REMOTE: A Framework to Create Fast Healthcare Interoperability Resources (FHIR) from Unstructured Clinical Data

Free text in clinical notes represents a rich but underutilized source of patient information within electronic health records (EHRs). However, its unstructured nature poses major challenges for use in population health, genomic research, precision medicine, quality improvement, and clinical decision support.This study introduces REMOTE, a systematic framework for generating Fast Healthcare Interoperability Resources (FHIR) from unstructured clinical notes. REMOTE is a stepwise pipeline that Reformats clinical notes, Extracts key medical concepts, Maps those concepts to standardized Ontologies, Transforms them into FHIR resources, and enables Exchange across health data repositories. We demonstrate the feasibility of this framework by processing 1,618 unstructured clinical notes, extracting chief complaints, signs and symptoms, diagnoses, and medications, mapping them to SNOMED CT codes, converting them into FHIR Observation, Condition, and MedicationRequest resources, and uploading them into FHIR repositories for data exchange.Clinical Relevance-Information embedded in free-text clinical notes can be made interoperable, exchangeable, and actionable through transformation into discrete FHIR resources.