www.metaintegration.com
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Cleveland, May 22-26, 2000
End Stage Renal Disease (ESRD)
http://www.hcfa.gov/medicare/esrdpage.htm
http://www.hcfa.gov/quality/qlty%2D5d.htm
Standard Information Management System (SIMS)
http://www.simsproject.com
http://www.esrdnetwork6.org
Vital Information System
to Improve Outcomes in Nephrology (VISION)
HCFA / ESRD E-Reporting based on HL7 v3 XML Technology
XML based Data Collection / ETL Tool
soon http://www.metaintegration.net/HCFA
Contacts @ HCFA
Contacts @ Meta Integration
Cyrus Karimian
Denis Stricker
Bill Le Clair
Christian Bremeau
CKarimian@hcfa.gov
DStricker@hcfa.gov
© 1997-2000 Meta Integration Technology, Inc.
leclair@metaintegration.com
bremeau@metaintegration.com
Page 1
HCFA ESRD Network SOW
Background
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Statement of Work (SOW) delineates the activities
to be conducted by each End Stage Renal Disease
(ESRD) Network Organization (Network) to meet the
requirements of section 1881(c) of the Social Security
Act; the Health Care Financing Administration's
(HCA's) Health Care Quality Improvement Program
(HCQIP); and other directives related to improving the
quality of care of patients with ESRD.
• The statute, regulations, the ESRD Network
Organizations manual, and other HCFA instructions
provide additional detail concerning Network functions,
activities, and responsibilities.
© 1997-2000 Meta Integration Technology, Inc.
Page 2
HCFA ESRD Network SOW
Goals
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• Improve the quality of health care services and quality
of life for ESRD beneficiaries;
• Improve data reliability, validity, and reporting among
ESRD providers/facilities, Networks and HCFA (or
other appropriate agency);
• Establish and improve partnerships and cooperative
activities among and between the ESRD Networks, Peer
Review Organizations (PROs), State Survey Agencies,
ESRD providers/facilities, ESRD facility owners, and
professional groups.
© 1997-2000 Meta Integration Technology, Inc.
Page 3
HCFA ESRD Network SOW
Information Management
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network shall be required to utilize the
Standard Information Management System (SIMS)
to support Network data processing, information
management and reporting contractual requirements to
HCFA.
• HCFA is redesigning the current Renal Beneficiary and
Utilization System (REBUS).
• The new system will be named the Renal Management
Information System (REMIS).
• The Network shall be required to utilize REBUS or
REMIS as directed by HCFA.
© 1997-2000 Meta Integration Technology, Inc.
Page 4
HCFA / ESRD / SIMS
Responsibilities
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network's responsibilities for data processing, information
management and reporting are:
– To have sufficient system capacity with the appropriate computer hardware
and software to carry out its contractual responsibilities;
– To effectively manage the collection, validation, storage and use of data,
including data provided by HCFA, for review, profiling, pattern analysis,
and sharing with the HCFA RO and State Survey Agency for use in its
ESRD Medicare survey and certification activities;
– To ensure timely and accurate reporting by the providers/facilities;
– To maintain an ESRD patient and facility database and ensure the integrity
and accuracy of the databases; and
– To ensure the quality and accuracy of the data submitted to HCFA for
inclusion in the ESRD Program Management and Medical Information
System (PMMIS) and the United States Renal Data System (USRDS).
© 1997-2000 Meta Integration Technology, Inc.
Page 5
HCFA / ESRD / SIMS
System Capacity
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network shall maintain a system that provides the capacity to meet its
contractual responsibilities for data collection, validation, entry, retrieval,
profiling, analysis, and reporting, and for electronic data interchange. The
system, at a minimum, shall utilize and consist of the following:
– SIMS software, and program documentation, for the entry and transmission of the
HCFA ESRD forms described in section C.5.E.;
– HCFA approved software for the entry and transmission of clinical performance
measures described in section C.2.C.;
– Internet enabled electronic mail capability compatible with HCFA, including the
ability to send and receive attachments;
– Dial-in capability for connection to REBUS and HCFA compatible web browser
access for connection to REMIS;
– Office automation software compatible with the HCFA standard;
– HCFA supplied or other statistical software for data analysis and profile analysis
including profiling patients and facilities by county to facilitate disaster planning
and other studies;
– Provisions for disaster recovery of the databases and data system; and
– Sufficient hardware to run the above software applications.
