The Standard

The HL7 FHIR at Scale Taskforce (FAST) is going international! As part of our mission to accelerate FHIR adoption and interoperability around the globe, FAST is taking its work beyond the U.S. to engage with the international health IT community. 

For the first time ever, FAST will be hosting a dedicated track at the HL7 FHIR Connectathon in Madrid, featuring two of our most critical and widely applicable Implementation Guides (IGs): 

🔐 FAST Security - https://build.fhir.org/ig/HL7/fhir-udap-security-ig/branches/main/ 
🆔 FAST Identity - https://build.fhir.org/ig/HL7/fhir-identity-matching-ig/ 

While these IGs were originally developed under the U.S. ONC's efforts to advance FHIR adoption, their guidance is intentionally broad and applicable globally. In fact, we're in the process of transitioning them to universal realm status, and your international input is vital. 

Why Participate? 
🌍 Help shape these key IGs to meet global needs 
🧪 Test and validate implementation with FAST experts
📚 Attend deep-dive breakout sessions focused on Security and Identity
🚀 Prepare for the future – FAST Security is a required standard for TEFCA FHIR exchange starting January 1, 2026 in the U.S. 

Da Vinci’s Feb. 26 Community Roundtable and Feb. 27 Joint Education Session with FAST to provide implementation resources.

Two free online events coming up soon will provide practical insights on how to improve interoperability by leveraging Health Level Seven’s Fast Healthcare Interoperability Resources (FHIR®) standard for APIs.

A Community Roundtable, to be held at 4 p.m. ET on Feb. 26, will focus on “Da Vinci’s Trebuchet: Launching Your Interoperability Implementations.”

The HL7 Da Vinci Project is a private-sector initiative that’s leveraging FHIR to improve data sharing in value-based care (VBC) arrangements. The goal of Da Vinci’s Trebuchet effort is to accelerate FHIR adoption and scaling of FHIR APIs through pilot projects.

Attendees at this month’s Community Roundtable will receive information to equip them with the knowledge and resources needed to successfully launch an implementation journey.

Pilot leaders and a panel of payer and provider implementers will share their expertise. After a level-setting session that reviews the purpose and current state of Trebuchet pilots, presenters will describe what’s involved with piloting and how to determine your organization’s readiness.

Attendees will learn about key elements of finding or creating a pilot, including identifying other parties of the willing, the role of vendors in your pilot design, Qualified Health Information Network (QHIN) and Health Information Network (HIN) implications and how your current trading partners fit into your vision. The session will conclude with a panel of payers and providers who will share their piloting journey.

Register Today for the February Community Roundtable! 

To register and attend this free webinar, visit:
https://zoom.us/webinar/register/WN_T5IyY_NQQLybrIZdQ0zifw#/registration 

Second Event

The second event, to be held at 2 p.m. ET on Feb. 27, will be a joint session of FAST and Da Vinci focusing on alignment of Trebuchet and network exchange goals.

FAST stands for the FHIR at Scale Taskforce (FAST) Accelerator, which is working to identify ecosystem-wide barriers to deploying FHIR at scale, define solutions to address those barriers and develop infrastructural standards to support FHIR implementations. The desired outcome is a national API interoperability approach that enables consistent clinical data exchange using FHIR. 

The FAST Security Implementation Guide (IG) supports a multi-party trust framework within payer-payer and payer-provider networks. It supports implementing dynamic client registration in scalable exchange.

David Pyke, FAST technical director, will discuss the FAST IG with a focus on the implementer’s perspective, including:

• What to consider before and during implementation of the IG
• What is of primary importance as you begin and progress through implementation
• For payers, providers and vendors: What are the implications and experiences of the client, vendors and EHRs.

To attend, access the Zoom link on this page under the  Conference Call Schedule and Dial-ins section: https://confluence.hl7.org/display/DVP/Da+Vinci+Trebuchet+FHIR+Pilots   

Don’t miss these two opportunities to learn how to implement FHIR as a critical component of ramping up the exchange of clinical data to improve the quality of care.

As the Trusted Exchange Framework and Common Agreement (TEFCA) moves ahead for FHIR usage within the framework, the use of the HL7 FAST UDAP Security for Scalable Registration, Authentication and Authorization FHIR IG (FAST Security) is becoming more important to the security framework for FHIR within the US and in other countries. As part of our mission, the FHIR At Scale Taskforce (FAST) wants to help people get ready for the TEFCA January 1, 2026, deadline to have Fast Security implemented for FHIR Exchange over TEFCA.

To help implementers, CISOs, and anyone interested in FHIR on TEFCA out, FAST is holding a 1-day event to introduce the Security IG and how TEFCA will use it and information about general TEFCA security, Security IG testing, and other aspects. This event is FREE on January 13, 2025, right before the FHIR Connectathon. If you’re interested in FHIR on TEFCA or want to know the latest in FHIR OAuth security, you can sign up at: https://info.hl7.org/fast-security

The latest FAST Focus webinar provided a comprehensive update on the progress and scope of the FAST Consent project, an initiative pivotal to streamlining data exchange in health IT. This quarterly series aims to engage the community, share updates, and encourage participation in ongoing FASTprojects. Below, we delve into the key takeaways from the session, with a spotlight on the objectives and contributions  

The FAST Consent Project: An Overview 

Consent management in healthcare is a complex issue that requires innovative solutions to manage and transmit consent records at scale. The FAST Consent project emerged in response to these challenges, focusing on how to make consent management effective across a diverse and multi-faceted ecosystem. Project leads—including Durwin Day, Mohammad Jafari, Kevin Day, Maidul Islam, Sam Schifman, and Jean Duteau—are spearheading efforts to define scalable consent handling strategies that align with both technical and legal requirements. 

