An HL7 FHIR and GraphQL approach for interoperability between heterogeneous Electronic Health Record systems

Heterogeneities in data representation and care processes create interoperability complexity among Electronic Health Record systems (EHRs). We can resolve such data and process level heterogeneities by following consistent healthcare standards like Clinical Document Architecture (CDA), OpenEHR, and HL7 FHIR. However, these standards also differ at the structural and implementation level, making interoperability more complex. Hence, there is a need to investigate mechanisms that can resolve data level heterogeneity to achieve semantic data interoperability between heterogeneous systems. As a solution to this, we offer an architecture that utilizes a resource server based on GraphQL and HL7 FHIR that establishes communication between two heterogeneous EHRs. This paper describes how the proposed architecture is implemented to achieve interoperability between two heterogeneous EHRs, HL7 FHIR and OpenMRS. The presented approach establishes secure communication between the EHRs and provides accurate mappings that enable timely health information exchange between EHRs.