Sending readable, usable healthcare data across a wide variety of health IT systems (called interoperability) has been a major headache, with computer systems and software using disparate document formats and speaking many different “languages.” Then, a few years ago along came Fast Healthcare Interoperability Resources (FHIR, pronounced "fire"). FHIR is a web-based suite that can make it easy to provide health care information to health care providers and individuals on a wide variety of devices from desktop or laptop computers to faxes to tablets to smart phones—whether they’re running a Windows, Apple, Android, or Linux operating system—and provide medical applications which can be easily integrated into existing systems. It’s revolutionary—like an internet for just for healthcare.
But in 2017, hospitals and other healthcare organizations are still confused about FHIR. It’s still a burning issue filled with concerns about cost, productivity, usability, data blocking, and security. A FHIR consultant can help your organization look at the bigger picture and evaluate the best interoperability and FHIR app options, so you can get a consistent view of the good quality data it takes to make better decisions for your patients and your business now and in the future.
Healthcare IT News recently reported that the newest version of FHIR (Release 3, as of March 22, 2017) features, “… improvements that are related to implementation experience, alignment with other interoperability standards and internal quality review processes.” Experts agree that it will be the preferred technology for new development, particularly when it involves accessing data you’re interested in across many servers.
Health Level Seven International (HL7) and Healthcare Services Platform Consortium (HSPC) have reached an agreement to work on the FHIR standard, the organizations announced in February 2017. HL7 is currently developing FHIR, and HSPC is looking to advance the technology. As reported in EHR Intelligence. “The duo also hopes to create tools to support standards of development and adoption, demonstrate the value of FHIR in real-world implementations by HSPC member organizations…”
The answer is not so simple. With as many as 35 different FHIR-compatible apps in development or in use, each vendor will tell you theirs is the best. But frankly, what’s right for your healthcare operation depends on the unique personality, goals, and mission of your organization and those of your patients.
When it comes to interoperability standards and solutions, you could use outside consulting help…independent of all the FHIR providers who want you to invest in their capabilities. As yet, there is no compelling economic argument to replace the billions of dollars’ worth of current systems that use existing standards and do what they do perfectly well.
“Vendors, and the organizations that use health IT systems, need to think about a strategy to live in this hybrid environment,” says Healthcare IT News.
So, before you can make any informed decisions, you need to have a sound FHIR strategy that runs alongside existing standards. Retrofitting systems with FHIR or connecting them with some sort of individual translator probably isn't a good long-term strategy.
For example, Boston Children’s Hospital is using a new plug-and-play emerging platform that enables them to build their own app or use another from an open community. Their open, standards-based app platform is so aptly called SMART—Substitutable Medical Applications & Reusable Technologies. The idea is that they wanted to support existing the EHR system, and then if a better app came along, they could get rid of the old one and swap the new one in.
While this strategy has worked for them, you need one that is customized to your organization today…and for years to come.
At the moment, the majority of health information exchange and data interoperability is based on documents. Healthcare IT Analytics reports that, “Whether faxed, emailed, or sent electronically, providers typically have to choose a set of data to transmit and then generate a message that contains only that data.”
However, while having complete information is important, document-based exchange doesn’t allow a provider to delve into the context of the data received. Health information exchange based entirely on documents doesn’t allow organizations to access information at a data level as well.
Using standardized application programming interface (API) standards, FHIR allows developers to create apps that transcend this document-based environment. But in the future, we’re going to have to coordinate care plans across boundaries of systems. FHIR may still be in formative stages, but that hasn’t stopped a slew of providers, developers, and vendors from getting started on creating new tools that leverage this promising data standard.
FHIR has the potential to make healthcare much more similar to the other internet-based experiences that consumers enjoy in other industries. It may also help to make all those wearable devices and monitoring gadgets worthwhile from a clinical perspective. FHIR may be the missing link between the EHR and the millions of Apple Watches, Bluetooth scales, blood glucose monitors, diet apps, and fitness trackers that are attracting so much consumer attention. FHIR may also help to make all those wearable devices and monitoring gadgets worthwhile from a clinical perspective.
The promises of FHIR are many, and the support for the data standard is strong across the care continuum. As developers continue to investigate innovative ways to address the fundamental problems of health data interoperability, providers and patients may not have to wait much longer to gain access to an incredibly rich new set of functionalities within their health IT systems.
Despite the promises to slash costs, improve outcomes, and overhaul care coordination, more data may just mean more problems—especially when the healthcare system is still struggling to define the data standards that will fuel the FHIR and form the basis for streamlined interoperability. Today, FHIR, one of the most popular contenders for becoming a universal standard for data exchange, is drumming up a great deal of enthusiasm among developers.
FHIR may be just the spark that the healthcare industry needs to turn providers and vendors into true partners for patient care. The truth is that complete, easy-to-use interoperability is not yet happening in the real world. And while FHIR holds big promises, it will need to coexist with other standards for the foreseeable future.