Applying FHIR in Remote Consultation in Dermatology: Interoperability of Information for Digital Dermatoscope

Because of the Coronavirus disease and the problem of uneven distribution of physicians between urban and rural areas, telemedicine is widely adopted, including tele-dermatology. However, there is still no formal and consistent format for telemedicine data exchange in Taiwan. In 2021, Ministry of Health and Welfare (MOHW) of Taiwan has announced that the National Electronic Medical Record Exchange Center (EEC) should follow Fast Health Care Interoperability Resources (FHIR) based on Health Level 7 (HL7) in Taiwan. Dermatoscope has become a significant tool for diagnosis in dermatology. It is used in diagnosing benign and malignant skin tumors, seborrheic keratosis, malignant melanoma, squamous cell carcinoma, and basal cell carcinoma, etc. With the advancement of medical optical imaging, dermoscope has become a convenient, portable, non-invasive, diagnostic instrument. In this study, we set FHIR standards for the interoperability of information for digital dermatoscope in teleconsultation, and built a FHIR-based teleconsultation system. There were two stages: Setting the FHIR standard for information of digital dermatoscope in teleconsultation and sharing information between teleconsultation system and the FHIR server.