What would it mean for healthcare if the countless electronic health records (EHR) and health information systems (HIS) could speak the same data language? That goal of healthcare data interoperability is a growing challenge in a complex healthcare continuum. What’s at stake is the ability to make patients and consumers part of the healthcare data cycle with a real shot at improving health outcomes for all patients.
Data in healthcare is big and complex with dozens of languages and codes that make Semantic interoperability between different systems an unrealized goal. But the latest draft of the Fast Healthcare Interoperability Resources standards framework (FHIR, pronounced fire ) may solve the healthcare data interoperability dilemma.
The Nature of FHIR and Health Data Interoperability?
FHIR works in conjunction with an application programming interface (API), which is the toolset used for building applications. This internet-based data standard has been developed by the not-for-profit the standards developing organization known as Health Level 7 (HL7), which is accredited by the American National Standards Institute (ANSI). FHIR works by assigning shareable identifiers to data elements or resources, which enables discrete data sharing rather than document-based exchange.
If a standardized version is adopted by all Health Information System (HIS) developers, it holds the potential to enable what is known as semantic interoperability for the electronic exchange of healthcare information. This would impact all the varied tools, devices, systems, and platforms that need to share healthcare data including EHRs and other HIS, mobile devices, cloud platforms, web applications and more.
In short, FHIR APIs give application developers the ability to create apps that can plug into EHR and other HIS to deliver a common language from system to system. The goal is to make it possible to achieve the following:
- Major cost reductions due to rework and delays in medical diagnosis and management,
- Reducing medical errors
- Improving population health through analysis of health big data to effect treatments, drug development preventative health and much more
- Advances personalized medicine
- Decreasing the emergency department and hospital stays
- Decrease repeat tests and procedures
- Seamless chronic condition tracking between providers and patients
- Increased patient engagement and control of health data, treatment and medication choices
These are only a few of the many possibilities that can come to fruition with healthcare data interoperability based on a unified standard. Although FHIR has come a long way towards this goal, it still has a considerable way to go in helping to support true interoperability.
FHIR Progression and Adoption
The FHIR standard has come a long way through several iterations in its journey to usher in semantic interoperability with most major EHR vendors investing in the standard. Its use by providers and especially application developers is also on the rise.
Currently, there 32 percent of developers are using FHIR R2 according to data published by the Office of the National Coordinator for Health IT (ONC). The data further states that 51 percent of developers are combining OAuth 2.0, the open standard for secure access delegation for online resources, with a version of FHIR.
HL7 recently announced the publication of FHIR Release 4, which includes FHIR resources that qualify it to be submitted to ANSI as a normative standard. This means a greater potential for improved interoperability between health systems, applications, and devices. While that’s one more hurdle passed towards interoperability, there are others ahead.
The Future of FHIR and Healthcare Data Interoperability
Despite the progress of FHIR, even its HL7 originators make it clear that this is just a start. They are already hard at work at version R5 that will expand the normative content, make implementation easier, and provide greater support to applications using different FHIR versions.
FHIR is not a silver bullet to interoperability because EHR vendors don’t implement the standard in a consistent way yet. Furthermore, while ONC and others support FHIR, they have yet to mandate a specific approach or implementation strategy. Although there are still a number of FHIR versions being used, HL7 has moved healthcare much further to the goal of solving integration challenges.
That’s a worthwhile goal with a growing world of big healthcare data out there that can be harnessed through semantic interoperability for better health continuum decisions. By bringing providers, payers, patients and consumers into the healthcare data-sharing loop it sets the stage for true transformation to a world of proactive and accurate value-based care.
