An FHIR-based Framework for Consolidation of Augmented EHR from Hospitals for Public Health Analysis

Abstract

Health Information Exchanges (HIEs) are the infrastructures for sharing health data between providers, patients, health agencies, researchers and other stakeholders. One of the important stakeholders are the public health policy makers or departments that can base their valuable decisions on real time Electronic Health record (EHR) data in addition to traditional surveillance data. Our proposed framework provides support to public health data systems to integrate data from a heterogeneous EHR and other sources, and consolidate them for public health analysis or mining. Models are created for both hospital EHR and FHIR formats and automated transformations are created to convert EHR to Public Health Record (PHR). This framework provides staff in public health departments a consolidated picture of a population's health based on individual EHR and contextual information such as social, economic, environmental and epidemiology elements. Unlike existing frameworks, this research proposes an infrastructure that sends complete longitudinal story of health record of public health interest instead of aggregated information. The framework also obviates the need for a single EHR format to be followed at every participating healthcare facility. This is done through an adapter at each site. This framework provides a comprehensive means of support for public health agencies to identify the determinants of health based on ground truth when considering priority populations and using EHR data and contextual information to focus public health action.