Interoperable HL7 FHIR platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government

This article was originally published here

JMIR Med Inform. 2020 Dec 19. doi: 10.2196/25149. Online ahead of print.


BACKGROUND: Testing, traceability, and isolation (TTI strategy) actions are a central strategy defined by WHO to contain the COVID-19 pandemic. In this sense, the countries have had difficulties in counting the number of people infected with SARS-CoV-2. Errors in reporting results are a common factor, as well as the lack of interoperability between laboratories and governments. Approaches aimed at sending spreadsheets via email expose patients’ privacy and have increased the probability of errors due to re-typing, which generates a delay in the notification of results.

OBJECTIVE: Design and develop an interoperable platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government.

METHODS: The methodology to design and develop the interoperable platform comprised six well-structured stages: 1) Creation of a minimum dataset for PCR SARS-CoV-2 tests, 2) Modeling processes and endpoints where institutions interchange information, 3) Standards and interoperability design, 4) Software development, 5) Software testing and 6) Software implementation.

RESULTS: The main result was that the interoperable FHIR platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government was successfully implemented. The platform was designed, developed, tested, and implemented following a structured methodology. The platform’s performance to 1,000 requests resulted in a response time of 240 milliseconds, throughput was 28.3 requests per second, and the process management time was 131 milliseconds. The security was assured through a private network exclusive for the Ministry of Health to ensure confidentiality and integrity. The authorization and authentication of laboratories were implemented with JSON Web Token (JWT). All the PCR SARS-CoV-2 tests were accessible through an Application Programming Interface (API) gateway with valid credentials and the right access control list.

CONCLUSIONS: The platform was implemented and is currently being used by UC Christus Laboratory. The platform is secure. It was tested adequately for confidentiality, secure authorization, authentication, and message integrity. This platform simplifies the reporting of PCR SARS-CoV-2 tests and reduces the time and probability of mistakes in counting positive cases. The interoperable solution with FHIR is working successfully and is open for the community, laboratories, and any institution that needs to report PCR SARS-CoV-2 tests.

PMID:33417587 | DOI:10.2196/25149

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