Healthcare in the Age of Interoperability: The Promise of Fast Healthcare Interoperability Resources
Abstract
The first article of this series (see "About This Series") mentioned that, after the success of its new messaging standard for electronic health record (EHR) systems, Health Level 7 (HL7) found it difficult to develop and widely deploy a standard for the rich representation of clinical data for use in patient care. This was due, in large part, to the complexity of medicine and the resulting complexity of the clinical terminologies developed to represent it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The interoperability of health care organizations requires interfaces between different systems to use a common protocol such as HL7.
“Given that different types of health care systems use different applications and also considering that these types of institutions need to exchange information about patients, so the interoperability of health care organizations requires interfaces between different systems use a common protocol such as HL7 [27].”
From Interoperability of heterogeneous health information systems: a systematic literature review (2023) · cites this paper as [27]
Cites
Untitled work
(2018) · clinFHIR Launcher
UnresolvedUntitled work
(2018) · UHN HAPI Server
UnresolvedUntitled work
(2018) · Fast Healthcare Interoperability Resources
Unresolved
Flagged first, then by citations
3 of the 3 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Artificial intelligence in COVID-19 drug repurposing
Zhou, Y., Wang, F., Tang, J., Nussinov, R., & Cheng, F. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(20)30192-8 · Cited by 636 · see citing works
Interoperability of heterogeneous health information systems: a systematic literature review
Torab-Miandoab, A., Samad-Soltani, T., Jodati, A., & Rezaei-Hachesu, P. (2023) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-023-02115-5 · Cited by 393 · see citing works
“FHIR has been used and recommended by many studies because it combines the features of HL7 with the latest web standards, is more secure, easy to implement, free to use, and highly flexible.”
BackgroundInfluentialThe Impact of Multimodal Large Language Models on Health Care’s Future
Meskó, B. (2023) · Journal of Medical Internet Research · doi:10.2196/52865 · Cited by 182 · see citing works
“Interoperability has been a major challenge in health care for decades [6].”
Deep learning applications for IoT in health care: A systematic review
Bolhasani, H., Mohseni, M., & Rahmani, A. M. (2021) · Informatics in Medicine Unlocked · doi:10.1016/j.imu.2021.100550 · Cited by 151 · see citing works
Nagarajan, S. M., Deverajan, G. G., Chatterjee, P., et al. (2021) · Sustainable Cities and Society · doi:10.1016/j.scs.2021.102945 · Cited by 128 · see citing works
Smart-Monitor: Patient Monitoring System for IoT-Based Healthcare System Using Deep Learning
Jeyaraj, P. R., & Nadar, E. R. S. (2019) · IETE Journal of Research · doi:10.1080/03772063.2019.1649215 · Cited by 122 · see citing works
Cheng, F., Wang, F., Tang, J., Zhou, Y., Fu, Z., Zhang, P., Haines, J. L., Leverenz, J. B., Gan, L., Hu, J., et al. (2024) · Cell Reports Medicine · doi:10.1016/j.xcrm.2023.101379 · Cited by 63 · see citing works
“Data transmission standards, such as the Fast Healthcare Interoperability Resource (FHIR) 127 for clinical data transmission, are key to data credibility and confidentiality.”
MethodUse of social media big data as a novel HIV surveillance tool in South Africa
van Heerden, A. C., & Young, S. D. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239304 · Cited by 39 · see citing works
“Standards such as the Fast Healthcare Interoperability Resources (FHIR) provide a modern scaffolding for exchanging healthcare information electronically [44].”
BackgroundChallenges for developing health-care knowledge in the digital age
Alrahbi, D., Khan, M., Gupta, S., Modgil, S., & Jabbour, C. J. C. (2020) · Journal of Knowledge Management · doi:10.1108/jkm-03-2020-0224 · Cited by 43 · see citing works
Blockchain-Based Interoperable Electronic Health Record Sharing Framework
Carter, G., Shahriar, H., & Sneha, S. (2019) · IEEE Annual International Computer Software and Applications Conference (COMPSAC) · doi:10.1109/compsac.2019.10248 · Cited by 39 · see citing works
“population [3], It is the intersection of freedom of choice coupled with protectionist policies by EHR developers that makes interoperability a difficult task [3, 4, 5], As medicine rapidly advances, Healthcare Information Technology (HIT) is striving to provide effective and affordable solutions to interoperability.”
