlInj:name

Description: medicine name
Omission: not allowed

mmlInj:code

Description: medicine code
Repetition: 0 or more
Attribute:

Attribute name

Data type

Omission

Table

Remarks

mmlInj:system

string

Not allowed

Enter the name of a used code system

mmlInj:dose

Description: dose
Omission: not allowed
Data type: decimal
Explanation: although recording is possible using customary medication units such as 1/2A and 2V, it is preferred that information be recorded using quantifiable mass units such as g and mg.

mmlInj:doseUnit

Description: dose units
Omission: not allowed
Data type: string

mmlInj:startDateTime

Description: administration start date/time
Omission: allowed
Data type: date
Explanation: records the time when administration of the medicine was started.

mmlInj:endDateTime

Description: administration end date/time
Omission: allowed
Data type: date
Explanation: records the time when administration of the medicine was ended. Omitted when there is no difference between start time and end time, such as for IV, subcutaneous injection, and intramuscular injection.

mmlInj:instruction

Description: use instruction
Omission: allowed
Data type: string
Explanation: records instructions related to the method of use.

mmlInj:route

Description: route of administration
Omission: allowed+
Data type: string
Explanation: records the injection route for medicine administration. Examples: right forearm placement route, right subclavian central vein route

mmlInj:site

Description: location of administration
Omission: allowed
Data type: string
Explanation: records the location of the injection. Examples: right upper arm deltoid, abdomen

mmlInj:deliveryMethod

Description: administration method
Omission: allowed
Data type: string
Explanation: records the method of injection. Examples: intramuscular injection, subcutaneous injection, intravenous injection, IV drip, central vein injection

mmlInj:batchNo

mmlInj:additionalInstruction

Description: additional instructions, comments
Omission: allowed
Data type: string
Explanation: additional instructions related to the method and dose of an injection. Record as necessary.

mmlInj:narcoticPrescriptionLicenseNumber

mmlInj:comment

Description: comment
Omission: allowed
Data type: string
Explanation:

