Promise of FHIR
Abstract
FHIR (Fast Healthcare Interoperability Resources) provides a set of guidelines for the security and structure of data exchanges between healthcare providers and systems. It would do any worker in the healthcare industry well to have a comprehensive understanding of the relevance of interoperability. "Interoperability" refers to the capacity of different information systems and software programmes to collaborate and share data with one another. Interoperability has been difficult to achieve in the healthcare industry due to the large number of complex systems that are being developed, utilised, and networked together. Despite this, many different types of software and computer systems are now capable of automatically sharing data with one another. When using integrated software, it is possible for data to be automatically exchanged between programmes that have been designed with consideration for one another. Application programmes that are generated independently of one another tend to be more intricate and may not comply to the same structure and format constraints as standardised software. Standardized software is developed by a single company. An interface is built in order to make it easier for the application that is receiving the data to translate the format into one that can process the data. By offering resources for mapping different proprietary formats to one another and making it easier to transport data, standard messaging protocols make it possible for different computer systems to work together. These laws are established by organisations that are referred to as standards development organisations (SDOs), and in order to be acknowledged as valid, these SDOs typically submit applications to the American National Standards Institute (ANSI).
Introduction
Interoperability in healthcare refers to "the ability of various HIT to exchange, comprehend, and utilise data cohesively." The health care business is increasingly converting to a digital infrastructure as a result of the high speed of technological progress. As a result, the healthcare business will be able to reach out to a wider audience more efficiently. Interoperability in healthcare is essential due to the necessity to share patient information across several platforms and devices. It is essential for Health IT that information be shared throughout many facilities, including but not limited to hospitals, laboratories, small medical practises, pharmacies, and clinics. This enhances the efficiency and effectiveness of all medical staff by facilitating better communication amongst them. The procedure of transferring patient records across healthcare facilities is easy and uncomplicated. Interoperability is very promising since it removes the necessity for all healthcare organisations to utilise the same software in order to share patient information. Professionals in the healthcare industry need to embrace new practises in the workplace if they are to stay up with the rapid changes in the industry and continue giving quality care to their patients. Interoperability aids healthcare providers in providing top-notch care by facilitating the rapid and seamless exchange of patient records between disparate computer systems (Lehne, Luijten, genannt Imbusch et al., 2019). The importance it now holds in the healthcare industry may be attributed to the positive effect it has had on patient outcomes. Electronic health records have revolutionised the healthcare industry by using the power of the internet to store and share medical data. Interoperability is essential in health IT so that doctors and nurses may exchange an infinite amount of patient data.
One of the key security challenges facing federal healthcare is the lack of consistent standards for exchanging information between systems. This can result in fragmented data and make it difficult to share information between healthcare providers, which can compromise the quality of care. FHIR helps to address this challenge by providing a consistent standard for exchanging information, making it easier for different systems to communicate with each other and share data. FHIR also includes built-in security measures to help protect the privacy of patient health information (Karhade, Schwab, Del Fiol et al., 2021). For example, it includes guidelines for the secure transmission of data, such as the use of encryption, and it also includes provisions for controlling access to information, such as the ability to grant or revoke access to data based on a patient's authorization.
Additionally, FHIR provides a flexible and scalable framework for developing applications that can support various healthcare use cases, such as the management of patient data and the exchange of clinical information. This can help to support the development of innovative solutions to address some of the security challenges faced by federal healthcare, such as the need to better manage and share sensitive information, while also ensuring that patient privacy is protected. The promise of FHIR is to provide a standardized and secure framework for exchanging healthcare information, which can help to improve the quality of care and support the development of innovative solutions to some of the security challenges facing federal healthcare.Top of For
Overview
In 1987, a standards organisation that did not operate for business but was approved by the American National Standards Institute (ANSI) came up with the idea for Health Level 7. The king of application standards is unquestionably HL7 when it comes to the storage of data and the exchange of data across different HISs. These standards define the terminology, structure, and data types that are required for systems to integrate without communication or data transfer disruptions. These programmes are able to make use of the data, and they do not require any additional software to do so. Because it is critical for medical practitioners to have the most recent information at their disposal when giving care, HL7 works hard to ensure that data may be accessed without cost by these individuals. There are several different iterations of Health Level 7, and each of these iterations specifies a distinctive group of standards for a certain kind of service. The quantity of healthcare data as well as its digitalization have experienced meteoric growth over the course of the past several years. The goal of the development of Fast Healthcare Interoperability Resources (FHIR), which is more commonly referred to as HL7, was to hasten the process of implementing the standard (Zenobia, 2022). In order to achieve this goal, the Fast Healthcare Interoperability Resources (FHIR) standard was designed to simplify the process by which patients and medical professionals may access their medical information using a broad variety of different types of electronic devices.
