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      Development of an HL7 FHIR Architecture for Implementation of a Knowledge-based Interdisciplinary EHR.

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          Abstract

          The treatment of multimorbid patients confronts physicians with special challenges. Complex disease correlations, insufficient evidence, lack of interdisciplinary guidelines, limited communication between physicians of different specialties, etc. complicate the treatment. To improve the present care situation for multimorbid patients we describe a development approach for an interdisciplinary Electronic Health Record (EHR). As part of the Dent@Prevent project, which aims to improve the intersectoral care of patients with correlating dental and chronic systemic diseases, the proposed EHR will first be tested in the field of dentistry and general medicine. Based on the HL7 FHIR standard the proposed EHR uses a modern three-tier (client-server) architecture. Crucial element of the EHR is a knowledge base, which comprises components for mapping diseases with their complex correlations, integrates patient reported parameters and classifies information in evidence levels. Using the FHIR standard the described elements need to be transferred into the data schema of FHIR resources. The development of an EHR to improve the treatment of multimorbid patients needs to be tailored to the specific needs of multimorbid patients. An interdisciplinary EHR offers the potential to facilitate communication between patients and physicians and provide them with evidence-based information on disease correlations. The next step is to test the practical implementation and applicability for further interdisciplinary disease correlations.

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          Author and article information

          Journal
          Stud Health Technol Inform
          Studies in health technology and informatics
          IOS Press
          1879-8365
          0926-9630
          Jul 04 2019
          : 262
          Affiliations
          [1 ] University of Heidelberg, Institute of Medical Biometry and Informatics, Heidelberg, Germany.
          [2 ] University Hospital Heidelberg, Department of Conservative Dentistry, Division of Translational Health Economics, Heidelberg, Germany.
          [3 ] Department of Quality and Safety of Oral Health Care, Radboud University, Nijmegen, The Netherlands.
          Article
          SHTI190067
          10.3233/SHTI190067
          31349316
          ba86e7ac-36af-4c9e-93b9-95eadb3ec6e6
          History

          Chronic systemic disease,Decision Support System (DSS),Dental disease,Electronic Health Record (EHR),HL7 FHIR,Interdisciplinary care,Multimorbidity,Noncommunicable disease

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