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•Design and implementation of a tethered PHR using HL7 Fast Healthcare Interoperability Resources (FHIR)•Implementation leverages FHIR healthcare data as service and API ...approach.•Advantages of using HL7 FHIR compared to previous efforts that relied on document-centric standards.•Ability to customize the PHR using FHIR resources and profiles.
The rapid growth and acceptance of Electronic Health Records (EHRs) and standards to exchange EHRs have improved various aspects of health practices and patient care. However, the data captured in an EHR is only accessible to the providers and specialists within an organization, but not the patient. The concept of a Personal Health Record (PHR) is to allow the patients to record and manage their health data beyond EHR and if possible, see the EHR data in the PHR. Experts agree that bi-directional communication between the PHR and EHR allows the PHR to be more effective and a valuable tool for both the providers and patients. Communicating near real-time patient recorded data in PHR with an EHR will allow the provider(s) to make appropriate clinical decisions and patients can see any changes to his/her diagnostics or treatment plans. This research explores and critically analyzes HL7 FHIR to design and prototype an interoperable mobile PHR that conforms to the HL7 PHR Functional Model and allows bi-directional communication with OpenEMR.
Interoperability of clinical data remains an issue in healthcare despite technology advancements. FHIR, Fast Healthcare Interoperability Resources, is a standard for electronic exchange of healthcare ...data that is built on web standards, flexible, user-friendly and easy to implement. This research aims to assess FHIR's potential as a solution for interoperability by identifying critical components of FHIR that can improve interoperability and bridge the gap between healthcare systems and sources of clinical data. By leveraging FHIR as a standard, healthcare professionals are able to more effectively communicate and access patient information leading to better patient care and more efficient clinical operations.
The integration of systems for adaptive business intelligence (ABI) in the healthcare industry has the potential to revolutionize and reform the way organizations approach data analysis and ...decision-making. By providing real-time, actionable insights and enabling organizations to continuously adapt and evolve, ABI has the potential to drive better outcomes, reduce costs and improve the overall quality of patient care.
This article proposes an interoperability architecture that allows the seamless use and integration of HL7 messages and the information they contain as an interface with these systems. The proposed architecture follows a microservices paradigm with an emphasis on its modularity and distribution capacity and is part of an effort to achieve interoperability and ease of integration with ABI systems, while never neglecting key characteristics such as speed, security and the best practices in software development and architecture.
Nowadays, with the digitalization of healthcare systems, huge amounts of clinical narratives are available. However, despite the wealth of information contained in them, interoperability and ...extraction of relevant information from documents remains a challenge.
This work presents an approach towards automatically standardizing Spanish Electronic Discharge Summaries (EDS) following the HL7 Clinical Document Architecture. We address the task of section annotation in EDSs written in Spanish, experimenting with three different approaches, with the aim of boosting interoperability across healthcare systems and hospitals.
The paper presents three different methods, ranging from a knowledge-based solution by means of manually constructed rules to supervised Machine Learning approaches, using state of the art algorithms like the Perceptron and transfer learning-based Neural Networks.
The paper presents a detailed evaluation of the three approaches on two different hospitals. Overall, the best system obtains a 93.03% F-score for section identification. It is worth mentioning that this result is not completely homogeneous over all section types and hospitals, showing that cross-hospital variability in certain sections is bigger than in others.
As a main result, this work proves the feasibility of accurate automatic detection and standardization of section blocks in clinical narratives, opening the way to interoperability and secondary use of clinical data.
•We present a system for Section Identification in medical texts written in Spanish.•The system follows the standard HL7 CDA/CCR.•We have defined an annotation model for Electronic Discharge Summaries (EDS).•We have applied it to annotate 300 EDSs, with a high Inter Annotator Agreement.•We evaluate the contribution of different Rule-Based and Machine Learning approaches.•Language Model tuning is a key factor as transfer learning provides the best results.•We also study the generalization ability of models trained in different hospitals.
