ONC FHIR status update

1. ONCFHIR status update Lloyd McKenzie June 6, 2013

2. (Really fast) FHIR Intro

3. Healthcare Standards What if it didn’t have to be like that? Complex…. Slow… Hard to use and understand Require specialist skills, tools Costly

4. Introducing FHIR • Fast Health Interoperability Resources • Pronounced “Fire” • Based on industry best practices, with a focus on simplicity and implementability • Leverage web technologies • Human readability as base level of interoperability • One syntax – documents, messages, services, REST • Computable templates/profiles that work in all architectures

5. Resources • “Resources” are: • Small logically discrete units of exchange • Defined behaviour and meaning • Known identity / location • Smallest unit of transaction • “of interest” to healthcare • E.g. Patient, Provider, Specimen, Drug, Lab Result, Allergy, Care Plan, Study, Adverse Reaction

6. Resources have 3 parts • Defined Structured Data • The logical, common contents of the resource • Mapped to formal definitions/RIM & other formats • Extensions • Local requirements, but everyone can use • Published and managed (w/ formal definitions) • Narrative • Human readable (fall back)

7. FHIR Status

8. Organizational penetration • Broad support from board and TSC • Significant uptake within main HL7 Work Groups • Redirecting energy from v3 • 50 FHIR-related quarters at last WGM • Leading effort on enhanced governance processes

9. Ballots • First DSTU (Jan 2014 latest) • 48 resources in scope • 10 Infrastructure • 25 for CCDA support • 6 for IHE (ATNA, XDS) & DICOM • 7 other sources • Significant up-front QA • Will pass after one, possibly two ballots • No guarantee of backward compatibility

10. Ballots • Second DSTU (~Jan 2015) • Additional “key” resources • Referral, Appointment, Diet, Radiation • Additional domains • Financial, Public Health, Clinical Studies, etc. • Resource Profiles • ‘Standard’ extensions? • Possibility of 3rd DSTU

11. Ballots • Normative ballot not likely until 2016 • Want significant (and broad) implementation experience • Promising wire-format compatibility, don’t want the overhead of workarounds for many years • Some resources may not go normative if they haven’t been sufficiently exercised • Will evaluate providing transforms for DSTU <-> Normative depending on need, resources

12. Implementer supports Multiple reference implementations Auto-generated interfaces in 4+ languages Public test servers Automated test tools Draft tooling to convert CCDA -> FHIR Tooling in progress for Profile development/maintenance

13. Implementer experience • 3 connectathons so far (30+ implementers) • Increasing attendance, including EMR vendors for first time • At least 20 companies/projects looking at/working on FHIR with intention of production use • (Possibly in limited environments) • Significant interface engine interest

14. Long range plans • Most resource development complete within 3 years • For some Work Groups, even sooner • Focus will change from resource development to: • Profile/extension development & maintenance • Vetting external profiles/extensions • Implementer support

15. Follow Up • Read the spec: hl7.org/fhir • Follow #FHIR on Twitter • Implementation questions on stackoverflow • Tag hl7_fhir • Shape the specification: • Make comments online (wiki linked to spec) • Try implementing it • Come to the next Connectathon and/or HL7 meeting • Sept. in Cambridge • Contact me • lloyd@lmckenzie.com