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FHIR encourages innovation in health app development

Health app developers can use the FHIR platform to create applications that support and facilitate interoperability between EHR systems.

Today more than ever, health IT professionals and executives are cautiously optimistic about the state of innovation...

in health app development. The availability of FHIR (Fast Healthcare Interoperable Resources) offers health app developers a unique opportunity to innovate in the healthcare space without encountering interoperability challenges, outdated APIs or lack of standards. FHIR offers a cheaper, easier and more modern platform that enables app developers to build suitable healthcare specific solutions that can easily interact with patient healthcare data regardless of EHR vendors.

In the past, health app development was a niche space left to only few players. Only vendors with a deep knowledge of healthcare and its complex X12 and HL7 standards were able to fund and use their expertise to develop solutions targeted at clinical folks. This greatly limited the number of candidates entering the healthcare innovation space. Over time, a number of private and public entities encouraged interoperability that would benefit patients, payers and healthcare organizations. These entities pushed for a common platform that enabled a modern set of web-based APIs to offer flexible methods of facilitating the exchange of information with many EHRs.

Because of this effort, which goes back as far as 2011, the President's Council of Advisors on Science and Technology and other organizations determined that there was a real need to address the health information exchange challenge. Having standards alone was not enough to encourage better exchange, but building a framework and platform that could simplify the data exchange, address the complexity and common use case scenarios, use modern technologies and make a solution that is open source would be the goal moving forward. This opened the door for FHIR; HL7 International published the first draft in February 2014. Several stakeholders then committed to the Argonaut Project, which will help drive the funding and political support for the initiative.

How developers can leverage FHIR for health app development

The FHIR platform is still under development and currently has a number of beta users in pilot mode. The users of the platform range from providers, genomics, precision medicine and healthcare payers. Some of the key drivers that are encouraging health app developers to build solutions by leveraging the capabilities offered by the FHIR are:

Offering a platform and tools designed with the modern app developer in mind: The current platform has been designed to enable web and app developers to leverage common health app development tools and APIs to interact with health data. This eliminates the need for expert knowledge of how EHR systems store health data or the common complex standards used behind the scenes. By abstracting the layer where clinical data is pulled and pushed from EHR systems, health app developers can focus on implementing their new ideas and concepts quickly and efficiently without focusing on the data exchange component itself.

Leveraging powerful web technologies: By incorporating new web technologies into the platform, FHIR can attract health app developers who have built web solutions based on platforms used by the likes of Facebook, Google and LinkedIn. Whether it's the use of JSON as the preferred method of transmitting lab results or REST messaging, the platform is extendable and likely to attract a much wider audience of app developers.

Open source to enable community contributions: Nothing pleases developers more than hearing the words open source. FHIR comes completely free and is available for anyone to contribute to it, or build their own flavor based off it.

Support for multiple architectures: The FHIR platform offers health app developers the flexibility to adopt any appropriate communication and interoperability method they feel fits their overall design. The current options available range from document, REST, message or service-based exchanges.

FHIR includes several example use cases and documentation: Developers always appreciate it when APIs include use case examples and good documentation, and FHIR includes both. The platform can not only help someone who may not be an expert in healthcare workflows understand the overall purpose of the transactions through its documentation, but it also highlights more details of what information is moving between systems to better engage the developer community to get more familiar with healthcare definitions.

The current normative version of FHIR is likely to be released in early 2017 as detailed on the HL7 timeline website, but a number of apps have been released that showcase the capabilities of the platform and how it can solve some challenges. Currently a dedicated website called the Smart App Gallery offers examples of what the community has developed.

The healthcare community sees that FHIR offers a unique opportunity in which systems can leverage the platform to interact easily with different health systems. Despite the open invitation for developers to build robust healthcare-based apps to support the needs of providers, patients and other entities,  health app developers must ensure the use of appropriate safeguards and security protocols to protect the health data being used. While it may be easier to build a quick app to solve a clinical challenge, it is paramount to ensure that whatever solution is built meets the overall expected protections that HIPAA and other regulatory compliance requirements need.

Next Steps

How developers are already using FHIR to build apps

HL7 CEO discusses FHIR evolution

EHR vendors show support for FHIR

This was last published in September 2016

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