FHIR Looks To Extend EHR's Capabilities
By Megan Williams, contributing writer
Fast Healthcare Interoperability Resources (FHIR) is making strides to open EHRs up to patients.
As the march toward true interoperability continues, the patient engagement and patient-generated data question is constantly in back of your client’s minds. And FHIR is back on the radar to address the issue.
At HIMSS15, FHIR demoed SMART (Substitutable Medical Applications & Reusable Technologies) during the interoperability showcase and, according to CIO.com, they’re making progress in opening up EHRs to both independent developers and those in-house with EHR vendors.
The Importance Of Resources
FHIR looks at data such as medications, diagnoses, and other clinical entities and groups them into snippets called resources. This helps transform EHR data into a format that app developers are already used to since they can be constructed on top of standardized data types
FHIR has been recognized by HL7 as a draft standard. The organization has so far identified 99 separate FHIR resources. However, the identification process requires that profiles be created for each resource — a drawn-out undertaking for HL7 members. On another front, the Argonaut Project is using OAuth (a separate common Internet standard) to help patients and providers authorize the use of healthcare data. It focuses on just 16 resources that correspond to the common data set in HL7’s CCDA (consolidated clinical document architecture.) Argonaut came to this decision because the MU program requires use of the CCDA format in care summary exchanges between providers.
So far, Argonaut members have tested the profiles for 12 resources as well as OAuth, and plans on testing more in the future. Argonaut members Epic and Cerner have also already begun experiments with FHIR-based apps and it is predicted that these apps will go on sale within a year.
FHIR Isn’t Enough
With all the potential that FHIR holds, developers will also need to understand the restraints on vocabularies as well as how data will be coded, according to research scientist Joshua Mandel, M.D., of Harvard Medical School’s Department Of Biomedical Informatics and research faculty member at Boston Children’s Hospital. This though, is where SMART comes in, in that it aids in locking down vocabularies and data profiles. SMART, which preceded Argonaut, is not the only UI that works with the FHIR-based API, but it is available out of the box.
Apps For Patients And Providers
SMART’s app gallery currently contains 33 apps, most of which are meant to help clinicians in their day-to-day tasks — in everything ranging from calculating a child’s blood pressure percentile to predicting how well a patient will adhere to their prescriptions — functions that are not generally available in an EHR.
Examples include, Cerner building an app that launches an HIE web portal within in its EHR and Crimson Care Management developing an app that expands EHR capabilities deeper into the care management space.
It is expected that as SMART on FHIR spreads, providers will be able to exchange data either by using the FHIR API to extract data directly from the EHRs of other providers, or by giving patients access to apps that will allow them to download their health records and then decide which providers (or family members) the information will be shared with. According to Micky Tripathi, CEO of the Massachusetts eHealth Collaborative and director of the Argonaut Project, healthcare can expect to see a combination of.