David Habsara Hareva
Pelita Harapan University Jl. M.H. Thamrin Boulevard Tangerang, 15811 Banten, Indonesia

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A SatuSehat Compliant FHIR R4 ECG Implementation Guide: Bridging Clinical and Informatics Domains in Indonesia Chaidir, Thomas Adhi Nugroho; Hareva, David Habsara
International Journal of Informatics, Information System and Computer Engineering (INJIISCOM) Vol. 6 No. 2 (2025): INJIISCOM: VOLUME 6, ISSUE 2, DECEMBER 2025 (ONLINE FIRST)
Publisher : Universitas Komputer Indonesia

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Abstract

Indonesia’s SatuSehat mandates HL7 FHIR (Fast Healthcare Interoperable Resources) R4 interoperability but limited medical informatics capacity leaves a translation gap. ECG was chosen as an exemplar for its ubiquity, as well as native FHIR waveform support (SampledData). Develop and validate a SatuSehat-compliant ECG data model and API-level contract as a FHIR Implementation Guide (IG). Using a normative modeling workflow, we mapped HL7 aECG (annotated ECG) v1 to FHIR R4 across six phases (inventory, mapping, terminology binding, extensions, IG authoring, validation) with FSH/SUSHI, IG Publisher, and the FHIR R4 Validator. The IG includes StructureDefinitions, ValueSets/CodeSystems, CapabilityStatement, Operation Definitions/ StructureMaps, and CI tests. From 312 schema attributes, 44 exchange-relevant fields were identified; 17 define the exchange surface. The model provides complete support for standard 12-lead ECGs (I, II, III, aVR, aVL, aVF, V1–V6). SNOMED CT covers 13/32 lead types; missing right/posterior leads are handled via provisional ValueSets/CodeSystems and ConceptMaps. The deliverable is a computable information model + API data contract: clients obtain ECG via FHIR REST (read/search) and at scale via FHIR Bulk Data export, enabling big-data analytics