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Charles Jaffe, M.D., chief executive officer of Health Level Seven (HL7) International, the nonprofit health IT standards organization, talks with SearchHealthIT about his group's fast-growing new health data exchange standard, Fast Health Interoperability Resources (FHIR). The ONC has identified FHIR as a recommended standard in the federal agency's recently released 10-year interoperability roadmap. HL7 -- the existing, widely used standard also developed by HL7 International -- is also recommended in the ONC plan.
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This is the first part of a two-part Q&A. Read the second part in which Jaffe discusses interoperability and the lack of a national patient identifier.
FHIR is rapidly becoming recognized as an emerging de facto standard for health IT. How much promise does this standards framework hold? And is the fact that it is used by a wide range of vendors and healthcare systems a sign that it is being accepted as a real standard?
Charles Jaffe, M.D.chief executive officer, HL7
Charles Jaffe: HL7 FHIR is a real standard. It has been validated within the HL7 community, and it's currently being developed as a draft. The standard will be important as the health IT community begins to develop its business requirements, irrespective of whether it is cited in regulations in the United States or anywhere else. If it brings value to the community that uses it, it will be adopted. At this point in its lifecycle, FHIR is rapidly undergoing an evolutionary process to enhance it. Entities in government, the private sector, academia and even the payer community are now using the draft standard as a potential means of connecting with the key intermediaries in their information chains.
We think it's important when HL7 FHIR becomes a normative standard, that it is sufficiently stable. FHIR was created to be practical and easily implemented by those who haven't developed a solution around it. It was not created for developers; it was created for implementers. If it reaches a stage in which implementation is as fast as we believe it will be, there will be very broad adoption. Even more importantly for some stakeholder groups are the characteristics of FHIR which allow for security and privacy … and allow for application interfaces that all vendors in the EHR community can embrace.
We think that the success of the Argonaut Project, which was first announced on December 4 , will reflect the broad adoptions of HL7 priority and commitment by those vendors to enable FHIR interface.
Editor's note: The Argonaut Project, with the support of 12 health IT companies and groups, is led by the Massachusetts eHealth Collaborative. Its goal is to quickly develop and promote FHIR as a standard.
Some in the health IT business, notably Marc Probst, CIO of Utah-based Intermountain Healthcare, have called on Congress to legislate health IT standards. What's your view of this position and is congressional intervention necessary, or are HL7, FHIR and other standards already becoming widely used enough to be considered as true standards?
Jaffe: Marc and I are colleagues and friends. I believe that there is a role for the federal government in defining standards requirements. I think the specific identification of HL7 FHIR has already been made, as part of the ONC 10-year roadmap. The specific requirements for any standard only reflect its value to the people who have to use it. Whether some standards which are specified in regulations are used, really determines whether they're valuable and will persist, and there are many discussions about such standards and I believe that FHIR will be adopted regardless of its citation and regulation.
What is HL7 doing as an organization to make the HL7 communication model backward compatible, or is that even necessary?
Jaffe: HL7 is committed to continuous backward compatibility. I think there's a simple question, which is: Is FHIR consistent with other specifications? Yes. The FHIR development team has worked very diligently to ensure FHIR's seamless compatibility with existing legacy standards. Secondly, when FHIR becomes a normative standard, it too, will be backward compatible.
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