10.17. MML Hd dialysis module

Table 25. Element list
	Elements	Attribute	Datatypes	Occurrence	Table id
1	MmlHd:HemoDialysysModule
1.1	mmlHd:HeMX			?
1.1.1	mmlCm:extRef			*
1.2	mmlFc:Facility
1.3	mmlPi:PatientModule
1.4	mmlHd:note			?
1.5	mmlHd:HDHistorySection			?
1.5.1	mmlHd:HdIntroduction			*
1.5.1.1	mmlHd:diagnosis			?
		code	string	#IMPLIED
		system	string	#IMPLIED
1.5.1.2	mmlHd:HdIntroDate		date	?
1.5.1.3	mmlFc:Facility			?
1.5.2	mmlHd:BloodAccess			*
1.5.2.1	mmlHd:dateMade		date	?
1.5.2.2	mmlHd:dateFirstUse		date	?
1.5.2.3	mmlHd:dateEnd		date	?
1.5.2.4	mmlHd:location		string	?
		code	string	#IMPLIED
		tableId	string	#REQUIRED
1.6	mmlHd:OrderSection			?
1.6.1	mmlHd:hdorders			*
		mmlHd:orderStatus	string	#REQUIRED
		mmlHd:dateOrdered	date	#IMPLIED
		mmlHd:dateEffective	date	#IMPLIED
1.6.1.1	mmlHd:orderGroups			*
1.6.1.1.1	mmlHd:effectiveDays			*
1.6.1.1.1.1	mmlHd:weekday		string	*
1.6.1.1.1.2	mmlHd:timeShift		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#REQUIRED
1.6.1.1.3	mmlHd:hdMethod			?
1.6.1.1.3.1	mmlHd:hdMethodName
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#REQUIRED
1.6.1.1.3.2	mmlHd:timeHdStart		timeperiod
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.3.3	mmHd:timeHdEnd		timeperiod
1.6.1.1.4	mmlHd:dryWeight		string
1.6.1.1.5	mmlHd:weightCorrection		string	?
		mmlHd:unit	string	#REQUIRED	"Kg"
		mmlHd:cnote	string	#IMPLIED	Comment
1.6.1.1.6	mmlHd:bloodFlow			*
1.6.1.1.6.1	mmlHd:bloodFlowRate		string	?
		mmlHd:unit	string	#REQUIRED
1.6.1.1.6.2	mmlHd:timeHdStart		timeperiod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.6.3	mmlHd:timeHdEnd		timeperiod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.7	mmlHd:dialyser		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:membraneArea	string	#IMPLIED
		mmlHd:unit	string	#IMPLIED	"m2"
1.6.1.1.8	mmlHd:dialysate			*
1.6.1.1.8.1	mmlHd:dialysateName		string
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:modification	string	#IMPLIED
1.6.1.1.8.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.8.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.9	mmlHd:dialysateFlow			*
1.6.1.1.9.1	mmlHd:dialysateFlowRate		string
		mmlHd:unit	string	#IMPLIED	"ml/min"
1.6.1.1.9.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.9.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.10	mmlHd:dialysateTemp			*
1.6.1.1.10.1	mmlHd:dialysateTempValue		string
		mmlHd:unit	string		"C"
1.6.1.1.10.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.10.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.11	mmlHd:substitution			*
1.6.1.1.11.1	mmlHd:substitutionValue		string
		mmlHd:unit	string	#REQUIRED
		mmlHd:dilution	string	#REQUIRED
1.6.1.1.11.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.11.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.12		mmlHd:needle	string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:position	string	#IMPLIED
1.6.1.1.13	mmlHd:medication			*
1.6.1.1.13.1	mmlHd:drugName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#REQUIRED
1.6.1.1.13.2	mmlHd:dose		string	?
		mmlHd:unit	string	#IMPLIED
1.6.1.1.13.3	mmlHd:timeHd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.13.4	mmlHd:note		string	?
1.6.1.1.14	mmlHd:injection			*
1.6.1.1.14.1	mmlHd:drugName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#REQUIRED
1.6.1.1.14.2	mmlHd:dose		string	?
		mmlHd:unit	string	#IMPLIED
1.6.1.1.14.3	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.14.4	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.1.1.14.5	mmlHd:routeName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#REQUIRED	hdInjectionRouteTable01
1.6.1.1.14.6	mmlHd:note		string	?
1.6.1.1.15	mmlHd:note		string	?
1.6.2	mmlHd:hdDailyOrder			*
		mmlHd:orderDateTime	dateTime	#IMPLIED
		mmlHd:dateEffective	date	#IMPLIED
1.6.2.1	mmlHd:imeShift		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#REQUIRED	hdTimeShiftTable01
1.6.2.2	mmlHd:hdMethod			*
1.6.2.2.1	mmlHd:hdMethodName		string
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#REQUIRED
1.6.2.2.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.2.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.3	mmlHd:targetWeight		string	?
		mmlHd:unit	string		"kg"
1.6.2.4	mmlHd:targetUF		string	?
		mmlHd:unit	string		"kg"
1.6.2.5	mmlHd:ufrPlan			*
1.6.2.5.1	mmlHd:ufRate		string
		mmlHd:unit	string		"kg./h"
1.6.2.5.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.5.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.6	mmlHd:weightCorrection		string	?
		mmlHd:unit	string		"kg"
		mmlHd:cnote	string	#IMPLIED
1.6.2.7	mmlHd:bloodFlow			*
1.6.2.7.1	mmlHd:bloodFlowRate		string
		mmlHd:unit	string		"mL/min"
1.6.2.7.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.7.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.8	mmlHd:dialyser		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:membraneArea	string	#IMPLIED
