Interoperability in Dialysis Platforms: Leveraging FHIR and Cloud APIs for Seamless Data Exchange

Aim: This study addresses the interoperability challenges affecting the care of patients with end-stage kidney disease (ESKD), a population requiring coordinated treatment across dialysis centers, hospitals, and ancillary providers. It aims to develop a technical framework that enables seamless data exchange among dialysis-specific electronic health record (EHR) systems through the integration of Fast Healthcare Interoperability Resources (FHIR) standards and cloud-based application programming interfaces (APIs), thereby reducing fragmentation and improving clinical outcomes. Methods: The research employs a technical and architectural analysis of current dialysis information systems to identify interoperability gaps and data silos. It evaluates FHIR implementation strategies using the Java-based HAPI FHIR library and assesses cloud API service models provided by major cloud vendors, including Microsoft Azure, Google Cloud, and Amazon Web Services. The proposed architecture integrates FHIR-based data modeling with secure cloud-hosted APIs to facilitate the standardized exchange of patient information across care settings. System performance, scalability, and security considerations are incorporated into the framework design. Results: The proposed interoperability framework demonstrates measurable improvements in data accessibility and exchange efficiency between dialysis centers and external healthcare providers. Implementation of FHIR standards reduces information silos and supports real-time data sharing, contributing to a decrease in medication errors, fewer instances of duplicate testing, and improved care coordination timelines. Cloud-based FHIR services provide scalable and secure infrastructure, ensuring compliance with healthcare data protection standards while minimizing technical overhead. The integration of cloud APIs enhances interoperability without requiring extensive redevelopment of existing dialysis systems. Conclusion: Siloed dialysis EHR systems significantly hinder coordinated care for patients with ESKD, increasing the risk of adverse clinical outcomes. Recommendation: Healthcare organizations operating dialysis platforms should prioritize FHIR-based interoperability strategies supported by secure cloud API infrastructure.