Interoperability of health data using FHIR Mapping Language: transforming HL7 CDA to FHIR with reusable visual components

Abstract

IntroductionEcosystem-centered healthcare innovations, such as digital health platforms, patient-centric records, and mobile health applications, depend on the semantic interoperability of health data. This ensures efficient, patient-focused healthcare delivery in a mobile world where citizens frequently travel for work and leisure. Beyond healthcare delivery, semantic interoperability is crucial for secondary health data use. This paper introduces a tool and techniques for achieving health data semantic interoperability, using reusable visual transformation components to create and validate transformation rules and maps, making them usable for domain experts with minimal technical skills.MethodsThe tool and techniques for health data semantic interoperability have been developed and validated using Design Science, a common methodology for developing software artifacts, including tools and techniques.ResultsOur tool and techniques are designed to facilitate the interoperability of Electronic Health Records (EHRs) by enabling the seamless unification of various health data formats in real time, without the need for extensive physical data migrations. These tools simplify complex health data transformations, allowing domain experts to specify and validate intricate data transformation rules and maps. The need for such a solution arises from the ongoing transition of the Estonian National Health Information System (ENHIS) from Clinical Document Architecture (CDA) to Fast Healthcare Interoperability Resources (FHIR), but it is general enough to be used for other data transformation needs, including the European Health Data Space (EHDS) ecosystem.ConclusionThe proposed tool and techniques simplify health data transformation by allowing domain experts to specify and validate the necessary data transformation rules and maps. Evaluation by ENHIS domain experts demonstrated the usability, effectiveness, and business value of the tool and techniques.