Oehm Johannes Benedict, Fuhrmann Lars, Hoffmann Katja, Schröder Daniel, Weich Cedric, Poschkamp Broder, Merle David, Paulet Lucian, Berthe Sebastian, Mirraziroudsari Delaram, Prus Sascha, Dickhoff Lothar, Heines David, Wahle Leonie, Brix Tobias J, Eter Nicole, Varghese Julian
Institut für Medizinische Informatik, Universität Münster, Münster, Germany.
Klinik für Augenheilkunde, Asklepios Klinik Nord - Heidberg, Hamburg, Germany.
Stud Health Technol Inform. 2025 Sep 3;331:213-220. doi: 10.3233/SHTI251398.
EyeMatics (Eye disease "treated" with interoperable medical informatics) is a clinical use case in Germany's Medical Informatics Initiative (MII). The objective of EyeMatics is to improve the understanding of the treatment effects of intravitreal injections, the most frequent procedure to treat retinal diseases. To achieve this, as part of the efforts, medical data of multiple hospital sites must be integrated into a local FHIR repositories using a common set of FHIR profiles.
A panel of medical and technical experts was formed to create a project-specific core data set. The core data set is compiled from different preliminary work like previously existing data models, the data donation of a synthetic patient encounter scenario, screenshots of UI forms used at the local sites and relevant MII profiles.
Complex profiling and custom code systems were required to represent central ophthalmic concepts such as visual acuity using FHIR. A common pattern for representing eye laterality in FHIR Observation resources was established. The resulting profiles are available in a public GitHub repository.
While our FHIR profiles will be sufficient for EyeMatics, our experience shows that the clinical complexity of basic ophthalmological observations requires some deviations from standard FHIR modelling patterns and would be limited by gaps in terminology if deployed elsewhere. Our experience indicates that project-specific FHIR profile development is possible within a short time frame but may harbor risks of contributing to a growing number of fragmented implementations unless closely coordinated or based on common data models. To counteract this, future ophthalmic MII extension modules should attempt to integrate both profiles described here and international standard data models for ophthalmology.
EyeMatics（通过可互操作的医学信息学“治疗”眼病）是德国医学信息学倡议（MII）中的一个临床用例。EyeMatics的目标是增进对玻璃体内注射治疗效果的理解，玻璃体内注射是治疗视网膜疾病最常用的方法。为实现这一目标，作为工作的一部分，必须使用一组通用的FHIR概要文件将多个医院站点的医疗数据集成到本地FHIR存储库中。
组建了一个医学和技术专家小组，以创建特定于项目的核心数据集。核心数据集是根据不同的前期工作汇编而成的，如先前存在的数据模型、合成患者诊疗场景的数据捐赠、本地站点使用的用户界面表单截图以及相关的MII概要文件。
使用FHIR表示诸如视力等核心眼科概念需要复杂的概要文件和自定义代码系统。在FHIR观察资源中建立了表示眼侧性的通用模式。生成的概要文件可在公共GitHub存储库中获取。
虽然我们的FHIR概要文件对EyeMatics来说足够了，但我们的经验表明，基础眼科观察的临床复杂性需要与标准FHIR建模模式有所偏差，并且如果在其他地方部署，会受到术语差距的限制。我们的经验表明，特定于项目的FHIR概要文件开发可以在短时间内完成，但可能存在导致越来越多碎片化实现的风险，除非进行密切协调或基于通用数据模型。为了应对这一问题，未来的眼科MII扩展模块应尝试整合此处描述的概要文件和国际眼科标准数据模型。
