Using HL7 FHIR to achieve interoperability in patient health record

Saripalle, Rishi Kanth; Runyan, Christopher M.; Mitchell, Russell

doi:10.1016/j.jbi.2019.103188

Cited by 187 publications

(109 citation statements)

References 28 publications

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“…When a patient directly controls a digital healthcare record (i.e., the subject manages information on the record), the system is defined Personal Health Record (PHR) (Flaumenhaft and Ben-Assuli, 2018). The PHR could be synchronized with the EHR on patient request (Saripalle et al, 2019). However, as regards interoperable EHRs, the processing is carried out by healthcare providers.…”

Section: Issues At Organizational Layermentioning

confidence: 99%

Data protection issues in cross-border interoperability of Electronic Health Record systems within the European Union

Bincoletto

2020

Data & Policy

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This study investigates the data protection concerns arising in the context of the cross-border interoperability of Electronic Health Record (EHR) systems in the European Union. The article first introduces the policies on digital health and examines the related interoperability issues. Second, the work analyses the latest Recommendation of the European Commission on this topic. Then, the study discusses the rules and the obligations settled by the General Data Protection Regulation to be taken into account when developing interoperable EHRs. According to the data protection by design and by default provision, EHR systems should be designed ex ante to guarantee data protection rules.

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Section: Issues At Organizational Layermentioning

confidence: 99%

Data protection issues in cross-border interoperability of Electronic Health Record systems within the European Union

Bincoletto

2020

Data & Policy

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“…According to the research of Saripalle et al [39], FHIR can be used as the basic structure of PHR and has the ability to customize the PHR. At present, Taiwan does not have any data that meet international standards and regulations, which leads to a gap in international medical treatment.…”

Section: Discussionmentioning

confidence: 99%

Implement an International Interoperable PHR by FHIR—A Taiwan Innovative Application

Lee

Hsu

et al. 2020

Sustainability

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Personal health records (PHRs) have lots of benefits for things such as health surveillance, epidemiological surveillance, self-control, links to various services, public health and health management, and international surveillance. The implementation of an international standard for interoperability is essential to accessing personal health records. In Taiwan, the nationwide exchange platform for electronic medical records (EMRs) has been in use for many years. The Health Level Seven International (HL7) Clinical Document Architecture (CDA) was used as the standard of the EMRs. However, the complication of implementing CDA became a barrier for many hospitals to realize the standard EMRs. In this study, we implemented a Fast Healthcare Interoperability Resources (FHIR)-based PHR transformation process including a user interface module to review the contents of PHRs. We used “My Health Bank, MHB”, a PHR data book developed and issued to all people by the Taiwan National Health Insurance, as the PHRs contents in this study. Network Time Protocol (NTP)/Simple Network Time Protocol (SNTP) was used in the security and user authentication mechanism when processing and applying personal health information. Transport Layer Security (TLS) 1.2 (such as HyperText Transfer Protocol Secure (HTTPS) was used for protection in data communication. User authentication is important in the platform. OAuth (OAuth 2.0) was used as a user authentication mechanism to confirm legitimate user access to ensure data security. The contents of MHB were analyzed and mapped to the FHIR, and then converted to FHIR format according to the mapping logic template. The function of format conversion was carried out by using ASP.NET. XPath and JSPath technologies filtered out specific information tags. The converted data structure was verified through an HL7 Application Programming Interface (HAPI) server, and a new JSON file was finally created. This platform can not only capture any PHR based on the FHIR format but also publish FHIR-based MHB records to any other platform to bridge the interoperability gap between different PHR systems. Therefore, our implementation/application with the automatic transformation from MHB to FHIR format provides an innovative method for people to access their own PHRs (MHB). No one has published a similar application like us using a nationwide PHR standard, MHB, in Taiwan. The application we developed will be very useful for a single person to use or for other system developers to implement their own standard PHR software.

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“…In this scheme, one was deployed as a web server on the front-end computer, as shown in Figure 1 . The submitters both from the Internet client and AIIA only need to call the web service interface to transmit the agreed XML stream to the web server [ 24 ], and the XML could be analyzed by the web server to complete the data exchange.…”

Section: Methodsmentioning

confidence: 99%

A Lightweight Internet Sharing Scheme for Sectional Medical Images according to Existing Hospital Network Facilities and Basic Information Security Rules

Qiao

et al. 2020

Journal of Healthcare Engineering

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Background. With the outbreak of COVID-19, large-scale telemedicine applications can play an important role in the epidemic areas or less developed areas. However, the transmission of hundreds of megabytes of Sectional Medical Images (SMIs) from hospital’s Intranet to the Internet has the problems of efficiency, cost, and security. This article proposes a novel lightweight sharing scheme for permitting Internet users to quickly and safely access the SMIs from a hospital using an Internet computer anywhere but without relying on a virtual private network or another complex deployment. Methods. A four-level endpoint network penetration scheme based on the existing hospital network facilities and information security rules was proposed to realize the secure and lightweight sharing of SMIs over the Internet. A “Master-Slave” interaction to the interactive characteristics of multiplanar reconstruction and maximum/minimum/average intensity projection was designed to enhance the user experience. Finally, a prototype system was established. Results. When accessing SMIs with a data size ranging from 251.6 to 307.04 MB with 200 kBps client bandwidth (extreme test), the network response time to each interactive request remained at approximately 1 s, the original SMIs were kept in the hospital, and the deployment did not require a complex process; the imaging quality and interactive experience were recognized by radiologists. Conclusions. This solution could serve Internet medicine at a low cost and may promote the diversified development of mobile medical technology. Under the current COVID-19 epidemic situation, we expect that it could play a low-cost and high-efficiency role in remote emergency support.

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Using HL7 FHIR to achieve interoperability in patient health record

Cited by 187 publications

References 28 publications

Data protection issues in cross-border interoperability of Electronic Health Record systems within the European Union

Data protection issues in cross-border interoperability of Electronic Health Record systems within the European Union

Implement an International Interoperable PHR by FHIR—A Taiwan Innovative Application

A Lightweight Internet Sharing Scheme for Sectional Medical Images according to Existing Hospital Network Facilities and Basic Information Security Rules

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