© 1997-2000 Meta Integration Technology, Inc.
Page 6
HCFA / ESRD / SIMS
Database Management
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network shall maintain a patient database containing the minimum/
critical data elements listed in the Draft ESRD Network Organizations Manual
instructions. The Network shall perform the following tasks related to its
patient database:
– The Networks shall consistently update the SIMS central repository based on data
received from the providers/facilities. HCFA will receive a data feed from the SIMS
central repository on a regularly scheduled basis to obtain an update of the
Networks‘ patient data for REBUS/REMIS.
– Upon notification from HCFA either by hardcopy or electronically through
REBUS/REMIS, update the Network's patient database with valid changes to
important data elements (e.g., beneficiary name, date of birth, Health Insurance
Claim Number (HICN) and Beneficiary Identification Code (BIC)).
• Through SIMS, the Network shall also maintain a facility database containing
the minimum data elements listed in the Draft ESRD Network Organizations
Manual instructions. HCFA has the capacity to create data files and labels, and
to verify data for the national listing, directly from the SIMS system. HCFA will
give the Networks two weeks notice prior to taking these actions so that
Networks can properly schedule their system updates for the date the file is
created.
© 1997-2000 Meta Integration Technology, Inc.
Page 7
HCFA / ESRD / SIMS
www.hcfa.gov
Collection, Validation & Maintenance of HCFA
ESRD Forms (Introduction)
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network shall obtain completed HCFA ESRD forms from each ESRD
provider/facility in the Network area. The Network will also include all
voluntarily submitted forms from the non-Medicare Department of Veterans
Affairs (DVA) facilities, and other institutions such as prisons and nursing
homes. These forms contain patient specific information necessary for the
operation of the national ESRD program. The HCFA ESRD forms and their
facility computer generated equivalents include the following:
– HCFA-2728-U4 - ESRD Medical Evidence Report Medicare Entitlement and/or
Patient Registration (completed on each incident ESRD patient);
– HCFA-2744 - ESRD Facility Survey (completed annually);
– HCFA-2746 - ESRD Death Notification (or computerized facility generated Death
Notification form) (completed within 30 days of the date of death);
– HCFA-820 - In-Center Hemodialysis (HD) Clinical Performance Measures Data
Collection Form; and
– HCFA-821 - Peritoneal Dialysis (PD) Clinical Performance Measures Data
Collection Form.
© 1997-2000 Meta Integration Technology, Inc.
Page 8
HCFA / ESRD / SIMS
www.hcfa.gov
Collection, Validation & Maintenance of HCFA
ESRD Forms (VISION)
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• It is anticipated the:
Vital Information System to Improve Outcomes in Nephrology (VISION)
project will be rolled out during this contract period, with National
Implementation slated for the first quarter of calendar year 2001. However,
until such time as the HCFA requires electronic reporting from all dialysis
facilities for all patients, it will be on a voluntary basis. At that time, the
Networks will be responsible for validating the data from the facilities.
• Monitoring the accuracy and completeness of reports, and the validation of
facility-level patient data are critical roles in assuring the integrity of the
patient tracking system. Similarly, capturing data forms on all incident cases
requires a mechanism for cross-checking so facilities can query and detect
unreported forms. As VISION is implemented, the activities specified below
will need to be retained in a format that is consistent with migration from
hardcopy to electronic reporting.
© 1997-2000 Meta Integration Technology, Inc.
Page 9
HCFA / ESRD / SIMS
www.hcfa.gov
Collection, Validation & Maintenance of
HCFA ESRD Forms (Activities)
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• The Network shall conduct activities to ensure that the data required on the
forms are collected, completed, and validated in accordance with Draft ESRD
Network Organizations Manual instructions, and the ESRD Program
Instruction Manual for Renal Providers. These activities include the following:
– Review forms received for accuracy and completeness and return to the
provider/facility (or otherwise query the provider/facility) for correction or
completion of those forms with missing or inaccurate data.
– Receive and process the ESRD Medical Evidence Report, Medicare Entitlement
and/or Patient Registration form (HCFA-2728-U4).
– Process and transmit the information on HCFA-2728 and HCFA-2746 forms
directly to the HCFA Data Center via SIMS.
– Process and transmit the information on the HCFA-2744 form directly to the HCFA
Data Center via SIMS by the fifth working day in April.
– Transmit corrections on the HCFA-2744 form by hard copy or through SIMS by the
third Friday in May.
