Ask Not What Your Server Can Do For You: A Fast Query Compatibility Strategy for Navigating FHIR Implementation Gaps

Area of Science:

• Health Informatics
• Clinical Informatics
• Medical Software Engineering

Background:

• The Fast Healthcare Interoperability Resources (FHIR) standard aims to enhance clinical data interoperability.
• Real-world FHIR implementations frequently face challenges with full compliance, leading to deployment difficulties.
• Clinical microbiology software integration is often hindered by server-side limitations and restricted FHIR capabilities.

Purpose of the Study:

• To present a tiered compatibility strategy for the Momo clinical microbiology software to overcome FHIR server limitations.
• To reduce the time and effort required for integrating clinical software with restricted FHIR servers.
• To demonstrate a practical solution for achieving operational deployment despite incomplete FHIR compliance.

Main Methods:

• Developed an adaptive query framework with three search resolvers: Basic, Advanced, and Full.
• Tailored the framework to adapt to the specific capabilities of a target FHIR server.
• Evaluated the strategy through a pilot integration with a severely restricted institutional FHIR server.

Main Results:

• Achieved successful operational deployment of Momo software in two weeks.
• Required only 52 person-hours of custom development and minimal institutional coordination.
• Demonstrated the framework's effectiveness even with missing FHIR resources and limited query parameters.

Conclusions:

• The adaptive query framework effectively reduces integration time for clinical microbiology software.
• This strategy circumvents server-side limitations in FHIR implementations.
• While effective, the availability of search parameters remains crucial for full system functionality.