Towards achieving semantic interoperability of clinical study data with FHIR

Abstract

BackgroundObservational clinical studies play a pivotal role in advancing medical knowledge and patient healthcare. To lessen the prohibitive costs of conducting these studies and support evidence-based medicine, results emanating from these studies need to be shared and compared to one another. Current approaches for clinical study management have limitations that prohibit the effective sharing of clinical research data.MethodsThe objective of this paper is to present a proposal for a clinical study architecture to not only facilitate the communication of clinical study data but also its context so that the data that is being communicated can be unambiguously understood at the receiving end. Our approach is two-fold. First we outline our methodology to map clinical data from Clinical Data Interchange Standards Consortium Operational Data Model (ODM) to the Fast Healthcare Interoperable Resource (FHIR) and outline the strengths and weaknesses of this approach. Next, we propose two FHIR-based models, to capture the metadata and data from the clinical study, that not only facilitate the syntactic but also semantic interoperability of clinical study data.ConclusionsThis work shows that our proposed FHIR resources provide a good fit to semantically enrich the ODM data. By exploiting the rich information model in FHIR, we can organise clinical data in a manner that preserves its organisation but captures its context. Our implementations demonstrate that FHIR can natively manage clinical data. Furthermore, by providing links at several levels, it improves the traversal and querying of the data. The intended benefits of this approach is more efficient and effective data exchange that ultimately will allow clinicians to switch their focus back to decision-making and evidence-based medicines.Electronic supplementary materialThe online version of this article (doi:10.1186/s13326-017-0148-7) contains supplementary material, which is available to authorized users.

Current applications and future directions for the CDISC Operational Data Model standard: A methodological review

“…The ODM specification does not include the means to automatically retrieve information using web services, as is the case in HL7 FHIR [101]. Leroux et al [102] made a comparison and mapping between HL7 FHIR and CDISC ODM with the goal of achieving semantic interoperability between clinical research and healthcare. They present an approach to integrating ODM with FHIR leading to a mapping of hierarchical ODM ClinicalData elements to a set of FHIR resources [102].…”

“…Leroux et al [102] made a comparison and mapping between HL7 FHIR and CDISC ODM with the goal of achieving semantic interoperability between clinical research and healthcare. They present an approach to integrating ODM with FHIR leading to a mapping of hierarchical ODM ClinicalData elements to a set of FHIR resources [102]. Adding RESTful web services support to ODM and specifying a standardized web services API for the incremental exchange of ODM content would advance the state of practice today.…”

“…Adding RESTful web services support to ODM and specifying a standardized web services API for the incremental exchange of ODM content would advance the state of practice today. Future ODM research and development would benefit by an examination of the HL7 FHIR approach to supporting RESTful interfaces, document-oriented aggregation, and semantic interoperability [98, 102]. …”

Semantic Integration of Clinical Laboratory Tests from Electronic Health Records for Deep Phenotyping and Biomarker Discovery

“…Recent advances in the standardization of EHR systems and phenotyping ontologies make it feasible to extract patient phenotypes from laboratory tests at a large scale. The Fast Healthcare Interoperability Resource (FHIR) was introduced in 2013 and provides a standardized interface to individual EHR systems for healthcare-related data 7 . FHIR separates healthcare-related data into granular components as "resources" such as observation, medication, patient identity and insurance claims, that have a standard definition and associated semantic bindings that can be computationally integrated even when they are created by different methods and organizations.…”

Experience in Developing an FHIR Medical Data Management Platform to Provide Clinical Decision Support

“…This definition demonstrates the variety and evolution of clinical decision support from small, focused applications to large-scale platforms capable of storing and managing medical data to assist doctors and patients by delivering recommendations [8,9].To provide efficient decision support, it is necessary to integrate CDSSs in information systems routinely operated by healthcare professionals, such as hospital information systems (HIS), or by patients deploying their personal health records (PHRs) [10]. CDSSs should be able to use the semantics and the clinical context of the data that were imported from other systems and data repositories [11][12][13].Semantic interoperability becomes a key issue when it comes to communication between heterogeneous information systems [14]. One of the ways to connect different information systems is to build a platform that processes standard-based medical data and provides unified interfaces.…”