FHIR: The Future of Healthcare Interoperability

HL7® FHIR® makes healthcare data accessible through industry-standard and scalable APIs, paving the path to a connected care ecosystem, easier interoperability, and better patient outcomes.

What is HL7 FHIR and why is it important?

HL7 FHIR is a standard developed by Health Level Seven International (HL7) for exchanging healthcare information electronically. It's designed to facilitate interoperability by sharing discrete, granular health data using application programming interfaces (APIs).

FHIR provides health data exchange in an intuitive and extensible way. This supports seamless communication between different healthcare providers, payers and third-party applications, ensuring secure, timely, and accurate access to health data crucial for patient care and operational efficiency.

FHIR leverages modern web technologies with a simple and flexible approach to making precise data available where and when needed. Previous HL7 standards shared documents or entire patient records, making them difficult for application developers to learn and use easily.

FHIR's modular structure supports efficient sharing and management of various types of healthcare data for both care and application development.

How does FHIR improve patient care in healthcare settings?

FHIR is transforming healthcare data access and exchange. Whether you work for a healthcare provider, a public health agency, an insurance company, or a medical technology provider, FHIR enables you to efficiently retrieve and share disparate healthcare data from EHR systems, medical devices, wearables, clinical trials, public health surveillance systems, and SMART on FHIR applications.

Evolving from previous standards, FHIR lets you easily build innovative applications that transform raw health and care data into meaningful and actionable information. Challenges in clinical decision support, patient engagement, care management, and research require diverse datasets with trusted, secure access. FHIR enables exchange in a secure, API-driven pattern both at patient and population levels for patient care, operational measures, and clinical research.

couple caring for their newborn baby in the hospital

How does FHIR improve patient care in healthcare settings?

The Key Components of FHIR

FHIR enables the easy exchange and retrieval of clinical data across various health systems. A few key components form the backbone of this innovative standard, ensuring it meets the needs of modern healthcare environments.

Resources

FHIR specifies a core set of Resources as the fundamental units of interoperability. Each Resource represents a specific type of information in healthcare, such as a Patient, an Observation, Medication, Diagnostic Reports, and more.

These Resources are defined in a reusable and extensible way for various clinical contexts, ensuring consistency across different systems.

RESTful API

FHIR is built on RESTful architecture: Resources are exchanged over REST APIs in JSON or XML and HTTP headers and parameters provide important query, identifiers, authorization, or metadata fields. This makes the interaction with web-based data straightforward, using familiar HTTP methods like GET, POST, PUT, and DELETE.

This approach facilitates the seamless integration of FHIR with existing client-server applications and cloud architectures while allowing developers to deploy interoperable solutions quickly.

Bundles

FHIR can package Resources into Bundles for efficient management of grouped or related healthcare data.

Bundles can support a variety of purposes including structured clinical document exchange, transactional operations across multiple resource updates, returning search results, providing historic resource versions, or providing event notifications via subscriptions.

Extensions

To accommodate the varied and complex needs of healthcare data, FHIR includes mechanisms for Extensions, which allow for the addition of custom elements to existing Resources.

This flexibility of the core standard ensures that FHIR can adapt to meet specific requirements of an almost infinite number of use cases to create interoperability.

Profiles

Profiles provide specific definitions and constraints to tailor standard resources to particular use cases or requirements. Profiles can be shared between interoperable systems and data quality can be guaranteed from validating Resources against the Profile structure definitions.

This tailored approach ensures that FHIR can support broad and varied applications, from simple data sharing between healthcare providers to complex clinical decision support systems.

Terminology Binding

FHIR supports detailed terminologies and vocabularies, ensuring that data is consistent and interpretable across different systems. This feature is vital for maintaining the accuracy and relevance of data as it moves between different stakeholders in the healthcare ecosystem.

These components work together to provide a comprehensive, adaptable, and robust framework for healthcare data interoperability. By leveraging these elements, FHIR facilitates real-time access to data, supports enhanced clinical decision-making, and ultimately improves patient outcomes.

Key FHIR Capabilities

There are multiple ways to develop, deploy, and use FHIR-based applications and data.

FHIR Server

The InterSystems FHIR Server is an enterprise-grade cloud solution that allows the creation and exchange of FHIR® resources and bundles, such as discrete EHR data, without the need to build your own FHIR infrastructure.

FHIR SQL Builder

The FHIR SQL Builder enables analytics directly on the FHIR Server without the need for converting or duplicating data. Queries can be run with SQL and industry-standard BI tools for operational analytics, clinical research, and dashboarding.

Bulk FHIR

Bulk FHIR allows you to move and import data from EHRs into your FHIR Server when working with population-level data and patient cohorts. While FHIR APIs are an ideal way for small datasets like an individual’s current medication, they are not as efficient for cohorts.

Are you a FHIR expert?

Take the Quiz. Test your FHIR knowledge while learning along the way.

Interoperability, Evolved

Interoperability, Evolved

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, heterogeneous, 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.

