FHIR: A Healthcare Data Standard Designed for the Future

Summary

Dr. Russ Leftwich narrates the evolution of healthcare data standards, highlighting the need for interoperability amidst a proliferation of IT systems. He introduces FHIR (Fast Healthcare Interoperability Resources), a new standard designed to simplify data exchange across healthcare platforms. FHIR uses RESTful APIs, enabling real-time data access and integration, crucial for decision-making with the exponential growth of healthcare data. The talk covers FHIR's core components, including resources, profiles, and extensions, and underscores the importance of shared profiles for true interoperability.

Takeaways

• 🔥 The story of FHIR (Fast Healthcare Interoperability Resources) begins with the need for interoperability in healthcare systems in the 1980s.
• 🏥 The average US hospital now has over 80 IT systems, highlighting the complexity and necessity for data integration.
• 🌐 Interoperability has evolved to mean accessing all patient or population data in real-time across various systems.
• 📈 The volume of data in healthcare has grown exponentially, with an estimated 1,000 facts per decision in 2020 compared to 10 in 1980.
• 🤖 Humans can only effectively handle about five facts at a time, making the need for advanced data standards like FHIR crucial.
• 🏗️ FHIR was developed by HL7 as a new standard to meet the evolving needs of healthcare data exchange, replacing older standards like HL7 v2 and v3.
• 🌐 FHIR operates as a RESTful API, allowing systems to request and receive data in a standardized format, similar to how travel websites aggregate flight data.
• 📚 FHIR resources are discrete data concepts with defined meanings, such as patient information, medications, and care plans.
• 📝 FHIR profiles define specific use cases, including required resources, value sets, and extensions, ensuring consistent data interpretation across systems.
• 🔄 FHIR supports multiple interoperability paradigms, including data exchange, messaging, documents, and services, without the need for data transformation.
• 🛠️ FHIR implementation guides provide the rules and examples for specific use cases, making it easier for systems to achieve interoperability.

Q & A

What is the significance of the 1980s in the context of healthcare interoperability?

The 1980s marked the beginning of healthcare interoperability as hospitals started to have more than one system within their walls and needed to connect those systems.

How many IT systems does the average hospital in the US have today?

The average hospital in the US has over 80 IT systems within its walls.

What does the term 'interoperability' mean in the context of healthcare data?

Interoperability in healthcare refers to the ability to access and view all the data from multiple systems for a patient or a population in real time from one place.

What is the estimated number of facts per complex decision in healthcare as of 2020?

Dr. William Stead estimated that there are about a thousand facts per complex decision in healthcare in 2020.

Why was the creation of a new healthcare data standard necessary?

The existing standards like HL7 version 2 and CDA were not meeting the evolving needs of healthcare data exchange, and HL7 version 3 was too complex for widespread implementation.

What is FHIR and how is it different from previous healthcare data standards?

FHIR, or Fast Healthcare Interoperability Resources, is a standard that uses a RESTful API to allow systems to exchange healthcare data without the need for complex transformations. It is different because it is designed to be more implementable and less complex than previous standards.

What is the analogy used to explain FHIR?

FHIR is compared to travel websites, where systems can request and receive data from each other in a standardized way, similar to how travel websites display flight information from different airlines.

What are FHIR resources and how do they function?

FHIR resources are discrete data concepts with a known location on a server, a defined meaning according to the FHIR specification, and they can be used across different interoperability paradigms.

What is the role of FHIR profiles in ensuring interoperability?

FHIR profiles define the specific use cases and consist of all the resources, value sets, and extensions needed for that use case, ensuring that systems using the same profile can exchange information with shared meanings.

How does FHIR handle data that is not part of the standard 80 percent of existing systems?

FHIR extensions are used to represent data that is not part of the standard 80 percent of existing systems, allowing for customization of the FHIR resources to fit specific use cases.

What are FHIR implementation guides and why are they important?

FHIR implementation guides are resources that include all the rules for a specific use case, with human-readable documentation and examples. They are important because they ensure consistent implementation of FHIR across different systems and applications.