Journal:Implement an international interoperable PHR by FHIR: A Taiwan innovative application
Full article title | Implement an international interoperable PHR by FHIR: A Taiwan innovative application |
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Journal | Sustainability |
Author(s) | Lee, Yen-Liang; Lee, Hsiu-An; Hsu, Chien-Yeh; Kung, Hsin-Yeh; Chiu, Hung-Wen |
Author affiliation(s) |
Taipei Medical University, Chunghwa Telecom Laboratories, Tamkang University, Smart Healthcare Center of Excellence, National Taipei University of Nursing and Health Sciences |
Primary contact | hwchiu at tmu dot edu dot tw |
Year published | 2020 |
Volume and issue | 13(1) |
Article # | 198 |
DOI | 10.3390/su13010198 |
ISSN | 2071-1050 |
Distribution license | Creative Commons Attribution 4.0 International |
Website | https://www.mdpi.com/2071-1050/13/1/198/htm |
Download | https://www.mdpi.com/2071-1050/13/1/198/pdf (PDF) |
This article should be considered a work in progress and incomplete. Consider this article incomplete until this notice is removed. |
Abstract
Personal health records (PHRs) have many benefits for things such as health surveillance, epidemiological surveillance, self-control, links to various services, public health and health management, and international surveillance. The implementation of an international standard for interoperability is essential to accessing PHRs. In Taiwan, the nationwide exchange platform for electronic medical records (EMRs) has been in use for many years. The Health Level Seven International (HL7) Clinical Document Architecture (CDA) was used as the standard for those EMRs. However, the complication of implementing CDA became a barrier for many hospitals to realizing standard EMRs.
In this study, we implemented a Fast Healthcare Interoperability Resources (FHIR)-based PHR transformation process, including a user interface module to review the contents of PHRs. We used “My Health Bank” (MHB), a PHR data book developed and issued to all people by the Taiwan National Health Insurance, as the PHRs' contents in this study. Network Time Protocol (NTP)/Simple Network Time Protocol (SNTP) was used in the security and user authentication mechanism when processing and applying personal health information. Transport Layer Security (TLS) 1.2 (such as HyperText Transfer Protocol Secure or HTTPS) was used for protection in data communication. User authentication is important in the platform. OAuth (OAuth 2.0) was used as a user authentication mechanism to confirm legitimate user access to ensure data security. The contents of MHB were analyzed and mapped to FHIR, and then converted to FHIR format according to the mapping logic template. The function of format conversion was carried out by using ASP.NET. XPath and JSPath technologies filtered out specific information tags. The converted data structure was verified through an HL7 application programming interface (HAPI) server, and a new JSON file was finally created.
This platform can not only capture any PHR based on the FHIR format but also publish FHIR-based MHB records to any other platform to bridge the interoperability gap between different PHR systems. Therefore, our implementation/application with the automatic transformation from MHB to FHIR format provides an innovative method for people to access their own PHRs through MHB. No one has published a similar application like us using a nationwide PHR standard, MHB, in Taiwan. The application we developed will be very useful for a single person to use or for other system developers to implement their own standard PHR software.
Keywords: FHIR, interoperability, PHR, data management, precision health management
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This presentation is faithful to the original, with only a few minor changes to presentation. In some cases important information was missing from the references, and that information was added.