Key result
Novel FHIR R4 Implementation Guide maps 17 attributes to enable standardized 12-lead ECG data exchange.
Why the study?
Indonesia's SatuSehat mandates HL7 FHIR R4 interoperability, but limited informatics capacity creates clinical-software translation gaps for ECG data exchange.
A novel FHIR R4 Implementation Guide successfully maps legacy aECG standards to modern interoperable formats, enabling standardized, scalable, and lossless ECG data exchange in resource-limited telemedicine settings.
Supports standard 12-lead ECG exchange on SatuSehat; leaves open broader aECG mapping and prospective validation.
Indonesia’s SatuSehat mandates HL7 FHIR R4 interoperability, yet limited informatics capacity creates clinical-software translation gaps. This study develops and validates a SatuSehat-compliant electrocardiogram (ECG) data model and API contract via a FHIR Implementation Guide (IG). We mapped the HL7 aECG v1 standard to FHIR R4 using a six-phase normative workflow. From 312 aECG attributes, 17 defined the core exchange surface, fully supporting standard 12-lead ECGs. Although SNOMED CT only covered 13 of 32 lead types, missing specialized leads were addressed using provisional ValueSets. The resulting computable IG enables standardized, scalable ECG data exchange via FHIR REST and Bulk Data export, effectively bridging clinical requirements with technical implementation in resource-limited settings.
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Chaidir et al. (2025) studied ECG Data Interoperability. FHIR R4 ECG Implementation Guide was evaluated on Mapping HL7 aECG attributes to FHIR R4. The development of a FHIR R4 Implementation Guide successfully mapped 17 of 312 HL7 aECG attributes to FHIR R4, fully supporting standard 12-lead ECG data exchange for Indonesia's SatuSehat platform.
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