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Improving Requirements Documentation in the Medical Informatics Initiative Core Data Set Using FHIR Obligations -

Julian Saß1, Sylvia Thun1

  • 1Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.

Studies in Health Technology and Informatics
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Summary
This summary is machine-generated.

FHIR Implementation Obligations clarify system responsibilities in Germany's Medical Informatics Initiative (MII). This approach improves clarity for Health Level Seven (HL7) FHIR Implementation Guides (IGs) but requires further tooling development.

Keywords:
Core Data SetFHIRInteroperabilityMedical Informatics Initiative

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Area of Science:

  • Health Informatics
  • Medical Informatics
  • Health Data Standards

Background:

  • The Medical Informatics Initiative (MII) in Germany seeks to enable secondary use of clinical data via a FHIR-based Core Data Set (CDS).
  • Current FHIR Implementation Guides (IGs) often lack specific guidance for actors, leading to implementation inconsistencies.

Purpose of the Study:

  • To explore the use of FHIR Implementation Obligations to define actor responsibilities and system behavior within the MII.
  • To enhance clarity and reduce ambiguity in FHIR-based data exchange specifications.

Main Methods:

  • Modeled FHIR Implementation Obligations using the FHIR obligation extension and ActorDefinition resources.
  • Applied obligations to the Patient profile within the CDS Person module.
  • Generated a prototype IG using HL7 FHIR IG publisher tooling.

Main Results:

  • Defined and rendered obligations for actors like Data Integration Centers (DIC) and the Health Research Data Portal (FDPG).
  • Linked obligations to specific FHIR operations for precise workflow targeting.
  • Increased the explicitness of previously implied responsibilities within the MII infrastructure.

Conclusions:

  • FHIR Implementation Obligations demonstrably enhance the clarity of FHIR IGs.
  • Limitations include lack of current MII IG tooling support for obligations and absence of conformance testing.
  • Further standardization of ActorDefinition resources and development of validation tooling are necessary.