FHIR consists of discrete, computable data objects called Resources for optimal efficiency. With FHIR Resources, applications can access individual healthcare record elements without retrieving all of the data contained in a summary document.

Learn More

FHIR Solutions in Real-World Healthcare

Here are a few examples of how the FHIR standard plays itself out in the real world:

Emergency Care Accessibility

In emergency healthcare scenarios, immediate access to a patient's medical history is crucial. FHIR facilitates the timely exchange of critical data such as allergies, current medications, and past medical history among emergency services, hospitals, and primary care providers.

This rapid data retrieval can be lifesaving, ensuring that emergency personnel have all the information they need to make informed decisions quickly.

Interoperable Health Apps

With FHIR, developers can create apps that provide tailored health interventions based on patient data sourced from multiple health systems.

For example, apps that generate personalized dietary plans for patients with specific nutritional needs can pull relevant data from their health records via FHIR APIs. These apps enhance patient engagement and adherence to treatment plans by providing customized, actionable guidance.

Chronic Disease Management

FHIR is instrumental in managing chronic diseases, where continuous monitoring and adjustments in care plans are necessary.

For example, FHIR-enabled systems can integrate data from wearables and home monitoring devices with electronic health records (EHRs), allowing care managers to track patient progress in real-time and adjust treatments as needed.

This integration supports proactive management of conditions like diabetes and heart disease, reducing hospital admissions and improving quality of life.

Prior Authorization

Many health plans require prior authorization for high-cost services. Existing manual processes rely on emails, data entry into multiple systems, faxes and phone calls.

FHIR APIs for electronic prior authorization developed collaboratively by payers, providers and vendors, can automate nearly the entire process, reducing burden on providers, delays in care, and freeing up payer staff for care management.

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.

Streamlined Referral Processes

FHIR helps streamline the referral process between primary care providers and specialists.

By using FHIR standards, primary care doctors can easily share the relevant information from patient records, including medical history and diagnostic information, with specialists.

This ensures that the specialist has all the necessary information before the patient’s visit, reducing delays in treatment and improving the overall efficiency of care coordination.

Public Health

FHIR offers high-level surveillance by aggregating data from multiple health systems. This offers critical data on outbreaks of diseases like COVID or other public health risks.

For example, the FDA used InterSystems IRIS and the FHIR system to collect data on adverse vaccine reactions.

Challenges to Implementing FHIR in Healthcare Organizations

Interoperability Complexity

The complexity of integrating FHIR with diverse healthcare systems is a significant challenge. Many hospitals and healthcare providers rely on older, mission-critical applications that continue to operate effectively, making it unrealistic and unnecessary to replace these systems entirely.

Interoperability can be more easily achieved with advanced integration tools and robust security functions that simplify the connection between FHIR and various systems.

InterSystems excels in this area by providing a robust set of solutions that enable systems to connect to FHIR without having to upgrade or replace their current technology.

Training and Skill Requirements

Healthcare staff often require training to utilize FHIR effectively. Staff need to be supported with educational resources, online learning tools and customer support, aiding their understanding and ability to use FHIR-based systems efficiently.

InterSystems provides an array of training and ongoing support opportunities, including videos and documentation, learning paths, and in-person and online classroom learning.

Resource Constraints

Smaller organizations may struggle with the financial resources needed for FHIR implementation. Scalable, cost-effective solutions that help organizations of all sizes adopt FHIR without significant financial strain are critical.

InterSystems meets the needs of these organizations in multiple ways, which includes providing managed services that remove the burden of purchasing, operating, securing and maintaining costly infrastructure.

Consistency and Quality of Data

Maintaining high-quality and consistent data in FHIR exchanges is essential. But having high-quality data isn't enough; it also needs to be usable.

InterSystems provides advanced data management capabilities to convert data to FHIR while keeping it accurate and organized.

Legacy Systems and Data Standards

A core challenge in FHIR implementation is the prevalence of data still represented in older standards. The ability of healthcare organizations to leverage FHIR's benefits without discarding existing systems is essential.

InterSystems allows organizations to do just that by providing the tools needed to move data from older systems out as FHIR, supporting a gradual transition and integration that respects the historical investments in IT infrastructure.

Portrait of smiling nurse at a nurses' station in hospital

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

Using GenAI to Guide you on the Use of FHIR

Legacy Data Transformation and Integration

Seamless Integration with Cloud Pipelines using APIs

Building Your Own FHIR Solutions and Façades using our FHIR Server as a Platform and Object Model

Bulk FHIR Data Exchange

Analytics and Business Intelligence with FHIR

Access to Comprehensive Patient Records

Clinical Research including capabilities like FHIR to OMOP

Explore and Develop with FHIR

Experience FHIR

We’ve created sandboxes where you can experience our “Build with InterSystems FHIR” examples and exercises. You can also explore FHIR resources such as clinFHIR, and join the Developers Community group–a place for discussion and finding answers to questions about FHIR implementation using InterSystems technology.

