FHIR Interoperability Implementation for Nutrition Management Portal

Success Story.

FHIR Interoperability Implementation for Nutrition Management Portal

About the Client

Founded in 1917, the client is one of the world’s largest association of food and nutrition professionals. They provide several products and services that are valuable resources to its 100,000 members as well as the general public. The Academy is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy.

Business Challenge

Client had an existing web application that nutritionists and dieticians used to track progress and outcomes of nutrition therapy for their patients. The client wanted to add new and advanced features as well as upgrade the underlying technology platform so as extend the usability and value of the portal.

As part of the enhancements, the application was upgraded with the Fast Healthcare Interoperability Resources (FHIR). FHIR is HL7 non-profit group’s internationally recognized API and structured data format used to simplify interoperability within the widespread EHR system vendors.

Silicus Solution

Silicus modernized the underlying platform from .NET to .NET MVC 5. As a portal for tracking patient progress while undergoing diet therapy, the portal consisted of the following modules:

  • User Self Registration
  • User Profile
  • Help & Training Centre
  • Patient Screen
  • Visit Entry
  • Administration
  • Reports

In keeping with the latest digital trends, the web pages were designed to be responsive using the Bootstrap framework. Source code version control while developing the portal was done using GitHub.

The portal was made compatible with FHIR standards, this entailed pushing data into an external FHIR server within the end user’s environment (external Care Provider).

FHIR adds a new architectural approach when compared to the previously used HL7v2 and CDA as it is a RESTful approach, which allows for individual resources to be retrieved, updated and queried for.

In HL7v2 and CDA, one is forced to retrieve a collection of data, irrespective of whether one requires only partial or relevant data about a particular patient. Using the RESTful API architecture, the integration between any two EHR systems has been much faster & simpler.

FHIR Standard Implementation

The workflow was designed as follows:

  • Patient referrals to a dietician request is sent to the client’s FHIR server by an external care provider
  • Client attaches some relevant details before pushing the final visit summary report back to its own FHIR Server as a response to the external care provider’s patient referral request.

The data to be pushed (known as resources) is a pre-defined list, with the following attributes:

  • Patient
  • Practitioner
  • Referral Request
  • Care Plan
  • Care Team
  • Condition
  • Goals
  • Observation
  • DiagnosticRequest
  • MedicationRequest
  • Organization

Patient details mapped to the resource list, and sent back to the FHIR server include:

  • Visit Entry: It contains patient visit related information and initial nutrition assessment details
  • Nutrition Diagnosis: It contains the patient problem, etiologies, signs/symptoms & diagnosis status
  • Intervention: contains encounter details data
  • Monitoring & Evaluation: contains diagnostic details
  • Final Visit Summary Report

Technologies Used

Language ASP.NET MVC4
Language

ASP.NET MVC, jQuery

Platform
Platform

Microsoft.NET

Database
Database

SQL Server 2016

Front End
Front End

Bootstrap

version-control
Version Control

GitHub Desktop Client

Client Benefits

Robust Data Exchange

The new application enabled a more granular way to exchange data without the rigid workflow of traditional HL7. FHIR simplified the healthcare data exchange (medical notes, visit records etc) across multiple healthcare systems

Faster Records Processing

RESTful architecture enabled the client to process clinical records faster, and rapidly expand connections to more 3rd party customer systems

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