The Standard

HL7 FHIR empowers patients to access health data with third-party apps in a growing number of countries. As nations, locales and regulators across the world look to increase their citizens’ access to health data through third-party apps, they naturally turn to FHIR. The International Patient Access (IPA) standard aims to enable regulators, empower patients, guide app developers, and promises greater consistency across countries for multinational apps and FHIR servers.

• For patients, greater access to health data empowers them to standardly and computably access and retain their digital health data.

• For regulators and national specification authors, the IPA specification provides a starting point to jumpstart a national health API ecosystem, with an emphasis on patient access. The IPA FHIR profiles are the result of an analysis of existing national base profiles, and is the lowest common denominator globally.

• For app developers, IPA outlines the global base set of access and security mechanisms and content format. This increases the size of the addressable market for apps, both in terms of geography and of systems.

• For systems vendors, IPA defines a base set of functionality, enabling less adaptation and custom work when the system is deployed to a new market. More apps and other systems are readily interoperable with the system.
  
• For healthcare systems, adoption of IPA means less expensive and more robust systems, as fewer market-specific customizations are required. Support of IPA will also enable healthcare systems access to a wide ecosystem of interoperable apps.

By Brian Douthit; Charles Jaffe, MD, PhD; Viet Nguyen, MD; and Titus Schleyer, DMD, PhD

Originally starting as an application showcase in 2018, the FHIR Apps Competition has become one of the most popular sessions at the AMIA Annual Symposium. From clinical decision support and health information exchange to problem-oriented displays and back-end data exchange, HL7 FHIR is enabling innovation across a whole range of health IT domains.

AMIA and HL7 recently reinvigorated their partnership to emphasize the importance of health data standards in informatics, and engage the AMIA implementer community in leveraging FHIR for research, patient care and education. The competition is intended to highlight the best and most innovative FHIR implementations – if you are planning to attend the Annual Symposium this year, you don’t want to miss it!

Two CodeX HL7 FHIR Accelerator use case teams are hosting monthly public calls to involve a broad community in early prototype development and pilot planning activities currently underway.

Da Vinci is creating the foundation to solve large scale industry problems.

The HL7 January FHIR Connectathon  was a success, with all examples from the implementation guides (IGs) tested, including over 20 test cases.

The HL7 Da Vinci Project, through its efforts that include Connectathons, “continues to focus on solving real-world data exchange challenges between payers and providers,” said Vanessa Candelora, Da Vinci’s project manager and senior consultant with Point-of-Care Partners, at the Jan. 26 Da Vinci Community Roundtable. “Da Vinci is creating the foundation to solve large scale industry problems, including, risk and quality data sharing and workflow; unlocking data or freeing data needed for patient costs; and reducing provider burden.”

Candelora called HL7 Connectathons, “a fundamentally human-powered endeavor,” praising Da Vinci as “a really great community,” with a multi-stakeholder membership that includes providers, payers, vendors, industry partners and EHRs. “We continue to grow and learn from each other in this party of the willing.”

Candelora added that founders of Da Vinci are pleased with the amount of work the group has accomplished in such a short time. “They really couldn't have envisioned the impact and the progress that this project has made,” she said.

Computable Publishing LLC was pleased to sponsor the January 2022 HL7 Working Group Meeting, which aligns with our work towards creating software tools that support data exchange for scientific knowledge with HL7 Fast Healthcare Interoperability Resources (FHIR®). In fact, many already know that our CEO, Brian Alper, is the leader of the Evidence-Based Medicine on the FHIR project (EBMonFHIR) and the COVID-19 Knowledge Accelerator (COKA) initiative.

Background & Expansion

EBMonFHIR (sponsored by the CDS, BR&R and CQI HL7 work groups) previously created Citation, Evidence, EvidenceReport and Evidenceariable Resources. The project expansion to the COKA initiative now involves 12 active working group meetings per week. The combination of volunteer efforts from about 100 people in many countries along with software tools (provided gratis to COKA by Computable Publishing LLC) has produced impressive results to advance evidence-based medicine (EBM) and promote the HL7 FHIR standard to the EBM community.

On behalf of the HL7 US Realm Steering Committee (USRSC), we are pleased to share an update on last year's priorities and highlight our focus for 2022.

2021 Highlights

Visibility was a key theme of our work in 2021 and included supporting pilot work on a standards dashboard, tracking accelerator activity and promoting key ballots.

Before we dive into 2022, we want to highlight a few key points for all US Realm (USR) members.

• SMART v2: published new guidance on granular controls
• Bulk Data v2: published with numerous new features 
• Errata release of Consolidated CDA (C-CDA): companion guide to support January 2022 ballot  
• C-CDA Companion Guide: January 2022 ballot to add USCDI v2 guidance
• US FHIR Core - January 2022 ballot: to add USCDI v2 guidance
• Hosted reviews on HL7 Standards Dashboard Prototype
• C-CDA Web Publishing Trial Draft using FHIR Structure Definition
• Facilitated US@ project with ONC team

The CodeX HL7 FHIR Accelerator will host three public calls next week covering project milestones in the Radiation Therapy Treatment Data (RTTD), Risk Evaluation and Mitigation Strategies[i] (REMS) and Prior Authorization in Oncology use cases.

• Join the CodeX Prior Authorization in Oncology team on February 15 (3-4 ET) for an update on its radiation oncology pilot planning. Use case team members will discuss progress relative to breast and prostate cancer patient demographic and clinical data elements discovery and health data standards mapping (e.g., mCODE and Da Vinci Project implementation guides). Find call information here.  
• Join the RTTD team on February 16 (11-12 ET) when they will share recent project achievements, including experience exchanging synthetic patient data using mCODE from a radiation oncology information test system to a FHIR server. Find call information here.
• Join the CodeX REMS team on February 17 (1-2 ET) to explore the value of an interoperable REMS ecosystem using FHIR and other health data standards, view details of the open source REMS on FHIR prototype under development and discuss CodeX membership details and benefits, including driving the REMS use case work forward. Find call information here.