Point-of-care medical devices and systems interoperability: A mapping of ICE and FHIR

Abstract

Medical devices at the point-of-care can be interconnected through standardised communication protocols to build an Integrated Clinical Environment (ICE), but in order to interoperate with clinical information systems, different data exchange standards need to be conformed to. The emerging HL7 Fast Healthcare Interoperability Resources (FHIR) framework appeals to developers and clinicians alike and is a promising candidate to modernise this domain. Novel IEEE 11073 standard proposals that specify a service-oriented architecture of networked medical devices are one example for an ICE architecture. They are based on expressing a device's capabilities and state in a machine-readable way in order to be safely accessed and manipulated by other participants in the networked device system. In this work, the domain information and service model of this ICE architecture was mapped to FHIR resources that were constrained and extended to support the modelling of this device architecture. Through the definition of a FHIR profile, the data structures were aligned, effectively allowing for the transformation of medical device observation data from ICE to FHIR representation without the need for any proprietary interface. The implementation of this transformation, e. g. as a gateway, bridges the structural interoperability gap between two contemporary communication architectures for medical devices and clinical information systems and thus lays the foundation for semantic interoperability that can be achieved through the combined use with controlled vocabularies. The consequent availability of device data enables secondary usage such as large-scale data analytics. Future sub-profiles for specific device types further simplify the transformation.