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Improving Healthcare Interoperability by Mapping Data to FHIR Resources

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Modern healthcare organizations operate more independently, leading to processing and exchanging data challenges. FHIR specifications address the problem of data interoperability by establishing standardized data storage methods in health systems, enabling a smooth exchange of healthcare data. In fact, with the implementation of the 21st Century Cures Act, FHIR adoption has become mandatory for medical companies in the United States. 

However, due to the intricate nature, diverse formats, and substantial volume of clinical information accumulated by healthcare organizations, implementing FHIR becomes complex and time-consuming. One of the major obstacles encountered is mapping healthcare data to conform to HL7 FHIR’s compliant format.

Our extensive experience handling large-scale FHIR projects allows our team to develop custom FHIR resource mapping solutions for transforming clinical resources into an FHIR mapping format. Thus, this article will analyze FHIR resources, their key formats and attributes, and how SPsoft can help healthcare organizations with resource mapping.

“Our team and custom-built solutions empower our clients to overcome the complexities of data integration and achieve true interoperability. Our FHIR mapping solutions enable our clients to optimize their workflows, unlock the full potential of FHIR resources, and revolutionize how healthcare data is exchanged and utilized.”

Romaniya Mykyta 
Head of Product Management, SPSoft

“At SPsoft, we focus on delivering exceptional results to our clients in the healthcare sector. We understand the criticality of seamless data exchange in the healthcare industry, so we develop custom FHIR mapping tools. By harnessing the power of these tools, we empower our clients to overcome the challenges of data integration and achieve true interoperability.”

Mike Lazor
CEO, SPsoft

What Are FHIR Resources?

In FHIR, healthcare data is categorized into patients, laboratory results, and insurance claims. FHIR resources represent each category, defining the constituent data elements, constraints, and relationships needed for a comprehensive patient record to be shared. The standard aims to create a collection of FHIR R4 resources that cover the most common usage scenarios, individually or in combination.

Each resource contains the specific data elements necessary for its intended use cases and includes links to relevant information in other resources. For instance, the Patient Resource covers essential patient demographics, contact details, and references to clinicians or companies stored in separate resources. FHIR Provider Resource, in turn, is focused on the clinical practitioner’s data.

Other types of resources, such as FHIR provider resources, FHIR groups, and more, contain defined data elements. Resources are located within an FHIR system implementation using Uniform Resource Locators (URLs), also known as web addresses.

Initially, a resource does not require most data elements to have assigned values. However, during the Profiling process, which tailors the resource for real-world applications, certain elements become mandatory to ensure the resource’s functionality. For example, a Profiled Patient Resource may necessitate the inclusion of a patient’s name, address, and telephone number to facilitate patient matching. There also are other types of resources such as FHIR condition, FHIR consent, FHIR encounter, and many more. The following table gives an example FHIR resource list, specifying what can be considered a resource and what cannot.

The example of the FHIR resource list
Figure 1. The example of the FHIR resource list

The Key Benefits of FHIR Resources

The FHIR specification aims to be understandable for non-technical users, customizable, and readily available. Most importantly, FHIR promotes interoperability by providing a standardized framework for exchanging healthcare data. That facilitates seamless communication and integration between different healthcare systems, enabling the secure sharing of patient information across various healthcare organizations and applications. 

As defined by HealthIT, the core benefits of using FHIR resources are the following: 

  • Swift implementation. Developers have successfully implemented straightforward interfaces within a single day.
  • Free of charge. The usage of these tools comes at no cost.
  • Unrestricted usage. There are no limitations or restrictions on utilizing these tools.
  • An abundance of free, online, and downloadable tools. Numerous resources are available for free online and can be easily downloaded.
  • Public examples for inspiration. Publicly available models can be a solid foundation for developing new applications.
  • Flexible customization options. Base resources can be used as-is or modified to align with specific local requirements.
  • Comprehensible online specifications. The specifications are readily understandable and accessible online.
  • Human-readable serialization format. The format allows for easy reading and comprehension by individuals.
  • Supportive global community. A worldwide community is present to offer assistance and support.

FHIR benefits extend beyond the technical realm, leading to improved patient care, enhanced healthcare delivery, and greater collaboration among healthcare stakeholders.

What Are the Core Principles Behind FHIR Resource Design Choices?

