Abstract
Fast Healthcare Interoperability Resources (FHIR) is an open interoperability standard that allows external software to quickly search for and access clinical information from the electronic medical record (EMR) in a method that is developer-friendly, using current internet technology standards. In this article, we highlight the new FHIR standard and illustrate how FHIR can be used to offer the field of radiology a more clinically integrated and patient-centered system, opening the EMR to external radiology software in ways unfeasible with traditional standards. We explain how to construct FHIR queries relevant to medical imaging using the Society for Imaging Informatics in Medicine (SIIM) Hackathon application programming interface (API), provide sample queries for use, and suggest solutions to offer a patient-centered, rather than an image-centered, workflow that remains clinically relevant.
Highlights
The field of radiology has been increasingly challenged by balancing multiple software platforms which often separate the picture archiving and communication system (PACS) from the electronic medical record (EMR)
Another study concluded there is Ban alarming lack of communication of pertinent medical information to the radiologist,^ requiring the radiologist to be able to access the EMR since awareness of important clinical information demonstrates a clear impact on the quality of radiologic interpretation [2]
Samples from the 2016 Society for Imaging Informatics in Medicine (SIIM) Hackathon are included in Fig. 3a–c and illustrate what a fully integrated system with Fast Healthcare Interoperability Resources (FHIR) and DICOMWeb could look like in the radiology workplace
Summary
The field of radiology has been increasingly challenged by balancing multiple software platforms which often separate the picture archiving and communication system (PACS) from the electronic medical record (EMR). Accessing DICOM information to allow for image retrieval from the appropriate DICOM server Obtaining basic information such as date of birth and gender http://api.hackathon.siim.org/fhir/DiagnosticOrder?status= requested&code=24627-2 Queries like this can be used to generate radiology worklists and can serve to dynamically compute metrics such as the number of pending studies. Accessing the Patient resource can be done as: http://api.hackathon.siim.org/fhir/Patient/123 This query will provide basic information such as the patient’s gender and date of birth. A query for the last clinical note written by the ordering provider of the study could be performed via: In this query, Observation is the resource that contains the results of laboratory data, 123 refers to the patient’s identifier, and 2160-0 is the LOINC code for creatinine. Retrieving the patient’s allergies can be performed with the patient identifier parameter on the AllergyIntolerance resource: where ClinicalImpression is a resource in development for storing clinical notes
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