It has been well over a year since we published our HL7 FHIR Primer, which has been downloaded an astonishing 675 times and counting. That primer lays out the basics of how the new health data standards will be used, including key diagrams and use cases such as mobile application access to hospitals’ Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform... More systems.
While An HL7 standard that is short for Fast Healthcare Interoperability Resources and pronounced “Fire”. The standard defines a set of “Resources” that represent granular clinical concepts. The resources provide flexibility for a range of healthca... More is still under development by HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message form... More, the second draft standard for trial use (DSTU) became available last year, and the first normative edition is planned for 2017. A few notable developments have occurred regarding FHIR since the primer was published, which provides a great opportunity for a refresh of the document.
Some of the notable advances of FHIR over the past year include:
SMART on FHIR
The FHIR standard can be used for a variety of workflows; however, the key step in enabling the FHIR technology is to have major vendors open up their clinical data in a FHIR repository so other applications can leverage it to solve creative workflow problems.
In addition to having the data available, there is an emerging technology that would take this even one step further. The technology is called SMART on FHIR, and it allows more robust functionality and creative usage of the data directly within the EHR itself. SMART on FHIR would embed third-party functionality directly within the EHR application itself.
In a nutshell, SMART on FHIR enables third party plug-in apps to run natively inside any compliant EHR.
The SMART project started in 2010 with a four-year, $15 million grant from the Office of the National Coordinator for Health Information Technology (ONC) – Located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS), the Office of the National Coordinator (ONC) coordinates nationwide ... More. The idea was to build an app platform for healthcare allowing support apps to be chosen by clinicians. At the HIMSS15 Interoperability refers to the ability of two or more systems or components to exchange information and to use the information that has been exchanged. Showcase, several vendors demonstrated the progress they are making by incorporating SMART on FHIR. All the apps use the same underlying set of platform specifications.
The SMART on FHIR specs provide means for health care organizations or developers to access discrete clinical data — such as medications, problems, lab results, immunizations and patient demographics.
SMART on FHIR opens up innovation in healthcare that has not been possible previously. If someone has a bright idea and creates a SMART on FHIR app, the healthcare provider doesn’t need to wait for an EHR vendor to adopt the idea. Assuming they have a SMART on FHIR-compliant EHR, they can immediately take advantage of the bright idea through the use of the app.
The The Argonaut Project addresses the recommendations of the JASON Task Force, a joint task force of the ONC‘s HIT Standards and Policy Committees and is a joint project between HL7 International and several vendor and provider organizations. The purp... More Project
Argonaut is a supporting movement of FHIR in the U.S. led by volunteers. Individuals within HL7 were focused on keeping the FHIR project on target with its self-proclaimed deadlines for adoption. This focus was especially important considering the Open API requirements for Meaningful Use Stage 3.
Several the major EHR vendor organizations also wanted to do what they could to help push development and adoption in the U.S. So HL7, along with these vendor organizations, set out to do two things through the Argonaut Project: First, they funded the work to build a U.S.-specific profile. Second, they combine resources to help market and drive adoption of the standard.
The organizations are working with HL7 and the ONC to shed light on the best way to use FHIR in the U.S. considering there are some parts of FHIR that are very international in perspective.
For instance, because there is no consistency around the world with how medication is encoded, FHIR doesn’t make any rules about how medication is encoded. But in the context of the U.S., RxNorm is the coding system used for medication. HL7 is working through many similar types of issues with the Argonaut members. This will hopefully help drive a cleaner, more consistent standard for the U.S., along with a speedier adoption due to the buy-in of the larger vendor organizations that are participating.
Where does FHIR go from here?
The industry is waiting to embrace a standard that offers something better, but given the embedded nature of HL7 V2, the transition will not happen overnight. FHIR tries to fill the gaps that exist with the standards in use today, as was discussed in the full FHIR stands for Fast Healthcare Interoperable Resource. This emerging standard combines the best features of HL7 V2, HL7 V3, and CDA, while leveraging the latest web service technologies. The design of FHIR is based on RESTful web services. With REST... More Primer.
While the healthcare marketplace will decide whether FHIR survives, coexists, or replaces other products, the modern technologies that it is based on (RESTful, JSON) have already won over other industries.
Additionally, other standards organizations are jumping on board to support HL7 in the development of FHIR. One of those is Integrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. Visit the IHE website. Synonyms: Integrating the Healthcare Enterprise International, which plans to leverage FHIR across several profiles including: MHD (mobile XDS), Patient Identifier Cross Referencing (PIX) What it is used for: Cross-referencing multiple local patient ID‘s between hospitals, sites, health information exchange networks, etc. Used when local patient ID’s have been registered with a PIX manage... More/PDQ (patient identification), and PCC (medical devices).
I encourage you to download the full FHIR document, which includes the basics of health data exchange using FHIR, along with the new developments listed in this blog post.
Stay tuned to for many exciting developments around FHIR as it continues to be utilized by many major EHR vendors and, of course, leading interoperability software vendors such as Corepoint Health.Tags: FHIR