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HeXEHRS: Design and Implementation of a FHIR-Based Cloud EHR and Client for Depopulated Regions with AI and
Tomohiro Sawa1,2, Ryota Sakurai3, Kazuhiko Ohe4,2
1Teikyo University, Japan.
Abstract:
Japan's national initiative for scientific infrastructure emphasizes equitable healthcare delivery in depopulated regions facing rapid aging and physician shortages. To address these challenges, we developed HeXEHRS, a cloud-based electronic health record (EHR) platform built on HL7 FHIR (R4) and aligned with JP Core profiles, serving as a reference implementation for Japanese clinics. HeXEHRS consists of a production-grade FHIR cloud server with native JP Core validation and terminology services and a standards-compliant client implemented with Svelte, supporting registration, documentation, ordering, and scheduling workflows. Integrated AI and digital-twin connectors enable summarization, speech recognition, and PHR integration. While prioritizing Japan's underserved areas, the architecture is applicable to clinics nationwide and offers a globally applicable approach to extend sustainable, interoperable healthcare services in remote or resource-limited regions worldwide.
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