– Maintain a file of all HCFA ESRD hardcopy forms that are processed for at least
two years.
© 1997-2000 Meta Integration Technology, Inc.
Page 10
www.hcfa.gov
HCFA / ESRD Data Flow
The big picture…
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
Social Security
Administration
(SSA)
Transforming the ESRD Reporting Process to HCFA
Health Care
Financing
Administration
(HCFA)
from Paper Forms to HL7 v3 XML based E-reporting
ESRD Medical Evidence Report
Medicare Entitlement And/Or Patient
Registration
Form HCFA-2728-U3
In-Center Hemodialysis (HD)
Clinical Performance Measures Data
Collection
Form 2000, Form HCFA-820
Peritoneal Dialysis (PD)
Clinical Performance Measures Data
Collection
Form 2000 Form HCFA-821
ESRD Medical Information
System
Facility Survey
Part One: Dialysis
Part Two: Kidney Transplants
Form HCFA-2744
Facility
Specific Information
Form SIMS-???
End Stage
End
Stage
Renal
Disease
End
Stage
Renal
Disease
(ESRD)
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
Patient
Specific Information
Form SIMS-???
Patient Death
Form HCFA-2746
ESRD Beneficiary Selection
(Home Patients Only)
Form HCFA-382
Dialysis Facility (DF)
Clinical Performance Measures Data
Collection
Form 2000 Form HCFA-???
© 1997-2000 Meta Integration Technology, Inc.
Page 11
www.hcfa.gov
HCFA / ESRD Data Flow
The SIMS front end
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
End Stage
End
Stage
Renal
Disease
End
Stage
Renal(ESRD)
Disease
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
SIMS Networks
(geographically
distributed)
Network #01
Health Care Financing Administration (HCFA)
Network #02
…
…
Reporting
HCFA
(Paper)
Forms
End Stage
End
Stage
Renal
Disease
End
Stage
Renal
Disease
(ESRD)
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
Network #20
HCFA-2728-U3
HCFA-2746
End Stage
End
Stage
Renal
Disease
End
Stage
Renal
Disease
(ESRD)
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
HCFA-2744
Replication
IBM Model 2.04 Databases
© 1997-2000 Meta Integration Technology, Inc.
Overnight
Updates
MS SQL Server Databases
Page 12
www.hcfa.gov
HCFA / ESRD Data Flow
Inside HCFA Today…
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Social Security
Administration
(SSA)
www.metaintegration.com
Cleveland, May 22-26, 2000
Health Care Financing Administration (HCFA)
MS SQL
Server
IBM Model 2.04
IBM Model 2.04
© 1997-2000 Meta Integration Technology, Inc.
Page 13
www.hcfa.gov
HCFA / ESRD Data Flow
Inside HCFA Tomorrow…
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
Health Care Financing Administration (HCFA)
Oracle
Business Intelligence (BI) &
Knowledge Management (KM) Solutions:
Data Warehousing
Data Mining
OLAP
Auxiliary
ESRD
Specialized
Databases
Very limited and primitive had-hoc
query and reports on the IBM mainframe
(no need for legacy software migration,
replaced by Oracle BI & KM tools: DW, DM, OLAP).
IBM Model 2.04
Legacy Migration ETL
Updates
ETL
Oracle 8i
Updates ETL
IBM Model 2.04
© 1997-2000 Meta Integration Technology, Inc.
Page 14
www.hcfa.gov
HCFA / ESRD Data Flow
Long Term Objective…
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Do they have
a database ?
Health Care
Financing
Administration
(HCFA)
MS SQL Server
Data Extraction, Transformation & Load (ETL)
Electronic Data Interchange (EDI)
www.metaintegration.com
Cleveland, May 22-26, 2000
End Stage
Renal Disease
(ESRD)
Facility
RDBMS ?
over Secure Internet (based on XML)
Are they connected
on internet / dialups ?
How about the security
of the medical information ?
© 1997-2000 Meta Integration Technology, Inc.
Is HL7 v3
XML Ready ?
Page 15
HCFA / ESRD Data Flow
The VISION Data Collection Tool
www.hcfa.gov
(Vital Information System to Improve Outcomes in Nephrology)www.metaintegration.com
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Cleveland, May 22-26, 2000
•Manual Entries of HCFA Forms
•Automatic Import (ETL from ESRD Facility Database)
•Automatic Export (ETL to HCFA SIMS)
•Form Editing, Browsing, Queries, Printing, etc.
