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Investigating the Use of the Fast Health Care Interoperability Resources (FHIR) Standard to Support Data Activities
Keith Marsolo1,2, Darcy Louzao1, Kim Hart1
1Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
Background:
Institutions that participate in PCORnet® transform their local electronic health record (EHR) data into the PCORnet® Common Data Model (CDM), which is then used to generate data extracts for PCORnet® Studies. PCORnet® Studies can also include institutions that do not participate in PCORnet, and for these organizations, the cost of instantiating a PCORnet® CDM can be prohibitive. Fast Health care Interoperability Resources (FHIR) provides an alternative method of obtaining EHR data.
Objective:
To determine whether data obtained through FHIR might be a viable study solution for those sites that do not participate in PCORnet.® This mixed-methods project had 2 objectives: (1) survey sites participating in PCORnet on the availability of FHIR (FHIR survey); (2) compare the coverage of a FHIR-based data extract using REDCap with one from the PCORnet® CDM across 3 sites (FHIR extract).
Methods:
(1) FHIR survey: A series of questions were asked about the use of FHIR in a production capacity. (2) FHIR extract: REDCap FHIR and PCORnet® CDM extracts were created based on study variables from 2 prior PCORnet® Studies. Data were extracted for 40 patients and concordance measures were computed between the 2 sources.
Results:
(1) FHIR survey: Of responding organizations, 73% (n=49) reported that FHIR was deployed in a production capacity. (2) FHIR extract: Results were highly variable. Cohen kappa ranged from 0.01 to 0.76 for certain diagnoses, 0.24 to 0.84 for laboratory results, and 0.1 to 0.87 for medications.
Conclusions:
Despite differences in data, certain studies may be well-suited for FHIR-based extracts.
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