A Federated Interoperability Framework for Seamless Health Data Exchange Using FHIR Standards Across Multi-Hospital Systems

In the modern healthcare landscape, seamless and secure exchange of patient health data across disparate hospital systems remains a critical challenge. Existing infrastructures are often siloed, leading to data fragmentation, increased administrative burden, and compromised patient outcomes. This study proposes a Federated Interoperability Framework leveraging Fast Healthcare Interoperability Resources (FHIR) standards to enable seamless, standardized, and secure health data exchange across multi-hospital systems. The framework integrates federated learning principles with robust data governance and compliance mechanisms to maintain data privacy while facilitating real-time interoperability. The proposed architecture consists of modular components including an interoperability gateway, FHIR-based APIs, consent management modules, and distributed data repositories. These components work in harmony to ensure that data remains within its originating institution while enabling dynamic query and access across the network. A consensus-driven validation mechanism ensures the accuracy and consistency of exchanged data. The framework was tested using a simulated environment comprising three hospital systems with varying electronic health record (EHR) platforms. Performance metrics such as latency, data integrity, scalability, and compliance with HL7 FHIR standards were assessed. Results demonstrated over 95% success in data retrieval accuracy, reduced latency by 38% compared to conventional centralized systems, and full adherence to FHIR protocols. Moreover, the federated model significantly reduced the risk of data breaches, as no raw data was transferred. The study underscores the transformative potential of adopting federated interoperability models to advance health information exchange, particularly in large healthcare networks and regional health information organizations (RHIOs). By aligning with global interoperability standards and emphasizing patient-centric data control, the framework supports value-based care delivery, clinical decision support, and population health management. Future work includes real-world implementation across diverse healthcare settings and incorporating advanced security features such as blockchain and homomorphic encryption. This research contributes a scalable, secure, and standards-compliant blueprint for health data interoperability that can be replicated across jurisdictions, ultimately improving patient care and health system efficiency.