For the past few months, Tucuvi’s team has been hard at work integrating its entire data infrastructure with the HL7/FHIR standard. It has been a fascinating learning process in which we have had the opportunity to ask ourselves deep questions about the way in which our data is structured, and how we can facilitate interoperability with our clients.
But what exactly is FHIR, how did it come to be and, more importantly, why do we consider its adoption to be a fundamental move for us?
It is well known to anyone who has dealt with medical data that standardization isn’t as widespread or mature as we’d like. The reasons for this are many, but it essentially boils down to the fact that, when it comes to medical data, building a good standard that works for everyone is an extremely hard problem to crack.
But why would we want to standardize healthcare data in the first place? Simply put, as healthcare becomes more and more digitized, and EHR solutions become more widespread, stakeholders are demanding more functionality from their data, especially in terms of interoperability between different healthcare systems. Therefore, the development of a good healthcare data standard has become a critical goal.
Many attempts have been made at achieving this goal throughout the past decades, and Health Level Seven (HL7), a non-profit standards development organization based in North America, has been at the center of some of the most important and impactful of them all. The most well known are the very widespread Version 2 (V2) and the Clinical Document Architecture standard (CDA). These standards, while extremely powerful for their time and still widely used today, are becoming incapable of keeping up with the demands of modern application design in terms of usability and interoperability. It is important to note that V2 was born in 1989 and CDA’s first implementation dates from 1996.
To answer the call for a new, modernized standard, in 2011 HL7 released their Fast Healthcare Interoperability Resources standard, more commonly known as FHIR. To understand what exactly FHIR brings to the table, we need only to look at its name and break it down:
The result of these design principles is a standard that provides a robust data model, with a RESTful API, complete with a full set of open source tools that make implementing and testing FHIR applications very easy. In a nutshell, FHIR builds on all the knowledge and experience gained from the previous HL7 standards and brings it up to date with the latest web standards.
Since its launch, FHIR has been constantly evolving, with the latest version (FHIR V4) being released in 2019. Its adoption has been steadily growing, and although it’s still not as widespread as its older siblings, particularly V2, it is clearly the way forward, as it is much more flexible and futureproof.
FHIR makes the exchange of information between healthcare systems extremely easy. When two different systems are integrated with FHIR, sharing patient or practitioner data, appointment schedules, test results, etc. becomes quick and efficient. This is due to the fact that FHIR resources are immediately compatible, thanks to the standard’s clear definition of how those resources must be described and structured. Furthermore, all the data exchange operations are done through simple RESTful requests and responses.
While this has obvious implications from a data management perspective, it is also enormously beneficial for patients. One of the keys to effective patient treatment is the quality and readiness of the data. The efficient, real-time sharing of good medical records and treatment histories between clinical teams is fundamental to the quality of healthcare. FHIR makes this exchange process safe and easy, which greatly enhances the patient’s experience.
In a nutshell, the most important benefit of FHIR lies in its promise of interoperability. Different healthcare providers and organizations rely on different systems, with a variety of third-party software tools as well as proprietarily developed software. FHIR is designed to greatly simplify the integration of these different scenarios into its ecosystem, making interoperability between organizations easier than ever. This is extremely positive from a value-based perspective, since a great deal of time and cost can be saved, but at the same time it has a direct positive impact on patient’s lives.
At Tucuvi, we have built a FHIR API from the ground up, complete with the tooling needed to deal with all possible requests and responses. We have also been hard at work mapping all our existing resources to their appropriate FHIR representation. We are therefore now ready to both receive and send crucial data to and from our clients in a fully FHIR compliant format.
This greatly adds to our current healthcare service interoperability capabilities, allowing medical teams to manage their data with full guarantees of compatibility, speed and security thanks to the different solutions we have to offer. Our focus has always been on providing healthcare professionals with the tools and solutions they need to be able to offer the highest quality of care to their patients. We strive to achieve this by leveraging the latest technological advancements, with the integration of FHIR being a definitive step forward.
Here are some interesting readings for further information:
There is no doubt whether FHIR will stay relevant. Some observations regarding this standard and it’s implementation.
The Fast Healthcare Interoperability Resource (FHIR) standard aims to improve data exchange, but how does it work and what does it mean for the future of health data interoperability?
How FHIR is taking hold as the industry eagerly awaits the ONC's proposals to tackle data blocking and other interoperability concerns.