Networking Aspects of the Electronic Health Records: Hypertext Transfer Protocol Version 2 (HTTP/2) vs HTTP/3.

Area of Science:

• * Digital Health
• * Network Protocols
• * Health Informatics

Background:

• * Digital healthcare and Electronic Health Records (EHR) rely on robust networking for data access.
• * The Hypertext Transfer Protocol (HTTP)/3 standard promises performance and security enhancements over HTTP/2.
• * Current digital health systems often lack the implementation of newer, more efficient protocols like HTTP/3.

Purpose of the Study:

• * To evaluate and compare the performance of HTTP/2 and HTTP/3 protocols in the context of EHR data transfer.
• * To quantify the speed differences in downloading and uploading FHIR Patient resources using both protocols.

Main Methods:

• * Utilized 45,000 FHIR Patient resources for testing.
• * Simulated data transfers using Bundle sizes of 20, 50, 100, and 200 resources.
• * Measured request times for both download (HTTP GET) and upload (HTTP POST) operations in local and remote network environments.

Main Results:

• * HTTP/3 demonstrated a significant performance advantage over HTTP/2 in downloading EHR data, particularly for remote requests (up to 3x faster).
• * Consistent performance gains for HTTP/3 were observed in remote download tests with varying Bundle sizes (50 and 100 resources).
• * HTTP/3 showed only marginal upload performance improvements in remote network scenarios.

Conclusions:

• * HTTP/3 offers substantial performance benefits for digital health applications, especially in retrieving data from distributed sources.
• * The adoption of HTTP/3 in EHR systems could lead to more efficient data exchange and improved healthcare services.
• * Further integration of HTTP/3 is recommended to leverage its capabilities in the evolving digital health landscape.