BackgroundYe, J., Hai, J., Song, J., & Wang, Z. (2024) · medRxiv · doi:10.1101/2024.05.01.24306690 · Cited by 33 · see citing works
“[75 ] FHIR could be used to improve the presentation and visualization of the integrated data.”
BackgroundMethodYe, J., Woods, D. M., Jordan, N., & Starren, J. B. (2024) · PubMed Central · Cited by 33 · see citing works
25 Years of Electronic Health Record Implementation Processes: Scoping Review
Finnegan, H., & Mountford, N. (2025) · Journal of Medical Internet Research · doi:10.2196/60077 · Cited by 33 · see citing works
New Standards for Clinical Decision Support: A Survey of The State of Implementation
Taber, P. A., Radloff, C. L., Fiol, G. D., Staes, C. J., & Kawamoto, K. (2021) · Yearbook of Medical Informatics · doi:10.1055/s-0041-1726502 · Cited by 29 · see citing works
“The most recent version as of December 2020, Version 4.0.1, was published in October 2019 [5, 6, 8, 9].”
BackgroundInfluentialMayston, R., Ebhohimen, K., & Jacob, K. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s204579602000030x · Cited by 28 · see citing works
“…or, at the very least, research teams and donors should ensure that systems have good interoperability, for example, by adhering to specifications for standardised content and structure of core information, such as those set out by Fast Healthcare Interoperability Resources (Braunstein, 2018).”
BackgroundXiao, D., Song, C., Nakamura, N., et al. (2021) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2021.106232 · Cited by 21 · see citing works
Cuevas-González, D., Garćıa-Vázquez, J. P., Bravo-Zanoguera, M. E., Avitia, R. L., Reyna, M. A., Zermeño-Campos, N. A., & González-Ramírez, M. L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191911941 · Cited by 22 · see citing works
“0 was followed by different versions of v2, then v3, and finally FHIR, a new specification based on emerging industry approaches and experiences from v2 and v3 [29,30].”
MethodEvaluation of digital vaccine card in nursing practice in vaccination room
Lopes, J. P., Dias, T. M. R., Carvalho, D. B. F., de Oliveira, J. F., Cavalcante, R. B., & de Oliveira, V. C. (2019) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.3058.3225 · Cited by 19 · see citing works
“Such possibilities are aligned with the need to use information technologies to integrate the health care network through interoperability(28).”
BackgroundMonsen, K. A., Heermann, L. K., & Lopez, K. D. (2023) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocad131 · Cited by 16 · see citing works
Esmaeilzadeh, P. (2022) · Technology in Society · doi:10.1016/j.techsoc.2022.102007 · Cited by 14 · see citing works
Esmaeilzadeh, P. (2023) · Interactive Journal of Medical Research · doi:10.2196/42685 · Cited by 15 · see citing works
“In addition, the Fast Healthcare Interoperability Resources standard is a recent effort to offer adequate beneficial interoperability without the complexity associated with a comprehensive interoperability solution [20].”
A REVIEW OF ARTIFICIAL INTELLIGENCE IN TREATMENT OF COVID-19
Gandla, K., Teja, K., Babu, P. V., Sagapola, R., & Sudhakar, P. (2022) · Journal of Pharmaceutical Negative Results · doi:10.47750/pnr.2022.13.s01.31 · Cited by 13 · see citing works
The Growing Need for Ophthalmic Data Standardization
Shweikh, Y., Sekimitsu, S., Boland, M. V., et al. (2022) · Ophthalmology Science · doi:10.1016/j.xops.2022.100262 · Cited by 12 · see citing works
Security in Electronic Health Records System: Blockchain-Based Framework to Protect Data Integrity
Faruk, M. J. H., Shahriar, H., Saha, B., & Barek, A. (2022) · Advances in information security · doi:10.1007/978-3-031-25506-9_7 · Cited by 16 · see citing works
Kim, H. H., Park, Y. R., Lee, S., & Kim, J. H. (2020) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-01168-0 · Cited by 11 · see citing works
Large Language Models in Neurosurgery
Ieva, A. D., Stewart, C., & Molina, E. S. (2024) · Advances in experimental medicine and biology · doi:10.1007/978-3-031-64892-2_11 · Cited by 11 · see citing works
Mazzucco, W., Stracci, F., Gatta, G., D’Argenzio, A., Bidoli, E., Carone, S., Vitarelli, S., Castelli, M., Fruscione, S., & Vitale, F. M. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.1052057 · Cited by 9 · see citing works
GAN-Based Dual Active Learning for Nosocomial Infection Detection
Wang, L., Ye, X., Li, J., et al. (2021) · IEEE Transactions on Network Science and Engineering · doi:10.1109/tnse.2021.3100322 · Cited by 7 · see citing works
“Several healthcare information standards have been published such as HL7 V2, HL7 V3, open-EHR, FHIR and adopted by vendors of clinical information systems and devices [4], [5].”
