2. FHIR: A POTENTIAL GLOBAL PHENOMENON

FHIR®, a messaging standard born out of demand for a simpler, faster way to develop and implement healthcare interoperability, is seen as the answer. It has arguably been the fastest ever standard to be embraced by the healthcare IT community and in just five short years has gone from whitepaper to releasing its fourth major version.

Major global technology companies have embraced FHIR®, and it’s notable that Apple (for health records), Google (for its Cloud Health API) and IBM (for connecting Watson’s cognitive computing to EHRs) are all using it to support healthcare services. Thousands of people are working on hundreds of live FHIR® projects in 45 countries according to HL7 International, the global standards organisation. Enthusiasm is clearly rife. Over 2,000 people regularly use the FHIR® on-line discussions board, whilst tri-annual ‘Connectathons’ 1 attract 200 people to each event.

Despite development of FHIR® across different countries, health systems, regions and individual care organisations, the standard has not had visible wide-scale implementations or success stories. Judgement on the true impact of FHIR® will be made when organisations can clearly demonstrate it has made a significant difference to ensuring the right information is available to the right carer at the right time to ultimately improve patient care.

What exactly is FHIR®?

Fast Healthcare Interoperability Resources (FHIR®) and IHE are modern messaging standards founded by Grahame Grieve and developed by HL7 International which use formats, elements (resources) and an application programming interface (API) for exchanging healthcare information. Its development was informed by years of learnings from defining and implementing HL7 v2, HL7 V3 and CDA. It is the only standard that uses the best features of its predecessors and can be used in conjunction with a variety of other standards.

FHIR® solutions use modular components called ‘Resources’ which are designed to be easily implemented to solve practical clinical and administrative problems at a fraction of the speed, and subsequently the cost of existing alternatives. The standard is remarkably flexible in comparison to others and is used in many contexts – mobile phone apps, cloud technologies, integration engines, data sharing across electronic health records and wider communication systems, and much more.

Adoption of FHIR® has so far been remarkably quick. It is the first, new modern standard to be released for a long time, and there was clear appetite for something new. It had a head start because it was the first messaging standard that is inherently web-orientated, using new technologies developed over the past 5-10 years.

RIK SMITHIES

CTO, HL7 UK

IN SUMMARY, FHIR®:

• Leverages development of existing HL7 standards and infrastructure
• Is fast and easy to implement – code is very visible, accessible and available in human-readable formats for developers
• Works with many web standards, such as XML, JSON code
• Has an active forum and communication tools for international developers to support each other.

1. A Connectathon is an event where people from business, academia and technical backgrounds meet to develop and test ideas and updates

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