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The inception of EHR has shown a lot of potentials and virtually eliminated the drawbacks of paper-based medical notes. However, the transition has not been seamless due to various technical and political drawbacks. One of the major technical challenges is interoperability. The biomedical community has established various structural and semantic standards to capture and share medical data across heterogeneous systems such as ASTM Community Care Record, Health Level 7 (HL7) Clinical Care Document, etc. The HL7 organization has recently published Fast Health Interoperability Resources (FHIR) – a standard to improve interoperability, overcome shortcomings of the previous standard and integrate lightweight web services. This article provides an overview of HL7 FHIR, its concepts and literature review on its current status, usage, and adoption. Based on the thorough research and literature review, the authors strongly believe that FHIR can bridge interoperability gap between the growing number of disparate and variety of healthcare entities.

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BACKGROUND: Virtual reality (VR) use as a platform for vestibular rehabilitation is widespread. However, the utility of VR based vestibular assessments remains unknown. OBJECTIVE: To compare dynamic visual acuity (DVA) scores, perceived balance, and perceived dizziness when using traditional versus VR environments for DVA testing among healthy individuals. METHODS: DVA testing occurred for both a traditional clinical protocol and in a VR variant. Horizontal, vertical, and no head motion conditions were conducted for both clinical and VR test protocols. DVA scores, balance ratings, and dizziness ratings were obtained per condition. Two-way ANOVAs with repeated measures were used to assess differences in DVA scores, balance, and dizziness ratings. RESULTS: No differences in DVA results, balance or dizziness ratings were observed when comparing traditional clinical protocol versus the VR variant. Differences across head motion conditions were observed, with no motion trials exhibiting significantly higher DVA scores and perceived balance, and lower perceived dizziness compared to vertical and horizontal head motion. Vertical head motion exhibited this same trend compared to horizontal. CONCLUSION: DVA testing conducted in VR demonstrated clinical utility for each measure. Effects of head motion were similar across test variants, indicating DVA testing in VR produces similar effects on vestibular function than traditional clinical testing. Additional research should be conducted to assess the feasibility of VR assessment in individuals with vestibular disorder.

The Unified Medical Language System (UMLS) is an internationally recognized medical vocabulary that enables semantic interoperability across various biomedical terminologies. To use its knowledge, the users must understand its complex knowledge structure, a structure that is not interoperable or is not compliant with any known biomedical and healthcare standard. Further, the users also need to have good technical skills to understand its inner working and interact with UMLS in general. These barriers might cause UMLS usage concerns among inter-disciplinary users in biomedical and healthcare informatics. Currently, there exists no terminology service that normalizes UMLS’s complex knowledge structure to a widely accepted interoperable healthcare standard and allows easy access to its knowledge, thus hiding its workings. The objective of this research is to design and implement a light-weight terminology service that allows easy access to UMLS knowledge structured using the fast health interoperability resources (FHIR) standard, a widely accepted interoperability healthcare standard. The developed terminology service, named UMLS FHIR, leverages FHIR resources and features, and can easily be integrated into any application to consume UMLS knowledge in the FHIR format without the need to understand UMLS’s native knowledge structure and its internal working.

Abstract. To facilitate collaboration in the patient-centered medical home (PCMH), our prior work extended the NIST role-based access control (RBAC) model to yield a formal collaboration on duty and adaptive workflow (COD/AWF) model. The next logical step is to place this work into the context of an integrated software process for security engineering from design through enforcement. Towards this goal, we promote a secure software engineering process that leverages an extended unified modeling language (UML) to visualize COD/AWF policies to achieve a solution that separates concerns while still providing the means to securely engineer dynamic collaborations for applications such as the PCMH. Once defined, these collaboration UML diagrams can be utilized to generate the corresponding aspect oriented policy code upon which the enforcement mechanism can be applied to at runtime.

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