Evolution of FHIR Analytics and Query Capabilities: Tracking SQL on FHIR WG Meetings

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This article summarizes meeting minutes from the FHIR Working Group (WG), with a primary focus on discussions surrounding 'SQL on FHIR.' The group is dedicated to standardizing advanced query methods for analyzing FHIR data. The key technical points discussed include: First, methods and efficiencies for compiling CQL (Connectable Query Language) into SQL format. Second, addressing the complexity of data models, such as the issue where a single concept like 'Condition' might map across multiple tables. Third, issues related to data integrity and governance, including standardizing how empty values are handled when moving from FHIRPath to SQL, and methods for authorizing queries during execution. These advancements represent a critical step toward enabling advanced research analysis and public health epidemiological studies—beyond simple electronic health record exchanges—in Japanese healthcare facilities. As the standardization of FHIR progresses, access to more complex and practical clinical information becomes possible.