Currently submitted to: JMIR Medical Informatics
Date Submitted: Mar 17, 2024
Open Peer Review Period: Mar 20, 2024 - May 15, 2024
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Best Practices for Implementation and Development of Data Models and Structures based on FHIR: A Systematic Scoping Review
ABSTRACT
Background:
Data models play a crucial role in facilitating clinical research and taking full advantage of clinical data stored in medical systems; data, as well as the clear relationships between them, are expected to be in a standardized format to establish reproducible research. Using the Fast Healthcare Interoperability Resources (FHIR) standard for clinical data representation would be a practical methodology to enhance and accelerate interoperability and data availability for research.
Objective:
To investigate data models utilizing the FHIR standard, to offer a comprehensive overview of the best practices for developing and implementing these data models as well as presenting a summary of tools, mappings, limitations and other important details in the selected models.
Methods:
To ensure the extraction of reliable results, we followed the instructions of Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We analyzed the indexed articles in PubMed, Scopus, Web of Science, IEEE Xplore, ACM digital library, and Google Scholar using Boolean operators to merge relevant keywords and their related terms.
Results:
Based on the reviewed articles, we categorized them into two main groups; pipeline-based data models and non-linear data models. We summarized each included article and extracted information about the FHIR resources, technologies and standards, and mappings. We additionally aimed to extract and summarize the limitations of each research to provide a comprehensive view of the potential challenges and limitations that future researchers may face.
Conclusions:
Based on the results of our review, FHIR can be a very promising standard in developing interoperable data models and infrastructures, despite presenting some challenges in the development phase. Policymakers and healthcare specialists can utilize this standard in any field such as healthcare, research, administration, finance, and so on. Additionally, when developing data models, this standard can also be integrated with other health-related standards to propose more interoperable solutions.
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