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Updated: May 13, 2025

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Data Interoperability in Context: The Importance of Open-Source Implementations When Choosing Open Standards.

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Journal of Medical Internet Research
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Summary

Open health data standards like openEHR, FHIR, and OMOP are crucial but not sufficient for interoperability. Context-specific choices and open-source software ecosystems are vital for effective health data sharing and federated learning.

Keywords:
FHIRFast Health Interoperability ResourcesLMICOMOPObservational Medical Outcomes Partnershipclinical caredata exchangedata interoperabilitydata sharingdeveloping countriesdeveloping nationsdigital platformhealth care informaticshealth information exchangeinformation standardslongitudinal analysislow and middle-income countrieslow incomemiddle-incomeopen source implementationsopen standardsopenEHRsecondary use

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Area of Science:

  • Health Informatics
  • Data Standards
  • Interoperability

Background:

  • A proposal suggests converging on openEHR, FHIR, and OMOP as default health data standards.
  • Open standards are necessary but insufficient for achieving health data interoperability.
  • The open-source software ecosystem influences the choice of appropriate standards.

Purpose of the Study:

  • Critically reflect on the proposed alignment of open health data standards.
  • Discuss the suitability of standards in specific contexts: federated learning and low- and middle-income countries.
  • Propose practical guidelines for context-specific adaptation of open health data standards.

Main Methods:

  • Critical viewpoint analysis.
  • Discussion of two specific contexts: federated learning and health data sharing in low- and middle-income countries.
  • Description of design principles, practical considerations, and implementation choices based on ongoing work.

Main Results:

  • Federated learning shows convergence towards OMOP and FHIR, usable together with mediators.
  • Health information exchanges in low- and middle-income countries strongly converge towards FHIR.
  • Open standards alone do not guarantee interoperability; context and software ecosystem matter.

Conclusions:

  • Context-specific adaptation of open health data standards is essential.
  • FHIR emerges as a primary standard for health information exchanges in LMICs.
  • Federated learning benefits from the combined use of OMOP and FHIR.