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Customer Experience and Design

It is time for Interoperability to catch fire! (FHIR(R) that is)

One of my healthcare consulting friends once said that interoperability was difficult because healthcare was interactional, not transactional. The interactive nature of the healthcare organization and the patient foretells the complexity of integrating and sharing information that is so critical to reducing costs, increasing patient safety and streamlining productivity. The challenge is inertia – we have so many healthcare applications and integration engines that are stuck on the older HL7 version 2.x as the means of implementing interoperability. The uptake of the proposed HL7 version 3.0 has been very, very slow due to support from the EMR vendors that are focused on bigger problems like Meaningful Use or ICD-10 support. In response, HL7 is hoping to set interoperability on fire with a new approach called FHIR(R) – Fast Health FHIRInteroperable Resources – it is a next generation standards framework created by HL7. FHIR combines the best features of HL7’s Version 2, Version 3 and CDA(R) product lines while leveraging the latest web standards and making sure that easy implementations are a top priority.

The key to the fast implementation speed of FHIR(R) is flexibility! FHIR solutions are built from a set of modular components called “Resources.” These resources can easily be assembled into working systems that solve real world clinical and administrative problems quickly and with a minimal amount of development, sometimes only one day. FHIR is designed to meet modern integration demands in a wide variety of contexts – social media on mobile phones, cloud communications, EHR-based data sharing, server communication in large institutional healthcare providers, and many other scenarios.

FHIR offers many improvements over existing HL7 standards and here is one of the most important: the specifications are FREE for use with no restrictions! Not only that, but there are many pre-built implementation libraries that can be tailored to get new integrations in place quickly. These available code libraries can jump start developers to get working interfaces in a single day, but still be adapted for the unique needs of a healthcare organization. The FHIR support for RESTful architectures allows the exchange of traditional HL7 Version 2 messages and CDA documents, and the different standards can be mixed and matched as needed. The strength of FHIR is in its support of widely used web standards including XML, JSON, HTTP, Atom and OAuth, for example. Developers will find the documentation to implement FHIR is easy to understand in addition to the many code examples and available on the website for downloads. For testing, there is a human readable wire format that developers can review to assure accurate data element mapping and help insure patient safety.

While FHIR is the trial stage of HL7 specification development, the strong early results point to quickly learning this new interoperability approach and fast implementations. Cruise over to and check out the great logo and explore the site for a glimpse of the future of faster healthcare interoperability.

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Martin Sizemore

Enterprise Architect with specialized skills in Enterprise Application Integration (EAI) and Service Oriented Architecture (SOA). Consultant and a trusted advisor to Chief Executive Officers, COOs, CIOs and senior managers for global multi-national companies and healthcare organizations. Deep industry experience as a consultant in manufacturing, healthcare and financial services industries. Broad knowledge of IBM hardware and software offerings with numerous certifications and recognitions from IBM including On-Demand Computing and SOA Advisor. Experienced with Microsoft general software products and architecture, including Sharepoint and SQL Server. Deep technical skills in system integration, system and software selection, data architecture, data warehousing and infrastructure design including virtualization.

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