Fast Healthcare Interoperability Resources (FHIR)-Based Interoperability Design in Indonesia: Content Analysis of Developer Hub’s Social Networking Service (Preprint)

Abstract

Background: Interoperability in healthcare is a critical aspect for the exchange of health information. The Fast Healthcare Interoperability Resources (FHIR) framework has become widely adopted to provide interoperable data exchange in the healthcare industry. The COVID-19 pandemic has demonstrated the significance of interoperable data in tracking patients who have contracted the virus and keeping track of the vaccinated population. Indonesia is one of the many countries that have implemented interoperable data systems to track COVID-19 patients, and it has aspirations to expand the system to other use cases, particularly in the primary healthcare setting. The primary healthcare providers in Indonesia include Puskesmas (community health centers) and private clinics.Objective: To promote interoperable health data exchange in the primary healthcare sector, the Indonesian government has launched the Satusehat project. The goal of the Satusehat platform is to make health data in Indonesia interoperable and exchangeable between healthcare organizations, particularly Puskesmas and private clinics.Methods: For a successful implementation of the Satusehat platform in Puskesmas and private clinics, it is crucial to understand the challenges that may arise. This study analyzed the pain points of the Satusehat platform based on a content analysis of the Satusehat Social Networking Service (SNS) Telegram group messages. The study revealed the pain points and suggested existing approaches to address them, which can be used as a proposed design of interoperability for Puskesmas and private clinics, making it easier for these organizations to adopt the Satusehat platform. Results:The pain points identified in this study include issues with the FHIR server, problems with FHIR profile selection, and the mapping of EMR data into standardized data, such as mapping into the SNOMED-CT terminology. To address these issues, the study proposed practical approaches, including a federated architecture for the FHIR server instead of a centralized architecture, a FHIR writer and FHIR viewer system inspired by the Standardized Structured Medical Record Information eXchange (SS-MIX) system in Japan, and a FHIR conversion framework that integrates with our FHIR writer and FHIR viewer system.Conclusions: These proposed solutions can help resolve the pain points identified in the study and ensure the successful implementation of the Satusehat platform in Puskesmas and private clinics in Indonesia.