Real World Performance of the 21st Century Cures Act Population Level Application Programming Interface.
Real World Performance of the 21st Century Cures Act Population Level Application Programming Interface.
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21 世纪治愈法案人口级应用程序编程接口的真实世界表现。
DOI：
10.1101/2023.10.05.23296560
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Sprouse,Elizabeth
中科院分区：
文献类型：
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作者：
Jones,JamesR;Gottlieb,Daniel;McMurry,AndrewJ;Atreja,Ashish;Desai,PankajaM;Dixon,BrianE;Payne,PhilipRO;Saldanha,AnilJ;Shankar,Prabhu;Solad,Yauheni;Wilcox,AdamB;Ali,MomeenaS;Kang,Eugene;Martin,AndrewM;Sprouse,Elizabeth
目的评估SMART/HL 7批量快速健康互操作性资源（FHIR）访问应用程序编程接口（API）的真实世界性能，该接口是为实现对大量人群电子健康记录数据的按钮访问而开发的，并且是21世纪世纪治愈法案规则所要求的。材料和方法我们从2023年4月至9月在5个医疗保健站点使用开源批量FHIR测试套件，其中包括4家医院使用经互操作性认证的电子健康记录（EHR），以及1家使用符合标准的定制API构建的健康信息交换（HIE）。我们测量了6种FHIR类型的导出速度、数据大小和完整性。结果在经过认证的平台中，Oracle Cerner的速度领先，以超过8000个资源/分钟的速度管理500 - 1600万个资源。三个Epic站点导出了FHIR数据子集，以1555-2500个资源/分钟的速度实现了100 - 1200万个资源。值得注意的是，HIE的自定义API表现出色，讨论HIE的自定义API展示了上级性能，认可了SMART/HL 7 Bulk FHIR在实现大规模数据交换方面的有效性，同时强调了对现有EHR平台进行优化的必要性。灵活性和可扩展性是必不可少的不同的健康，研究和公共卫生usecases.ConclusionTo充分实现互操作性的目标，21世纪世纪治愈法案，解决散装FHIR API的性能限制是至关重要的。将业绩衡量标准纳入认证和报告进程将是有益的。
ObjectiveTo evaluate the real-world performance of the SMART/HL7 Bulk Fast Health Interoperability Resources (FHIR) Access Application Programming Interface (API), developed to enable push button access to electronic health record data on large populations, and required under the 21st Century Cures Act Rule.Materials and MethodsWe used an open-source Bulk FHIR Testing Suite at 5 healthcare sites from April to September 2023, including 4 hospitals using electronic health records (EHRs) certified for interoperability, and 1 Health Information Exchange (HIE) using a custom, standards-compliant API build. We measured export speeds, data sizes, and completeness across 6 types of FHIR.ResultsAmong the certified platforms, Oracle Cerner led in speed, managing 5-16 million resources at over 8000 resources/min. Three Epic sites exported a FHIR data subset, achieving 1-12 million resources at 1555-2500 resources/min. Notably, the HIE’s custom API outperformed, generating over 141 million resources at 12 000 resources/min.DiscussionThe HIE’s custom API showcased superior performance, endorsing the effectiveness of SMART/HL7 Bulk FHIR in enabling large-scale data exchange while underlining the need for optimization in existing EHR platforms. Agility and scalability are essential for diverse health, research, and public health use cases.ConclusionTo fully realize the interoperability goals of the 21st Century Cures Act, addressing the performance limitations of Bulk FHIR API is critical. It would be beneficial to include performance metrics in both certification and reporting processes.