MethodKoutitas, G. C., Nolen, K., Attal, S., et al. (2023) · IEEE Access · doi:10.1109/access.2023.3299866 · Cited by 6 · see citing works
“Both objectives leverage Fast Healthcare Interoperability Resources (FHIR) CDS Cards/Hooks communication protocols to enable interoperable and scalable solutions [14], [15].”
BackgroundElectronic Paper Displays in Hospital Operations: Proposal for Deployment and Implementation
Jambaulikar, G. D., Marshall, A. D. A., Hasdianda, M. A., Cao, C., Chen, P., Miyawaki, S., Baugh, C. W., Zhang, H., McCabe, J., Su, J., et al. (2021) · JMIR Formative Research · doi:10.2196/30862 · Cited by 5 · see citing works
“Fast Healthcare Interoperability Resources [28] provides an open-source and widely accepted means for packaging and delivering clinical data.”
MethodBeyond the Spreadsheet: Data Management for Physicians in the Era of Big Data.
Eckert, C. (2023) · Surgical Clinics of North America · doi:10.1016/j.suc.2022.11.007 · Cited by 4 · see citing works
Santos, A. A., Firmino, R. M., Soto, J. C. H., et al. (2020) · doi:10.5753/sbc.4710.8.4 · Cited by 4 · see citing works
“[Braunstein, 2018] Braunstein, M. L. (2018).”
I-CovidVis – A Visual Analytics Tool for Interoperable Healthcare Databases using Graphs
Linhares, C. D. G., de Lima, D. M., Bones, C. C., et al. (2021) · IEEE International Symposium on Computer-Based Medical Systems (CBMS) · doi:10.1109/cbms52027.2021.00059 · Cited by 4 · see citing works
Application of Machine Learning in Healthcare IoT
Pradhan, A. K., Yadav, A., Mishra, N., Nayak, R. K., Mohapatra, H., Jena, L., & Tripathi, A. K. (2025) · IGI Global eBooks · doi:10.4018/979-8-3693-7210-4.ch007 · Cited by 3 · see citing works
A Healthcare Data Management System on Blockchain Framework
Saha, S., Majumder, A., Bhowmik, T., Basu, A., & Choudhury, A. (2021) · International Conference on Smart Generation Computing, Communication and Networking (SMART GENCON) · doi:10.1109/smartgencon51891.2021.9645890 · Cited by 5 · see citing works
A Conceptual Framework for Blockchain-based Intelligent Healthcare Data Management
Majumder, A., Saha, S., Bhowmik, T., & Basu, A. (2021) · IEEE Bombay Section Signature Conference (IBSSC) · doi:10.1109/ibssc53889.2021.9673339 · Cited by 3 · see citing works
Matheny, M. E., Lucila Ohno-machado, A., Davis, S. E., & Nemati, S. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-91200-6.00031-0 · Cited by 3 · see citing works
Artificial Intelligence to Guide Repurposing of Drugs
Fu, Z., Yang, Y., Chung, M. K., & Cheng, F. (2026) · Annual Review of Medicine · doi:10.1146/annurev-med-050224-122802 · Cited by 4 · see citing works
Addressing the global Challenge of NCDs using a Risk Factor approach: voices from around the world
Saran, R., Randolph, E., & Omollo, K. L. (2021) · FASEB BioAdvances · doi:10.1096/fba.2020-00131 · Cited by 2 · see citing works
Telemedicine System Based on Medical Consultation Assistance Integration
Lin, J.-W., Siao, C.-Y., Chang, R., et al. (2021) · Journal of Software Engineering and Applications · doi:10.4236/jsea.2021.1410031 · Cited by 2 · see citing works
“…the data format and data elements of Electronic Health Records, and provide standard system information in the Application Programming Interface [13], and streng-thened patient data exchange, covering not only medical institutions, medical records, hospital stay, and discharge and referral…”
BackgroundNogueira, S. A., Luz, F. A. B., de Camargo, T. F. O., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0312257 · Cited by 2 · see citing works
Atta, S., Emmerich, M., & Basto-Fernandes, V. (2026) · Computational methods in applied sciences · doi:10.1007/978-3-032-21893-3_14 · Cited by 1 · see citing works
Medical Integrated Development Platform Based on Community and Hospital
Lin, J.-W., Siao, C.-Y., Chien, T.-H., et al. (2023) · International Conference on Applied System Innovation · doi:10.1109/icasi57738.2023.10179511 · Cited by 1 · see citing works
“FHIR represents the patient health record information and provides systematic legal data in the functional program interface [8].”
