Developers using FHIR interoperability standard

While still a draft standard, FHIR, the younger sibling of interoperability standard HL7, is already being used by developers.

The creators of Fast Health Interoperability Resources (FHIR) consider it a draft standard for trial use. But Charles Jaffe, M.D. -- peripatetic CEO at Health Level Seven (HL7) International, the nonprofit health IT standards organization behind FHIR -- travels the U.S. and Europe urging developers not to wait until FHIR is an officially approved standard, but to put it into action now. FHIR can help organizations build easy-to-use cloud-, Web- and mobile-friendly healthcare applications by simplifying patient record database queries.

Some developers are already listening.

Software company uses FHIR for consent work

Jericho Systems Corp., a Dallas-based software firm active in the health information exchange (HIE) and HIPAA consent spaces, employed FHIR to build Consentral, a patient-directed consent management program that is part of Jericho's EnterSpace Exchange HIE system.

Consentral started five years ago as a pilot that grew out of a U.S. Department of Defense grant. It then became a demonstration project for patient-controlled health data supported by the U.S. Office of the National Coordinator (ONC) for Health IT.

The program had a sort-of public coming-out at the giant HIMSS 2015 health IT trade show in Chicago in April, when it was featured in the ONC section of the HIMSS Interoperability Showcase.

Amid the din and busy foot traffic on the show floor, Jericho software engineer Ross Freeman demonstrated to all who were interested how Consentral's multiple tree-structured screens allow patients to manage the layers of consent involved in their medical care.

Freeman told SearchHealthIT that FHIR's tools simplified the application's development by allowing Jericho to segment health data contained in the Continuity of Care Document and only move the data Consentral needs instead of transferring whole CCDs with FHIR's health data interoperability parent standard, HL7.

"The advantage of FHIR is it makes everything transactionally less intensive," Freeman said.

Consentral allows users to indicate degrees of consent specificity -- for example, who gets to view psychiatry notes -- with an easy-to-manipulate user interface.

"FHIR is an enabler for users to transport their consent directives," said Brynn Mow, Jericho's CEO. "It allows consumers to get engaged."

FHIR interoperability standard hot at HIMSS 2015

Meanwhile, HIMSS 2015 was also the scene of a slew of FHIR education sessions. Among them was a freewheeling panel discussion in front of about 200 show-goers hosted by Jaffe and featuring such health IT luminaries as Carl Dvorak, president of EHR market leader Epic Systems Corp., and John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston, who took part by phone.

Also on hand were independent health IT consultant Grahame Grieve and Boston Children's Hospital researcher Joshua Mandel, M.D., both of whom represented the Argonaut Project, an accelerated FHIR development effort backed by a coalition of prominent health IT vendors and providers.

The panelists hailed FHIR as a breakthrough for interoperability and ease-of-development for health IT applications to talk to each other. And Halamka likened FHIR's usability benefits to how consumer-oriented tech companies use Java and other simpler programming languages to make their products easy to use.

"Building a healthcare [application] ought to be as simple as watching Game of Thrones," Halamka said, referring to the popular HBO show. "The days of walled gardens are over."

All health applications "should be able to interoperate with the Epics, Cerners, athena[health]s, McKessons and Meditechs of the world," Halamka added, referring to competing EHR vendors, all of which are charter members of the Argonaut project.

Mandel, the lead architect of Boston Children's Hospital's "SMART on FHIR" app development platform, said FHIR -- which is now in the first round of balloting, a step toward becoming an official HL7 standard -- is a promising development for all of health IT.

"There are some key roles, especially for patient access," he said.

Let us know what you think about the story; email Shaun Sutner, news and features writeror contact @SSutner on Twitter.

Next Steps

Epic VP discusses barriers to healthcare interoperability standards

Healthcare payer user group started by HL7

Professor promotes HL7 at mHealth conference

Charles Jaffe explains the evolution of FHIR

Dig Deeper on Health information exchange implementation and management