The Standard

As the global authority for interoperability in health care information technology with affiliates in 35 countries, we're excited to announce the publication of Release 4 of the HL7 Fast Healthcare Interoperability Resources (FHIR^®) standard. This new version is the culmination of 18 months of extensive work to finalize the base parts of the specification and incorporates changes and enhancement requests received from implementation partners around the world.

"HL7 FHIR R4 is a beginning," said HL7 CEO Dr. Charles Jaffe. "It is the legacy of eight years of innovation and collaboration among a community of thousands around the world. It is a commitment from HL7 to create a platform from which Interoperability can someday emerge. It is a promise to provide reusable data across the continuum of biomedical research, patient care, and population health."

HL7 FHIR is a next generation standards framework that leverages the latest web standards and applies a tight focus on implementation. FHIR includes a RESTful API, which is an approach based on modern internet conventions and widely used in other industries. The standard represents a significant advance in accessing and delivering data while offering enormous flexibility and ease of development. For patients and providers, its versatility can be applied to mobile devices, web-based applications, cloud communications and EHR data-sharing using modular components. FHIR is already widely used in hundreds of applications across the globe for the benefit of providers, patients and payers.

The most significant change in HL7 FHIR Release 4 (R4) is that the base platform of the standard has passed a normative ballot and will be submitted to the American National Standards Institute (ANSI) as a normative standard. This means that future changes should be backward compatible so applications that implement the normative sections of R4 no longer risk being nonconformant to the standard. The following portions of the standard are now normative:

• The RESTful API, the XML and JSON formats, and the basic datatypes
• The Terminology Layer (CodeSystem and ValueSet)
• The Conformance Framework (StructureDefinition and CapabilityStatement)
• The key resources Patient and Observation

Thousands of other R4 updates and changes have been made in response to implementation experience and quality review processes.

“FHIR Release 4 marks a significant milestone with the introduction of a normative base. This new maturity will help support our very active and growing community,” said Grahame Grieve, HL7 FHIR Product Director.

The FHIR specification is expected to continue to evolve in the future as it responds to the interoperability needs of the robust FHIR implementation community. HL7’s priority for the next release is to bring more sections of the standard to normative status and continue to respond to the needs of the community that is building solutions. The FHIR Maturity Model helps implementers understand how the various parts of the standard are advancing through the standards development life-cycle.