		mmlHd:unit	string	#IMPLIED	"m2"
1.6.2.9	mmlHd:dialysate			*
1.6.2.9.1	mmlHd:dialysateName		string
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:modification	string	#IMPLIED
1.6.2.9.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.9.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.1.6.2.10	mmlHd:dialysateFlow			*
1.1.6.2.10.1	dialysateFlowRate		string
		mmlHd:unit	string		"mL/min"
1.6.2.10.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.10.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.11	mmlHd:dialysateTemp			*
1.6.2.11.1	mmlHd:dialysateTempValue		string
		mmlHd;unit	string		"C"
1.6.2.11.2	mmlHd:timeHdStart		timePeriod
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.11.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.12	mmlHd:needle		string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:position	string	#IMPLIED
1.6.2.13	mmlHd:medication			*
1.6.2.13.1	mmlHd:drugName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.6.2.13.2	mmlHd:dose		string	?
		mmlHd:unit	string	#IMPLIED
1.6.2.13.3	mmlHd:timeHd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.13.4	mmlHd:note		string	?
1.6.2.14	mmlHd:injection			*
1.6.2.14.1	mmlHd:drugName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.6.2.14.2	mmlHd:dose		string	?
		mmlHd:unit	string	#IMPLIED
1.6.2.14.3	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.14.4	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.6.2.14.5	mmlHd:routeName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdInjectionRouteTable01
1.6.2.14.6	mmlHd:note		string	?
1.6.2.15	mmlHd:note		string	?
1.7	mmlHd:HDProgressSection			?
1.7.1	mmlHd:dailyHDRecord			*
		mmlHd:calendarDate	date	#IMPLIED
		mmlHd:serialNumber	string	#IMPLIED
1.7.1.1	mmlHd:hdMethodRecord		string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdMethodTable01
		mmlHd:startDateTime	dateTime	#IMPLIED
		mmlHd:endDateTime	dateTime	#IMPLIED
1.7.1.2	mmlHd:dryWeight		string	?
		mmlHd:unit	string		"kg"
1.7.1.3	mmlHd:preWeight		string	?
		mmlHd:unit	string		"kg"
1.7.1.4	mmlHd:postWeight		string	?
		mmlHd:unit	string		"kg"
1.7.1.5	mmlHd:totalUF		string	?
		mmlHd:unit	string		"kg"
1.7.1.6	weightCorrection		string	?
		mmlHd:unit	string		"kg"
1.7.1.6.1	mmlHd:note		string	?
1.7.1.7	mmlHd:dialyser		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:membraneArea	string	#IMPLIED
		mmlHd:unit	string		"m2"
1.7.1.8	mmlHd:dialysate			*
1.7.1.8.1	mmlHd:dialysateName		string
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:modification	string	#IMPLIED
1.7.1.8.2	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.8.3	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.9	mmlHd:needle		string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
		mmlHd:position	string	#IMPLIED
1.7.1.10	mmlHd:hdMachine		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdMachineTable
1.7.1.11	mmlHd:observation			*
1.7.1.11.1	mmlHd:timeHd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.11.2	mmlHd:observationItem			*
1.7.1.11.2.1	mmlHd:obItemName		string
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdObservationTable01
1.7.1.11.2.2	mmlHd:value		string	?
		mmlHd:unit	string	#IMPLIED
1.7.1.11.3	mmlHd:staffName		string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.7.1.11.4	mmlHd:machineName		string	*
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED
1.7.1.11.5	mmlHd:note		string	?
1.7.1.12	mmlHd:medication			*
1.7.1.12.1	mmlHd:drugName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.7.1.12.2	mmlHd:dose		string	?
1.7.1.12.3	mmlHd:timeHd		timePeriod	?
		mmlHd:unit	string	#IMPLIED
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.12.4	mmlHd:note		string	?
1.7.1.13	mmlHd:injection			*
1.7.1.13.1	mmlHd:drugName		string	?
		mlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.7.1.13.2	mmlHd:dose		string	?
		mmlHd:unit	string	#IMPLIED
1.7.1.13.3	mmlHd:timeHdStart		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.13.4	mmlHd:timeHdEnd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.7.1.13.5	mmlHd:routeName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdInjectionRouteTable01
1.7.1.13.6	mmlHd:note		string	?
1.7.1.14	note		string	?
1.8	mmlHd:HDTestResultSection			?
1.8.1	mmlHd:testResultItem			*
		mmlHd:calendarDate	date	#IMPLIED
1.8.1.1	mmlHd:testCondition		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:tableId	string	#IMPLIED	hdTestConditionTable01
1.8.1.2	mmlHd:timeHd		timePeriod	?
		mmlHd:timeDirection	string	#REQUIRED
1.8.1.3	mmlHd:testItemGroup			*
1.8.1.3.1	mmlHd:testName		string	?
		mmlHd:code	string	#IMPLIED
		mmlHd:type	string	#IMPLIED
1.8.1.3.2	mmlHd:testResult		string	?
		mmlHd:unit	string	#IMPLIED
1.8.1.3.3	mmlHd:note		string	?
1.8.1.3.4	mmlHd:extRef			*
		mmlHd:contentType	string	#IMPLIED
		mmlHd:medicalRole	string	#IMPLIED
		mmlHd:title	string	#IMPLIED
		mmlHd:href	string	#IMPLIED
2	mmlHd:HeMX			*
2.1	mmlCm:extRef

Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances

#REQUIRED: Required attribute, #IMPLIED: Omissible attribute

10.17.1. Element explanation

MmlHd:HemoDialysysModule

mmlFc:Facility

Description: facility information. Refer to the MML common format for the structure.

mmlPi:PatientModule

Description: patient information. Refer to the mmlPi:PatientModule for the structure.

mmlHd:note

Description: dialysis comments
Omission: allowed (?)

mmlHd:HDHistorySection

Description: dialysis history +
Omission: allowed (?)

mmlHd:HdIntroduction

Description: dialysis introduction information
Omission: allowed (*)

Repetition: allowed. If introduced multiple times, this element should be repeated.

1.5.1.1 mmlHd:diagnosis

Description: primary disease
Omission: allowed (?)
Attribute:

Attribute name

Data type

Omission

Remarks

code

string

#IMPLIED

Disease code

system

string

#IMPLIED

Disease code system name

mmlHd:HdIntroDate

Description: dialysis introduction date
Data: date
Omission: allowed

mmlFc:Facility

Description: refer to the MML common format for the structure.
Omission: allowed (?)

mmlHd:BloodAccess

Description: blood access
Omission: allowed
Repetition: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

baStatus

string

#IMPLIED

Blood access status
active: good, inactive: bad

mmlHd:dateMade

Description: blood access creation date
Data type: date
Omission: allowed (?)

mmlHd:dateFirstUse

Description: blood access use start date
Data type: date
Omission: allowed (?)

mmlHd:dateEnd

Description: blood access use end date
Data type: date
Omission: allowed (?)

mmlHd:location

Description: blood access location name
Data type: string
Omission: allowed (?)+
Attribute:

Attribute name

Data type

Omission

Remarks

code

string

#IMPLIED

Blood access ID

tableId

string

#REQUIRED

Table ID

Example:

<mmlHd:location mmlHd:code="0102" mmlHd:tableId="mmlhd0001">Left forearm</mmlHd:location>

mmlHd:OrderSection

Description: dialysis order information
Omission: allowed

mmlHd:hdorders

Description: order units
Omission: allowed
Repetition: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:orderStatus

string

#REQUIRED

Flag identifying the order status + active: current order, alteration: altered order

mmlHd:dateOrdered

date

#IMPLIED

Order issue date

mmlHd:dateEffective

date

#IMPLIED

Altered order issue date

mmlHd:orderGroups

Description: order group
Repetition: allowed
Omission: allowed (*)

mmlHd:effectiveDays

Description: effective days
Omission: allowed (?)