HCFA-2728-U3
HCFA-2746
HCFA-2744
End Stage
Renal Disease
(ESRD)
Facility
VISION Data Collection Tool
Health Care
Financing
Administration
(HCFA)
(Windows Standalone Utility)
Graphical User Interface
Graphical User
Interface
(GUI)
Graphical User
Interface
(GUI) Visual Basic)
(Windows
(GUI) Visual Basic)
(Windows
(Windows MFC Visual Basic)
MS SQL Server
MS Access DB
ETL
© 1997-2000 Meta Integration Technology, Inc.
RDBMS ?
ETL
Page 16
HCFA / ESRD Data Flow
ETL #1 & 2 : VISION Import/Export of
HL7 v3 XML “Based” HCFA Documents
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
VISION Data Collection Tool
Meta Integration Works
(Windows Standalone Utility)
Data Extraction,
Transformation
|& Load (ETL)
Graphical User Interface
(GUI)
Graphical
User Interface
(Windows Visual Basic)
(GUI)
Graphical
User Interface
(Windows Visual Basic)
(GUI)
Generation & Maintenance of the
Data Movement Components
(C++ based, Windows Plug&Play)
(Windows MFC Visual Basic)
Import
MS Access DB
Data Movement Component
Export
Data Movement Component
XML Files
HL7 v3 XML
based
HCFA-2728-U3
Import
Data Movement Component
Export
HL7 v3 XML
based
HCFA -2744
HL7 v3 XML
based
HCFA -2746
© 1997-2000 Meta Integration Technology, Inc.
Page 17
HCFA / ESRD Data Flow
www.hcfa.gov
ETL #3 : HCFA / SIMS Import of
HL7 v3 XML “Based” HCFA Documents
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
Meta Integration Works
Data Extraction,
Transformation
|& Load (ETL)
Health Care
Financing
Administration
(HCFA)
Generation & Maintenance of the
Data Movement Components
(C++ based, Windows Plug&Play)
XML Files
MS SQL
Server
Import
Data Movement Component
HL7 v3 XML
based
HCFA-2728-U3
Import
Data Movement Component
Import
HL7 v3 XML
based
HCFA -2744
HL7 v3 XML
based
HCFA -2746
© 1997-2000 Meta Integration Technology, Inc.
Page 18
HCFA / ESRD Data Flow
www.hcfa.gov
ETL #4, 5, … : ESRD Facility Export of
HL7 v3 XML “Based” HCFA Documents
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
Meta Integration Works
Data Extraction,
Transformation
|& Load (ETL)
Generation & Maintenance of the
Data Movement Components
(C++ based, Windows Plug&Play)
End Stage
Renal Disease
(ESRD)
Facility
XML Files
Any RDBMS
via ODBC
Export
Data Movement Component
HL7 v3 XML
based
HCFA-2728-U3
Export
Data Movement Component
Export
HL7 v3 XML
based
HCFA -2744
HL7 v3 XML
based
HCFA -2746
© 1997-2000 Meta Integration Technology, Inc.
Page 19
HCFA / ESRD Data Flow
www.hcfa.gov
Generating Data Movement Components
HL7 v3 XML “based” HCFA Documents www.metaintegration.com
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Cleveland, May 22-26, 2000
Meta Integration Works
Data Extraction,
Transformation
|& Load (ETL)
(step 1) Model Converter (Import Bridges)
HL7 v3 XML DTD
based
HCFA-2728-U3
(step 2) Model Mapper
Database Schema
Logical Model (ERwin, Rose, etc.)
Physical Model (DDL)
(step 3) Data Bridge Builder
MS Access DB
HL7 v3 XML
based
HCFA-2728-U3
© 1997-2000 Meta Integration Technology, Inc.
HCFA-2728 HL7 v3 XML to VISION
Data Movement Component
Page 20
www.hcfa.gov
HCFA / ESRD Data Flow
Introducing VISION phase 1
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Health Care Financing
Administration (HCFA)
www.metaintegration.com
Cleveland, May 22-26, 2000
End Stage
End
Stage
Renal
Disease
End
Stage
Renal(ESRD)
Disease
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
Network #01
Network #02
…
…
Network #19
Conventional
Reporting
HCFA
(Paper)
Forms
Network #20
E-Reporting
“HyperShip”
Secured
Transport
U.S. Postal
Office
Certified !
