FHIR® - The Basics
FHIR® or Fast Healthcare Interoperability Resources is an IT healthcare standard that will help to improve the day to day running of community medical practices and hospitals. FHIR® can contribute to improving the care of patients by providing timely access to their electronic healthcare record.
FHIR® is one of the next generation HL7® standards in healthcare data integration and is focused on decreasing interoperability costs and unlocking innovation in healthcare. FHIR® represents a major standards upgrade that will boost access to health information and support ambitious plans for an app store for the health sector. FHIR® aims to speed application development and interoperability, plus boost information sharing in healthcare, especially on mobile platforms.
Built around the concept of “resources”, the basic unit of interoperability. In health, these could include a patient, condition, or a clinician. FHIR® covers the format of information and how data is exchanged, so it is both a Model and an API. It promises to make health information easily and securely accessed from any device, anywhere. FHIR® is an open source standard, available for all to use at no cost.
FHIR® will help to break down the information silos that exist in healthcare. For example, a lack of readily available patient health history can force doctors in emergency departments to make educated assessments about appropriate medication when there is no one to speak for the patient. FHIR® could support access to such vital data at the push of a mobile app button. It will also support the creation of an “app store” of independently developed mobile applications because it supports the collection of data and availability via APIs. APIs or Application Program Interfaces are a set of routines, protocols, and tools for building software applications. An API specifies how software components should interact.
In 2011, the board of HL7® noted that interoperability requirements were increasing; there was a need for real-time access for APIs, especially with the uptake of mobile use. They saw a vast increase in the amount, type and source of data particularly with the increasing use of personal devices. There was a movement to include the patient in their own healthcare. In addition, data from genomics and precision medicine have increased the amount of data available to be included in a patient’s electronic health record. With aging populations and the increase in chronic diseases, the ability to data mine for analytics and to be proactive with population health management was required. To be able to do this, implementers expected a modern standard as the existing standards were lacking, and to handle this huge increase in data a fresh look was needed and so FHIR® was born.
FHIR® has proven results for the following groups
Clinicians: FHIR® improves access to a more complete, higher quality electronic healthcare record, by being able to include data both from traditional sources like laboratory results, and evolving sources like genomic information.
Patients: with more applications targeted at patient engagement FHIR® helps remove the technical barriers for data from patient engagement apps to be included in clinical systems.
Developers: familiar tooling and technologies are used. Predefined resources and APIs allow implementers to focus on the core application functionality.
Healthcare providers: vendors such as hospitals are committed to FHIR®, which is beneficial as it increases the range of applications able to be deployed, which should lead to faster deployments, lower cost interoperability, and reduced ‘vendor lock-in’.
There is enormous interest internationally in FHIR® as it promises to revolutionize sharing of healthcare information. For this reason, it is important that clinicians become actively involved in FHIR.
There is a range of open source tools used both to educate and to assist the developers of FHIR® such as clinfhir.com. which evolved in response to user need (where the users are the clinicians involved in the development of the FHIR® standard). It serves 2 main purposes:
As a training tool to help people wanting to learn more about FHIR® visualize how the parts combine to represent clinical information in a structured and coded manner.
As a development tool with features to build some of the required artifacts, particularly as an aid to learning, but also being used by some organizations.
clinFHIR is primarily an educational tool, that allows clinicians to learn how FHIR® can facilitate healthcare projects. Successful health IT can improve patient care and enable patients to become more involved. The health IT domain is complicated and FHIR® helps to reduce the complexity.
FHIR® will allow clinicians to become more involved in the delivery of health-related IT projects – it is widely recognized that clinician lead IT projects have a higher success rate than technically lead ones. FHIR® represents a major standards upgrade that will boost access to health information, which will improve access to a patient’s electronic health record.
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