mmlHd:weekday

Description: order day of week
Data type: string (ISO8601 WeekDay)+
Omission: allowed (*)
Repetition: allowed

mmlHd:timeShift

Description: dialysis shift name
Data type: string
Omission: allowed (?)
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Time range code

mmlHd:tableId

string

#REQUIRED

Table ID

Example:

<mmlHd:timeShift mmlHd:code="01" mmlHd:tableId="mmlhd0002">Morning</mmlHd:timeShift>

mmlHd:hdMethod

Description: blood purification method
Omission: allowed (?) ===== mmlHd:hdMethodName
Description: blood purification method name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Blood purification code

mmlHd:tableId

string

#REQUIRED

Table ID

Example:

<mmlHd:hdMethodName mmlHd:code="01" mmlHd:tableId="mmlhd0003">Dialysis</mmlHd:hdMethodName>

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dryWeight

Description: dry weight
Data type: string
Omission: allowed (?)
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#REQUIRED

Units

mmlHd:weightCorrection

Description: weight correction
Data type: string
Omission: allowed (?)
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#REQUIRED

"Kg"

MmlHd:cnote

string

#IMPLIED

Comment

mmlHd:bloodFlow

Description: blood flow
Omission: allowed (*)
Repetition: allowed

mmlHd:bloodFlowRate

Description: blood flow rate
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#REQUIRED

"ml/min"

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialyser

Description: dialyser name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialyser ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:membraneArea

string

#IMPLIED

Membrane area

mmlHd:unit

string

Default: "m2"

mmlHd:dialysate 　

Description: dialysate
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateName

Description: dialysate name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialysate ID

mmlHd:type

string

#IMPLIED

Code type. At present the drug price code is used.

mmlHd:modification

string

#IMPLIED

Dialysate preparation

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialysateFlow 　

Description: dialysate flow
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateFlowRate Dialysate flow rate

Description: dialysate flow rate
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "ml/min"

ml/min

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialysateTemp

Description: dialysate temperature
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateTempValue

Description: dialysate temperature value
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "C"

"C"

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:substitution

Description: refill
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:substitutionValue

Description: refill quantity
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#REQUIRED

"ml/min"，"L/Session"

mmlHd:dilution

string

#REQUIRED

"pre", "post”

mmlHd:timeHdStart

Description: start time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:needle

Description: puncture needle name
Data type: string
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Puncture needle ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:position

string

#IMPLIED

Location where used

mmlHd:medication

Description: medication
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugName

Description: drug name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Internal medicine ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose

Description: single dose
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHd

Description: medication time
Data type: timeperiod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:injection

Description: injection
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugname

Description: injection drug name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Injection drug ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose

Description: single does or rate of administration
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHdStart

Description: medication start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: medication end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:routeName

Description: administration route name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Administration route ID

mmlHd:tableId

string

#REQUIRED

hdInjectionRouteTable01

Example:

　<mmlHd:routeName mmlHd:code = "icv" mmlHd:tableId = "hdInjectionRouteTable01">Injection to venous side circuit </mmlHd:routeName >

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:hdDailyOrder

Description: daily order
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:orderDateTimes

dateTime

#IMPLIED

Date/time of order issue

mmlHd:dateEffective

date

#IMPLIED

Order effective date

mmlHd:timeshift

Description: dialysis shift name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Time range code

mmlHd:tableId

string

#REQUIRED

hdTimeShiftTable01

Example:

<mmlHd:timeShift mmlHd:code = "01" mmlHd:tableId = "hdTimeShiftTable01">Morning</mmlHd:timeShift>

mmlHd:hdMethod

Description: blood purification method
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:hdMethodName

Description: blood purification method name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Blood purification code

mmlHd:tableId

string

#REQUIRED

hdMethodTable01

Example:

<mmlHd:hdMethodName mmlHd:code="01" mmlHd:tableId="hdMethodTable01">Dialysis</mmlHd:hdMethodName>

mmlHd:timeHdStart 　　　

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmHd:timeHdEnd 　　　　

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:targetWeight

Description: target body weight
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:targetUF

