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James R Jones1, Daniel Gottlieb1,2, Andrew J McMurry1,3
1Computational Health Informatics Program, Boston Children's Hospital, Boston, MA 02215, United States.
SMART/HL7批量快速健康互操作性资源 (FHIR) API显示了大规模健康数据访问的潜力. 然而,性能各不相同,定制解决方案的性能优于认证的电子健康记录平台,突出了优化需求.
科学领域:
- 医疗信息学 医疗信息学
- 健康数据互操作性 互操作性
- 卫生信息交换健康信息交换
背景情况:
- "21世纪治疗法"要求改善对电子健康记录 (EHR) 数据的访问.
- SMART/HL7批量快速健康互操作性资源 (FHIR) API是为了促进大规模数据访问而开发的.
- 现实世界的绩效评估对于广泛采用和有效性至关重要.
研究的目的:
- 为了评估SMART/HL7批量FHIR访问API的现实世界性能.
- 评估其在为大量人群启用按访问EHR数据方面的能力.
- 确定绩效基准和需要改进的领域.
主要方法:
- 在5个医疗保健网站使用开源批量FHIR测试套件 (2023年4月至9月).
- 包括4家拥有认证EHR的医院和1家拥有自定义API的健康信息交换 (HIE).
- 测量了6种FHIR资源类型的出口速度,数据量和完整性.
主要成果:
- 甲骨文Cerner在5-16万个资源中展示了超过8000个资源/分钟的速度.
- 史诗网站实现了1555-2500资源/分钟,为1-12万资源.
- 在HIE的自定义API显著表现出色,产生超过1.41亿资源在12,000资源/分钟.
结论:
- HIE的自定义API表现出卓越的性能,验证了批量FHIR用于大规模数据交换.
- 现有的EHR平台需要优化以满足性能需求.
- 解决批量FHIR API性能限制对于实现Cures Act互操作性目标至关重要.
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