BackgroundCommentary: Outcomes of truncus arteriosus repair: Insights from time and numbers
Hornik, C. P. V. (2020) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2020.05.025
Personal Health Record Manager and Appointment Scheduler (PHARMAS)
Sadre, A., Bhargava, A., Doshi, P., et al. (2022) · International Journal for Research in Applied Science and Engineering Technology · doi:10.22214/ijraset.2022.42797
Value-Based Pricing for Specialty Drugs: Solving the implementation puzzle using Blockchain
Bhattacharjee, A., Chaudhary, M., & Ranganathan, S. (2023) · doi:10.1109/otcon56053.2023.10113934
“Braunstein [21] and Gonçalves et al. [19] have suggested a direct correlation of automation of this data flow and the success of VBP.”
BackgroundThe Generation of Standardized e-Learning Content Packages from Interoperable FHIR Clinical Cases
García, F. B., Gayoso-Cabada, J., Díaz, J. G., et al. (2023) · IEEE International Symposium on Computer-Based Medical Systems (CBMS) · doi:10.1109/cbms58004.2023.00250
The regulation of telemedicine: a Latvian–EU perspective
Ciekurs, R. (2023) · SOCRATES Rīgas Stradiņa universitātes Juridiskās fakultātes elektroniskais juridisko zinātnisko rakstu žurnāls / SOCRATES Rīga Stradiņš University Faculty of Law Electronic Scientific Journal of Law · doi:10.25143/socr.25.2023.1.74-80
Understanding Innovation in Interoperable Systems: A Podcasting Case StudyPreprint
Luria, M., & Nicholas, G. (2024) · doi:10.31219/osf.io/t65mw
Torab-Miandoab, A., Samad‐Soltani, T., Jodati, A., & Rezaei‐Hachesu, P. (2023) · Figshare · doi:10.6084/m9.figshare.22612778
Gamal, A., El–Sappagh, S., Abuhmed, T., El-Rashidy, N. M., & Adel, E. (2026) · Neural Computing and Applications · doi:10.1007/s00521-026-12298-3
- Authors
- Braunstein, M. L.
- Affiliations
- Georgia Institute of Technology (US)
- Corresponding author
- Braunstein, Mark L.
- ORCID
- Braunstein, Mark L.
- Venue
- IEEE Pulse
- Published
- 2018-11
- Volume
- 9
- Issue
- 6
- Pages
- 24-27
- ISSN
- 2154-2287 (ISSN-L)
- 2154-2317
- OpenAlex
- W2900834200
- Cited by
- 53
- References
- 3
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 12 · 2022: 7 · 2021: 12 · 2020: 7 · 2019: 3
- FWCI
- 6.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- IEEE Pulse (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- Fast Healthcare Interoperability Resources, FHIR, healthcare interoperability, clinical data representation, medical terminology, electronic health records, Health Level 7
- MeSH terms
- Health Information Interoperability, Delivery of Health Care, Humans, Semantics, Internet, Systematized Nomenclature of Medicine, Electronic Health Records
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
