It’s been almost a year since HL7 announced their latest version of FHIR, version 4. Many healthcare industry players have been eagerly awaiting the fourth iteration of FHIR. As it continues to evolve, the FHIR standard will be backwards compatible from now onwards. Many foundational artefacts of FHIR 4 are now defined as “normative”, meaning, they will go through a standard development lifecycle before they can be modified.   

As the latest version of FHIR, anyone involved in the sharing or consuming of healthcare information will need to pay close attention to version 4 for all it has to offer.  

What does FHIR version 4 offer?

FHIR community resources

FHIR is now a global healthcare standard, indicated by many official HIT bodies and organisations as the means to achieve interoperability. 

For instance, the Office of the National Coordinator for Health Information Technology (ONC) in the US and the National Health Service X (NHSx) in the UK, are adopting the FHIR standard to coordinate nationwide data-sharing programmes. The version they rely on is FHIR R4 v 4.0.1.

Due to its global prevalence, the FHIR community provides tooling, training and resources available with country-specific content. HL7 encourages and supports all adopters of FHIR, from established healthcare networks to entities just starting on their interoperability journey. 

Updated implementation guides 

The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. We see an increasing number of Implementation Guides that utilise FHIR 4 as their base. These new guidelines can be set to represent the needs of a specific country, with the related variations in the structure of FHIR resources (e.g. the US Core Implementation Guide) or to define rules of integration to satisfy specific use cases in an open ecosystem. (e.g. SMART App Launch Framework). 

Increased resource maturity 

Version 4 boasts a vast number of changes regarding the detail of the individual resources that FHIR defines and new resources needed as FHIR continues to extend.  

The FHIR standard has now reached a high level of maturity. This means any changes to “normative” aspects of FHIR resources will be backward compatible. All resources have a “maturity” level associated with them, which indicates how well they have been exercised in the real world. The higher the number, the more mature they are and the less likely to change between FHIR releases.  

Related specifications 

FHIR 4 features associated standards and projects that build on the FHIR Core to address specific implementation issues. The CDSHooks, DaVinci project and FHIR Bulk Data Access APIs are some examples. These projects embraced the FHIR standard and added value that goes beyond the enablement of a data-sharing environment. They respectively leverage decision support, payers’ workflows and population management, through the standard clinical resources provided by FHIR.

How is Orion Health involved in FHIR 4?  

Orion Health has been working with FHIR APIs for a number of years now, since the early versions were released. Keeping up to date with the evolving FHIR standard, Orion Health is currently building FHIR R4 APIs. This will help clients to break down silos, take advantage of the ever-growing number of smart apps, easily integrate with third parties, and become an active player in the competitive and innovative API ecosystem.   

Interested in learning more about how Orion Health incorporates FHIR? 

This blog is the fourth in the series on all things FHIR. The next in the series is focused on the security for APIs. 

Read our previous blog on What is FHIR and how does it influence healthcare delivery?