FHIR delivers more effective interoperability, at lower cost 

Gone are the days when patients saw one doctor for all their health needs. Now patients are often cared for by a team of providers with different specializations. This is especially true for patients with chronic conditions, who often see multiple clinicians on a regular basis as part of their ongoing management.

A chronic-care patient, in the course of a week, could visit a primary care physician, a radiology clinic, a lab, and a cardiologist, for example.

The stakes are high, as clinicians require comprehensive patient records to ensure they make the best decisions for the safety of the patient. Getting the latest test results and encounter records can be problematic, however, as many systems still don’t talk to each other.

Interoperability: Interoperability – or sharing information between systems – is a frequent pain point for hospitals and clinics for a number of reasons, including the lack of agreed standards that make information exchange possible, and frequent advances in technology that are only partially adopted – leaving many systems incompatible with each other.

Cost is also a major factor. The sheer volume of data that needs to be stored, shared, exchanged and accessed quickly becomes a major expense. Coupled with the fact that there are many different systems speaking to one another, interoperability is a modern healthcare issue in need of fixing.

The FHIR standard: Fast Healthcare Interoperability Resources (FHIR) is the next generation Health Level Seven (HL7) international standard in healthcare data integration. It is focused on reducing the cost of interoperability in terms of both time and money and unlocking technical innovation in healthcare. It was created with implementers in mind and is broadly supported in the vendor community, as well as by many healthcare providers.

FHIR provides a framework for the exchange, integration, sharing, retrieval and even storage of electronic health information. Built around existing industry approaches, FHIR’s purpose is to make it easier to exchange all healthcare data between systems in a straightforward yet secure manner.

Central to FHIR is the concept of resources – self-describing, discrete blocks of data that make sense in the healthcare environment, and which can be adjusted (or “profiled” in FHIR speak) to meet specific scenarios.

FHIR aims to speed application development and interoperability, thereby giving a boost to information sharing in healthcare.

FHIR helps to make health information easily and securely accessed from any device, anywhere. It is an open source standard, available for all to use at no
cost. As well as being easy to use for implementers, it is designed to be comprehensive with resources already defined for much of healthcare. Examples of resources include a Patient, Condition, or an Observation.

Use of this standard will help to break down the information silos that exist in healthcare. For example, a readily available patient health history can help ER physicians make educated assessments appropriate medication when there is no one to speak for a patient.

FHIR supports access to such vital data at the push of a mobile app button. It also supports the creation of an “app store” of independently developed mobile applications because it supports the collection of data and availability via APIs.

Using FHIR and APIs, interfaces can be quickly produced that offer patients the ability to add their own health data to patient portals, even from their smartphones – an emerging trend.

In addition, data from genomics and precision medicine has increased the amount of data available in a patient’s record. As the population of ageing patients and the prevalence of chronic disease has increased, the ability to data mine and to be proactive with population health management has emerged as a key driver for health systems. Implementers needed a modern standard to handle this huge increase of data.

For clinicians, FHIR improves access to a more complete, higher quality EHR by including data from traditional sources like lab results and also evolving sources such as personal devices and genomic information. The standard allows for a greater choice of applications and devices to support clinical workflow. The ability to share information seamlessly will result in time-saving for clinicians, placing their focus back on the patient.

The proliferation of patient apps means more forms of asymmetrical data exist than ever before. FHIR helps remove the technical barriers for data from patient engagement apps and allows it to be included in clinical systems while also preserving provenance. A boon for developers is that FHIR uses familiar tooling and web related technologies such as XML/JSON, HTTP, REST, SSL and OAuth2. Predefined resources and APIs allow implementers to focus on the core application functionality.

FHIR has resulted in lower cost-of-entry for new vendors, improved access to data and an increase in the commercial viability of app development. The standard encourages the development of an ecosystem of FHIR compliant apps that can work with different FHIR servers.

Challenges: Despite all its advantages, FHIR is not a panacea for interoperability. There are many other requirements that need to be met, particularly establishing data-sharing agreements between the involved business level participants, developing and verifying safeguards for security and privacy, defining a common terminology among healthcare partners, and agreeing on the workflows involved.