J P Systems HIT Blog
What is FHIR's Role in Complex Healthcare IT Transactions?
There is a great deal of misunderstanding out there now about HL7's new FHIR (TM) standard. Non-techncal people think it is a software system or a utility or an application of some kind. It is not even middle ware. It is a data exchange standard. It is a way of wrapping various types of healthcare data in well defined structured shells so it can be understood when sent from one agency to another.
I find FHIR is surprisingly mature for its age. It may surpass CDA in a few years as the developers are all jumping on this bandwagon early due to many years’ worth of pent up frustrations with the overly complex HL7 V. 3 standard. FHIR is tailor made for the web and for developers. It will be critical for data sharing between EHRs. I agree that since it is not even a standard yet, it should not be in MU. Development of profiles and resources is growing at a surprisingly furious pace. The attendance at the Connectathon conference which Galen and I attended is growing at a satisfactory pace. A developer from Vanderbilt University who had studied FHIR for two weeks created a mobile App in only 2 days to display cancer patient data on genetic tendencies in a graphic form. Many far flung (meaning of various focuses and natures), HIT applications were being done right here. I can see need for a future mega-conference with just FHIR development people around 2018.
Galen has identified problems with the FHIR messages and FHIR documents for data exchange, especially for complex transactions. Stateless technologies like REST can’t handle multiple step processes which request ‘compound’ queries from multiple sources. But the one area everyone forgets about is FHIR SOA services. I spoke to Lloyd McKenzie (one of the FHIR authors) about this and he says he sees complex transactions being done in FHIR services. A standard library of American SOA FHIR services will be a critical need over the next two to five years.
Mobility & Managed Mobility
The mobility of health information is an imperative piece of the efficient healthcare model. A mobile trends report was released by Athena health and Epocrates indicating that, “nurse practitioners, physician assistants, and pharmacists are emerging as the most engaged users of mobile technology.” At first glance this is great news! This means that health professionals are taking advantage of mobile technologies, thus increasing the availability and speed with which information is transferred.
With a closer look, however, the study also indicated that only “one-third of clinicians claim their EHR is optimized for tablet or smartphone use.” There seems to be a problem integrating mobile technology with electronic health records, which are typically compatible with computer software.
With an increasing need to manage mobile devices, health institutions are starting to hire out these services to companies that specialize in “managing mobility.” The advantage of having an outside entity perform this service is verified compatibility between smartphones, tablets, and computers, as well as pre-established security measures.
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