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Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems

  • Systems-Level Quality Improvement
  • Published:
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Abstract

We sought to enable better interoperability and easy adoption of healthcare applications by developing a standardized domain independent Application Programming Interface (API) for an Electronic Medical Record (EMR) system. We leveraged the modular architecture of the Open Medical Record System (OpenMRS) to build a Fast Healthcare Interoperability Resources (FHIR) based add-on module that could consume FHIR resources and requests made on OpenMRS. The OpenMRS FHIR module supports a subset of FHIR resources that could be used to interact with clinical data persisted in OpenMRS. We demonstrate the ease of connecting healthcare applications using the FHIR API by integrating a third party Substitutable Medical Apps & Reusable Technology (SMART) application with OpenMRS via FHIR. The OpenMRS FHIR module is an optional component of the OpenMRS platform. The FHIR API significantly reduces the effort required to implement OpenMRS by preventing developers from having to learn or work with a domain specific OpenMRS API. We propose an integration pathway where the domain specific legacy OpenMRS API is gradually retired in favor of the new FHIR API, which would be integrated into the core OpenMRS platform. Our efforts indicate that a domain independent API is a reality for any EMR system. These efforts demonstrate the adoption of an emerging FHIR standard that is seen as a replacement for both Health Level 7 (HL7) Version 2 and Version 3. We propose a gradual integration approach where our FHIR API becomes the preferred method for communicating with the OpenMRS platform.

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Contributorship Statement

In addition to the International Committee of Medical Journal Editors (ICMJE) specified author-ship eligibility criteria,

  • Primary author Suranga N. Kasthurirathne let the system development and manuscript preparation efforts.

  • Burke Mamlin contributed towards the OpenMRS architectural design

  • Harsha Kumara contributed towards system development efforts

  • Graham Grieve contributed FHIR specific knowledge for the project

  • Paul Biondich contributed towards the OpenMRS architectural design

Author information

Authors and Affiliations

  1. School of Informatics and Computing, Indiana University – Purdue University, 535 W. Michigan Street, IT 475, Indianapolis, IN, 46202, USA

    Suranga N. Kasthurirathne

  2. Indiana University School of Medicine, Indianapolis, IN, USA

    Burke Mamlin & Paul Biondich

  3. Regenstrief Institute Inc., Indianapolis, IN, USA

    Burke Mamlin & Paul Biondich

  4. WSO2 Inc., 20 Palm Grove, Colombo, Sri Lanka

    Harsha Kumara

  5. Health Intersections Pty. Ltd., Ringwood, VIC, Australia

    Grahame Grieve

Authors
  1. Suranga N. Kasthurirathne
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  2. Burke Mamlin
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  3. Harsha Kumara
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  4. Grahame Grieve
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  5. Paul Biondich
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Corresponding author

Correspondence to Suranga N. Kasthurirathne.

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Funding Statement

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Competing Interests Statement

The authors have no competing interests to declare.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Kasthurirathne, S.N., Mamlin, B., Kumara, H. et al. Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems. J Med Syst 39, 182 (2015). https://doi.org/10.1007/s10916-015-0356-6

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  • DOI: https://doi.org/10.1007/s10916-015-0356-6

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