The Standard

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.

The CodeX team believes the Minimal Common Oncology Data Elements (mCODE™) standard could be leveraged to achieve more equitable health outcomes for cancer patients from diverse populations. As part of our exploration, we are releasing a white paper, “Advancing Health Equity in Cancer Research, Care, and Surveillance,” available here and will host a companion webinar, "Leveraging Interoperability to Drive Health Equity in Cancer Care, Research and Surveillance." Please join us on January 27, 2022 at 1PM ET by registering here.

The Organization Welcomes Daniel Vreeman, D.P.T., Viet Nguyen, M.D., and Diego Kaminker

The Next Generation Standard Has Transformed Health Information Technology Across the Globe

HL7 Fast Healthcare Interoperability Resources (FHIR®), the widely adopted, open-source standard from the HL7 International community, celebrates 10 years of international development and implementation. With the ability to streamline the many variations in health information technology (HIT) systems and the capacity to accommodate modern technology, FHIR is at the forefront of healthcare interoperability. In keeping with HL7’s vision of a world where access to health data is readily available to everyone whenever and wherever it is needed, FHIR creates connections between different parts of the healthcare system to facilitate the secure, real-time exchange of data and, ultimately, improve patient care.

Since its inception, FHIR has fostered a collaborative culture. HL7 International Chief Executive Officer Charles Jaffe, M.D., Ph.D., recalls, "The development and adoption of FHIR was advanced by a remarkable and committed international community. The impact that FHIR has had on global healthcare was driven by an unprecedented level of collaboration that today continues to grow." Grahame Grieve, principal at Health Intersections, FHIR product director at HL7 and the inventor of FHIR, agrees. “Most people think about FHIR as a technical specification, but I look at it first of all as a community.”

Alliance of government, private sector and philanthropic partners aims to use widely accepted healthcare standard to help advance public health

A new initiative launched by HL7 and jointly supported by the Centers for Disease Control and Prevention (CDC) and the Office of the National Coordinator for Health IT (ONC) seeks to use widely recognized data exchange standards to help advance public health. The effort, called Helios, intends to strengthen the capacity and streamline data sharing across all levels of public health using the HL7 Fast Healthcare Interoperability (FHIR®) standard.

“Public health has risen in urgency and importance over the last 18 months,” said the ONC’s National Coordinator for Health IT Micky Tripathi, PhD, MPP, “FHIR accelerators have had great success in engaging implementers as early as possible to help identify and overcome longstanding barriers to interoperability. The Helios alliance is a market-based implementation collaboration that will help to ensure FHIR development is coordinated and focused on real world public health needs.”

The initiative is the latest to use HL7’s FHIR Accelerator program, which seeks to speed the development and availability of FHIR to deliver better data that leads to better health outcomes. The Helios alliance represents an ambitious new use of the FHIR Accelerator program, pulling together a diverse group of state, tribal, local, territorial, and Federal public health agencies, private and philanthropic sector partners, and other groups interested in the equitable and effective use of data for the advancement of public health.

HL7's Chief Technology Officer, Wayne Kubick, will retire  at the end of this year. We want to take this opportunity to formally announce it and begin recognizing the many accomplishments and contributions he made to the betterment of HL7 International and its entire global community.

Wayne's responsibilities will be assumed by two new C-level officer positions, a Chief Standards Officer and Chief Implementation Officer, and he will remain in an advisory role into early 2022 to support the transition. 

We would like to express our deepest appreciation and thank Wayne for his dedication and unparalleled commitment to HL7 International over the past six years. His leadership has been instrumental in advancing HL7’s mission and vision of a world in which everyone can securely access and use the right health data when and where it is needed.

If there is one word that describes Wayne’s work philosophy at HL7, it is Essentialism. He introduced us to the concept when he joined the organization and has been a staunch proponent of incorporating Essentialism across the board, encouraging the organization to focus its efforts on its highest contributions to the industry while letting go of non-essential work.

Weclome to CodeX's New Patient Voices Series!

CodeX recently talked with cancer patients, survivors, and advocates to hear their stories and learn more about their perspective through the cancer care coordination process. CodeX (Common Oncology Data  Elements eXtensions) is a HL7 FHIR Accelerator, launched at the end of 2019, that is building a community to enable interoperable cancer data modeling and applications that lead to step-change improvements in cancer patient care and research.  

How is the Standard of Care Defined?

“Everyone just said this is the standard of care!” Today, Desiree D. has no evidence of disease, but in 2017 she was diagnosed with stage 2b breast cancer at the age of 40. When trying to make decisions about her course of treatment, Desiree was repeatedly told by doctors that she was getting the standard of care. In reality, the “standard of care” is relatively loose terminology. When making treatment decisions, Desiree felt that the standard of care where she was living in Virginia meant something different than the standard of care in Massachusetts or the standard of care in Vermont. 

Imagine if a chef could not make a soup because he only understood Portuguese and the soup’s instructions were in Hindi. The chef could look elsewhere and find a solution after further research; however, the lack of a common language has cost the chef time and the chef’s soup is not going to be the same as he wished. This scenario is harmless, but a similar and much more serious situation exists across healthcare systems. The healthcare industry remains significantly less standardized than other industries. This means that treatments for the same type of cancer might vary greatly by geographic location, cancer center, and even oncologist in part because healthcare data is not collected or shared in a standard manner.