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3 Programs Supporting Health IT Standard FHIR Development

While still a draft standard and application programming interface, FHIR is undergoing significant development thanks to support from both the public and private sectors.

By Kyle Murphy, PhD

- As HL7 CEO Charles Jaffe, MD, PhD, said in an interview published earlier this week, "the marketplace will decide the utility of FHIR."

FHIR in action

So how exactly will Fast Healthcare Interoperability Resources (FHIR) — the specifications and API — transition from an emerging standard to one making a tangible difference in advancing health IT interoperability and its benefits for care delivery and patient outcomes?

In a follow-up to our earlier story, here are three programs currently exploring the utility and applications of FHIR in the healthcare industry, as described by Jaffe himself.

First up in the privately-funded Argonaut Project, which includes the likes of EHR vendors Epic Systems, Cerner Corporation, and athenahealth and health systems such as Beth Israel Deaconess Medical Center and Mayo Clinic:

Six vendors and eight healthcare systems said, 'We have an abiding interest to make this work and we are going to eschew the normal process of quarterly connectathons. Heck, IHE does it once a year, right? Instead, we're going to have mini-connectathons. We're going to call them sprints."

Twenty to thirty to forty vendors get together and test out a specification. This specification is based on the consensus of this small but very active group. It's not validated by the way ANSI requires, but it's very fast and very agile. It's akin to the notion of agile development in software around the world. It makes for a great deal of collaboration as well as improving timelines in orders of magnitude.

Second, there's the Partners in Interoperability Program:

The partnership was suggested to us by the HL7 Advisory Council in October. They said, "You need to identify those groups who would best benefit from FHRI and bring them together." It's a listening session whereby those groups identify their needs — business, workflow — and unique dimensional expertise. We have identified three of those groups.

One are the clinicians — physicians, nurses, pharmacists, etc. — who tell us what they need and how the data needs to be presented.

The second is the payer community. The payers, particularly in accountable care, can no longer rely on claims attachments and data because they are so "unhelpful." Instead they want clinical data, the granular data. If a child has wheezing increase with exercise, a cough at night, and allergy symptoms around a cat, and you give them a bronchodialator and medicines for asthma and then the diagnosis is bronchitis, you really haven't helped. But now whether it's CMS or third-party payers, they can now look at the granular critical data and have a prediction about the cost, efficacy, and expectations on the granular critical data that FHIR provides.

The third group of people is the biopharma industry. The double-blind, placebo-controlled clinical trial is an anachronism. It costs $2 billion to have a new chemical entity that only works half the time. So they realized by extracting data from the clinical record, they have far better understanding of condition, outcome, efficacy, and safety than they ever got from a clinical trial.

Lastly, a group of genomicists whose efforts should provide support for precision medicine:

A group of leaders in genomics are trying to tie this all together because if precision medicine is going to be successful, we'll need to be able to integrate data that is more than the somatic clinical data — the descriptions in phenotypic terms, that is. You've got swollen tonsils and that's fine if you want to make a diagnosis for tonsillitis. But if you're trying to understand a patient's rheumatoid arthritis, having the genomic data, the metabolomic data, is critical for prognosis, therapy, and even for prevention as we move ahead.

FHIR may be in a draft state, but it already enjoys the backing of prominent healthcare and health IT organizations which bodes well for its maturation as a viable and useful health IT standard.

Dig Deeper:

• Will FHIR, APIs Help or Hinder Health Information Exchanges?

• Why Health Data Interoperability is Setting EHR Vendors on FHIR