Currently submitted to: Journal of Medical Internet Research
Date Submitted: Oct 22, 2020
Open Peer Review Period: Oct 19, 2020 - Oct 29, 2020
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Interoperable HL7 FHIR platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government
Testing, traceability, and the isolation (TTI strategy) actions are a central strategy defined by WHO to contain the COVID-19 pandemic. In this sense, 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 and generate a delay in the notification of results.
Design and develop an interoperable platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government.
The methodology to design and develop the interoperable platform was comprised of six well-structured stages: 1) Creation of a minimum dataset to PCR SARS-CoV-2 tests, 2) Modeling process and endpoints where institutions interchange information, 3) Standards and interoperability design, 4) Software development, 5) Quality assurance and 6) Software implementation.
The main result was the interoperable FHIR platform to report PCR SARS-CoV-2 tests from laboratories to the Chilean government. 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 platform has availability of 99.9 %. The security was implemented with JSON Web Token (JWT) to ensure confidentiality, authorization, and authentication. 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.
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.
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