Electronic Health Records

Integration & Interoperability News

Cerner Hopes to Boost EHR Interoperability with FHIR Release

By Frank Irving

- Envisioning third-party developers enhancing electronic health record interoperability within an open platform, Cerner is putting HL7’s FHIR standard into production in its Millennium EHR system. Kansas City-based Cerner reported on Oct. 8 that clients would be testing SMART on FHIR applications within Millennium. In fact, one such test is already underway.

The Substitutable Medical Applications & Reusable Technologies (SMART) application programming interface (API) uses the Fast Healthcare Interoperability Resources (FHIR) standard to define health data resources. SMART on FHIR is a collaborative project operated by the informatics departments at Boston Children’s Hospital and Harvard Medical School.

“SMART enables an app developer to readily access underlying health system data without needing specialized knowledge about the configuration of the health information technology it will connect to, or even which EHR it will run on,” according to SMART’s website.

Cerner said it has begun working with Mosaic Life Care in nearby St. Joseph, Mo., to test VisualDX, a SMART on FHIR app that helps clinicians recognize and diagnose visually presenting conditions. VisualDX will be available to clinicians in Mosaic’s ambulatory clinics, emergency departments and other areas throughout the hospital.

Brennan Lehman, CIO at Mosaic, said the development of SMART on FHIR apps within Millennium “is comparable to smartphones replacing pagers.” He explained:

“For years, we’ve struggled with complex interfaces, faxing and scanning to piece together the patient story. From the patient’s perspective, care isn’t limited to the four walls of the hospital. FHIR-enabled apps seamlessly integrated with Cerner Millennium create the platform to solve the puzzle.”

Cerner said it will continue to build FHIR services to support clinical resources and track along with FHIR’s ongoing development, including the recently balloted Draft Standard for Trial Use Version 2.0. By the end of this year, Cerner plans to have an initial catalog of SMART on FHIR apps generally available for use on the Millennium platform.

David McCallie, Cerner’s senior vice president of medical informatics, described FHIR in a statement as a “next-generation standards framework” enabling healthcare organizations to “improve interoperability capabilities with other FHIR-compliant EHR systems.

“This integrated approach will provide clinicians access to ‘pluggable apps’ directly within their workflows that are designed to expand and transform the way care is delivered,” explained McCallie.

Cerner is hosting its annual Health Conference this week in Kansas City, where an expected 14,000 attendees will get a look at a variety of SMART on FHIR apps in the event’s Solutions Gallery. In addition to VisualDX, product demonstrations will include a rheumatology app from xG Health and two open-source apps created by Boston Children’s Hospital.

The company also noted that its FHIR “sandbox” and API documentation are available to clients and third-party developers at fhir.cerner.com.

Cerner’s support of FHIR bolsters the company’s open-source branding in its EHR market leadership battle with rivals MEDITECH and Epic Systems. Among hospitals participating in EHR Incentive Programs, Cerner had more EHR systems installed — over 1,100 — than any other vendor, according to March 2015 statistics released by the Office of the National Coordinator for Health IT. MEDITECH had 976 systems installed at EHR Incentive Program hospitals, while Epic had 838, as of May 2015.






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