The Internet standards that internet companies like Yahoo, Facebook, and Google use were utilised in the development of the FHIR framework. It is possible that using this strategy, computers will be able to exchange particular pieces of material more simply as compared to whole texts. One of these well-defined elements is a collection of primary objects or classes referred to as resources. These resources, which may be used to construct functional systems that illustrate how particular kinds of data are represented in the healthcare industry, are one of the well-defined parts. It's possible that the doctor treating a patient needs only one piece of information. If a non-FHIR system transfers too many records, it's possible for a doctor to waste time digging through material that isn't essential. The Fast Healthcare Interoperability Resources (FHIR) standard enables more speedy and accurate data transfer in the healthcare business by enabling users to request just the information that they really want (Chatterjee, Pahari & Prinz, 2022).
Because of its many advantages, FHIR has recently seen significant growth and is gaining popularity in an increasing number of countries throughout the world. despite the fact that it is still going through the testing phase. Because of this, the development of FHIR is being carefully monitored and evaluated so that "implementations" might potentially contribute to making the standard more malleable to the requirements of users. This technical advancement makes it far more likely that future healthcare systems will be able to communicate with one another more effectively. The Federal Health IT Coordinating Committee has suggested that the HL7 FHIR standard be utilised in the process of developing and managing a public API architecture (Chatterjee, Pahari & Prinz, 2022). In order to get certification, EHR vendors would need to comply with the standards. The Office of the National Coordinator for Health Information Technology (ONC) has been collecting feedback from the developer community that validates health IT in accordance with API standards in order to determine which version of FHIR will be the most appropriate.
HIT Interoperability
There are several conversations that need to take place for HIT interoperability to reach its full potential, and this adds to its complexity. There is still a need for healthcare industry veterans to set out objectives and a strategy for expanding HIT interoperability. There is already widespread availability of infrastructure allowing hospitals to electronically communicate a variety of patient data to various medical practises. Although the current pool of hospitals willing to exchange patient data is small, it has potential to expand. A major challenge for hospitals nowadays is moving data from one network to another (Dolin et al., 2022). For there to be real interoperability, information must be transferred and received in a certain format. If information is not in a consistent format, data input into EHR systems is hampered.
There needs to be a precedent set for how data is shared, making the present moment crucial. Filtering patient data is crucial for a great technical match. For data to reach its intended recipients, a mechanism must be in place that allows for its rapid and precise decoding from its enclosing packaging. Now, the government is working with private companies and the federal government to upgrade the network infrastructure. Data flows, including patient information, must be unhindered. It is imperative that all impediments to the open interchange of data between sectors be eliminated if we are to achieve true interoperability (Lambarki et al., 2021). Lastly, in order for interoperability to reach its full potential, certain goals and standards must be established and adhered to. Most medical centres are doing the bare minimum to respond to this new health threat because of budget constraints. Inadequate HIT interoperability calls for new measures to spur development.
Challenges
There are three main problems with Health IT interoperability. The healthcare industry's primary challenge today is the widespread lack of shared patient data. One contributing aspect is the tendency of some EHR sectors to discourage openness by suppressing data. The problem here is that sending internal data outside might cause vendors to raise pricing. When it comes to HIT interoperability, information sharing is crucial since without it, there can be no networking. If communication is impeded, it will interrupt the ongoing transmission of patient data to other places. The leader of health IT wants strict regulations to be put in place to prevent any information from being hidden. This would allow for more effective communication between healthcare practitioners and easier access to electronic health records (EHRs). Patient identification across several interconnected systems is another obstacle to HIT interoperability. It's difficult to centralise patient data due of the healthcare industry's complexity. One effective strategy for dealing with this issue is to implement a nationwide system that utilises patient identification consistently and consistently (Chaves, Guimarães, Duarte et al., 2021). By assigning a unique identifier to each patient, data can be quickly organised and filed away for easy access. Another benefit of this cutting-edge innovation is that it may help doctors avoid accidentally prescribing the incorrect dosage to their patients. Also, providers have a tough time just copying and pasting the information into another EHR system. However, problems may arise if the two applications have different fonts, which would prohibit the data from being shared. It is essential that all parties involved in a data exchange adhere to a standard format. A universal adoption of standards and file formats by the healthcare industry is the simplest solution.
