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Comment by gdevenyi | Hacker News Reader

> I like the gateway concept as an alternative to opening the firewall.

Cheers, it was a real revelation when we worked out how to do it!

> Are there any plans to add FHIR compatibility, for integrating with other FHIR systems?

We've definitely looked at such standards and systems but they seem to be targeted towards EHR data exchange and we are explicitly not an EHR. Our target is structuring research and research clinical data. The summary tool at the end of each instrument is designed to produce reports which can be fed into classic digital paper style EHRs where real clinical record keeping is required.

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Not utilizing FHIR b/c you think EHRs will (a) consume your proprietary reports, and (b) be a downstream data system seems a big footgun. Additionally, while FHIR isn’t quite right for many research use cases, there are ongoing efforts such as mCODE [0], that use FHIR as a base because it is not proprietary and highly specified.

Maybe your EDC has other awesome characteristics. Based on the interest I’ve seen the FHIR ingestion of REDCap [1] is a winner for research nurse efficiency.

0. https://build.fhir.org/ig/HL7/fhir-mCODE-ig/

1. https://www.project-redcap.org/

Right now, we're building first to address the needs of our institution, there's no FHIR enabled software there, and the clinicians make a direct request to generate reports for ingestion into their existing EHR system, so we oblige.

Interoperability is on our roadmap.

Meanwhile, we don't consider RedCap a competitor, the old-school LAMP stack is showing its age, and its "closed source" by most interpretations, including a hostile position on external developers.

We welcome contributions to accelerate FHIR support.

Oh, I forgot another aspect of FHIR, SMART on FHIR EHR integrations so the clinical research folks can optionally go straight in from the EHR.

I can’t say I disagree with your assessment of REDCap’s base tech except that it works sufficiently well to have pretty broad adoption, which can be approximated by the number of local endpoints exposed in their EHR-internal client record. A single institution project is certainly not a competitor and I wish y’all good fortune in ever getting beyond your patrons.

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