Developing a shared sepsis data infrastructure: a systematic review and concept map to FHIR.

Area of Science:

• Health Informatics
• Clinical Research
• Public Health

Background:

• Shared data infrastructure is crucial for advancing research, clinical care, and health policy, especially for diseases like sepsis.
• The COVID-19 pandemic highlighted the need for real-time, interoperable data networks to effectively manage public health crises.
• Existing electronic health record systems often lack interoperability, hindering data sharing and collaborative efforts.

Purpose of the Study:

• To establish a dynamic, federated, and interoperable system for sharing sepsis data from multiple hospitals.
• To identify and map essential clinical variables for defining sepsis and its subtypes using Fast Healthcare Interoperability Resources (FHIR).
• To create a framework for a flexible data-sharing infrastructure applicable to sepsis and other public health conditions.

Main Methods:

• Conducted a systematic review of 55 manuscripts to identify clinical variables for sepsis definitions.
• Excluded studies not in English, published before 1970, or grey literature.
• Mapped identified clinical variables to US Core FHIR resources and specific code values.

Main Results:

• Identified 151 unique clinical variables relevant to sepsis definitions and subtypes.
• Successfully mapped these variables to corresponding FHIR resources and code values.
• Established a conceptual framework for an interoperable sepsis data infrastructure.

Conclusions:

• The Sepsis on FHIR collaboration provides a foundational framework for a flexible sepsis data-sharing infrastructure.
• Utilizing FHIR enables the standardization and interoperability of clinical data across diverse healthcare systems.
• This approach has the potential to be extended to other critical public health conditions, improving data accessibility and utilization.