Data

FHIR is the Future of Interoperability and Application Development in Healthcare

HL7 FHIR® (Fast Healthcare Interoperability Resources) closes the gap between the explosion of healthcare data and our ability to make that data accessible, computable, and usable to improve outcomes.

FHIR allows us to access exactly the information needed to improve decisions and outcomes across the health and care continuum.

The Meaning of Interoperability Has Changed

Advances in healthcare technology have created exponential growth in the amount of data available for patient care, from an increasing number of sources. But our ability to access and use the data in real time hasn’t kept up.

With healthcare data more widely dispersed, heterogenous, and overwhelming, interoperability is more important and more challenging than ever. Interoperability today begins with access to data in multiple systems in real time, from one application.

The Right Information, Exactly When Needed

FHIR enables access to data distributed across systems, databases, and devices in real time, like a “Web for healthcare.” Think of Web apps that pull flight or financial data to you whenever you need it. Using FHIR-based applications, clinicians in any situation can query for exactly the set of information needed, such as medication history, allergies, or test results. FHIR helps care providers avoid the burden of sifting through long summary of care documents to get to the information they need.

 

Interoperability Data Sources

Working With FHIR

FHIR is the latest healthcare data interoperability standard from the HL7 organization. The content below provides more information about FHIR and what people are doing with FHIR-enabled InterSystems technology. The video covers the considerations that inspired development of FHIR and explains its fundamental concepts and basic components.

SMART on FHIR

SMART (Substitutable Medical Applications, Reusable Technology) on FHIR is a platform architecture for creating portable FHIR apps, such as one that generates a pediatric growth chart on demand using the latest data, or clinical decision support that can use data from any FHIR-enabled system. The basic components are an open application programming interface (API), one or more “data containers,” and industry-standard user authentication and authorization services. FHIR serves as the API and one of the data containers is usually an EHR system.

doctors in a meeting

Architecture

An overview of the structure of FHIR data, including resources, bundles, and extensions.

FHIR makes it easier to break down the barriers between different systems and deliver just the information needed, to whomever needs it, in near real-time.

Meeting U.S. Regulations on Patient Data Sharing

Regulations issued by the US Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology will drive greater sharing of patient healthcare data among CMS-regulated health plans. According to the regulations, by January 1, 2021, health plans must allow their members to access their healthcare data in claims systems, EHRs, and other sources via applications using the secure FHIR Release 4 (R4) API. InterSystems IRIS for Health and HealthShare fully support this standard.

Value-based Care Initiatives & FHIR

Health plans (a.k.a. “payers”) and provider organizations benefit when implementing FHIR to improve collaboration and care coordination.

The HL7 Da Vinci Project is a multi-organization initiative focused on improving data sharing in value-based care arrangements by leveraging HL7 FHIR. The project is currently working on use cases in 5 categories:

  • Quality Improvement
  • Coverage/Burden Reduction
  • Member Access
  • Process Improvement
  • Clinical Data Exchange
Da Vinci HL7 Logo

Member Access

In the Member Access category, InterSystems HealthShare Provider Directory software supports the Da Vinci Payer Data Exchange (PDeX) use case. PDeX leverages FHIR for health plans, enabling compliance with the final CMS Interoperability Rule that requires sharing of provider directory content via FHIR R4 APIs.

Quality Improvement

For the Quality Improvement category, view this AHIP webinar to learn what it takes to implement the Da Vinci Data Exchange for Quality Measures (DEQM) use case. You’ll see how FHIR enables sharing of data for health plan performance measurement, while reducing the burden of compliance on providers.

 

Optimize Data Transfer for Care Providers

FHIR-based interoperability can help care provider organizations streamline and automate processes, freeing up valuable resources to focus on patient care. Examples include:

  • Updating key patient-specific medical information in real-time
  • Event notifications
  • Transitions of care
  • Medication management

Updates in Real-Time

In the UK, thanks to NHS Digital and FHIR APIs, key patient data can be brought into a hospital’s EMR on-demand from external sources. In a medical emergency or prior to surgery, for example, clinicians can query a general practitioner’s medical record system for information such as medications and allergies, and instantly populate the correct fields in the hospital’s system.

Event Notifications

Also in the UK, FHIR messaging and InterSystems technology is driving clinical event notifications across a network of healthcare information systems. Users, including parents, can subscribe to an event management system and receive notifications on a per patient basis. The event management system receives FHIR messages, stores them, and updates each subscriber based on filtering preferences. Examples of event types include vaccinations, pediatric developmental milestones, or routine screening exams.

Transitions of Care

FHIR-based messaging enables smooth transitions of care through the exchange of information between providers and across care facilities and organizations. When discharging patients from the hospital, Emergency Department, out-patient appointments, or elective surgery, this timely information-sharing helps enable uninterrupted patient care.

Due to the ease and speed with which FHIR applications are created, and the availability of FHIR as a public API (Application Programming Interface), the potential of FHIR for clinical care is extraordinary. This video reviews the basics of FHIR and the aspects that give the FHIR standard its potential for clinical care.

Medication Management

In contrast to the traditional concept of medication lists, FHIR introduces a new architecture for medication management. One limitation of current medication lists is that whether it is the list of medications that a physician has prescribed, the list of medications that the pharmacy has dispensed, or the list of medications that a patient says they currently take, they all look the same.

The medication module in FHIR includes 9 different FHIR Resources – self-describing units of structured data and references to other resources or data sources. They allow for a much more meaningful and useful exchange of medication information between different systems. Adoption of the FHIR standard has the potential to address patient safety risks from medication errors – the most common category of medical mistakes.