FAQs about HL7 FHIR

How does FHIR handle the security and privacy of health data?

FHIR (Fast Healthcare Interoperability Resources) handles the security and privacy of health data through several key mechanisms:

Data Access Controls: FHIR specifies strict access controls, ensuring that only authorized individuals can access sensitive health data.
Encryption: Data transmitted using FHIR is typically encrypted, both in transit and at rest, providing a high level of security against unauthorized access.
Audit Trails: FHIR supports extensive audit trails, recording who accessed what data and when, which is crucial for monitoring and ensuring compliance with privacy regulations.
Compliance with Standards: FHIR is designed to be compliant with major healthcare privacy standards, such as HIPAA in the United States, ensuring adherence to legal requirements for data privacy.
User Authentication and Authorization: FHIR includes mechanisms for robust user authentication and authorization, further securing access to health data.

What makes FHIR different from other healthcare data standards?

FHIR differs from other healthcare data standards in its modern web-based approach, flexibility, and ease of implementation.

It uses a modular structure with "resources" as fundamental units, making it simpler and more efficient for developers to work with. FHIR supports RESTful architectures, JSON, and XML for data representation, aligning with current web development trends.

This contrasts with older standards that often relied on complex and rigid structures, making FHIR more adaptable and user-friendly in today's digital healthcare environment.

How does FHIR support mobile and web applications in healthcare?

FHIR supports mobile and web applications in healthcare by providing a flexible and web-friendly set of standards. It uses modern web technologies like RESTful APIs, JSON, and XML, which are widely used in web and mobile app development.

It supports real-time data sharing, which is vital for organizations that need up-to-date patient information on mobile devices.

FHIR's use of modern RESTful web services makes it straightforward for developers to integrate healthcare data into diverse applications, leading to innovative solutions for telehealth, remote monitoring, and patient engagement. This results in improved healthcare delivery, personalized patient care, and better health outcomes.

What role do APIs play in FHIR?

Application Programming Interfaces (APIs) in FHIR enable seamless interaction between different healthcare systems and applications.

They act as intermediaries, allowing software programs to exchange data using FHIR standards. This integration is essential for modern healthcare applications, where timely access to accurate health data is necessary for effective care delivery.

APIs make it possible to incorporate a wide range of functionalities into healthcare applications, from accessing patient records to updating treatment plans, thereby enhancing the overall efficiency and effectiveness of healthcare services.

Can FHIR be integrated with legacy healthcare systems?

FHIR can indeed be integrated with legacy healthcare systems. This integration is facilitated by FHIR's flexible and adaptable design, which allows it to interface with a wide range of data formats and communication protocols used in older systems.

By providing a standard method for exchanging healthcare data, FHIR bridges the gap between new and existing technologies in healthcare IT, enabling legacy systems to communicate with more modern applications and platforms.

This capability is crucial for the gradual and seamless transition of healthcare organizations towards more advanced data management practices.

How is FHIR being adopted and implemented globally in the healthcare sector?

FHIR is being adopted and implemented globally in the healthcare sector in various ways. Many countries are integrating FHIR into their national healthcare systems for better data exchange. It's being used in telehealth services, mobile health applications, and EHR systems to improve patient care and coordination.

Additionally, international health organizations and IT developers are creating FHIR-based solutions to address specific healthcare needs and challenges. This global adoption highlights FHIR's versatility and effectiveness in enhancing healthcare data interoperability.

How is FHIR evolving to meet future healthcare challenges?

FHIR is evolving to meet future healthcare challenges by enhancing its capabilities in exchanging healthcare data across diverse platforms and systems. It's continuously updating to support various data formats, ensuring that it remains compatible with emerging technologies and healthcare practices.

As healthcare data becomes more complex and voluminous, FHIR's adaptability in exchanging data is key to addressing these evolving needs. This includes expanding its resource definitions, improving its support for real-time data exchange, and ensuring its standards are in line with the latest developments in healthcare and technology.

What is interoperability in a healthcare context?

In the context of FHIR and healthcare, interoperability refers to the ability of different healthcare systems, applications, and devices to exchange, interpret, and use health information in a coordinated manner.

This ensures that patient data can be shared seamlessly across various platforms and organizations, enhancing the efficiency and quality of healthcare delivery. FHIR plays a key role in achieving this by providing a standardized framework for data exchange.

What's the difference between CDA and FHIR?

Clinical Document Architecture (CDA) and FHIR are both standards developed by HL7 for healthcare data exchange, but they serve different purposes. CDA focuses on the structure and semantics of clinical documents for exchange, using XML.

It's well-suited for comprehensive patient records and reports. FHIR, on the other hand, is more flexible and adaptable, designed for real-time data exchange and interoperability across healthcare systems.

It uses modern web technologies and supports a wider range of data types and interactions, making it more suited for dynamic data access and integration in various healthcare applications.