FHIR resources help in achieving interoperability on different devices

All of these principles are a part of the FHIR bundle. They provide healthcare software developers with a convenient and easily available set of tools for achieving the primary goal of the specification – data interoperability. And healthcare facilities can achieve interoperability through well-structured data models and efficient data exchange mechanisms. To accomplish this goal, FHIR incorporates the following principles:

  1. Reuse. FHIR R4 resources are designed to fulfill the general requirements of healthcare, avoiding unnecessary complexity and redundancy. Extensions and customizations allow the adaptation of resources for specific use cases through the Profiling process. Additionally, resources can link to other resources, enabling the creation of more intricate structures.
  2. Performance. Compared to previous standards, FHIR R4 resources are constructed more simply, making them more suitable for network exchange. This simplicity also contributes to easier comprehension and implementation by developers.
  3. Usability. FHIR resources are designed to be understandable by technical experts and non-technical individuals. Non-technical users can view the contents of resources in a browser or text reader without comprehending the underlying XML/JSON format.
  4. Fidelity. FHIR resources enforce strict restrictions on mixing values with different data types, such as strings and numeric values. They can be validated not only by syntax but also against predefined business rules.
  5. Implementability. A central objective of FHIR is to foster broad adoption within diverse developer communities. FHIR R4 resources are designed to be easily understood and readily exchanged using industry standards, common programming languages, and established data exchange technologies.

Take the first step towards data interoperability with FHIR — reach out to us and discover the best practices.

Resource Data Formats

FHIR solutions are constructed using modular components called resources, which represent healthcare data and can be easily combined to address real-world clinical and administrative challenges. 

Resources are crucial in a detailed depiction of data at the instance level. They serve to exchange, store, and manage data effectively. FHIR resource types encompass the following essential data formats:

  • URL. Each resource is identified by a unique URL, enabling precise identification and referencing.
  • Metadata. Metadata associated with resources assists in search operations and cataloging, facilitating efficient retrieval and management of data.
  • XHTML summary. An XHTML summary is provided to enable individuals to quickly comprehend the resource’s content.
  • Definitions. Resources include definitions for their data elements, ensuring clarity and consistency in understanding and interpretation.
  • Extensibility framework. FHIR incorporates an extensibility framework explicitly tailored for healthcare, allowing the extension and customization of resources to accommodate specialized requirements.

Approximately 150+ FHIR resource types are typically available in XML, JSON, or RDF/Turtle formats. These resources adhere to formal definitions and logical structures, including matching standards like RIM (Reference Information Model) and other relevant formats.

To learn more about other FHIR resources that allow for developing healthcare applications for patients, check out the insights from our Epic on FHIR experts.

Attributes of FHIR Resource Types 

In addition to the essential elements mentioned earlier, resources encompass common and resource-specific metadata attributes. FHIR resources are designed to facilitate storing and exchanging clinical and administrative data. And the ultimate goal is to establish a flexible framework that can be interpreted by any system, accommodating a wide range of applications such as mobile apps, cloud communications, electronic health records (EHRs), and more. 

Resources are built upon the following underlying structures:

  1. XML: FHIR resources can be represented and serialized in XML format, conforming to XML-based standards.
  2. JSON: FHIR resources can also be expressed and serialized in JSON format, adhering to JSON-based standards.
  3. HTTP: FHIR leverages the HTTP protocol as a means of communication, enabling the exchange and retrieval of resources between systems.
  4. Atom: The Atom syndication format is utilized by FHIR to support publishing and subscribing to resource feeds, facilitating real-time updates and notifications.
  5. OAuth: FHIR incorporates the OAuth protocol for secure authentication and authorization, ensuring controlled resource access.

By embracing these structures, FHIR provides a versatile and interoperable framework that can be implemented across diverse systems and applications. 

See how you can secure data access with SMART on FHIR used by the team of expert developers.

Mapping Healthcare Data to HL7 FHIR Resources

One of the major problems with FHIR implementation is mapping healthcare data to a format compliant with HL7 FHIR standards. Although complex, resource mapping transforms any clinical resource into an FHIR format.  

Resource mapping helps address the challenges of health data interoperability

What Is an FHIR Mapping and How Does It Work?

When it comes to matching fields between databases, the process of aligning the data is called data mapping. In the context of FHIR specifications, data mapping involves converting your existing data into FHIR resources. For instance, you may have a Patient resource stored in a database in a specific format but need it in an FHIR-compliant format. And manually handling this task would be laborious, time-consuming, and expensive if data analysts do that.

Fortunately, there is a more efficient approach. You can automate the mapping of healthcare data to the FHIR resource list by utilizing FHIR mapper tools. It can streamline the process and eliminate the need for manual intervention. Employing an FHIR mapper can effectively convert your data to the desired FHIR format, saving significant time and cost resources.

The process of FHIR mapping
Figure 2. The process of FHIR mapping

Our team has experience creating customized FHIR mapping tools that leverage resource templates, which data analysts can easily tailor to meet specific requirements. These templates serve as a flexible foundation for mapping data to FHIR resources.

The Process Behind the FHIR Patient Resource Mapping  

HL7 has introduced the FHIR Mapping Language to address the need for mapping content from one structured source data format to another. This language offers a solution for various use cases, including:

  • Mapping FHIR resources between different versions of FHIR.
  • Mapping sections of HL7 C-CDA CCD documents to multiple FHIR resources.
  • Mapping HL7 V2 messages to the FHIR resource list.
  • Mapping any structured data format to any other format, including mapping multiple FHIR resources.