As a leader in healthcare data technology and standards-based interoperability, we’re committed to tackling your challenges through FHIR-based solutions.

Legacy Data Integration

At the core of healthcare data interoperability is the need to integrate data from different sources, utilizing a myriad of standards, formats, and technologies. You can use InterSystems IRIS for Health or InterSystems HealthShare Health Connect to:

  • Bridge between FHIR and older standards and document formats such as HL7v2, CDA, and X12
  • Transform CDA documents into FHIR resources
  • Send portions of HL7v2 messages or CDA documents out as FHIR data
  • Enable new applications to access legacy data by transforming the data to FHIR resources for use in value-based care, quality improvement, and research

InterSystems’ Craig Lee talks about how HealthShare Health Connect provides powerful FHIR-based data transformations.

Building Your Own FHIR Solutions

InterSystems IRIS for Health provides a choice of programming languages and the building blocks needed to develop FHIR applications, including:

  • Support for different FHIR versions, including R4 and STU3
  • A base FHIR server implementation supporting a standard FHIR RESTful API
  • A FHIR resource repository supporting all FHIR resource types
  • FHIR client components for handling client-side operations
  • Support for FHIR-based IHE Profiles, including PIXm (patient identity queries), PDQm (patient demographics queries), and MHD (for health document sharing)

The InterSystems IRIS for Health FHIR repository offers full read/write capabilities, receiving or sending FHIR resources via the FHIR RESTful API in JSON or XML formats. This allows applications built on the latest technologies to use FHIR data — new or mapped from legacy systems — for patient care, quality improvement, research, and other use cases.

InterSystems IRIS for Health provides everything a developer needs to access data from across the care continuum, including data transformations and a read/write HL7 FHIR resource repository.

Creating Applications and Building Complementary Solutions Around MedTech

InterSystems IRIS for Health provides a platform that communicates easily with all versions of FHIR, and a FHIR Resource Repository to store FHIR data. The platform includes advanced data management, interoperability, natural language processing, analytics, and out-of-the-box machine learning technology. With InterSystems IRIS for Health, MedTech companies can access and combine device data with data from clinical information and other systems to:

  • Accelerate development of complete solutions around your devices or treatments
  • Decrease the time, effort and cost of post-market surveillance while preventing adverse clinical events
  • Go beyond post-market surveillance to monitor devices and understand quickly where product improvements are needed
  • Capture outcome metrics for use in value-based care contracts
Checking medical devices

Population Health & Analytics on FHIR

InterSystems HealthShare aggregates data from multiple electronic health records and other types of systems – even those that may only expose their data using legacy interfaces.

Through HealthShare, all data for an individual can be transformed and aggregated as a FHIR representation, and applications developed with FHIR can access it, such as SMART on FHIR apps. This FHIR repository of data allows applications based on the latest technology to use that data for patient care, value-based care, quality improvement, research, and other use cases.

crowd in lobby

Access to Comprehensive Patient Records

InterSystems HealthShare Unified Care Record provides a rich and comprehensive data source for SMART on FHIR apps. SMART on FHIR apps can access all of the data HealthShare aggregates for each patient from multiple EHRs, public and private health information exchanges, and other sources.

InterSystems TrakCare unified healthcare information system supports SMART-on-FHIR through the HL7 Argonaut profile, allowing developers to pull patient data from TrakCare into SMART on FHIR apps.

Clinical Research

Access to real-world clinical data is essential to improving clinical trial recruitment, therapy improvement, and post-marketing surveillance. Yet few companies have mastered its access and use. Recent US regulations, implementing the 21st Century Cures Act, mandate patient access to their data using FHIR R4 applications. This will make acquisition of patient data much easier for researchers with patient consent. FHIR has the potential to help in-the-field research by:

  • Monitoring protocol execution
  • Pre-populating case report forms
  • Collection of patient-reported outcomes
  • Bulk transfer of clinical data for analytics

 

Experience FHIR

We’ve created sandboxes where you can experience our “Build with InterSystems FHIR” examples and exercises, or begin with the samples below.

Legacy Data Integration

Want to try integrating FHIR with HL7 and other legacy systems?

Legacy Data Integration
Free registration & login required.

 

Building Your Own FHIR Solutions

Want to try building a FHIR application with IRIS for Health?

Building Your Own FHIR Solutions
Free registration & login required.

 

Population Health & Analytics

Want to try making FHIR requests to the aggregated patient information in the HealthShare Unified Care Record database?

Population Health & Analytics
Free registration & login required.

 

FHIR API Management

Learn how you can use the InterSystems IRIS for Health API management portal to make it easier and faster to create apps using FHIR. This is just one of the benefits of working with the advanced database, connectivity, and interoperability technology of InterSystems IRIS for Health data platform and InterSystems HealthShare interoperability platform.

InterSystems Learning Services

Check out our FHIR resource guide (requires account registration) for more information on FHIR in InterSystems products, online courses, documentation, and presentations.

FHIR resource guide

InterSystems Developer Community

The FHIR Group is for developers using FHIR and those who have an interest in understanding more about creating FHIR-based solutions. The group is a place for discussion and finding answers to questions about FHIR implementation using InterSystems technology. Free registration required to participate.

Whatever your reasons for joining, the group shares the same spirit of open collaboration and cooperation that has been a driving force in the rapid advancement of FHIR. You’ll find a knowledgeable FHIR community and a willingness to answer your questions whether you are new to FHIR or an established developer.

FHIR Group

Raised Hand

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HL7, FHIR and the FHIR FHIR are the registered trademarks of Health Level Seven International.