Initiatives
Before there can be any progress made toward improving HIT interoperability, there are a few actions that need to be taken. Integrating the Healthcare Enterprise, also known as IHE, and the Personal Connected Health Alliance, also known as PCH Alliance, have collaborated on a project with the goal of improving and bolstering interoperability. Because of this relationship, we have been able to successfully carry out a significant number of experimental initiatives aimed at increasing the efficacy of data sharing. These initiatives have been a success because they have been able to effectively improve the efficiency of data exchange. Their primary objective is to increase the degree of interoperability on a national scale in order to effect change in the healthcare institutions. The professionals who work in the health care industry will have access to a more in-depth understanding of interoperability as a direct result of the initiatives that PCH Alliance and IHE wish to undertake (Duda et al., 2022). The next step in the process is for the Office of the National Coordinator for Health Information Technology (ONC), which is striving to improve patient matching and patient safety in order to promote HIT interoperability. The designers are planning to give the patient identification system a look that is fully modernised. As a direct result of this innovation, the process of patient matching will shift from being very subjective to being more systematic. Only when clinicians treating patients have access to information that is both comprehensive and free of errors on those patients will the quality of treatment those patients get be able to improve (Matheny, Israni, Ahmed et al., 2019).
Conclusion
Today, a large number of companies, including Apple, have included FHIR Release 2 into their production processes. Apple's HealthKit gives users a centralised destination for all of their medical information, as well as an organised and straightforward presentation of that information. Patients have access to their medical records, which may come from a variety of facilities and may even include data that they have developed themselves. The number of healthcare providers who have access to health information technology that is certified using FHIR2 is rather large, despite the fact that there is still a significant amount of work to be done in defining standards and putting them into practise. In the same way as other consumer technologies, application programming interfaces (apps) are rapidly becoming a de facto manner of system architecture. This has the potential to significantly transform the shape, function, and experience of electronic health records in the not too distant future.
References
Chatterjee, A., Pahari, N., & Prinz, A. (2022). HL7 FHIR with SNOMED-CT to achieve semantic and structural interoperability in personal health data: a proof-of-concept study. Sensors, 22(10), 3756.
Chaves, A., Guimarães, T., Duarte, J., Peixoto, H., Abelha, A., & Machado, J. (2021). Development of FHIR based web applications for appointment management in healthcare. Procedia Computer Science, 184, 917-922.
Dolin, R. H., Heale, B. S., Alterovitz, G., Gupta, R., Aronson, J., Boxwala, A., ... & Chamala, S. (2022). Introducing HL7 FHIR Genomics Operations: a developer-friendly approach to genomics-EHR integration. Journal of the American Medical Informatics Association.
Duda, S. N., Kennedy, N., Conway, D., Cheng, A. C., Nguyen, V., Zayas-Cabán, T., & Harris, P. A. (2022). HL7 FHIR-based tools and initiatives to support clinical research: a scoping review. Journal of the American Medical Informatics Association, 29(9), 1642-1653.
Karhade, A. V., Schwab, J. H., Del Fiol, G., & Kawamoto, K. (2021). SMART on FHIR in spine: integrating clinical prediction models into electronic health records for precision medicine at the point of care. The Spine Journal, 21(10), 1649-1651.
Lambarki, M., Kern, J., Croft, D., Engels, C., Deppenwiese, N., Kerscher, A., ... & Lablans, M. (2021). Oncology on FHIR: a data model for distributed cancer research. Stud Health Technol Inform, 278, 203-210.
Lehne, M., Luijten, S., genannt Imbusch, P. V. F., & Thun, S. (2019). The Use of FHIR in Digital Health-A Review of the Scientific Literature. GMDS, (September), 52-58.
Matheny, M., Israni, S. T., Ahmed, M., & Whicher, D. (2019). Artificial intelligence in health care: The hope, the hype, the promise, the peril. Washington, DC: National Academy of Medicine.
Zenobia, B. (2022, August). If You Build It, Will They Come?: An Adoption Analysis of the HL7/FHIR/Da Vinci Healthcare Interoperability Stack. In 2022 Portland International Conference on Management of Engineering and Technology (PICMET) (pp. 1-14). IEEE.
