By: Dieter Menne, Menne Biomed Consulting, Tübingen
The HRM consensus group has designed an XML based protocol for HRM data exchange and protocol definition which can be downloaded from the addresses below. As of April 7, 2009, all major companies (alphabetically MMS, Sandhill and Sierra) will support the format and are actively working on revisions of the definition.
The full zipped package with the document in Microsoft Word format, the schema file, two sample files and the formal documentation created from the schema can be downloaded here:
- Version 1.0_0 No changes after experimental version 0.3.2 (May 09)
- Flyer on XRHM for DDW09
- A short presentation of some XHRM features (pdf)
XHRM File Format
The proposed file format with extension xhrm is a zip-compressed version of an XML file containing data and metadata, and optional files, for example with figures of X-ray images or thumbnail previews.
Scenarios for XHRM Files
While it is possible to use XHRM as a primary storage of HRM data, we do not expect that it will replace proprietary data formats. In the following, we present some scenarios to show that XHRM is not only useful for research, but that it could provide a competitive advantage when used in standardized browser-based reporting and archiving of patient records.
Print Data Screen
Most commercial HRM software supports the direct export of the data range visible on the screen into an ASCII file. The format is different for each vendor and not self-documenting. The minimal XHRM export for this type of output is easy to program. It can be augmented by adding a preview image with proprietary amendments or patient information.
Clinical Documentation
There is increasing pressure from the authorities to provide clinical data in a archivable format that is vendor-independent. XML files, when accompanied by Schema definitions, can be stored in clinical databases with full support for field-based searches.
Browser-Based Reporting
XML files can viewed directly as formatted reports reports in all web browsers; the structure of the format is defined by an external style sheet (xhrmFull.xsl in the example) that can be created with standard web-design tools both by vendors or end users. Portal pages dispatching to patient records is possible without a web server for a small number of records, and can made more efficient in a server-based setting.
Protocol Reporting
The primary endpoint of the HRM consensus group is to define standardized procedures used in clinical tests. Detailed procedure definition is part of the XHRM format. Vendors can implement these protocols, and provide timer and procedure information (“10 ml water bolus, supine, in 3 minutes”); When the procedure is completed, patient information, non-contiguous swallow data, images and vendor-specific diagnostic parameters can be exported into an XHRM file for storage in clinical documentation systems and previewed in a web browser.
