# Standardized Model Representation using FHIR

HL7’s Fast Healthcare Interoperability Resources (FHIR) has emerged as an industry standard for representing and exchanging electronic health data. When dealing with synoptic cancer reports, there are different ways to represent the information using FHIR resources. Two of the options include creating a new FHIR resource or using the FHIR Questionnaire resource. The decision between creating a new FHIR resource or using the FHIR Questionnaire largely depends on the specific needs of the project, the desired level of granularity, and the available resources for development and maintenance. A thorough analysis considering both the short-term implementation and long-term maintenance aspects will help guide the best approach.

## New FHIR Resource for Synoptic Cancer Report

### Pros

1. **Tailored Representation**: Creating a bespoke resource allows for a more tailored and granular representation of the specific data elements in synoptic cancer reports.
2. **Improved Semantics**: Custom semantics can be built into the new resource, ensuring that the meaning of the data is captured more precisely.
3. **Standardized Structure**: With a custom resource, all implementers would follow the same structured format, promoting consistency across systems.
4. **Optimized Queries**: Custom indices can be built into the resource, potentially optimizing query performance.

### Cons

1. **Development Time**: Creating a new resource requires more time and effort, from design to validation to publication.
2. **Adoption Barrier**: Introducing a new resource might create an adoption barrier, as systems need to be updated to recognize and process this new entity.
3. **Maintenance**: There’s a need to maintain and update the new resource in line with FHIR’s evolution and updates in clinical knowledge.
4. **Interoperability Challenges**: While FHIR aims to promote interoperability, introducing new resources can sometimes add complexity to integrations, as other systems might not immediately support the new resource.

## FHIR Questionnaire for Synoptic Cancer Report

### Pros

1. **Pre-existing Structure**: Leveraging the FHIR Questionnaire means using an already defined and recognized resource, potentially speeding up development.
2. **Flexibility**: Questionnaires are inherently flexible and can be adapted to capture various kinds of data, including that of synoptic cancer reports.
3. **Broad Adoption**: Since the Questionnaire resource is already a part of the FHIR specification, many systems will already support it, potentially easing integration efforts.
4. **Evolves with FHIR**: As FHIR evolves, so will the Questionnaire resource. Using it means benefiting from ongoing enhancements and updates.

### Cons

1. **Generalized Semantics**: As a generic tool, Questionnaires might not capture the specific semantics of synoptic cancer reports as precisely as a dedicated resource.
2. **Potential Complexity**: Capturing complex clinical data in a questionnaire format can become unwieldy or confusing.
3. **Less Optimized**: Queries might be less efficient when searching for specific data elements in a generic Questionnaire compared to a custom resource.

The following sections will outline both methods. However, it's important to note that in most cases, the advantages of using FHIR Questionnaires outweigh the reasons for developing new FHIR Resources. The upcoming implementation examples will, therefore, be provided as FHIR Questionnaires.

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