Interoperability and Security in the Implementation of Health Web Applications with SMART on FHIR

Authors

  • Leonardo Souza dos Santos IFSul
  • Gabriela del Mestre Martins Unimed Litoral
  • Fábio Pires Itturriet IFSul
  • Juliano Costa Machado IFSul
  • André Luís del Mestre Martins IFSul

DOI:

https://doi.org/10.59681/2175-4411.v15.iEspecial.2023.1096

Keywords:

Interoperability, Confidentiality, Telemedicine

Abstract

Objectives: Develop a cloud server to enable interoperability between different healthcare web applications regarding authentication protocol for IoT (Internet of Things) applications and user interface applications. Method: TThe server sends and receives data in the FHIR (Fast Healthcare Interoperability Resources) standard. The server authenticates applications with user interfaces using SMART (Substitutable Medical Apps and Reusable Technologies) on FHIR while IoT applications are registered in advance to authenticate with SMART on FHIR. Results: A third-party FHIR application was modified to authenticate by using the proposed server instead of the original one. A prototype IoT device was developed to perform authentication with the server. The server successfully authenticated both applications. Conclusions: Third-party applications and IoT devices communicating with the proposed SMART on FHIR server prove the interoperability and security of this work.

Author Biographies

Leonardo Souza dos Santos, IFSul

IFSul campus Charqueadas, Charqueadas (RS), Brasil.

Gabriela del Mestre Martins, Unimed Litoral

Unimed Litoral, Balneário Camboriú (SC), Brasil.

Fábio Pires Itturriet, IFSul

IFSul campus Charqueadas, Charqueadas (RS), Brasil.

Juliano Costa Machado, IFSul

IFSul campus Charqueadas, Charqueadas (RS), Brasil.

André Luís del Mestre Martins, IFSul

IFSul campus Charqueadas, Charqueadas (RS), Brasil.

References

Benson T, Grieve G. Principles of health interoperability: SNOMED CT, HL7 and FHIR. Springer; 2016 Jun 22.

FHIR Release 4 [Internet]. HL7.org. 2022. [Acessado em 15/08/2022]. Disponível em: https://www.hl7.org/fhir/

Fantonelli M, Celuppi IC, de Oliveira FM, Burigo F, Dalmarco EM, Wazlawick RS. Lei geral de proteção de dados e a interoperabilidade na saúde pública. Journal of Health Informatics. 2021 Mar 15;12.

Mandel JC, Kreda DA, Mandl KD, Kohane IS, Ramoni RB. SMART on FHIR: a standards-based, interoperable apps platform for electronic health records. Journal of the American Medical Informatics Association. 2016 Sep 1;23(5):899-908.

Rosa M, Faria C, Barbosa AM, Caravau H, Rosa AF, Rocha NP. A fast healthcare interoperability resources (FHIR) implementation integrating complex security mechanisms. Procedia Computer Science. 2019 Jan 1;164:524-31.

Barbosa P, Santos D, Lucena C, Bastida L, Ferreira JF, Cea G. The OCARIoT Data Acquisition App. In2020 IEEE 33rd International Symposium on Computer-Based Medical Systems (CBMS) 2020 Jul 28 (pp. 409-414). IEEE.

Bloomfield Jr RA, Polo-Wood F, Mandel JC, Mandl KD. Opening the Duke electronic health record to apps: implementing SMART on FHIR. InternationalJournalof Medical Informatics. 2017 Mar 1;99:1-0.

Szabó Z, Bilicki V. Access Control of EHR Records in a Heterogeneous Cloud Infrastructure. Acta Cybernetica. 2021 Dec 7;25(2):485-516.

Setyawan R, Hidayanto AN, Sensuse DI, Suryono RR, Abilowo K. Data Integration and Interoperability Problems of HL7 FHIR Implementation and Potential Solutions: A Systematic Literature Review. In2021 5th International Conference on Informatics and Computational Sciences (ICICoS) 2021 Nov 24 (pp. 293-298). IEEE.

Ayaz M, Pasha MF, Alzahrani MY, Budiarto R, Stiawan D. The Fast Health Interoperability Resources (FHIR) standard: systematic literature review of implementations, applications, challenges and opportunities. JMIR medical informatics. 2021 Jul 30;9(7):e21929.

Wagholikar KB, Mandel JC, Klann JG, Wattanasin N, Mendis M, Chute CG, Mandl KD, Murphy SN. SMART-on-FHIR implemented over i2b2. Journal of the American Medical Informatics Association. 2017 Mar 1;24(2):398-402.

Kondylakis H, Petrakis Y, Leivadaros S, Iatraki G, Katehakis D. Using XDS and FHIR to support mobile access to EHR information through personal health apps. In2019 IEEE 32nd International Symposium on Computer-Based Medical Systems (CBMS) 2019 Jun 5 (pp. 241-244). IEEE.

Ahmad A, Azam F, Anwar MW. Implementation of SMART on FHIR in developing countries through SFPBRF. InProceedings of the 2018 5th International Conference on Biomedical and Bioinformatics Engineering 2018 Nov 12 (pp. 137-144).

Mandl KD, Gottlieb D, Ellis A. Beyond one-off integrations: a commercial, substitutable, reusable, standards-based, electronic health record–connected app. Journal of Medical Internet Research. 2019 Feb 1;21(2):e12902.

Estratégia de Saúde Digital para o Brasil 2020-2028 [recurso eletrônico] Brasília : Ministério da Saúde, 2020. [Acessado em 09/09/2022]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/estrategia_saude_digital_Brasil.pdf

STM32 Nucleo-64 development board with STM32F411RE MCU, supports Arduino and ST morpho connectivity. [Internet]. STMicroelectronics. 2022. [Acessado em 15/08/22]. Disponível em: https://www.st.com/en/evaluation-tools/nucleo-f411re.html

Published

2023-07-20

How to Cite

Santos, L. S. dos, Martins, G. del M., Itturriet, F. P., Machado, J. C., & Martins, A. L. del M. (2023). Interoperability and Security in the Implementation of Health Web Applications with SMART on FHIR. Journal of Health Informatics, 15(Especial). https://doi.org/10.59681/2175-4411.v15.iEspecial.2023.1096

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