Is Fast Healthcare Interoperability Resources (FHIR) the “Prescribed Burn” that Healthcare Data Needs?

Farmers sometimes burn their fields to the ground to enrich and enliven the soil in what is known as “prescribed burns.”

Prescribed burns have a variety of benefits including removal of debris, soil restoration, and mitigation of hazards (pests, bad crops, etc.). Some may see parallels between this and the current state of Healthcare data. Many healthcare data systems are a house of cards built on legacy platforms that have been band-aided together over decades. Is it time to let the cards fall and set healthcare data practices on FHIR?

There has been a steady trend over the past couple of decades for all (or at least most) healthcare records to become digitized which helps support the ease of data exchange and can also provide better patient outcomes. As patients move through the healthcare ecosystem, it is vital that their records be readily available, discoverable, and understandable to users via a trusted digital platform. Further, in order to implement automation applications and other machine-based processing, this data must follow an agreed-upon structure and standardization. The global healthcare community believes they are close to achieving this with Fast Healthcare Interoperability Resources (FHIR).

FHIR is a modern framework that facilitates the interoperability between legacy healthcare systems and current digital platforms such as electronic health record (EHR) devices. It is the systematic standardization of how a patient’s data will be collected, organized, and formatted so that it can be easily shared and understood across all healthcare organizations and departments. By incorporating the FHIR framework, clinical care data can seamlessly integrate with administration, research, and payer data. In a nutshell, FHIR will soon be the standard of how the world packages and moves health data which will facilitate higher levels of quality and effectiveness of care.

At this point you’re probably asking yourself, how can this be done? Well, the basic components of FHIR are known as Resources. Resources represent most exchangeable data, per the 80% principle, the resources are designed to include elements that were found to be in common between all implementors. Any additional data needs can be satisfied by using extensions. The idea is that with a collection of resources you should be able to coherently collect and organize all data for your organization because FHIR resources were designed to accommodate all common data requirements with the least amount of excess or duplicative data. Additionally, contained within the FHIR resources, you should be able to find all the resources necessary to accurately represent ANY healthcare-related organization. All these resources have defined “terminology bindings” which act as a global level data governance in addition to core content that is recommended for all resources. FHIR describes each of these resources in detail on their website.

On top of the Resource building blocks in place, another benefit of FHIR is that it was architected using HTTP Secure protocol. This allows for real-time data gathering for reporting and analytics and ensures that users will be able to pull real-time data from defined FHIR resource models. These resources are connected to a data store where they can then interact with other informatics data. The potential use cases range from real-time epidemic tracking to the standardization and modernization of quality measures such as the Healthcare Effectiveness Data and Information Set (HEDIS). Other FHIR benefits include:

  • Easy to learn, develop, and productionalize
  • Can leverage several modern tools (JSON, XML, HTTP)
  • Incorporates human-readable artifacts
  • Provides automated validation
  • Open license (you don’t have to be a FHIR member to implement it)

And while FHIR is gradually being rollout to the global healthcare community, it hasn’t stopped healthcare agencies from promoting its immediate adoption. In 2020, the U.S. Centers for Medicare & Medicaid Services (CMS) issued their Interoperability and Patient Access ruling requiring the use of FHIR by a variety of CMS-regulated payers, including Medicare Advantage organizations, state Medicaid programs, and qualified health plans in the Federally Facilitated Marketplace by 2021.

With that said, most healthcare organizations are not ready to adopt FHIR wholesale just yet. And that’s ok. Whether you are looking to implement a standalone FHIR server (FHIR Native) or just looking to implement a FHIR server in front of your existing application (FHIR façade), Data Ideology can help! We have extensive experience determining what FHIR resources best fit business needs, organizing enterprise data to best fit into the FHIR resources, and working with FHIR vendors to make sure that vendor implementations accurately capture and represent your enterprise’s data. To learn more about our FHIR services contact us here.

Written by Rebecca Gazda

Managing Director at Data Ideology

Rebecca Gazda is the Managing Director with 15+ years of experience in Data and Analytics, Statistics, and Data Team Management.

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