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Progress towards Interoperability in Health Information Technology Solutions October 17, 2013

The key requirement to success in healthcare information technology has been interoperability. Interoperability offers efficient yet secure means for IT systems and software applications to communicate and exchange patient data. In order for the healthcare industry to move toward preventive care and population health management, clinical information needs to flow freely across networks and between hospitals and physicians.

The current state of Health Information Technology (HIT) is poor in its lack of shared infrastructure between EHR systems and other technologies.

Organizations such as HL7 have facilitated a degree of integration in healthcare but widespread interoperability has not yet been achieved. [4] Although tremendous resources have been invested by industry and jurisdictional health programs around the world, the goal of interoperability has remained elusive in the healthcare industry.

HL7 has recently embarked in the development of a new standard that would increase interoperability within healthcare. This standard evolved from the pressure and disappointment that stemmed from HL7 v3.  In January 2011, the HL7 Board of Governors initiated a “fresh look task force” to examine how HL7 messaging standards could be improved. This inspired the evolution of Fast Healthcare Interoperability Resources (FHIR). FHIR is a new HL7 standard that combines the pros of HL7 v2 and fills the gaps of HL7 v3. According to HL7, “The FHIR development process itself employs an incremental, iterative approach to develop the standard reflective of today’s industry best practices for complex systems design. There is a deep focus by the FHIR development team on the usability and fitness for purpose of the end-product.” [1]

FHIR is built around the concept of resources. Resources are small, discrete concepts that can be maintained individually. Each resource has its own unique id. Resources can be compared to the concept of CMET’s, however, there’s only one model per resource.

In addition to the basic resources, FHIR defines a lightweight framework that supports the use of these resources in various implementation approaches such as RESTful environments, classic message exchanges, human-centric clinical documents, and enterprise SOA architectures. Each of these approaches provides its own benefits – FHIR provides the underpinning enablement that makes the choosing one of these approaches easier, and enables enterprises to choose their own paradigm without forsaking interoperability with other approaches. [2]

The question that may exist with many analysts in healthcare is will this standard fall short of acceptance like HL7 v3? The good thing to note about FHIR is the creators have made adoption easier by using open internet standards where possible. This shifts away the need for custom tooling and creates greater adaptability from multiple EHR systems.

Comments and discussion are welcomed from our readers.

-Alicia Brown





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