Thirty years ago, interoperability was much simpler. If you could exchange data between two computer systems, you had interoperability. But over the next three decades, both the amount of data and the number of data sources for an individual or a population have increased exponentially.
Interoperability now consists of accessing data from many systems, both inside and outside the organization, in the form of a single, concordant view , and present them to clinicians in a usable and workable way in their workflows.
FHIR (HL7 Fast Healthcare Interoperability Resources) is rapidly becoming the foundation of the future of interoperability. The FHIR standard has the ability to provide extremely simplified, accelerated and efficient clinical information sharing between systems, and it creates opportunities for significant innovations in the healthcare IT industry.
Not surprisingly, the FHIR theme was once again one of the most discussed themes at the annual HIMSS conference, the largest IT conference in the United States. At HIMSS17, there were over 60 presentations on the standard. less than 10 sessions on the subject last year.
I have also personally seen suppliers of the HIMSS showcase capabilities and "FHIR-compatible" tools, leaving the old HL7 standards in the dust. This is a clear indicator of the growth rate of FHIR.
However, although we all agree that the FHIR is very promising for the future of interoperability, the industry should not jump too fast on the existing standards HL7 v2 and CDA.
This does not mean that the FHIR will not gain from building new systems (because it will), but I believe that the FHIR will have to coexist with other standards in the foreseeable future. Reason to be – there is no compelling economic case to replace the billions of dollars of existing health systems that use other standards.
What I'm waiting to do is that FHIR will serve as a translation layer. In fact, it was the first time we tackled InterSystems – separating V2 messages or CDA documents and storing them temporarily as FHIR resources.
The use of FHIR as a translation layer allows systems to take advantage of FHIR and its capabilities. The reverse transformation can occur when the data is exported from the platform to systems that only include the old standards.
So, what does this mean for health organizations? They must think of a strategy to live in this environment of hybrid standards by implementing solutions that can work with a variety of standards.
Rather than replacing or abandoning existing technology investments in systems that are far from the end of their life cycle, companies must look for solutions that aggregate data from a variety of standards-based systems older, as well as new systems based on FHIR.
These organizations can then use FHIR to access this aggregated data, now represented as FHIR, for analysis, decision support, clinical care, and secondary uses made possible by the technology that is available. -tends FHIR. Although the total value of the FHIR is still under development, this capability can and will become a reality.
About the Author:
Russell Leftwich, MD, is the Senior Clinical Counselor, Interoperability, for InterSystems and Assistant Associate Professor of Biomedical Informatics at the School of Medicine. Vanderbilt University.
Twitter: @ DocOnFHIR