Interoperability with multiple Fast Healthcare Interoperability Resources (FHIR®) profiles and versions

Objective: To provide a method for evaluating the interoperability of Fast Healthcare Interoperability Resources (FHIR (R)) clients and servers supporting different FHIR resources, profiles, and versions, and to determine the feasibility of FHIR servers supporting multiple FHIR Implementation Guides (IGs). Materials and Methods: A method of analysis, the FHIR Interoperability Table (FHIT), is proposed. The FHIT involves the concept of a "catchment," the type or category of data that a profile is intended to represent. The solution first aligns sender and/or receiver profiles according to their catchments, then determines the relationship between the admittances of those profiles, and finally interprets the relationship in terms of the feasibility of data exchange. Results: The FHIT method is demonstrated by analyzing the FHIR-based exchange between the US Core IG and the International Patient Summary IG. Discussion: The last few years have witnessed a significant growth in Fast Healthcare Interoperability Resources (FHIR), resulting in several major versions of FHIR, hundreds of IGs, and thousands of FHIR profiles. Previous work and available tools have not fully addressed the problem of interoperability between clients and servers that support different FHIR resources, profiles, and versions. Conclusion: Application of the proposed methodology allows interoperability problems in FHIR networks to be identified. In some cases, new profiles that resolve those conflicts can be derived, using intersections of the original profiles. There is a need for additional tools that implement the proposed method, as well as structured methods for expressing catchments in FHIR profiles.