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FHIR – HL7’S Hottest New Standard SEPTEMBER 2012 FHIR – HL7’s Hottest New Standard By Austin Kreisler, Chair, HL7 Technical Steering Committee Austin Kreisler and Lloyd McKenzie, FHIR Project Coordinator If you were at the May Working Group Meeting in Vancouver, you likely no- ticed the excitement about a new standard called FHIR. If you were not at that meeting, you may be somewhat puzzled about what FHIR is and why there is so much buzz about this new standard. First, the name FHIR stands for “Fast Healthcare Interoperability Resources.” FHIR is pronounced “Fire.” Let’s look at that name a little closer: • Fast – it’s intended to be fast to develop and, more importantly, fast to implement • Interoperability – it’s focused on being a standard for interoperability (no Lloyd Mckenzie different from most HL7 standards) • Healthcare – no surprise here, HL7 is about healthcare • Resources – what the heck are those? The introduction to FHIR states: “These resources represent granular clinical concepts that can be exchanged in order to quickly and effectively solve problems in healthcare and related processes. The resources cover the basic elements of healthcare – patients, admissions, diagnostic reports, medications, and problem lists, with their typical participants, and also support a range of richer and more complex clinical models.” A FHIR Resource is analogous to an HL7 Version 2.x “Segment” or a Version 3 “CMET” (Common Message Element Types). FHIR Resources are: • Granular – they are the smallest unit of operation, and a transaction scope of their own • Independent – the content of a resource can be understood without reference to other resources • Simple – each resource is easy to understand and implement without needing tooling or infra- structure (though that can be used if desired) • RESTful – resources are able to be used in a RESTful exchange context • Flexible – resources can also be used in other contexts, such as messaging, document or SOA architectures, and moved in and out of RESTful paradigms as convenient • Extensible – resources can be extended to cater for local requirements without impacting on interoperability • Web Enabled – where possible or appropriate, open internet standards are used for data representation • Free for use – the FHIR specification itself is open - anyone can implement FHIR or derive related specifications without any IP restrictions You can find out a lot more about the technical details regarding FHIR at: http://www.hl7.org/fhir. Continued on page 2 ® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered in the US Trademark Office In This Issue... FHIR, continued from page 1 FHIR is built on the HL7 Reference Informa- as example applications using FHIR. Obvi- FHIR – HL7’s Hottest Standard................................. 1-2, 9 tion Model (RIM), data types and vocabulary. ously, these are all based on what is currently FHIR hides the complexity of Version 3 (V3) the draft specification of FHIR. Economics of Interoperabily....... 3,7 from the implementer while leveraging the Update From Headquarters.......... 4-6 semantic strength of V3. FHIR also leverages One thing to understand about FHIR today is the concept of extensions from HL7 2.x which that it is under development as an HL7 Stan- Save the Date for HIMSS 2013....... 7 has the capability of z-extensions. It will al- dard. Like any other HL7 Standard, it will go Information Exchange Standards low extensions, but does so in a controlled through the HL7 ballot process. The current Meet Supply Chain Standard........ 8-9 fashion that should avoid many of the issues plan is for FHIR to be balloted as draft for with the 2.x extension mechanism. comment this summer. That ballot will cover News from the PMO and Project Services Work Group..................... 10 the methodology for developing FHIR as well FHIR is built on certain design premises. It’s as a small set of draft resources. During the HL7 Launches New Membership designed for the 80%, not 100%, meaning it May Working Group Meeting in Vancouver, Program and Webpage for Caregivers...................................... 11 only includes data elements in the artifacts if the FHIR team (Grahame Grieve, Ewout 80% of all implementers of that artifact will Kramer and Lloyd McKenzie) joined a num- 26th Annual Plenary Meeting; use the data element. FHIR extensions allow ber of work groups to discuss development HL7 in the Era of Patient Empowerment......................... 12-13 sharing of those data elements expected to of FHIR resources. One project for develop- be used by fewer than 80% of implement- ing FHIR resources for Pharmacy has been HL7 Tooling Challenge................. 