CAMP FHIR: Lightweight, Open-Source FHIR Conversion Software to Support EHR Data Harmonization and Research

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Project Summary Since our inception in 2008, the UNC CTSA affiliate, the North Carolina Translational and Clinical Sciences Institute (TraCS) has transformed clinical and translational science at UNC through interdisciplinary research, training, collaboration with partners and stakeholders, and strong engagement across the CTSA consortium. We have built a dynamic regional network of universities, research institutes, health care providers, and >130 community organizations across our state. In our current funding cycle, we are translating the best science from UNC and across the CTSA consortium into creative, effective, and accessible clinical and community interventions, addressing the public health problems of our state and advancing national CTSA goals by completing our Overall Aims. Aim 1 Workforce Development: Develop and support a skilled and diverse clinical and translational research workforce to advance translational innovations and address healthcare priorities. Aim 2 Collaboration and Engagement: Engage diverse stakeholders as active partners in translational research, and promote innovative approaches to team science. Aim 3 Integration: Integrate translational research for disciplines and populations across the research continuum and throughout the lifespan; Aim 4 Methods/Processes: Develop and disseminate innovative methods and approaches to address scientific and operational barriers to translating scientific findings. Aim 5 Informatics: Incorporate cutting-edge informatics tools and methodologies in every aspect of translational research. The TraCS Informatics and Data Science (IDSci) component provides services and develops new tools that increase research productivity and reduce the effort required by individual researchers and teams to conduct effective clinical and translational research. We have built sustainable, cross-institutional informatics infrastructure and data governance processes that keep data secure while removing barriers to getting research done. In our current funding cycles, we are building on our experience in developing local resources and tools to support leading national informatics initiatives, training our translational workforce on the use of informatics tools including those from other CTSA hubs, providing secure and compliant data management services, disseminating open source software locally and nationally, and engaging communities of stakeholders in translational research via the sharing of data and tools. TraCS IDSci developers conceptualized CAMP FHIR in 2018 in response to a need to work with electronic health record (EHR) data in “bulk” Fast Healthcare Interoperability Resources (FHIR) format, despite HL7 not having released a finalized bulk FHIR specification. (Bulk FHIR enables EHR data extraction for large cohorts of patients rather than one patient at a time, which is essential for population-based research.) CAMP FHIR fills this gap, enabling users to convert large amounts of data stored in common data models (CDMs; i2b2/ACT and PCORnet) directly to FHIR. After inquiring with informatics teams at peer institutions, we realized that demands to use FHIR data for research (including NIH’s request to do so, as described in 2019’s NOT-OD-19-122) were ahead of “official” FHIR specifications and capabilities from EHR vendors and HL7 itself. This encouraged us to continue development of CAMP FHIR to support more resources and fields than originally envisioned. This current proposal is in response to NOT-OD-21-091 and builds on IDSci’s aim to develop leading-edge informatics tools and methods and make these available to the CTSA consortium. Through this supplement, we will update and harden CAMP FHIR (i.e., make CAMP FHIR more robust) using software engineering best practices, as well as ensure deployability on the cloud. Our ultimate goal is to create and support a CTSA community of CAMP FHIR users who can use the tool both independently and collaboratively, and continue to engage in open-source development over time. The work to update CAMP FHIR in the proposed manner will greatly increase the number of users and impact of the software, and is within the mission of the CTSA and the scope of our parent award. However, the activities to prepare CAMP FHIR for broad dissemination across the CTSA consortium require resources beyond what is provided in our current CTSA award. We believe the entirety of the CTSA consortium could benefit from having the capability to convert CDM data to FHIR (and vice versa), facilitating the efficient investigation of novel research questions and hastening discoveries that improve human health and patient care.