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Related Experiment Video

Updated: Jul 1, 2025

Real-time Cytotoxicity Assays in Human Whole Blood
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Real world performance of the 21st Century Cures Act population-level application programming interface.

James R Jones1, Daniel Gottlieb1,2, Andrew J McMurry1,3

  • 1Computational Health Informatics Program, Boston Children's Hospital, Boston, MA 02215, United States.

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|March 6, 2024
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.

Keywords:
computerizedhealth information interoperabilityhealth information systemsmedical informaticsmedical records systemspublic health informatics

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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.