Real world performance of the 21st Century Cures Act population-level application programming interface
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View abstract on PubMed
Summary
This summary is machine-generated.The SMART/HL7 Bulk Fast Health Interoperability Resources (FHIR) API shows potential for large-scale health data access. However, performance varies, with custom solutions outperforming certified electronic health record platforms, highlighting a need for optimization.
Area Of Science
- Health Informatics
- Health Data Interoperability
- Health Information Exchange
Background
- The 21st Century Cures Act mandates improved access to electronic health record (EHR) data.
- SMART/HL7 Bulk Fast Health Interoperability Resources (FHIR) API was developed to facilitate large-scale data access.
- Real-world performance evaluation is crucial for widespread adoption and effectiveness.
Purpose Of The Study
- To evaluate the real-world performance of the SMART/HL7 Bulk FHIR Access API.
- To assess its capability in enabling push-button access to EHR data for large populations.
- To identify performance benchmarks and areas for improvement.
Main Methods
- Utilized an open-source Bulk FHIR Testing Suite across 5 healthcare sites (April-September 2023).
- Included 4 hospitals with certified EHRs and 1 Health Information Exchange (HIE) with a custom API.
- Measured export speeds, data volumes, and completeness for 6 FHIR resource types.
Main Results
- Oracle Cerner demonstrated speeds of over 8000 resources/min for 5-16 million resources.
- Epic sites achieved 1555-2500 resources/min for 1-12 million resources.
- The HIE's custom API significantly outperformed, generating over 141 million resources at 12,000 resources/min.
Conclusions
- The HIE's custom API demonstrated superior performance, validating Bulk FHIR for large-scale data exchange.
- Existing EHR platforms require optimization to meet performance demands.
- Addressing Bulk FHIR API performance limitations is critical for achieving Cures Act interoperability goals.
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