Patient information exchange guideline MERIT-9 using medical markup language MML

Michio Kimura, Kazuhiko Ohe, Hiroyuki Yoshihara, Yutaka Ando, Fumiaki Kawamata, Teruyoshi Hishiki, Katsunori Ohashi, Takaya Sakusabe, Shigeki Tani, Masanori Akiyama

Research output: Chapter in Book/Report/Conference proceedingConference contribution

3 Citations (Scopus)


To realize clinical data exchange between healthcare providers, there must be many standards in many layers. Terms and codes should be standardized, syntax to wrap the data must be mutually parsable, then transfer protocol or exchange media should be agreed. Among many standards for the syntax, HL7 and DICOM are most successful. However, everything could not be handled by HL7 solely. DICOM is good for radiology images, but, other clinical images are already handled by other 'lighter data formats like JPEG, TIFF. So, it is not realistic to use only one standardfor every area of clinical information. For description of medical records, especially for narrative information, we created SGML DTD for medical information, called MML(Medical Markup Language). It is already implemented in more than 10 healthcare providers in Japan. As it is a hierarchical description of information, it is easily used as a basis of object request brokering. It is again not realistic to use MML solely for clinical information in various level of detail. Therefore, we proposed a guideline for use of available medical standards to facilitate clinical information exchange between healthcare providers. It is called MERIT-9 (MEdical Records, Images, Texts,- Information eXchange). A typical use is HL7 files, DICOM files, referred from an MML file in a patient record, as external entities. Both MML and MERIT-9 are research projects of Japanese Ministry of Health and Welfare, and the purpose is to facilitate clinical data exchanges. They are becoming to be used in technical specifications for new hospital information systems in Japan.

Original languageEnglish
Title of host publicationMedInfo 1998 - 9th World Congress on Medical Informatics
PublisherIOS Press
Number of pages5
ISBN (Print)9051994079, 9789051994070
Publication statusPublished - 1998
Externally publishedYes
Event9th World Congress on Medical Informatics, MedInfo 1998 - Seoul, Korea, Republic of
Duration: 18-08-199822-08-1998

Publication series

NameStudies in Health Technology and Informatics
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365


Conference9th World Congress on Medical Informatics, MedInfo 1998
Country/TerritoryKorea, Republic of

All Science Journal Classification (ASJC) codes

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management


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