As healthcare's digital transformation accelerates and data fluidity improves, the need to ensure patients maintain control over their health data becomes more urgent. While better interoperability brings many benefits, it also raises significant challenges around consent. The key question is: how do we efficiently manage patient consent to ensure privacy preferences are respected at scale, across multiple organizations and systems? 

The FHIR at Scale Taskforce (FAST), is focused on identifying scalability gaps, defining solutions to address current barriers, and identifying needed infrastructure for scalable HL7 Fast Healthcare Interoperability Resources (FHIR®) solutions so taking on consent as a use case was a natural evolution. 

The upcoming FAST Focus Webinar on November 7, 2024, will delve into this critical topic, offering stakeholders valuable insights into the FAST Consent team's efforts to develop a standardized framework for consent management. The webinar will provide an update on their progress, highlighting the collaborative work that has shaped the project’s evolution, as well as specific use cases that are central to its scope. 

"Our response to interoperability isn’t just about managing data—it’s about building the future of healthcare through open standards." - Dan Vreeman, DPT, Chief Standards Development Officer, HL7 International

Last week at Civitas 2024 in Detroit, HL7 International/s Chief Standards Development Officer,Dan Vreeman, DPT, led an insightful panel session on how HL7® Fast Healthcare Interoperability Resources (FHIR®) is revolutionizing interoperability. As data sharing becomes increasingly critical, HL7 is at the forefront, driving collaboration with over 45 organizations and developing 35-45 new FHIR implementation guides annually! Dan was joined by leaders from the Da Vinci Project, FAST, Gravity Project, and Helios, to discuss their HL7 FHIR Accelerator projects, including objectives and progress made to date in advancing open data standards development and interoperability.

The FHIR at Scale Taskforce (FAST) community has been at the forefront of shaping the future of healthcare interoperability. By working closely with the FHIR community and other FHIR Accelerators, FAST is building the framework for a robust FHIR infrastructure that supports the scalability of FHIR solutions across the healthcare ecosystem. Today, we are excited to announce an important leadership transition as we continue this vital work.

A New Opportunity for Dana Marcelonis

Dana Marcelonis, who has been a cornerstone of FAST as our Program Manager, will be transitioning to a new role at Point-of-Care Partners, where she will provide program support for the Coalition for Health AI (CHAI) project. Dana’s expertise, dedication, and leadership have been instrumental in guiding FAST’s efforts, and her impact on our work cannot be overstated. While Dana managed both roles admirably, the increasing demands of these projects have made it necessary to have a dedicated resource for each. Dana will continue to support Janice and the team through November to ensure a smooth transition.

If you can’t think of a reason to pay attention to FAST's work, we have a couple for you! Recent requirements related to TEFCA (Trusted Exchange Framework and Common Agreement) and the latest HTI-2 proposed rule have named the FAST Security Implementation Guide (IG). This recognition underscores the importance and foundational nature of FAST's contributions to healthcare interoperability. 

On July 1st, the Recognized Coordinating Entity (RCE) released the Facilitated FHIR Implementation Standard Operating Procedure (SOP), outlining the requirements for using FHIR within the TEFCA framework. Notably, these requirements include adopting the FAST HL7 UDAP Security for Scalable Registration, Authentication, and Authorization FHIR Implementation Guide (SSRAA) by January 1, 2026. This timeline allows organizations to implement FAST Security while still using SMART or other security options in the interim. 

Specifically, the SOP states: 

Prior to January 1, 2026: 

• All FHIR Adopters MAY follow the requirements of HL7 SSRAA FHIR IG 1.0.0 STU 1 US Section 3 Registration. 

• Manual registration requests for client_id MUST be resolved within 5 business days where sufficient information has been provided. Information requirements MUST NOT exceed those in Section 3 of HL7 SSRAA FHIR IG and this SOP. 

• All FHIR adopters MUST use one of the following: 
  • HL7 SSRAA FHIR IG 1.0.0 – STU 1 US Sections 4 and 5; 
  • SMART Release 1.0.0; or 
  • Another authentication and authorization framework that adheres to the QTF requirements is based on out-of-band agreements between exchange partners. 

In the realm of healthcare, accurately managing patient identities across various systems is pivotal. The FHIR at Scale Taskforce (FAST) has developed the Interoperable Digital Identity and Patient Matching implementation guide (FAST Identity IG) to address these challenges effectively. This blog delves into the nuances of this implementation guide and encourages participation in its continuous improvement. 

Exploring the FAST Identity Implementation Guide 

The FAST Identity IG aims to enhance the FHIR patient $match operation for use in cross-organizational workflows. It serves as a comprehensive set of best practices not only for transactions directly invoking $match but also for other healthcare transactions that require robust identity matching and management.