By utilizing the FHIR Mapping Language, healthcare organizations can efficiently transform and map data across different formats, enabling seamless interoperability and data exchange within the healthcare ecosystem. The FHIR Mapping language offers multiple avenues for utilization. It can be directly executed or translated into another programming language.

A mapping engine is employed to carry out transformations, and various options are available for implementing it effectively. There are several code libraries to choose from:

Mapping Code Libraries

The FHIR Mapping Language can be implemented using various code libraries, each providing a transform engine.

Java:

  • HAPI FHIR – HL7 FHIR Core: The transform engine can be found in the package org.hl7.fhir.r5.utils.StructureMapUtilities. Alternatively, you can use the service wrapper org.hl7.fhir.r5.validation.NativeHostServices. The versioning convention is generally org.hl7.fhir.rX.utils.StructureMapUtilities.

Pascal:

  • FHIR.R4.MapUtilities: This code library is generally referred to as rX/FHIR.RX.MapUtilities and offers a transform engine for the FHIR Mapping Language in Pascal.

JavaScript:

  • fhir-kit-mapping-language: This JavaScript library implements the FHIR Mapping Language, offering a transform engine for FHIR mappings.

C#:

  • FHIR Mapper: This closed-source library is no longer available for use.
  • fhir-net-mappinglanguage (NuGet package): This is a C# implementation of the FHIR Mapping Language, which is compatible with the Firely .NET SDK. It offers a transform engine for executing FHIR mappings.

These code libraries are valuable resources for implementing the FHIR Mapping Language in different programming languages, facilitating seamless data transformation and mapping within the FHIR ecosystem.

Analyze the similarities and differences between HL7 and FHIR and explore the role of both in improving healthcare data interoperability.

Web Services

FHIR servers can incorporate custom operations for executing transformations using the FHIR Mapping Language. Typically, the workflow for these transformations can be divided into two distinct phases — mapping authoring and mapping execution:

FHIR Mapping Language workflow diagram
Figure 3. FHIR Mapping Language workflow diagram

Naturally, it takes a team of experts to know all the ins and outs of the FHIR provider resource mapping process and experience to execute the mapping properly. 

How a Reliable Partner Assists in Healthcare Data Interoperability

Enabling healthcare data interoperability serves many purposes and caters to various stakeholders. Taking proactive measures to ensure seamless interoperability is imperative, resulting in improved health outcomes and enhanced patient experiences. 

Different measures, such as cloud solutions and the use of a well-planned approach and standardized terminology, are crucial for achieving interoperability. But the most important factor is your partnership with a reliable technology provider.

Collaborating with a reliable healthcare software development partner is vital for achieving healthcare interoperability. That ensures the safeguarding of data and the ability of the software to meet the rigorous demands of the healthcare industry. By choosing an experienced partner, you can ensure the system is meticulously designed, rigorously tested, and adheres to stringent security protocols and industry standards.

A proficient vendor also brings valuable expertise and knowledge to provide ongoing support and maintenance for the software, ensuring its optimal performance and reliability. At SPsoft, we offer a cost-effective solution for healthcare interoperability that fulfills all requirements while upholding the highest quality standards.

Final Thoughts

Standards are the foundation for systems and processes, establishing agreed-upon rules and formats. Non-standardized and outdated data formats, in turn, pose significant challenges to achieving seamless interoperability in healthcare. However, the right team of experts can address data mapping in the healthcare domain. Our team has experience developing user-friendly data mapping tools designed explicitly for HL7 FHIR. Such tools provide a simple and practical solution to the interoperability challenge in the healthcare sector.

At SPsoft, we aim to alleviate the burden that healthcare organizations frequently encounter when adopting FHIR. We can simplify working with FHIR and enable healthcare organizations to overcome the complexities associated with data mapping, fostering a smoother transition to FHIR adoption.

Ready to deal with the complexities of FHIR compliance and data interoperability? Contact us today for expert guidance.

FAQ

How many resources are there in FHIR?

In the most recent release of FHIR (version 5), there are 153 resources. The FHIR specification is a dynamic and evolving standard, constantly undergoing active development. Consequently, new resources are consistently being added to enhance its capabilities.

What are the three main components of FHIR?

The development of FHIR revolves around three key components: resources, references, and profiles. These components form the core aspects of FHIR’s framework.

What are the basics of FHIR?

FHIR is a standard for exchanging healthcare information electronically. Its basics include resources representing specific healthcare concepts, such as patients, practitioners, medications, and observations. FHIR also provides APIs for seamless data exchange between systems and incorporates standardized terminologies for consistent healthcare data representation. FHIR aims to enable interoperability, making sharing and integrating healthcare information easier across different healthcare systems and applications.

What does FHIR R4 stand for?

FHIR R4, or Release #4, refers to the previous specification version. It represents the previous version of the FHIR standard.

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