Q&A: A Beginner’s Guide to FHIR

GeorgeColeBy George E. Cole, Jr., Principal Scientist, Community Solutions, Allscripts
Twitter: @Allscripts

Interest in FHIR (Fast Healthcare Interoperability Resources) is growing as the standard for exchanging healthcare information takes shape. What is it and what will it mean for healthcare providers? Here are some frequently asked questions and answers:

Q. What is FHIR?
A. FHIR (pronounced “fire”) is a newly emerging international specification that standardizes the exchange of electronic healthcare information. First sponsored by Health Level Seven International (HL7) in 2011, FHIR incorporates the best features from previously developed standards.

Q. How is FHIR different from other interoperability standards?
A. The major difference between FHIR and other standards is simplicity and flexibility. Fast – the F in FHIR – expresses the intent to make this standard faster to learn, develop and implement.

Essentially, each application of the FHIR standard requires a resource approach to the information model (e.g., Medication, Procedure, or Immunization), which is more granular than other standards. Systems can use those FHIR Resources to then create commonly used content groupings that we see today, such as lists and documents. It is flexible and can enable faster and easier implementations.

FHIR supports four information exchange paradigms, most notably REST, the software architectural style that forms the basis for the World Wide Web. This approach aligns FHIR development more closely to other Internet development efforts outside of health care.

FHIR’s flexibility also means it will work across the entire spectrum of health care – from an orthopedic surgeon in Urbandale, Iowa, U.S.A. to a pediatrician in the heart of London.

Q. What is the current status of FHIR?
A. FHIR is currently a Draft Standard for Trial Use (DSTU2). The Office of the National Coordinator (ONC) 2016 Interoperability Standards Advisory lists FHIR as a Draft Standard, with Piloted Implementation Maturity, Low Adoption (less than 20%), Free Standard, with no currently available test tool to evaluate conformance.

Essentially, we expect to see Implementation Maturity, Adoption, and Test Tool development accelerate rapidly in 2016. FHIR is expected to be final in 2017.

Q. What is the Argonaut Project’s role with FHIR?
A. The Argonaut Project is a group of volunteer healthcare providers, health IT companies and universities working together to test the interoperability of FHIR implementations and profiles. Think of it this way: FHIR defines what can be sent, and Argonaut defines what must be sent. One of the strengths of FHIR is that the healthcare community is defining how to use it and what works best for the community’s needs.

Argonaut phase one focused on both data and document queries in support of U.S. Realm requirements, mostly as expressed by the Common Clinical Data Set. Phase two has continued with a focus on security for cross-enterprise authentication.

Q. What is Allscripts doing with FHIR?
A. Allscripts supports the ongoing work with the development of this new standard and participates in the Argonaut Project testing workgroup, HL7 Working Groups and Connectathons. We’ve completed initial development of a web service that will enable user applications to request and receive clinical data using FHIR. We’ll also attend the HL7 working group meeting, January 10-15, 2016.

Because we’ve written our own Open application programming interfaces (APIs), we have extensive experience addressing interoperability challenges across multiple systems. Having this set of robust, commercially proven APIs will make it easier for us to help our clients succeed with FHIR and interoperability more broadly.

Q. What should healthcare providers be doing to prepare for FHIR?
A. Preparing for FHIR is more of a technical issue for health IT companies to incorporate and test, so there are no immediate action steps providers need to be doing. Of course, healthcare providers should already be working towards meeting requirements aimed at improving interoperability, such as Meaningful Use Stage 3 and the 2015 Certification API requirements, which will likely be tied to FHIR in future versions.

FHIR is an exciting standard that we believe will become widely adopted. It is a logical next step along the path Allscripts started in 2007 with our own Open API, and we look forward to taking working with others in the industry to keep the progress happening.

About the Author: Currently the lead of the Content Standards Workgroup for The CommonWell Health Alliance. He is an active member of HL7’s Structured Document and also Health Standards Integration workgroups. George was a member of the HIT Standards Committee’s Architecture, Services and APIs Workgroup. This article was originally published on Allscripts and is republished here with permission.