Objective In early 2010, Harvard Medical School and Boston Children’s Hospital began an interoperability project with the distinctive goal of developing a platform to enable medical applications to ...be written once and run unmodified across different healthcare IT systems. The project was called Substitutable Medical Applications and Reusable Technologies (SMART).
Methods We adopted contemporary web standards for application programming interface transport, authorization, and user interface, and standard medical terminologies for coded data. In our initial design, we created our own openly licensed clinical data models to enforce consistency and simplicity. During the second half of 2013, we updated SMART to take advantage of the clinical data models and the application-programming interface described in a new, openly licensed Health Level Seven draft standard called Fast Health Interoperability Resources (FHIR). Signaling our adoption of the emerging FHIR standard, we called the new platform SMART on FHIR.
Results We introduced the SMART on FHIR platform with a demonstration that included several commercial healthcare IT vendors and app developers showcasing prototypes at the Health Information Management Systems Society conference in February 2014. This established the feasibility of SMART on FHIR, while highlighting the need for commonly accepted pragmatic constraints on the base FHIR specification.
Conclusion In this paper, we describe the creation of SMART on FHIR, relate the experience of the vendors and developers who built SMART on FHIR prototypes, and discuss some challenges in going from early industry prototyping to industry-wide production use.
A pathology order interface using Health Level 7 standards (HL7) generally has an HL7 client program that gathers information from the clinical electronic medical record system, packages the ...information in the form of HL7 message, and sends the message using secure communication protocols to an HL7 interface engine located on the pathology side. We describe an alternative approach that transmits the texts obtained from requisitions, with subsequent just-in-time construction of HL7 messages.
The order interface is between a dermatology clinic EMR and pathology information system. A text acquisition and processing program runs in the background in desktop computers in dermatology clinic so that a copy of pathology requisition text is obtained each time when the clinic prints a pathology requisition. Discrete elements of the data are extracted from this text, prepended to the text and saved on a shared drive within the dermatology office intranet. This text file is then transferred to pathology intranet using secure File Transfer Protocol (sFTP). Once received, an HL7 message construction program extracts the discrete data elements to construct an HL7 message. The HL7 message is then forwarded to an HL7 interface engine and entered into the pathology information system as an order.
Using an actual case as an example, the content and format of the information flowing through different steps of the interface are demonstrated.
The construction of such an interface does not involve the clinic EMR vendor, thus avoiding its associated cost and potential delay. This interface has advantages over our other order interfaces constructed using the conventional approach in that it does not require a change of order process and it avoids duplicate orders.
Purpose: With the ongoing work on the Health Level Seven (HL7) standards and the IEEE 11073 Serviceoriented Device Connectivity (SDC) family, the demand for open integration of medical devices in the ...operating room (OR) has become clear. Nevertheless, there are very few interoperable medical devices available to date. This work describes a practical example of connecting an intraoperative neuromonitoring (IONM) device with a radiofrequency (RF) surgical device based on SDC and with the hospital information system (HIS) based on HL7. Methods: Before starting the surgery, patient-related data must be entered into the neuromonitoring system. To minimize manual input, we integrated an automized patient data query based on HL7, which completes all other necessary data provided by the HIS after entering the patient identification number. During the surgery, while mapping neural structures in the situs using IONM, the parallel operation of RF devices for coagulation generates artifacts in the neuromonitoring signals, which makes a reliable interpretation of the IONM signals impossible. Therefore, we developed an IEEE 11073 SDC interface for the neuromonitoring device and implemented an SDC-based OR control panel. While placing the hand probe for mapping neural structures in the situs, the OR control panel suppresses the coagulation of the electrosurgical instrument and only reenables it, after the mapping has been terminated. After the surgery, the generated IONM report can be uploaded into the HIS using HL7. Therewith it is assigned automatically to the previously selected patient. Result: With the SDC- and HL7-enabled neuromonitoring system, we showed a practical use case of interoperable medical devices to optimize surgical workflow.
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