Description: fluid removal
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:ufrPlan

Description: fluid removal speed setting
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mlHd:ufRate

Description: fluid removal speed
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg/h"

kg/h

mmlHd:timeHdStart

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:weightCorrection

Description: weight correction
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:cnote

string

#IMPLIED

Comment

mmlHd:bloodFlow

Description: blood flow
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:bloodFlowRate 　　

Description: blood flow rate
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "ml/min"

ml/min

mmlHd:timeHdStart

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialyser

Description: dialyser name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialyser ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:membraneArea

string

#IMPLIED

Membrane area

mmlHd:unit

string

Default: "m2"

mmlHd:dialysate

Description: dialysate
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dyalysateName 　　

Description: dialysate name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialysate ID

mmlHd:type

string

#IMPLIED

Code type. At present the drug price code is used.

mmlHd:modification

string

#IMPLIED

Record when dialysate is prepared. Example: Ca = 2.5 mEq/L

mmlHd:timeHdStart 　　

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialysateFlow

Description: dialysate flow
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateFlowRate

Description: dialysate flow rate
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "ml/min"

ml/min

mmlHd:timeHdStart

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:dialysateTemp

Description: dialysate temperature
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateTempValue

Description: dialysate temperature value
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "C"

mmlHd:timeHdStart

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:needle

Description: puncture needle name
Data type: string
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Puncture needle ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:position

string

#IMPLIED

Location where used

mmlHd:medication

Description: medication
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugName

Description: drug name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Internal medicine ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose

Description: single dose
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHd

Description: medication time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:injection

Description: injection
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugName 　

Description: injection drug name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Injection drug ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose 　　　　　　　　

Description: single does or rate of administration
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHdStart 　　　　　

Description: medication start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd 　　　　　　

Description: medication end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:routeName 　　　　　　

Description: administration route name
Data type: string
Omission: allowed
Attribute:

mmlHd:code

string

#IMPLIED

Administration route ID

mmlHd:tableId

string

#REQUIRED

hdInjectionRouteTable01

Example:

<mmlHd:routeName mmlHd:code="icv" mmlHd:tableId="hdInjectionRouteTable01">Injection to venous side circuit </mmlHd:routeName>

mmlHd:note 　　

Description: remarks
Data type: string
Omission: allowed

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:HDProgressSection

Description: dialysis record information
Omission: allowed

mmlHd:dailyHDRecord

Description: daily HD record
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:calendarDate

date

#IMPLIED

Calendar date

mmlHd:serialNumber

string

#IMPLIED

Any starting date can be used.

mmlHd:hdMethodRecord

Description: blood purification method name
Data type: string
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Blood purification method ID

mmlHd:tableId

string

#IMPLIED

hdMethodTable01

mmlHd:startDateTime

dateTime

#IMPLIED

Dialysis start date/time

mmlHd:endDateTime

dateTime

#IMPLIED

Dialysis end date/time

Example:

<mmlHd:hdMethodRecord mmlHd:code="01" mmlHd:tableId="hdMethodTable01" mmlHd:startDateTime="2005-01-01T09:00:00" mmlHd:endDateTime="2005-01-01T14:00:00">Dialysis</mmlHd:hdMethodRecord >

mmlHd:dryWeight

Description: dry weight
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:preWeight

Description: body weight before dialysis
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:postWeight

Description: body weight after dialysis
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:totalUF

Description: fluid removal
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:weightCorrection

Description: correction
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

Default: "kg"

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:dialyser

Description: dialyser name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialyser ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:membraneArea

string

#IMPLIED

Membrane area

mmlHd:unit

string

Default: "m2"

mmlHd:dialysate

Description: dialysate
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:dialysateName

Description: dialysate name
Data type: string
Omission: not allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Dialysate ID

mmlHd:type

string

#IMPLIED

Code type. At present the drug price code is used.

