April 17, 2018
At this year’s HIMSS, I posed the question about whether the HL7® FHIR® standard will always and forever be the standard track to interoperability. In working with FHIR, I can say it holds great promise and has already helped us accomplish many interoperability goals that were just not possible previously. But in our quest for connectivity, I think we also need to take a thoughtful and careful approach, and not be afraid to ask some questions along the way.
For example: What about the growing proliferation of new technologies—mobile device and apps? I have seen some impressive patient-centered apps built with FHIR and proprietary APIs. There are some very good developments here, but we need to be careful not to unintentionally create digital divides. To recognize the true value of healthcare interoperability, we need to bring all of the important and pertinent data sources into the fold, including our legacy systems that hold the lion’s share of clinical data. We also need to identify how all our data assets fit into the total interoperability picture.
I covered this in much more depth in a recent white paper, Discovering if and how FHIR creates a fast path to interoperability. In it, I evaluate the pros and cons of a variety of standards. For example, HL7 messaging is mature and useful for large volume data transactions, yet is largely limited to intra-enterprise push transactions. When we look at C-CDA, we see benefits such as being able to handle a number of use cases, including inter-enterprise interoperability and to be able to see information in a snapshot of time with context. A drawback, however, is that it is not often great for getting current and right sized data, not to mention and the complexity of the standard.
Ultimately, no matter how many of us get together and promote a standard, it will be its usability and ability to prove value where it’s most needed—patient care and outcomes—that will determine its depth and breadth of adoption. What is predictable, however, is that, no matter the standard, we will likely need transformational technologies like Infor Cloverleaf Integration Suite and Infor FHIR Bridge to continue to create speed, efficiency and accuracy across the care continuum while gaining the ability to create a fully connected Health IT ecosystem.
Corey Spears, Healthcare Interoperability Standards Director, Infor Healthcare
FHIR® is the registered trademark of HL7 and is used with the permission of HL7