What Happens When Things Finally Catch FHIR®? 3 Lingering Questions

While I’m excited for us to get through it, I do have some questions.

1. What developments are we going to see in the short term? As the industry began to evaluate the landscape that ultimately lead to the initiation of FHIR as a standard, it recognized some of the limitations the way healthcare information has been exchanged. One issue was the lack of context in messages—there was no elegant way to offer further explanations, when necessary. If a piece of data was missing and you added it manually, you couldn’t readily explain why you added it, nor make it easy for a recipient to understand it. But with FHIR® extensions, there is a mechanism—one that’s much more elegant than the one offered by HL7 v2 or v3—to offer further explanations. Of course, supporting user-suggested improvements like this do increase complexity, and this needs to be managed by the community. The last thing we need is for there to be a number of different profiles that are all doing the same thing, so it’s important that we work together to avoid that happening by being aware of what others are doing in this space, and how we can learn and re-use rather than doing the same thing in a different way
2. How will legacy applications handle FHIR®? Cool new applications that can speak FHIR® are great, but the sector will still need to work in the current interoperability marketplace, and that’s where an integration engine platform comes into play: it will help systems communicate using the different standards and bespoke solutions that already exist – and the FHIR® newcomer. This will be especially important over the next few years as FHIR® and the related standards like SMART mature, and people become familiar with the capabilities that it brings – and how useful the community that has grown up around it is.
3. What is the timeline? And by that, I mean this: when do we actually reach the panacea stage where the full potential of FHIR® is realized? We seem to be moving toward it quickly, thanks to the efforts of software vendors and standards bodies, but in the real world, things never move as quickly as people would like. There is little doubt that software vendors will need to support those different maturity levels across that interoperability spectrum – and an Integration Engine is an invaluable and powerful tool to achieve our [the industry’s] goal of simple, easy, reliable, healthcare interoperability.