Combining the best of IHE XDS with HL7 FHIR

What would happen if one were to combine the best features of XDS with FHIR? This post is not just about IHE MHD, but speculates as to what one could achieve by combining some of the fuatures of FHIR with IHE XDS.

XDS and FHIR

IHE XDS is an architectural approach which separates the management of documents (well, any kind of data blob, really) from the management of metadata (data which describes the data blob). FHIR offers things like FHIR Documents, current medication/allergy/concern lists, and the profiling of data-sets comprised of FHIR resources.

Although not always a popular topic at a FHIR DevDays (most attendees are solely focused on FHIR) real live implementations of FHIR will surely bump into existing data sharing infrastructures such as XDS. As such I volunteered to speak about this combination during the recent FHIR DevDays in Redmond WA (USA).

XDS, adding two table spoons of FHIR (DevDays 2019 presentation)

Should you already know about IHE MHD, then please skip the video to 18:57. Should you also know about FHIR Documents, then please skip to 21:45. That's the point in the presentation were I start to discuss the nature of documents (what is a "document" anyway?). Effectively (kudos to John Moehrke for pointing it out) a document in XDS is effectively a blob with a mime type, which has been authored by some source. As such any bundle of FHIR Resources would qualify as a document. Such bundles could be $current-lists, or comply with the structure of a GraphDefinition resource if its contents comply with a particular graph based resource structure.

The XDS on-demand feature is a nice extension point in XDS, effectively allowing for the invocation of a FHIR like operation to create on the fly documents. However, if the content of the to-be-assembled document is fully defined by a client, there is no real authorship of its content (the content is automatically assembled, but not authored).

One could limit ones implementation to IHE MHD, but if one extrapolates what the future options could be when combining XDS and FHIR, there are many more options. However, all the world is not a doccument, and as such there are plenty of use cases where FHIR will be used next to the XDS document/metadata architectural approach.

-Rene

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Index of columns:

HL7 Version 3 Tooling (Nov 16, 2022)
Bye bye IHE XDS and CDA. (Sep 01, 2021)
Combining the best of IHE XDS with HL7 FHIR (Jun 27, 2019)
FHIR DevDays and the year in review (Dec 27, 2018)
Creation and Curation of FHIR Profiles - process and governance (Dec 14, 2017)
Impact of the GDPR on the use of interoperability standards (Jun 27, 2017)
Next XDS Release (Oct 27, 2016)
Five years of FHIR (Aug 11, 2016)
Update from the trenches on CDA R2.1/R3 and HL7v2. (Oct 15, 2015)
Most often implemented IHE Profiles (Jun 08, 2015)
Mapping HL7v2 messages to FHIR. (Apr 13, 2015)
Recent and Future developments of the DICOM standard (Mar 06, 2014)
Documenting the history of HL7 (Sep 03, 2013)
Interoperability Standards - the no-sales pitch (Jul 09, 2013)
CDA Implementation Guides - (not) invented here (Apr 17, 2013)
Usage of IHE Profiles (Feb 25, 2013)
10 year anniversary - Dutch Ringholm HL7 v2 training courses. (Feb 19, 2013)
HL7 Connectathons (Sep 09, 2012)
Frequency of use of HL7 message types (Jul 24, 2012)
Reflections on the HL7 membership model - the affiliate life cycle (Dec 28, 2011)
RFH (Resources for Health): HL7 version 3 taken to the next step (Aug 18, 2011)
Timezone Hotel (Mar 29, 2011)
The changing role of HL7 country organizations (Jul 16, 2010)
How to lower the hurdle for HL7 v3 implementers (Jan 21, 2010)
The HL7 roadmap for CDA R3 and the CCD (Jan 17, 2009)
HL7 based Tree inventory system (Jan 30, 2007)
Workflow Bribery (Sep 15, 2006)

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Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT. We provide the industry's most advanced training courses and consulting on healthcare information exchange standards.