These days, there’s a lot of data being exchanged in the healthcare industry. As technology advances, a wider variety of systems and devices are programmed to produce, send, and receive patient data. With these advancements, it raises the question: how can this data be shared amongst disparate systems, healthcare providers, or clinics?
Created specifically for facilitating the exchange of healthcare information, FHIR (charmingly pronounced fire) sets the standard that drives healthcare interoperability.
FHIR, known as Fast Healthcare Interoperability Resources, regulates the very necessary exchange of healthcare information between different healthcare systems. With secure access to patients’ full medical history, a holistic visualization of patient health is presented. Having access to a patient’s complete medical history allows for more accurate diagnoses, informed decision making, improved patient experiences and health outcomes.
Not only is there more data in the healthcare field than ever before, but there are also more sources and repositories of data than ever before. From data from hospitals, labs, and pharmacies to data produced by patients’ medical wearables, home devices, and mobile phones, there is a need for all of that information to be viewed in one place.
At the intersection of healthcare and technology is interoperability. Healthcare professionals need to be able to access and exchange critical health information regarding patients. FHIR, as a framework for exchanging, sharing, and retrieving electronic health information, serves as a connector between those (and the things) that provide healthcare data and those that rely on it to deliver care.
Raw health data is created every second, as people move through the healthcare system’s continuum of care, and enters several different EHR/EMR databases. That data is then accessed by and securely shared with patients, doctors, nurses, pharmacists, and other health providers, through information networks, or Health Information Exchanges (HIEs).
Patients, doctors, pharmacists, and other healthcare professionals rely on this data to make critical decisions about a patient’s ongoing care. Without full integration between systems, these healthcare providers can’t get a complete picture of the patient’s history or current care.
Created by Health Level Seven (HL7), FHIR essentially offers a set of Application Programming Interfaces (APIs) that allow systems in the healthcare industry to communicate with each other. The components of FHIR are combined by healthcare software developers to target different clinical use cases or to extend core specifications.
Established as a response to the need for faster, easier methods of exchanging health data, FHIR enables developers to build standard browser applications that allow every user to see the patient’s information regardless of the software their EHR/EMR is using. Just as any user can use a website from any operating system and any location in the world, a FHIR browser is usable by any EHR/EMR database on any operating system.
Resources are the main structural element of FHIR solutions. These core sets of data elements determine what data will be shared when combined with references.
These packets of information are used to store or exchange data for the satisfaction of most clinical setting use cases, from appointment scheduling to medical billing.
Mentioned before, resources usually have references to other resources. Resources, represented in UML, XML, or JSON, are linked in order to provide information being requested by a medical professional. For example, linking “patient” to “condition” and then “medication” can produce patient, diagnosis, and current medication information to the requester.
Profiles are what define the use of resources, dependent on the circumstances involved. Using FHIR-based APIs, developers create these profiles and publish them in FHIR standardized Implementation Guides.
Access to health data used to be limited to the application patient information was collected through. Now that there are so many applications, systems, and devices collecting and transmitting data, set standards are necessary to give healthcare professionals a 360-degree view of patient health.
The necessity for integration has led to the development of standards that most FHIR-focused developers use, including:
SMART on FHIR: This is a widely applicable template that makes it easy for developers to build health apps that integrate with EMR and EHR databases.
CDS Hooks: This is a security API that supports the heightened privacy concerns inherent in healthcare information.
Bulk Data: Sometimes called FLAT FHIR, this allows information to be stored in a temporary NDJSON file format before being transferred to another database.
FHIRCast: This API synchronizes healthcare applications in real-time. Many clinicians must use more than one patient database, and FHIRCast allows them to see all the information at once.
Subscriptions: This API permits a push-based subscription service to send information from the server to any system.
Mapping Language: This mapping language API allows maps, metadata, and data sets to transfer easily.
Much like how the adoption of standards allows users of different cellphone company plans to talk to each other, commonly agreed-upon standards are necessary for systems to work synchronically.
Fast, easy data exchanges has long been a goal of government and industry software developers. The most recent FHIR standards represent the culmination of years of effort, making FHIR far superior to previous guidelines.
With full EHR and EMR integration, doctors and other healthcare providers have access to the information they need to make safe, accurate diagnoses and treatment plans.
Online data sharing is streamlined with web-based resources. Using them doesn’t require advanced technical knowledge or extensive training.
Built-in REST APIs make it easy to share documents, notes, messages, and other documentation.
The streamlined FHIR solutions are adaptable to any existing system. They employ simple, well-known technologies. Ease of use ensures adoption of these resources is affordable and cost-effective.
FHIR software is always free to use and free of restrictions. This ensures widespread adoption by healthcare providers, healthcare-related businesses, and other interested parties.
An expanded health HIE is essential to improved interoperability, better patient care, and better public health outcomes. These exchanges allowed doctors and public health organizations to share test results, track vaccinations, monitor outcomes and provide reliable, accurate data about transmission rates.
The move to full integration through FHIR will allow the same fast, coordinated response to both everyday healthcare needs and community health initiatives. APIs are an essential part of this transition.
FHIR relies on open APIs, which are key to its implementation. An open or public API, as its name implies, is open to the public. It allows developers to get access to proprietary software applications. An open API is available with no restrictions, backed by open data, and based on an open standard.
Why does this matter? An open, web-based API creates secure, reliable communication between electronic devices regardless of the operating system or software each is using.
For years, providers and healthcare companies have been asking for this type of data sharing from their EHR vendors. Now, it is finally a reality.
FHIR-based data exchange standards have already been implemented by healthcare organizations and software providers.
The use of FHIR gives a patient complete, confidential access to their Personal Health Record (PHR). Using a web-based browser, patients can update their personal information. They can also add information from fitness apps, blood pressure monitors, blood sugar testers, exercise monitors, and other standalone health trackers.
This physician-focused API connects doctors to medical images and machine learning. This allows them to make more accurate diagnoses and prescribe care across specialties. Doctors can use it from their mobile phones or a browser.
The ability to share medical documents is critical to patient care. Radiology scans, test results, clinical notes, prescriptions, and other documents give important insights into patient care. Coordination is easy and accurate when healthcare providers have all the documentation they need.
Currently, there is no standardized way to collect or share SDOH data. This is data that concerns a patient’s environmental health factors, including the patient’s access to housing, shelter, and transportation. Public and community health organizations have used FHIR to create standardized methods of defining, collecting, and sharing this data.
Building APIs and other solutions through FHIR framework is a major step in providing patient-centered, value-based care. Interoperability and compliance would be inherent when working with the resources provided by FHIR guidelines.
Repositories such as EHR/EMRs are now integral to every aspect of healthcare, but full integration remains an elusive goal. As EHRs become increasingly important for keeping track of patient information, compliance and interoperability have become critical and coveted features of the most dependable healthcare solutions.
The implementation of FHIR standards by expert developers is key to achieving full compliance with guidelines set forth by the Health Insurance Portability and Accountability Act (HIPAA), enabling seamless interoperability with databases, and facilitating a bilateral exchange of health information with medical providers and other key partners.
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