What’s happening with FHIR®?
Since we posted our beginner’s guide to Fast Healthcare Interoperability Resources (FHIR) more than a year ago, we’ve seen a lot of change with this standard for health data exchange. Here are some of the most frequently asked questions and answers:
What is an example of how FHIR will be used in health care?
One example is Sync for Science (S4S) started by the National Institutes of Health (NIH) in collaboration with the Office of the National Coordinator for Health IT (ONC). The effort’s goal is to enable better patient access to data and to create a million-patient database for precision medicine research. S4S is working with vendors, including Allscripts, to enable data sharing via FHIR Application Programming Interfaces (APIs) for patients who opt in to participate.
Is FHIR final?
Not quite. Health Level Seven® International (HL7) still classifies FHIR as a Draft Standard for Trial Use and the current version is DSTU2. For the past year the industry has been developing and testing with DSTU2, and the next version, STU3, is scheduled to be released in late March.
You’ll notice the “D” is missing in STU3. HL7 no longer produces “Draft” Standards; they are now designated as Standards for Trial Use (STU). Also of interest is that balloted FHIR has the same HL7 status as the Consolidated CDA (Clinical Document Architecture).
The FHIR management team plans to take the next version to ballot in mid-2018 and publish in late 2018. This version will contain some normative content, which will be fixed, and some content that’s still in draft and open to evolution going forward.
What is Allscripts doing with FHIR?
Allscripts is fully engaged with implementing FHIR for our solutions. We’ve gone from having a simple interface to a fully realized FHIR API. We intentionally designed a platform-neutral API, which returns the same FHIR formatted data from all of our electronic health records (EHRs).
We decided to use FHIR to meet the government requirements for providers to have an API that enabled patients to have access to their data. We expanded the API to support all the elements of the Common Clinical Data Set (CCDS), and passed all certifications in 2016. We’re releasing the API with the MU3 versions of each EHR. An early adopter has Allscripts FHIR API installed in one of its development environments.
How is Allscripts collaborating with the industry to further FHIR as a means to interoperability?
We’ve participated in several HL7 Connectathons, where developers from all over the world come together to write and test applications to help develop FHIR’s maturity. One of the exciting developments that has come from these events is our work on the ability to pull care plan data via our API and share it with other systems. Other organizations have recognized our work in this area. We also sponsored the FHIR Applications Roundtable in March 2017.
Allscripts continues to work with the Argonaut Project and has joined the Healthcare Services Platform Consortium (HSPC), a provider-led consortium that includes more than 270 contributors, to tackle the interoperability challenge. Its goal is to come up with a common model to enable health systems to connect, and the primary structure is FHIR.
These are just a few of many ways Allscripts is collaborating with industry efforts to improve interoperability.
What else is Allscripts doing to encourage use of FHIR APIs?
We continue to work with third-parties to ensure the success of our FHIR API to exchange data with other solutions. The API is available to anyone (you can sign up on our developer portal to get started). It’s fully supported and documented, so developers can connect, test and publish applications using our FHIR API.
Last year, Allscripts issued a Developer Challenge to increase the number of patient-facing applications using our API that meet the MU3 requirements. We had 22 companies submit applications for the challenge, and named first-place winner Medlio and runner-up PatientLink Enterprises for their innovative solutions.
PatientLink also won first place in the ONC’s Consumer Health Data Aggregator Challenge for its application that makes it easy for patients to gather, manage and share health data using methods that include FHIR. Allscripts worked closely with this partner to verify that it worked on all our EHR platforms.
We’ve seen progress with some exciting collaborative demonstrations. For example, in December 2016 we participated in an interoperability showcase sponsored by the ONC at the Connected Health Conference. Three different application development companies (CareEvolution, Medisafe and RxRevu) participated to demonstrate connectivity with Allscripts, CareEvolution, Cerner and Epic systems to retrieve and reconcile medication lists for a single patient. Phase 2 of the project has already started and we’re participating with an Allscripts client serving as a pilot site, preparing to go live in June.
We’ll continue to coordinate efforts to make true interoperability a reality in health care and to continue to invest in our FHIR initiatives and capabilities.