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Lighting the FHIR, HL7s new major interoperability standard

Publication date: Jun 15, 2012

Fast Healthcare Interoperability Resources (FHIR) is a new HL7 standard, which has just changed status from a skunkworks project into a major new draft interoperability standard for healthcare.

So first of all: what's FHIR?

FHIR (pronounced as "fire") can be described as (a qoute from the FHIR specification itself): "Fast Healthcare Interoperability Resources (FHIR) defines a set of "resources" for health. These resources represent granular clinical concepts that can be exchanged in order to quickly and effectively solve problems in healthcare and related process. The resources cover the basic elements of healthcare - patients, admissions, diagnostic reports, medications, and problem lists, with their typical participants, and also support a range of richer and more complex clinical models." The FHIR specification also documents how a RESTful interface (based on underlying standards such as HTTP and Atom feeds) can be used to exchange resources.

Some background

In May 2011 Grahame Grieve and others with HL7 noticed that the uptake of HL7 version 3 messaging was relatively low - there are significant hurdles towards its implementation. Grahame created the initial draft of FHIR (then called RFH) out of frustration - he tried to answer the question how one would approach interoperability if one were to apply cross-industry best architectural practices, combined with the good (and not so good) aspects of the HL7 version 2 and version 3 standards. His original RFH announcement contains a summary of some of his architectural decisions.

During subsequent HL7 meetings there was significant interest in the (now renamed) FHIR standard. The standard was significantly extended by a core team of developers including Grahame Grieve (Australia), Lloyd Mckenzie (Canada) and Ewout Kramer (the Netherlands). The FHIR project has been embraced by HL7 at various organizational levels, with various working groups comitting time towards the definition of resources.

Next steps

  • The FHIR standard has reached a level of maturity where the infrastructural issues have been discussed and documented. In the near future we'll see the first resources being defined (and balloted) within the organization.
  • There are some open issues related to the exact license under which the specification is to be published. The draft license is based on an OMG license. Although one would prefer to use a standard open license there is an issue in that they're aimed at software, and not at standards. HL7 has stated that the FHIR standard, up to and including the first normative specification (which will probably be created next year), can be used for free by any implementer.
  • A FHIR Connectathon will be held at the Hyatt Regency Hotel in Baltimore, Maryland, USA on Saturday, September 8, 2012. A preparatory/informational conference call for (potential) participants will be held on Tuesday, June 26, 2012, at 16:00 EDT. The list of participants that has already signed up to the connectathon is impressive - as is the list of applications that have already implemented FHIR (which is still a standard in flux at this point in time).

As Ringholm we have a lot of confidence in the success of this new standard - we'll be offering a FHIR training course starting November 2012.


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About Ringholm bv

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.
See http://www.ringholm.com or call +31 33 7 630 636 for additional information.
Rene's Column (English) Rene is the Tutor-in-chief of Ringholm.