Abstract
BackgroundInformation technology has shifted paper-based documentation in the health care sector into a digital form, in which patient information is transferred electronically from one place to another. However, there remain challenges and issues to resolve in this domain owing to the lack of proper standards, the growth of new technologies (mobile devices, tablets, ubiquitous computing), and health care providers who are reluctant to share patient information. Therefore, a solid systematic literature review was performed to understand the use of this new technology in the health care sector. To the best of our knowledge, there is a lack of comprehensive systematic literature reviews that focus on Fast Health Interoperability Resources (FHIR)-based electronic health records (EHRs). In addition, FHIR is the latest standard, which is in an infancy stage of development. Therefore, this is a hot research topic with great potential for further research in this domain.ObjectiveThe main aim of this study was to explore and perform a systematic review of the literature related to FHIR, including the challenges, implementation, opportunities, and future FHIR applications.MethodsIn January 2020, we searched articles published from January 2012 to December 2019 via all major digital databases in the field of computer science and health care, including ACM, IEEE Explorer, Springer, Google Scholar, PubMed, and ScienceDirect. We identified 8181 scientific articles published in this field, 80 of which met our inclusion criteria for further consideration.ResultsThe selected 80 scientific articles were reviewed systematically, and we identified open questions, challenges, implementation models, used resources, beneficiary applications, data migration approaches, and goals of FHIR.ConclusionsThe literature analysis performed in this systematic review highlights the important role of FHIR in the health care domain in the near future.
Highlights
BackgroundIn 2011, the proponent of Australian Health Level Seven (HL7) standards, Grahame Grieve, proposed an interoperability approach called Resources for Healthcare (RFH) as a new standard for better interoperability in digital health
We considered the categories of general Fast Health Interoperability Resources (FHIR) implementation [48,59], using Substitutable Medical Applications Reusable Technologies (SMART) on FHIR [3,14,22,31], HL7 application programming interface clinical document architecture (CDA) (API) (HAPI)-FHIR server/library/applications [14,16,20,32,34,35,36,40,43,51,54,55,73,76,81,82], and FHIR general framework [14,40,78]
This study provides a systematic literature review regarding the FHIR electronic health record FHIR (EHR) standard, with the main objective of identifying and discussing the main issues, challenges, goals, and possible benefits from adoption of the FHIR standard in the health care sector
Summary
BackgroundIn 2011, the proponent of Australian Health Level Seven (HL7) standards, Grahame Grieve, proposed an interoperability approach called Resources for Healthcare (RFH) as a new standard for better interoperability in digital health. FHIR uses components called resources to access and perform operations on patient health data at the granular level. This feature makes FHIR a unique standard from all other standards because it was not available in all previous versions of HL7 (v2, v3) or the HL7 clinical document architecture (CDA). A solid systematic literature review was performed to understand the use of this new technology in the health care sector. Objective: The main aim of this study was to explore and perform a systematic review of the literature related to FHIR, including the challenges, implementation, opportunities, and future FHIR applications. Results: The selected 80 scientific articles were reviewed systematically, and we identified open questions, challenges, implementation models, used resources, beneficiary applications, data migration approaches, and goals of FHIR. Conclusions: The literature analysis performed in this systematic review highlights the important role of FHIR in the health care domain in the near future
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