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Reducing FHIR "Profiliferation": A Data-Driven Approach.

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Summary
This summary is machine-generated.

The rapid growth of Fast Healthcare Interoperability Resources (FHIR) profiles reveals a high dependency on customization. Inconsistent use of FHIR resources like Observation suggests a need for better management and standardized profiling practices.

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Area of Science:

  • Health Informatics
  • Health Data Standards
  • Healthcare Interoperability

Background:

  • Fast Healthcare Interoperability Resources (FHIR) enables healthcare data customization through profiles.
  • The proliferation of FHIR profiles, termed "Profiliferation," indicates rapid adoption and customization.
  • Understanding FHIR profile usage patterns is crucial for assessing its practical implementation and interoperability.

Purpose of the Study:

  • To analyze usage patterns of nearly 3000 FHIR profiles from 125 implementation guides.
  • To determine the extent of FHIR's dependency on profiling for specific use cases.
  • To identify inconsistencies in FHIR resource utilization, particularly the Observation resource.

Main Methods:

  • Systematic review of a large sample of FHIR profiles (approx. 3000) across 125 implementation guides.
  • Quantitative analysis of profile usage frequency to identify dominant resources and patterns.
  • Assessment of FHIR's 80/20 rule adherence based on observed profiling practices.

Main Results:

  • Two elements, Observation and Extension, constitute approximately 50% of all analyzed FHIR profiles.
  • FHIR's actual usage pattern is closer to a 65/35 rule, indicating greater reliance on profiling than anticipated.
  • Significant inconsistencies were found in the utilization of the FHIR Observation resource.

Conclusions:

  • FHIR demonstrates a higher dependency on profiling than initially projected, with Observation and Extension being heavily utilized.
  • Inconsistent use of FHIR resources, especially Observation, highlights challenges in standardization.
  • Recommendations include improved management of reusable components and revised FHIR profiling practices to enhance consistency and reduce incompatible profiles.