13 ers (“the 20%”). Unlike V3, FHIR focuses on approved and there are likely more projects HL7 Argentina Welcomes New documenting what the implementer needs, being considered by other work groups. The Chair Fernando Campos............... 14 not what the modelers thought or design- first DSTU ballot for FHIR is expected to occur ers need to remember. FHIR documentation as part of the January 2013 ballot cycle. Member Spotlight on Grant Wood 14 strives to be concise; every word written is a News from the PBS Metrics word that must be read thousands of times. How will HL7 be managing the development Team............................................ 15 FHIR focuses on the physical wire format and balloting of the FHIR standard? As this Certification Exam (XML), not an abstract implementable tech- article is being written, the Technical Steer- Congratulations....................... 16-17 nology specification (ITS). FHIR also requires ing Committee is considering how FHIR wire format stability from release to release. will be managed within the HL7 organiza- HL7 Benefactors........................... 17 FHIR retains the semantic rigor of HL7 V3 but tion. The TSC is using another HL7 standard HL7 Welcomes New Director of hides it from implementers. The V3 semantic called SAIF (Service-Aware Interoperability Education, Sharon Chaplock........ 18 richness is still there for implementers who Framework) to set up the FHIR governance, Upcoming International want to leverage it. management and methodology within HL7. Events........................................... 18 FHIR governance will define and oversee the The “Fast” aspect of FHIR is very important. boundaries of the FHIR standard and FHIR Organizational Members......... 19-21 Fast to develop means that the FHIR stan- resources. FHIR management will be respon- 2012 Technical Steering dard development is intended to be a rapid sible for coordinating development of re- Committee Members .................... 22 process. FHIR resources are documented sources, ensuring that developers are follow- Steering Divisions......................... 22 in a spreadsheet format. Java tooling has ing FHIR methodology, as well as performing already been developed to create the techni- quality assurance on the FHIR artifacts being HL7 Work Group Co-Chairs......23-25 cal artifacts from these resource definitions. developed. FHIR methodology will be respon- HL7 Facilitators...................... 26-27 Fast to implement means that developing a sible for defining guidelines, validation rules FHIR based interface or application should be and best practices for use by work groups in Affiliate Contacts.......................... 28 quick and simple. FHIR has been designed to constructing FHIR artifacts. At this point, the HL7 Staff Members....................... 29 utilize off the shelf tools to enable very rapid methodology group will likely be the Model- implementation. There are already a couple of ing and Methodology Work Group. 2012 Board of Directors.............. 30 FHIR test servers publically available as well continued on page 9 Educational Summits....................31 Upcoming Working Group Meetings...................................... 32 is the official publication of: Health Level Seven International 3300 Washtenaw Avenue, Suite 227, Ann Arbor, MI • 48104-4261 USA Phone: +1 (734) 677-7777 • Fax: +1 (734) 677-6622 • www.HL7.org 2 Mark McDougall, Publisher • Andrea Ribick, Managing Editor • Karen Van Hentenryck, Technical Editor Economics of Interoperability Report from an HL7-organized panel at the eHealth Week/World of Health IT, Copenhagen, May 7-9, 2012 Catherine Chronaki by Catherine Chronaki, Affiliate Director, HL7 Board of Directors Interoperability in healthcare IT in to worry about her health record, as it ments, business conditions that sup- Europe is characterized by strong po- will be available in the cloud. port interoperability, interoperability litical support, increased awareness, guidelines, interoperability compli- and pockets of best practice. The Although there is some awareness ance testing, and promotion (market- European Union (EU) digital Agenda of the direct and indirect economic ing, education, conferences), present- 2020 has recognized interoperability benefits of interoperability, the busi- ing WiFi as a successful model. standards as one of the main pillars ness models for interoperability need in its mission to achieve the triple to be reworked to unlock win: sustainable healthcare systems, the market potential. quality care, and innovative solutions This was the topic of an that unlock market potential. EU- HL7-organized panel at wide initiatives such as the European the recent eHealth Week eHealth Project (epSOS), the Se- & World of Health IT 2012 mantic Healthnet network of excel- Congress in Copenhagen lence, the European Interoperability
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