XML for immediate discharge letters in Scotland

This paper describes the results of the first UK project to send and receive discharge letters using XML as a message format for clinical data. The SIGN guideline for immediate discharge has broad clinical acceptance across Scotland and forms the basis for the discharge message content. NHS net as a secure private network and X400 as a secure e-mail message format is intended for the final production systems. Internet mail was used for validating. The Scottish Immediate Discharge Project has the advantage of transferring readable clinical information between computer system and giving the receiving GP choice of decoding and saving clinical and administrative data into his practice system. The design of the Document Type Definition was built using the established standard for XML version 1.0. A number of existing discharge letter systems and a variety of written letters were studied. Existing trial standards, including the EDIFACT and CEN standards were taken into consideration. The project worked with the receiving GP system supplier, GPASS, and the NHSiS Information and Statistics Division in defining the DTD for the pilot. GPASS undertook production of a module for their system to parse the XML message into the patient record on the GP system. The system allows the GP to read and print the original document and modify the content prior to storing in the practice system. Care was taken to avoid sending real patient information for the pilot project. SMTP email messages were used rather than X400 because NHS net was not yet implemented at the pilot hospital sites. Resulting messages were parsed into the GP system and validated by a variety of GP users.