Der HL7 FHIR Standard im Überblick

Wissenswertes

October 1, 2024

1.10.2024

Die Digitalisierung des Gesundheitswesens ist nicht zuletzt dank der Erlassung des Krankenhauszukunftsgesetzes in aller Munde.  Mit seiner Umsetzung soll zukünftig unter anderem die Datenübertragung in medizinischen Einrichtungen durch moderne Gesundheitsstandards, wie HL7 FHIR, revolutioniert werden.

 

Was ist HL7 FHIR?

 

Bei FHIR handelt es sich um den neusten, von der Non-Profit-Organisation HL7 (Health Level 7) entwickelten Standard für die Ressourcenübertragung im Gesundheitswesen. Als solcher, bestimmt der Standard FHIR, wie verschiedene Systeme innerhalb medizinischer Einrichtungen untereinander Daten austauschen. Das Ziel von FHIR: Die Interoperabilität von Systemen ganzheitlich verbessern.

 

 

Was sind FHIR-Ressourcen?

 

Die Grundbausteine des FHIR-Standards sind die von ihm für den Datenaustausch verwendeten Ressourcen. Diese repräsentieren für sich klar definierte Gesundheitsdaten, die in den jeweiligen Systemen verwendet werden können, um medizinische Sachverhalte abzubilden. Die einzelnen Ressourcen können sich jeweils eigene Kategorien zuweisen lassen.

 

Zu diesen können folgende Ressourcentypen zählen:

1.      Klinische Ressourcen – Diese beziehen sich auf die Versorgung von Patienten und beinhalten Faktoren wie Allergien, den Pflegeplan oder den Zustand des/der Patient*in

2.      Administrative Ressourcen – Sie beinhalten verwaltungstechnische Gegebenheiten in Bezug auf den/die Patient*in, die jeweilige Gesundheitseinrichtung und ihren Standort.

3.       Infrastrukturelle Ressourcen – Diese Ressourcen dienen der Verwaltung des Datenaustauschs selbst. Hierzu gehört unter anderem die Gruppierung mehrerer Ressourcen.

4.      Finanzielle Ressourcen – Sie umfassen sämtliche Daten die in Bezug zu finanziellen Informationen über medizinische Leistungen stehen, wie in etwa Rechnungen und Versicherungen.

 

Zwei Hände tauschen Daten aus

 

Revolutioniert FHIR die Interoperabilität im Gesundheitswesen?

 

Die Zukunft der Krankenhäuser ist interoperabel. Daran besteht kein Zweifel. In kaum einer anderen Branche bietet ein sicherer, schneller und vor Allem korrekt zu interpretierender Datenaustausch derartig existenzielle Vorteile, wie im Gesundheitssektor. Eine Effizienzsteigerung der Kommunikation in medizinischen Einrichtungen kann mitunter den Unterschied zwischen der reibungslosen Behandlung eines/einer Patient*in und einer potenziell lebensbedrohlichen Fehlkommunikation machen. Doch wie genau trägt FHIR zum Fortschritt der Interoperabilität bei?

 

Zu einem der größten Vorteile des FHIR-Standards gehören seine klar definierten Ressourcen, die zur Abbildung der diversen Prozesse innerhalb medizinischer Einrichtungen dienen. FHIR-Ressourcen können durch ihre einheitliche Darstellung problemlos zwischen sämtlichen Systemen ausgetauscht werden. Somit ermöglicht FHIR sinnbildlich, dass alle Systeme in derselben Sprache miteinander kommunizieren können. FHIR ist zudem als webbasierter Standard mit mehreren, in der Softwareentwicklung gängigen Datenformaten kompatibel, wie etwa JSON oder XML.

 

FHIR ermöglicht darüber hinaus, im Gegensatz zu älteren Standards, den ständigen Zugriff auf Datensätze in Echtzeit, mithilfe von REST APIs. Dadurch kann medizinisches Fachpersonal sofort auf Informationen zu beispielsweise Laborergebnissen oder Medikation, zugreifen. So kann eine generelle Beschleunigung von zahlreichen medizinischen Prozessen erzielt werden.

 

Trotz der zahlreichen Vorteile des Standards, zeigen sich bei FHIR insbesondere auf internationaler Ebene auch Schwierigkeiten bei seiner Implementation. So können bestimmte länderspezifische Gesetze, die der Regulation des Datenaustausches im Gesundheitswesen dienen, mitunter eine Anpassung des FHIR-Standards an die jeweiligen, nationalen Rahmenbedingungen zur Folge haben.

 

 

Wie aufwendig ist die Implementation von HL7 FHIR?

 

Die Dauer und auch die Kosten einer FHIR-Implementation können stark anhand verschiedener, oft schwierig vorhersehbarer Faktoren, variieren. Hierzu zählt unter anderem die Größe der Einrichtung, sowie die dort bereits vorhandene IT-Infrastruktur. So können in etwa kleinere Kliniken mit einer geringeren Implementationsdauer, sowie geringeren Implementationskosten rechnen, da die dort bestehenden oder noch benötigten Systeme auch eine insgesamt geringere Komplexität umfassen als in einem größeren Krankenhaus.

 

Kommen jedoch in einer medizinischen Einrichtung noch veraltete Systeme zum Einsatz, so wird oftmals neben der Implementation des FHIR-Standards auch die Implementation bestimmter Schnittstellen benötigt, um die in den älteren bestehenden Systemen vorhandenen Daten in das von FHIR verwendete Format zu konvertieren.

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A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila! Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

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A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila! Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

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A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila! Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

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