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Preparing for interoperability? More information you need to know about FHIR

Editor’s note – Learn the basics in  A beginner’s guide to FHIR. The article below answers additional frequently asked questions about FHIR.Slide1

Clients are asking good questions about FHIR and what it means for them. Here are a few that we’ve received about the emerging interoperability standard:

How does FHIR relate to the API requirement for 2015 certification?

To achieve 2015 certification, the Office of the National Coordinator for Health Information Technology (ONC) requires EHRs to be able to retrieve patient data using APIs. ONC did not specify FHIR as a requirement for the API certification, categorizing FHIR in the 2016 Draft Interoperability Standards Advisory as piloted with low adoption. However, ONC’s documentation reflects FHIR in its phrasing and direction, so it’s clear that ONC is generally supportive of the evolving standard.

How do FHIR Resources compare to Clinical Document Architecture?

The HL7 Clinical Document Architecture (CDA) is an interoperable content standard to help organizations exchange clinical data. CDA takes a document approach, providing the ability to group related content about the patient into a single document format.

In contrast, FHIR presents discrete elements of information – individual lab results, demographic information, medications and more – as data representations called Resources. An excellent overview is the Summary Introduction to HL7 FHIR. We can still aggregate information into larger constructs, similar to documents, using the Composition FHIR Resource.

What happens at an HL7 FHIR Connectathon?

FHIR Connectathons are hands-on collaborative coding sessions for developers that usually take place over the course of a weekend. These events have been growing in attendance over the last few years, attracting about 125 people at the most recent event in January 2016.

Before the event, HL7 proposes functionalities that the industry may want to implement as FHIR Connectathon Tracks. For example, this year the clinical track looked at clinical decision support.  On Saturday, participants work on their projects, and on Sunday they have an opportunity to demonstrate their final product to the group.

Anyone who is a member of HL7 is welcome to participate or just to observe. FHIR Connectathons draw people from across the industry, including EHR vendors, insurance companies and client application developers. FHIR architects and subject matter experts also attend.

Is FHIR really the future of interoperability?

In a recent Forbes article, several industry experts debated the pros and cons of FHIR. FHIR is a promising standard for discrete data access to EHRs’ common clinical data set. Other methods, such as HL7 v2 or Direct Project, may be better suited to solve other interoperability requirements. We’re encouraged by the industry’s continued progress with interoperability through these approaches.

Does Allscripts offer FHIR support for SMART devices?

SMART, an open-standards API, started about six years ago as a private-sector attempt to help developing applications to connect with EHRs. Recently the API has expanded so application vendors can also use FHIR, and we’re talking with these vendors about testing SMART on FHIR applications on our service.

Can I test FHIR with Allscripts?

Allscripts is currently a member of the Argonaut Implementation program. As part of this program we’re building and testing an API service that will support FHIR queries and resources. We expect to share more about client access and application developer access in 2016. A version of Allscripts FHIR services is being used now at HL7 FHIR Connectathons.

Where can I learn more at HIMSS 2016?

At HIMSS (Booth #2612), Allscripts subject matter experts will be available to discuss our plans for supporting FHIR and demonstrate our FHIR API service and its interoperability with Allscripts EHRs.

Also, as part of a symposium before HIMSS Annual Conference, Allscripts Senior Vice President Rich Elmore will co-lead a discussion with experts about the potential solutions to interoperability, such as FHIR and public API approaches enabling SMART applications.

Have other questions about FHIR? Ask them in the comments below.

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