The Fast Health Interoperability Resources (FHIR) Standard: Systematic Literature Review of Implementations, Applications, Challenges and Opportunities

BACKGROUND: Information technology has shifted paper-based documentation in the health care sector into a digital form, in which patient information is transferred electronically from one place to another. However, there remain challenges and issues to resolve in this domain owing to the lack of proper standards, the growth of new technologies (mobile devices, tablets, ubiquitous computing), and health care providers who are reluctant to share patient information. Therefore, a solid systematic literature review was performed to understand the use of this new technology in the health care sector. To the best of our knowledge, there is a lack of comprehensive systematic literature reviews that focus on Fast Health Interoperability Resources (FHIR)-based electronic health records (EHRs). In addition, FHIR is the latest standard, which is in an infancy stage of development. Therefore, this is a hot research topic with great potential for further research in this domain.

OBJECTIVE: The main aim of this study was to explore and perform a systematic review of the literature related to FHIR, including the challenges, implementation, opportunities, and future FHIR applications.

METHODS: In January 2020, we searched articles published from January 2012 to December 2019 via all major digital databases in the field of computer science and health care, including ACM, IEEE Explorer, Springer, Google Scholar, PubMed, and ScienceDirect. We identified 8181 scientific articles published in this field, 80 of which met our inclusion criteria for further consideration.

RESULTS: The selected 80 scientific articles were reviewed systematically, and we identified open questions, challenges, implementation models, used resources, beneficiary applications, data migration approaches, and goals of FHIR.

CONCLUSIONS: The literature analysis performed in this systematic review highlights the important role of FHIR in the health care domain in the near future.