Migration from HL7 Clinical Document Architecture (CDA) to Fast Health Interoperability Resources (FHIR) in Infectious Disease Information System of Estonia

Abstract

Objective: Many countries have successfully implemented HL7 V3 and CDA (Clinical Document Architecture) standards to ensure document-based interoperability between EHRs (Electronic Health Records), registries, and healthcare institutions [26] [32] [5]. The biggest drawback of the HL7 CDA document-based approach is the timing of sharing the information. The document is generally shared once all the agreed data elements have been precisely filled in and the necessary confirmations received. Today, Estonia is transitioning the Estonian National Health Information System (ENHIS) from a document-based approach to an event-based approach by utilising the HL7 FHIR (Fast Healthcare Interoperability Resources) standard. During this transition, one of the tasks is to describe the patient's socioeconomic status according to the FHIR profile.