A grammar of integrity constraints in medical documentation systems

An essential aspect for the utilization of medical data is their quality, thus a main feature of computer-based medical documentation systems should be to assist the user in complete and plausible data acquisition and maintenance. In this paper we define a grammar for modeling medical documentation systems to increase integrity and completeness of collected data, focusing attention on integrity constraints. An integrity constraint defines requirements that involved entities had to comply with. Furthermore it defines possibly implications in case of failure. The constraints presented in this paper are type constraint, length constraint, domain constraint, key constraint, quantity constraint, reference constraint, search constraint, result constraint, hierarchy constraint, and semantic constraint. Their grammar is declared using a schema in extensible markup language-format (XML-schema). The model introduced here can be used in computer-aided design and implementation of clinical documentation both minimizing effort and ensuring data quality, which was tested by an evaluation based on a specification of a registry for HIV-infected patients.