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Bridging Fragmented PHR Ecosystems Through a Unified Document Terminology
Eizen Kimura1, Tsubasa Takahashi2, Saori Sawada2
1Department of Medical Informatics, Medical School of Ehime University, Japan.
Studies in Health Technology and Informatics
|July 3, 2026
Summary
Japan's fragmented personal health record (PHR) system was improved using FHIR Storage for data exchange. A new naming method enables automated document identification, enhancing health data portability and interoperability.
Area of Science:
- Health Informatics
- Digital Health
- Interoperability Standards
Background:
- The Japanese personal health record (PHR) ecosystem is characterized by fragmentation among private vendors.
- This fragmentation impedes seamless health data exchange and portability.
- Lack of standardized metadata for health documents exacerbates these challenges.
Purpose of the Study:
- To address the challenges of data fragmentation in Japan's PHR landscape.
- To implement a standardized method for health data exchange using FHIR Storage.
- To improve automated document identification and routing within the PHR system.
Main Methods:
- Adoption of Fast Healthcare Interoperability Resources (FHIR) Storage for health data exchange.
- Identification and analysis of 30 distinct health document types within the PHR system.
- Development and implementation of a FHIR CodeSystem naming convention for programmatic document identification.
Main Results:
- FHIR Storage was successfully adopted to facilitate health data exchange.
- Half of the identified document types lacked essential schema and versioning metadata.
- A FHIR CodeSystem naming method was established, enabling automated document type recognition.
- The study identified the need for a central metadata registry for automated routing.
Conclusions:
- The PHOENICS project demonstrated the feasibility of using FHIR Storage to improve health data interoperability in Japan.
- Standardized metadata and a central registry are crucial for automated document routing and efficient PHR system management.
- Addressing metadata gaps is essential for enhancing the portability and usability of personal health records.
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