FHIRconnect: A DSL for Seamless Integration of openEHR and FHIR

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The paper addresses the critical challenge of interoperability between openEHR and HL7 FHIR in electronic health record systems. The fundamental differences in data modeling and lack of standardized transformation mechanisms have historically hindered clinical data utilization. FHIRconnect is presented as a novel DSL and open-source engine designed to bridge this gap. This approach achieves 65% mapping reuse across projects using international archetype-based foundations while still accommodating local customizations. Specifically, the system successfully mapped 24 international archetypes to 15 FHIR profiles across seven clinical domains. By providing a comprehensive DSL for openEHR-FHIR transformation and an open-source execution engine (openFHIR), this work establishes a technical foundation that reduces reliance on custom ETL solutions and advances both syntactic and semantic interoperability in healthcare IT based on open standards. The necessity of this work is highlighted by the European Health Data Space (EHDS) regulation, which points to significant potential through digitalization. However, current reality shows patient data are fragmented across multiple systems and institutions using distinct structures and terminologies, making clinical decision support and secondary research difficult.