Why FHIR for LATAM?
Latin America (LATAM) arrived on the scene late in terms of the use of earlier HL7 standards. HL7 Version 2 was created in 1985 but we (LATAM) did not begin using it until after 2000). HL7's Clinical Document Architecture (CDA®) was published in 2000 but we began using it after 2005. HL7's Fast Healthcare Interoperability Resources (FHIR®) is being created now and we are starting to use it in LATAM. Two implementation guides have been developed in Argentina and Colombia; Chile is working on one. We can discuss the ‘we’ (as in ‘Who in LATAM’?), but the trend cannot be discussed. Some countries in our region have yet to use any standard—there is NO installed base— why get stuck with stuff that’s 10 or 20 years old?
However, work is still in progress. While CDA Release 2 is good for document repositories, when it comes to mobile, what you can/should exchange is more discrete and granular. The choices will come down to how to use FHIR for examples such as:
- Only display allergies
- Only display the lab results for a graph.
Is FHIR ready for LATAM?
FHIR is still in the peak phase of the Gartner Hype Cycle. There are inflated expectations, such as it’s supposed to heal all the worlds illnesses, stop world hunger, and even transform ashes into gold!
However, several resources—particularly those most often used in patient portals (lab results, patient conditions and demographic information, providers)—have achieved a good degree of maturity and are usable (and used) now for patient portals and mobile interoperability. We hope to complete most core FHIR resources and mature them through connectathons during this year and the next.
One of the complaints when reviewing architectures for healthcare information sharing has been the lack of an overall framework. FHIR supports all the paradigms (REST, services, messaging, documents) so you can create any architecture and leverage FHIR for content.
FHIR also incorporated SMART (or the other way around), which combines structured data (FHIR), scopes and permissions (oAuth), simple sign in (OpenID), and UI integration (HTML5), to create a usable framework for connecting APPS to EHR systems.
The answer is yes!
My conclusion is that FHIR is ready for us, and LATAM is ready for FHIR.