mmlHd:modification

string

#IMPLIED

Record when dialysate is prepared. Example: Ca = 2.5 mEq/L

mmlHd:timeHdStart

Description: start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:needle

Description: puncture needle name
Data type: string
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Puncture needle ID

mmlHd:type

string

#IMPLIED

Code type. At present the product number is used.

mmlHd:position

string

#IMPLIED

Location where used

mmlHd:hdMachine

Description: machine name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Machine ID

mmlHd:tableId

string

#IMPLIED

Machine identifier code table. Set for each facility. hdMachineTable

mmlHd:observation

Description: observation record
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:timeHd

Description: time elapsed after artificial kidney start
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:observationItem

Description: observation items
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:obItemName

Description: observation item name
Data type: string
Omission: not allowed
Attribute:

mmlHd:code

string

#IMPLIED

Observation item ID

mmlHd:tableId

string

#IMPLIED

Observation item code table hdObservationTable01

Example:

<mmlHd:obItemName mmlHd:code="sBP" mmlHd:tableId="hdObservationTable01">Systolic blood pressure</mmlHd:obItemName >

mmlHd:value

Description: observation value
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:StaffName

Description: observation staff name
Data type: string
Omission: allowed
Repetition: allowed. If there are multiple staff members, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED Staff ID

mmlHd:type

mmlHd:machineName

Description: machine name
Data type: string
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Machine ID

mmlHd:tableId

string

#IMPLIED

Machine identifier code table. Set for each facility. hdMachineTable

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:medication

Description: medication
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugName

Description: internal medicine name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Internal medicine ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose

Description: single dose
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHd

Description: administration time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:injection

Description: injection
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:drugName

Description: injection drug name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Injection drug ID

mmlHd:type

string

#REQUIRED

Code type. At present the drug price code is used.

mmlHd:dose

Description: single does or rate of administration
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:timeHdStart

Description: medication start time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:timeHdEnd

Description: medication end time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:routeName

Description: administration route name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Administration route ID

mmlHd:tableId

string

#REQUIRED

hdInjectionRouteTable01

Example:

<mmlHd:routeName mmlHd:code="icv" mmlHd:tableId="hdInjectionRouteTable01">Injection to venous side circuit </mmlHd:routeName >

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:HDTestResultSection

Description: dialysis related test result information
Omission: allowed

mmlHd:testResultItem

Description: test result
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:calendarDate

date

#IMPLIED

Calendar date

mmlHd:testCondition

Description: test conditions
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Condition ID

mmlHd:tableId

string

#IMPLIED

hdTestConditionTable01

mmlHd:timeHd

Description: administration time
Data type: timePeriod
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:timeDirection

string

#REQUIRED

Time direction
before: before start time, after: after start time

mmlHd:testItemGroup

Description: test item group _
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlHd:testName

Description: test name
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:code

string

#IMPLIED

Test ID

mmlHd:type

string

#IMPLIED

Code type. At present the **billing process code is used.

mmlHd:testResult

Description: test result
Data type: string
Omission: allowed
Attribute:

Attribute name

Data type

Omission

Remarks

mmlHd:unit

string

#IMPLIED

Units

mmlHd:note

Description: remarks
Data type: string
Omission: allowed

mmlHd:extRef

Description: test result external reference. Refer to the MML common format for the structure.
Omission: allowed
Repetition: allowed. If there are multiple external reference files, then this element should be repeated the same number of times.

mmlHd:HeMX

Description: HeMX external reference
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.

mmlCm:extRef external reference

Description: refer to the MML common format for the structure.
Omission: not allowed

Modules that express facility information use the mmlFc module.
Modules that express patient information use the mmlPi module.
Modules that express disease names use the mmlRd module.
Drug administration (1.1.6.1.1.13, 1.1.6.2.13, 1.1.7.1.12) and injection (1.1.6.1.1.14, 1.1.6.2.14, 1.1.7.1.13) are expected to be drug administration and injection performed during dialysis. Ordinary drug administration and injections shall use the prescription and injection modules that are prescribed in MML4.