{"id":7568,"date":"2019-01-23T22:51:35","date_gmt":"2019-01-23T22:51:35","guid":{"rendered":"http:\/\/orionhealth.weareiceberg.co\/?p=628"},"modified":"2024-06-10T03:58:38","modified_gmt":"2024-06-10T03:58:38","slug":"fhir-release-4-is-published","status":"publish","type":"post","link":"https:\/\/orionhealth.com\/global\/blog\/fhir-release-4-is-published\/","title":{"rendered":"FHIR Release 4 is published"},"content":{"rendered":"\n<p>Grahame Grieve, the Product Director for FHIR, has\u00a0<a href=\"https:\/\/onfhir.hl7.org\/2019\/01\/02\/fhir-r4-is-published\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">recently announced<\/a>\u00a0that\u00a0<a href=\"http:\/\/hl7.org\/fhir\/index.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">FHIR release 4<\/a> was finalised at the end of 2018 \u2013 it has been over a year and a half since the previous version \u2013 Standard for Trial Use 3 (STU3). So, what\u2019s new since then?<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong><a href=\"https:\/\/orionhealth.com\/blog\/fhir-the-basics\/\">What is FHIR?<\/a><\/strong><\/h5>\n\n\n\n<p>HL7\u00ae&nbsp;FHIR\u00ae&nbsp;or Fast Healthcare Interoperability Resources is a specification for healthcare interoperability. It defines the format of information in the form of resources to be shared, as well as describing a number of exchange mechanisms \u2013 real-time REST, Document and Messages among others (though you can use others if needed).<\/p>\n\n\n\n<p>The progress from FHIR\u00a0STU3\u00a0to Release 4 can be summarised as:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Global adoption<\/li>\n\n\n\n<li>Updated implementation guides<\/li>\n\n\n\n<li>Increased resource maturity<\/li>\n\n\n\n<li>Additionally, related specifications<\/li>\n<\/ol>\n\n\n\n<p><strong>1. Global adoption<\/strong><\/p>\n\n\n\n<p>FHIR is now a global healthcare standard, and it is available in every country in the world. It has been adopted by large organisations such as the\u00a0<a href=\"https:\/\/www.healthit.gov\/buzz-blog\/interoperability\/onc-is-fhird-up-unwrapping-the-new-inferno-testing-suite\">O<\/a><a href=\"https:\/\/www.healthit.gov\/buzz-blog\/interoperability\/onc-is-fhird-up-unwrapping-the-new-inferno-testing-suite\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">N<\/a><a href=\"https:\/\/www.healthit.gov\/buzz-blog\/interoperability\/onc-is-fhird-up-unwrapping-the-new-inferno-testing-suite\">C<\/a>\u00a0in the US and\u00a0NHS\u00a0in the UK, where FHIR-based APIs enable the seamless exchange of information between different organisations. What\u2019s very exciting for the community is that the list of adopters includes developing countries as well.\u00a0<\/p>\n\n\n\n<p>The FHIR community provides tooling,&nbsp;<a href=\"http:\/\/www.hl7.org\/training\/fhir-fundamentals.cfm?ref=nav\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">training,&nbsp;<\/a>and events to help implementers learn more about FHIR. HL7 encourages and supports all adopters of FHIR, from established healthcare networks right through to those starting at the beginning of their healthcare interoperability journey.<\/p>\n\n\n\n<p>The\u00a0<a href=\"https:\/\/chat.fhir.org\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">FHIR chat<\/a>\u00a0is a community of FHIR users which is free to join and has a large number of streams for the various programmes of work:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Country-specific streams<\/li>\n\n\n\n<li>General streams like the implementer\u2019s stream<\/li>\n\n\n\n<li>Project-specific streams such as the bulk download specification or\u00a0<a href=\"https:\/\/orionhealth.com\/white-papers\/how-to-maximize-security-by-adding-smarts-to-your-fhir-apis\/\">SMART<\/a><\/li>\n\n\n\n<li>There\u2019s even a stream for\u00a0<a href=\"https:\/\/chat.fhir.org\/#narrow\/stream\/179262-patient-empowerment\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">patient empowerment<\/a>\u00a0discussions<\/li>\n<\/ul>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>2. Updated implementation guides<\/strong><\/h5>\n\n\n\n<p>We see an increasing number of\u00a0<a href=\"http:\/\/www.fhir.org\/guides\/registry\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Implementation Guides<\/a>\u00a0\u2013 artifacts that describe how to use FHIR to meet specific requirements often in particular countries. Also, these guides are bringing in new groups to the community \u2013 such as the\u00a0<a href=\"http:\/\/www.hl7.org\/about\/davinci\/index.cfm?ref=common\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Da Vinci project<\/a>\u00a0which is focused on the needs of the payer community as the way we deliver healthcare continues to evolve.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>3. Increased resource maturity<\/strong><\/h5>\n\n\n\n<p>There have been a vast number of changes that have occurred since the FHIR STU3\u00a0<a href=\"http:\/\/hl7.org\/fhir\/STU3\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">version<\/a>,\u00a0both concerning the detail of the individual resources that FHIR defines as well as new resources needed as the scope of FHIR continues to extend.<\/p>\n\n\n\n<p>There\u2019s a tab on each\u00a0<a href=\"http:\/\/hl7.org\/fhir\/resourcelist.