The Standard

Report from Virtual FHIR DevDays 2020 on the Patient Innovator Track

Initiatives seeking to expand the use of HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard were highlighted at the recent HL7 FHIR Dev Days 2020 virtual event.

The Patient Innovator track included four presentations highlighting its recent move to encourage the use of technology to support patient involvement in care. HL7’s Patient Empowerment Work Group has a mission of promoting and amplifying the viewpoint of patients and caregivers in HL7’s standards work. Its initial priorities include enabling patients to correct errors in records, contribute their data to records, plan care, and efficiently gather and store patient consents.

The four presentations were judged by a panel of HL7 experts for their use or projected vision for the use of FHIR to solve problems in patient empowerment in healthcare. In addition, attendees at the virtual Dev Days event could vote to award one of the participants a People’s Choice award.

Report from Virtual FHIR DevDays 2020

The Cleveland Clinic and Oscar Health announced a partnership in mid-2017 that was going to require a level of provider-payer integration that the organization hadn’t attempted before.

More challenging still was the fact that the timeline was short – some of the capabilities that would enable improved patient interactions had to be in place by January 2018. The use of the HL7 Fast Healthcare Interoperability Resources (FHIR®) standard addressed many of the technical challenges in hitting those deadlines.

Integration between the entities still was difficult to achieve, noted Matthew Coolidge, who was then the IT product director at the Cleveland Clinic and is now CEO of Orbital Health. When he was in his Cleveland Clinic role, he was the organization’s subject matter expert on FHIR. Coolidge shared lessons learned in the initiative in a keynote presentation at the recent HL7 FHIR DevDays virtual meeting.

Report from Virtual FHIR DevDays 2020

A New York State initiative is aiming to change its approach for exchanging patients’ health information among the state’s health information exchanges, using HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard as the conduit.

In addition, the new approach being implemented for the State Health Information Network for New York (SHIN-NY) has taken less time to develop and is expected to enable the exchange of more granular patient data than is possible with the current approach.

Speaking at the HL7 FHIR DevDays virtual meeting on June 15, Luke Doles, senior director of services management for the New York eHealth Collaborative (NYeC), said further implementation of the FHIR-based framework has been delayed because of the urgency to shift resources to support the state’s COVID-19 response. However, the initiative has thus far proven that the concept can be expanded to provide more information across SHIN-NY.

Report from Virtual FHIR DevDays 2020

Work on incorporating application programming interfaces using HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard can help healthcare organizations better manage the COVID-19 crisis, but much more could be done.

A virtual panel at HL7’s FHIR DevDays indicated that API usage can help with the sharing of data, but more widespread use of this supportive programming could provide more benefits.

“If you look inside the typical hospital, there are more than 20 different clinical systems being used, but only one is the electronic health record getting the API love,” said Keith Boone, enterprise architect for Audacious Inquiry. “COVID data is showing up in bed management systems, command and control systems, ICU central monitoring and more.” Those systems are five years behind EHRs in enabling data exchange.

Report from Virtual FHIR DevDays 2020

A new initiative is making rapid progress in developing a way to improve how providers report COVID 19 data to public health agencies.

Started in late March, the Situational Awareness for Novel Epidemic Response (SANER) Project has made “huge progress in a short period of time,” said Keith Boone, enterprise architect for Audacious Inquiry, a consulting firm that helped to start the initiative.

HL7's Commitment to Diversity, Equity and Inclusion

The COVID-19 pandemic is helping to reveal new ways to use HL7’s Fast Healthcare Interoperability Resource (FHIR®) standard to share healthcare information and coordinate services, but systemic shortcomings in existing health information systems are hampering coordination of a national response.

FHIR is being used in some initial efforts to support public health efforts, and it has the potential to rapidly address approaches to gather data and coordinate research across the planet, said Wayne Kubick, chief technology officer for HL7 International.

“The FHIR platform can enable multiple apps to rapidly address urgent new use cases, such as public health,” said Kubick during a webinar on April 30, hosted by HL7 and sponsored by CitiusTech, entitled “Data Sharing in the Spotlight: COVID Gaps, Interop Rules and The Path Forward.”

Because FHIR enables data to be easily accessed by open source apps, it can help in the rapid response needed to the current pandemic, Kubick said. “Increased global adoption can help to get to a common platform of collaboration around the world; a FHIR infrastructure is the first step in a long process – to take advantage of this infrastructure, it will require further innovative, agile methods to build out implementation guides. Standards can’t solve the problem entirely – we need the infrastructure there to support rapid response capabilities.”

This is a time of great health policy discussion and activity, especially given the challenge of COVID-19 and the finalization of significant federal regulations that will now move into the implementation stage. HL7 and its standards, such as Fast Healthcare Interoperabilty Resources (FHIR^®), are a strong fiber in these developments. Discussed here are key aspects of the final interoperability, patient access and information blocking rules recently released related to implementing provisions in the 21^st Century Cures Act (Public Law 114-155). The intersection of policy, HL7 standards and COVID-19 will be highlighted in this space soon. Stay tuned!

HL7 collaborates with the U.S. Centers for Disease Control and Prevention (CDC), the Council of State and Territorial Epidemiologists (CSTE), and the Association of Public Health Laboratories (APHL) to support eCR Now through the use of HL7 FHIR in the nationwide initiative formulated for the rapid roll-out of automated electronic case reporting (eCR) from EHRs to state and local public health agencies.

HL7 is developing the SANER HL7® Fast Healthcare Interoperability Resources (FHIR®) Implementation Guide (IG) to support standards-based communication to emergency response authorities regarding critical COVID-19 resources such as ICU beds, ventilators and other essential equipment and treatment supplies. Audacious Inquiry is leading the development of open source solutions that will follow the SANER HL7® FHIR® IG.