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The Missing FHIR-Link Between Privat Practices and Hospitals in Germany
Regina Fischer1, Holger Stenzhorn1
1Saarland University, Faculty of Medicine, Data Integration Center.
Studies in Health Technology and Informatics
|August 8, 2025
Summary
Germany's electronic patient record (ePA) uses the FHIR standard, but decentralized development of sector-specific profiles may cause interoperability issues. This study examines these challenges to ensure seamless healthcare information exchange.
Area of Science:
- Health Informatics
- Digital Health
- Healthcare Systems Engineering
Background:
- Germany is implementing an electronic patient record (ePA) system to enhance healthcare quality.
- The ePA system is designed to improve information availability for better patient care.
- The system's foundation is the Fast Healthcare Interoperability Resources (FHIR) standard.
Purpose of the Study:
- To investigate potential interoperability challenges in Germany's ePA system.
- To analyze the impact of a decentralized development approach on FHIR profile implementation.
- To identify risks to seamless healthcare information exchange due to varied sector-specific profiles.
Main Methods:
- Analysis of the FHIR standard's application in a decentralized healthcare system.
- Review of sector-specific FHIR profile development processes within Germany's digital health agency.
- Identification of potential conflicts and inconsistencies arising from independent profile creation.
Main Results:
- Decentralized development of sector-specific FHIR profiles introduces significant interoperability challenges.
- Lack of centralized governance in profile creation can lead to data fragmentation.
- Potential for inconsistent data interpretation across different healthcare sectors.
Conclusions:
- The decentralized approach to developing sector-specific FHIR profiles for Germany's ePA poses a risk to system-wide interoperability.
- Recommendations for standardized governance and validation are crucial for successful ePA implementation.
- Addressing these interoperability challenges is vital for realizing the full benefits of digital health in Germany.
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