Editor’s note – Learn the basics in  A beginner’s guide to FHIR. The article below answers additional frequently asked questions about FHIR. Clients are asking good questions about FHIR and what it means for them. Here are a few that we’ve received about the emerging interoperability standard: How does FHIR relate to the API requirement for 2015 certification? To achieve 2015 certification, the Office of the National Coordinator for Health Information Technology (ONC) requires EHRs to be able to retrieve patient data using APIs. ONC did not specify FHIR as a requirement for the API certification, categorizing FHIR in the 2016 Draft Interoperability Standards Advisory as piloted with low adoption. However, ONC’s documentation reflects FHIR in its phrasing and direction, so it’s clear that ONC is generally supportive of the evolving standard. How do FHIR Resources compare to Clinical Document […]

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Q&A: A beginner’s guide to FHIR

  • George E. Cole, Jr.
  • 01/06/2016

Interest in FHIR (Fast Healthcare Interoperability Resources) is growing as the standard for exchanging healthcare information takes shape. What is it and what will it mean for healthcare providers? Here are some frequently asked questions and answers: Q. What is FHIR? A. FHIR (pronounced “fire”) is a newly emerging international specification that standardizes the exchange of electronic healthcare information. First sponsored by Health Level Seven International (HL7) in 2011, FHIR incorporates the best features from previously developed standards. Q. How is FHIR different from other interoperability standards? A. The major difference between FHIR and other standards is simplicity and flexibility. Fast – the F in FHIR – expresses the intent to make this standard faster to learn, develop and implement. Essentially, each application of the FHIR standard requires  a resource approach to the information model (e.g., Medication, Procedure, or Immunization), […]

Clinical Exchange Document (CED)™ is a term we use at Allscripts to cover the multitude of standards-based, XML-format documents that are interoperable in healthcare exchanges. To improve their “meaningful usefulness,” the HL7 Structured Document Workgroup launched a short survey, which will gather feedback from providers about what data is most relevant and pertinent to them. Widespread use and variation of CED With Meaningful Use, providers have used CED (in the form of C-CDA) more frequently to exchange content between healthcare sites and providers. The Certification Rules have called out different HL7 Implementation Guides for use, such as Transitions of Care, Data Portability and View Download and Transmit. With each iteration of these Implementation Guides, the industry moves closer to constructing content that is semantically interoperable. However, we continue to hear that these documents, in spite of improved guides and constraints, […]

Editor’s Note: The following article originally appeared in CIO Review’s Healthcare Technology Special, October 2014. You can access the article here, pages 42-43. Open is a journey, not a destination. Open means you facilitate the exchange of information between programs; you make it easy for your software to talk to other people’s software. The need for Open technologies has shaped standards, which evolve over time to meet new challenges and address shortcomings of previous standards. It all started with punch cards, EBCDIC and ASCII Back in the ‘60s there were two competing standards for how computers would store data – one was proprietary to IBM main frame computers called EBCDIC. Pretty much everyone else used the other standard, called ASCII. EBCDIC can trace its roots back to the punch card standard, invented by Herman Hollerith in 1894 to help tabulate the […]

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What’s your Innovation Surface?

Every healthcare IT company wants to be Open, so every company comes up with a convenient, somewhat self-serving definition of it. As technologies change, the definition of Open also evolves over time. We all need a simple concept we can use to objectively measure how Open a product really is. I’ll start by proposing some new language: Innovation Surface. In the security and vulnerability space, we talk about “Attack Surface” – that’s “What are the ways hackers can attack you?” You want your Attack Surface to be as small as possible. Don’t expose anything you don’t have to. It’s time to coin the phrase “Innovation Surface” – that’s “How many different kinds of technologies are available to a developer?” You want your Innovation Surface to be as BIG as possible, with multiple tools to enable creativity. How big is the […]

Others agree that embracing Open is critical for the future of health care. Take for example this article: Coalition Calls for Action Against EHRs That Block Interoperability. After a RAND Corporation report found that Open technologies could help lower costs and improve care, calls for interoperability are stronger than ever before. A non-technical explanation of Open Open means interchangeability. Take car batteries for example. How big are the posts that you connect the battery wires to? And how many volts? These attributes are standard for all car batteries, no matter who makes them. In health care, unfortunately, the specifications can be very broad, such as HL7 including “industry standard” Continuity of Care Documents. In a car battery scenario, this breadth might allow the posts to be between 5/8” and 2” and power to be between 5 and 20 volts. So […]

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HL7 is as Open as a fax machine

I’ve blogged a lot about Open from a technical perspective. But there is a market perspective of Open, too. As international standards bearer for interoperability, HL7 plays a vital role in health care today. But that doesn’t mean that HL7 fosters an Open marketplace. Why? Because transactions in an Open system shouldn’t be so costly. Open can help solve two of the chief complaints about Health IT 1) the cost of interfaces, and 2) the lack of scalability. There’s more to Open than standard forms Let’s think about transactions as they occur out in the marketplace. Suppose you owned an office supply store, and I wanted to buy things from you every week. We agree to use fax machines to conduct our transactions. I’ll fax you my orders on your order sheet. If you’re out of something, you’ll fax the […]