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Linking FHIR-Based Medication Data to a Computable Algorithm for Heart Medication Optimization: A Critical Component

Joey LeGrand1, Mohamed S Ali2, Allen Flynn3

  • 1CodeRx Nashville Tennessee USA.

Learning Health Systems
|January 22, 2026
PubMed

Insights

SmartHF enhances guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) by integrating Fast Healthcare Interoperability Resources (FHIR) medication data with clinical algorithms. This system improves adherence and care quality by overcoming data integration challenges.

Area of Science:

  • Cardiology
  • Health Informatics
  • Clinical Decision Support

Background:

  • Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) has proven efficacy, yet consistent application remains a challenge.
  • Electronic health records (EHR) offer a potential solution for optimizing GDMT delivery.
  • Bridging the gap between EHR data and clinical algorithms is crucial for improving patient outcomes.

Purpose of the Study:

  • To develop and evaluate SmartHF, a clinical decision support system.
  • To enhance adherence to GDMT for HFrEF through improved medication management.
  • To demonstrate the feasibility of integrating Fast Healthcare Interoperability Resources (FHIR)-based medication data with clinical algorithms.

Main Methods:

  • Developed SmartHF, a system linking FHIR-based medication data with clinical algorithms for HFrEF management.
  • Utilized CodeRx platform for mapping medication products to ingredients via RxNorm.
  • Addressed challenges in interpreting structured and unstructured medication instructions, focusing on data granularity for precise ingredient identification.

Main Results:

  • SmartHF successfully processed FHIR MedicationRequest data resources.
  • The system accurately converted free-text dosing instructions into usable formats.
  • Validated functionality with real and synthetic patient data, including handling edge cases like non-standard products and missing dose information.

Conclusions:

  • FHIR-based medication data integration holds significant potential for enhancing clinical decision support tools.
  • SmartHF demonstrates a viable approach to improving care quality in HFrEF management.
  • The study highlights key challenges and solutions in integrating diverse medication data for clinical applications.
Abstract

Keywords:
clinical decision supportdata integrationfast healthcare interoperability resourcesguideline‐directed medical therapyhealth informatics

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