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Key elements

The three following basic elements are essentials to build a KMEHR message and are used at all structure level.

cd

This is the key element used to code information. It is thus the element that makes the link between the messaging level and the codification level.

The cd element has five attributes.

S

Specifies the reference table. Depending on the context of use, the range of values is limited or not. Often, the special value ‘LOCAL’ may be used to indicate the use of a local codification system.

Mandatory

SV

Specifies the version of the reference table.

Mandatory

SL

Specifies a local reference table when S=’LOCAL’.

Mandatory if S='LOCAL'

DN

Provides a meaning of the code. Can optionally be used when S=’LOCAL’. Should not be used otherwise.

Optional

L

Specifies the language within the meaning if expressed.

Mandatory if DN is used
nullflavor This optional atttribute clarifies why information is missing. It uses the values as defined in the XML definition of HL7 messages. (http://www.hl7.org/documentcenter/public_temp_EF70C3FF-1C23-BA17-0C0D076B34123F97/wg/inm/datatypes-its-xml20050714a.htm#comp-ANY.nullFlavor)
This attribute may only be used in transactions that explicitely support this attribute. If this attribute is not supported in a specific transaction it must not be used in the message.		 Optional

XML example 

<urgency>
    <cd S="CD-URGENCY" SV="1.0">asap</cd>
    <cd S="LOCAL" SL="MyOwnSystem" SV="3.2" DN="dans la minute"
    L="fr">mm</cd>
</urgency>

id

This element is used to uniquely identify key elements like kmehrmessage, folder, patient, hcparty, transaction, heading and item. It can also be used to specify any unique identifier.

The id element has three attributes.

S

Specifies the identifying system. Depending on the context of use, the range of values is limited or not. Often, the special value ‘LOCAL’ may be used to indicate the use of a local identification system.

Mandatory

SV

Specifies the version of the version of the identification system.

Mandatory

SL

Specifies a local identification sytem when S=’LOCAL’.

Mandatory if S=’LOCAL’

Five identifying systems are currently recognized.

ID-KMEHR

This is the string that uniquely identifies a KMEHR element: a message (throughout its header), a folder, a transaction, a heading or an item.

By the way, this virtually identifies uniquely the element within the Belgian HealthCare Telematics System through the concatenation of parent ids (separated by dots and starting with the header id).

Consult the page describing the element for the corresponding identification rule.

ID-PATIENT

This is the string that uniquely identifies a patient within the Belgian Healthcare System. (INSS may alternatively be used in version 20100601).

It is thus the INSS number of the patient.

ID-HCPARTY

This is the string that uniquely identifies a HealthCare Party referenced within the Belgian HealthCare System.

Currently, this corresponds to a complete INAMI/RIZIV number coded on 11 positions, without dots, for a physical person and on 8 positions for an organization.

ID-INSURANCE

This is the string that uniquely identifies a healthcare insurance.

INSS

Introduced in version 20100601, this string identifies a physical person (patient or healthcare professional) registrated in the National Register or in the Bis Register. As ID-PATIENT, it contains the INSS number of the physical person but its use is not restricted to patients.

XML examples 

<person>
    <id S="INSS" SV="1.0">62031012311</id></patient>
    <id S="LOCAL" SL="MyOwnSystem" SV="3.2">CPO12378903</id>
    ...
</person>

lnk

This element is used to describe a link within a KMEHR message. Such a link may be put in any KMEHR element that has an official identifier (such as messages, folders and transactions).

We can distinguish between the following common usages.

  • A link with an external file such as an image stored on a web server.
  • A link with an element within an element of another KMEHR message.
  • A link with another element of the current KMEHR message.
  • A link within the lnk element itself (attachment).

The lnk element has four attributes.

TYPE

Describes the semantics of the relationship. It must belong to the reference table CD-LNK.

Mandatory

MEDIATYPE

Provides the format of a multimedia attachment. It must belong to the reference table CD-MEDIATYPE.

Optional

SIZE

Provides the size of a multimedia attachment, in bytes.

Optional

URL

Contains the url of the targeted element (if empty, the target is encapsulated in the content of the lnk element itself). The URL must be specified using the XPATH specification.

Optional

XML examples

The following lnk element indicates that the current transaction “is a response to the request” expressed in the first transaction of the message.

<transaction>
    ...
    <lnk TYPE="isareplyto" URL="//transaction[position()=1]"/>
</transaction>

The following lnk element indicates that the current transaction ‘is documented through’ the document provided in attachment.

<transaction>
    ...
    <lnk TYPE="multimedia" MEDIATYPE="application/pdf" 
    SIZE="36.864"> … </lnk>
</transaction>

The following lnk element indicates that the current transaction ‘is documented through’ a document available on an external server.

<transaction>
    ...
    <lnk TYPE="multimedia" URL="http://www.chu-charleroi.be/sim/12344556788.jpg"/> 
</transaction>