- DirectTrust and HL7 recently released a white paper proposing ways Fast Healthcare Interoperability Resources (FHIR) and Direct standards can work together to achieve technical improvements to health data exchange.
HL7 is one of many standards developing organizations (SDOs) accredited by the American National Standards Institute (ANSI). In the white paper, the organization offered insight into the myriad uses for its standards framework, FHIR.
FHIR comprises a web application programming interface (API) and related specifications designed to facilitate seamless health data exchange.
As a healthcare industry alliance created by and for participants, DirectTrust provides a health information exchange network for secure, interoperable protected health information (PHI) exchange between provider organizations as well as providers and their patients.
Both DirectTrust and HL7 provide standards for health data exchange. However, because both frameworks serve different functions, the standards can work as complements to strengthen information exchange.
This newest white paper authored by the two organizations seeks to clarify the appropriate ways to use the sets of standards in conjunction to optimize health data exchange for both communities.
While FHIR providers a means of standardizing many aspects of health data exchange, DirectTrust provides a nationwide trusted exchange framework that FHIR presently lacks.
"The existing work in the FHIR eco-system does not standardize all aspects of establishing trust between systems,” said FHIR original architect and HL7 Product Director for FHIR Grahame Grieve. "While FHIR offers SMART-on-FHIR as a way to delegate authorization, underlying trust frameworks are needed to provide a framework in which these are managed.
“Working with DirectTrust could potentially save the FHIR community from the costs of building a new trust framework by using one already proven to scale high identity assurance," Grieve added.
Grieve co-authored the white paper outlining the ways to use the Direct framework with FHIR alongside DirectTrust President and CEO David Kibbe, MD, and members of the DirectTrust Policy Committee.
Entitled Direct, DirectTrust, and FHIR: A Value Proposition, the white paper accomplishes the following:
- identifies the context, advantages, and challenges for Direct and FHIR;
- describes two main ways to use the existing Direct and DirectTrust assets with FHIR— using DirectTrust’s trust framework to support FHIR’s RESTful API and pushing FHIR resources in Direct Messages; and
- Recommends the leadership of the DirectTrust and the FHIR communities seek opportunities to build engagement between the respective communities to build out both the technical specifications they describe, and their policy and adoption implications.
In combination, these health information exchange standards could promote interoperability improvements across the healthcare industry.
“Collaboration is key to getting the best out of standards,” said Kibbe. “We should take every opportunity to combine the strengths of different interoperability standards, so that they enrich and support each other.”
DirectTrust has been assisting in streamlining health information exchange through its trusted exchange framework for five years.
“No single standard, either for transport, or for content, or for trust in identity, can do everything that is needed by providers and patients wanting to securely share and exchange health information using various tools and technologies,” Kibbe said. “At DirectTrust, we’re delighted to share insights and innovations with the HL7 FHIR implementation community this way.”
This white paper intended to improve interoperability across the healthcare industry follows a similar effort earlier this year to promote EHR usability and health data exchange using the Direct standard.
The paper consisted of 50 recommendations for over 350 EHR vendors and health IT companies providing Direct interoperability.