Luis Castillo is President and CEO for Ensocare, a SaaS care coordination company.
The health IT industry has been buzzing about FHIR (or fast healthcare interoperability resources — pronounced “fire”) since it was introduced by Health Level Seven (HL7) as a proposed interoperability standard. HL7 is a not-for-profit organization that has been developing ANSI-accredited standards for hospital information systems since 1987.
Take a moment to think about the various administrative systems in place in today’s health systems (such as billing and scheduling) and the many disparate clinical systems (like laboratory services, radiology, etc.) with which they need to interact. HL7 standards created a standardized application programming interface (API) to enable the exchange of these business and clinical transactions. In other words, it created a common language that all health IT systems could use to interpret and process medical records and data.
As someone who works in health IT, I appreciate the basic and straight-forward approach FHIR takes. Because it is based in simple API design, it allows developers to create plug-and-play applications that can interface with any EHR (electronic health record) and feed information directly into the provider workflow. It eliminates the problematic gaps that may take place in a typical document-based exchange.
Not only is it simple, but it also creates more usable data that can be searched even at a granular level. Today’s standards are based on C-CDA (consolidated clinical document architecture), which is designed to transfer entire documents rather than single resources or singular pieces of data. FHIR technology, on the other hand, enables the exchange of smaller resources or specific data elements and is based on modern, open-web protocols like those used by search engine browsers. For a physician needing access to a single immunization record, FHIR technology can process and return exactly the piece of data needed, not an entire case file of hundreds of pages that must then be searched through like a proverbial needle in a haystack.
If you believe the hype (and I think I do), the latest proposed standard could be a game-changer — and just in time to answer the need created by value-based health care models. Now more than ever, all stakeholders — patients, providers and payers — need secure ways to exchange data and information. And as a greater focus on population health emerges, the need for systems that can work together and stream real-time data to guide decision making will be essential.
What is especially exciting to me is the potential for FHIR to contribute to the development of technology apps to help manage patients outside of the hospital. Imagine an app that could passively collect blood glucose readings from a patient and simultaneously transmit them to a personal health record, to a physician’s smartphone and to a pharmacy to adjust insulin levels for a refill prescription that is picked up and delivered to the patient within minutes. Without the technical capabilities provided by FHIR, this real-time exchange of data would not be possible.
FHIR also stands to be the conduit by which patients themselves are finally able to access their longitudinal records to manage their own health. FHIR will enable the multitude of data files that reside in disparate systems to sync, creating one source of patient data. Multiple provider records, test results, data gathered from wearable devices, medication details and much more can converge into one all-inclusive medical record that can then be used to guide and improve health care decisions and delivery.