© 1997-2000 Meta Integration Technology, Inc.
End Stage
End
Stage
Renal
Disease
End
Stage
Renal
Disease
(ESRD)
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
VISION
Data Collection
Tool
(Windows
Standalone
Utility)
HCFA-2728-U3
End Stage
End
Stage
Renal
Disease
End
Stage
Renal
Disease
(ESRD)
Renal(ESRD)
Disease
Facility
(ESRD)
Facility
Facility
HCFA-2746
HCFA-2744
Page 21
HL7 Development
Environment
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
Interaction
Model
Interaction
InteractionModel
Model
Unused?
Domain
Information Models
(DIM)
Reference
Information Model
(RIM)
Refined Message
Information Model
(R-MIM)
Harmonization
Process
The HL7 Development Environment is composed of:
•A repository called “RIM” implemented on Microsoft Access
•Represents the master copy of all HL7 metadata,
•Contains RIM tables as well as R-MIM, HMD, more?
•Can be populated from Rational Rose
(with referential integrity, and version management))
•But contains more information than in Rose?
•Can export to Rose
•A toolset called “RoseTree” implemented with Visual Basic
© 1997-2000 Meta Integration Technology, Inc.
Message Object Diagram
Message
Object
Diagram
Message
Object
Diagram
Hierarchical
Message
Descriptions
(HMD)
HL7 v2.x
(EncodingRules 7) ER7
HL7 v3.x
(XML DTD)
Messages
Page 22
HL7 v3 XML “Based” HCFA Documents
Document/Message Construction
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• Goal
–
–
–
–
–
Build HL7 XML documents/messages for HCFA forms
Use Message Development Framework Version 3.2 April 1999
Use RoseTree
RIM095 with no modifications
Use standard coding schemes
• LOINC codes (Logical Observation Identifiers, Names and Codes ) for
identifying laboratory and clinical observations.
• ICD-9 (International Classification of Diseases)
– Fortunate that USAM 2.4 (Unified Service Action Model)
existed
© 1997-2000 Meta Integration Technology, Inc.
Page 23
HL7 v3 XML “Based” HCFA Documents
Current Message Choices
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• What about the current documents
– Patient Record Architecture Framework
• Not enough RIM information
• Not all the information seems to be in the RIM
(i.e.,Clinical_Document_Header with Patient relationship)
• Closest to what we need but timeliness is an issue
– Could not find other documents dealing with documents
© 1997-2000 Meta Integration Technology, Inc.
Page 24
HL7 v3 XML “Based” HCFA Documents
Classes Used
www.metaintegration.com
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
Clinical_document(1)
Clinical_document_header(1)
Authentication(0..1)
Healthcare_document_authenticator(1)
Person(1..n)
Person_name(1)
Service(0..n)
Target(0..n)
Material(1)
Master_patient_service_location(1)
Dependent_Service(1..n)
Service(1)
Healthcare_provider_organization(1)
Master_patient_service_location(1)
Patient(1)
Person(1)
Person_name(1)
Employee(0..n)
Person_Employment(0..n)
Administrative_patient_death(1)
Cleveland, May 22-26, 2000
Master_patient_service_location (from previous box)
Patient(1)
…
Patient_Encounter(0..n)
Service(0..n)
Target(0..n)
Material(0..1)
Master_patient_service_location(0..1)
Dependent_Service(0..n)
Service(1..n)
Consent(1)
Consent.Actor(1)
Consent.Witness(0..1)
Master_healthcare_benefit_product(0..1)
Insurer(0..1)
Organization(1)
Material(0..n) (Statistical)
Target(0..n)
Service(0..n) (statistical)
Service is an Observation, Procedure, Condition_node, Medication, or Supply
© 1997-2000 Meta Integration Technology, Inc.
Page 25
HL7 v3 XML “Based” HCFA Documents
Status
www.hcfa.gov
Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML
www.metaintegration.com
Cleveland, May 22-26, 2000
• Lessons learned
– The RIM is fairly complete – found no needs create new
relationships or to create new attributes
– It is sometimes hard to choose a path when several paths are
possible and valid (Services for example)
– Yes/No questions require interpretation
– Members of HL7 are very cooperative
• Waiting on
– Statistics – not yet defined
• Used Xeena tool from IBM (free validating XML editing
tool)
© 1997-2000 Meta Integration Technology, Inc.
Page 26