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">resource page<\/a>\u00a0in the specification that describes the changes from the\u00a0<a href=\"http:\/\/hl7.org\/fhir\/STU3\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">previous version<\/a>\u00a0on the \u2018R3 diff\u2019 tab) and there\u2019s a\u00a0<a href=\"http:\/\/hl7.org\/fhir\/diff.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">complete list<\/a>\u00a0of all resource changes as well, this includes the new resources. In addition, the project provides transforms to map between STU3 and R4 in the form of\u00a0<a href=\"http:\/\/hl7.org\/fhir\/mapping-language.html\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">mapping language<\/a>\u00a0statements. (Though there will always be the need to check these mappings in practice \u2013 completely automated translations for all possible uses is problematic).<\/p>\n\n\n\n<p>Also, most significantly, a number of the resources are now at a maturity level of \u2018Normative\u2019 which means any changes to those resources will be backward compatible. If you weren\u2019t aware, all resources have a \u2018maturity\u2019 level which indicates how well they have been \u2018exercised\u2019 in the real world. The higher the number, the more mature they are and the less likely to change between FHIR releases. This concept of resource maturity has always been the strength and the weakness of FHIR. It does mean that we can be as sure as we can that the resources are \u2018fit for purpose\u2019, but it also means that applications need to have a strategy for managing different versions of FHIR.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>4. Additionally related specifications<\/strong><\/h5>\n\n\n\n<p>Finally, we see a number of associated standards and projects that build on the \u2018FHIR Core\u2019 to address specific implementation issues. These include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"http:\/\/hl7.org\/fhir\/smart-app-launch\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">SMART App launch<\/a>\u2013 an authentication mechanism based on Outh2<\/li>\n\n\n\n<li><a href=\"https:\/\/cds-hooks.org\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">CDS-Hooks<\/a>\u00a0\u2013 for invoking functionality like Decision Support within the context of an EHR (The \u2018hook\u2019 part describes how specific workflow events like prescribing can trigger these actions)<\/li>\n\n\n\n<li><a href=\"http:\/\/fhircast.org\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">FHIRcast<\/a>\u00a0is a mechanism for different applications to synchronise their context \u2013 which patient they have selected, who is the user and so forth<\/li>\n\n\n\n<li><a href=\"https:\/\/github.com\/smart-on-fhir\/fhir-bulk-data-docs\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Bulk download<\/a>\u00a0\u2013 a way to extract FHIR resources in bulk, rather than for individual patients<\/li>\n<\/ul>\n\n\n\n<p>All of these are going to be necessary to support the ecosystem that we are working toward.&nbsp;<\/p>\n\n\n\n<p>So, what\u2019s coming next? Grahame recently\u00a0<a href=\"https:\/\/onfhir.hl7.org\/2019\/01\/20\/fhir-r5-roadmap\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">posted the goals<\/a>\u00a0for the next release; they are about addressing issues in implementing FHIR, as well as continuing to mature the resources, for example, managing multiple versions of FHIR, migrating between FHIR and other standards, and creating Implementation Guides.<\/p>\n\n\n\n<p>One thing\u2019s for sure though if you are involved in sharing or consuming healthcare information, you need to pay close attention to FHIR.<\/p>\n\n\n\n<p>To learn more about FHIR, read my white paper Enabling the Ecosystem with FHIR which discusses how healthcare information can be made available where and when it is needed.<\/p>\n\n\n\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/orionhealth.com\/white-papers\/enabling-the-ecosystem-with-fhir\/\">Go to White Paper<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Grahame Grieve, the Product Director for FHIR, has\u00a0recently announced\u00a0that\u00a0FHIR release 4 was finalised at the end of 2018 \u2013 it has been over a year and a half since the previous version \u2013 Standard for Trial Use 3 (STU3). So, what\u2019s new since then? What is FHIR? HL7\u00ae&nbsp;FHIR\u00ae&nbsp;or Fast Healthcare Interoperability Resources is a specification [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":15600,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1],"tags":[96],"region":[23],"class_list":["post-7568","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","tag-interoperability","region-global"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>FHIR Release 4 is published - Orion Health<\/title>\n<meta name=\"description\" content=\"FHIR Release 4 is published: Grahame Grieve, the Product Director for FHIR, has\u00a0recently announced\u00a0that\u00a0FHIR release 4 was..\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/orionhealth.com\/global\/blog\/fhir-release-4-is-published\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"FHIR Release 4 is published - 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