The Standard

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.

CMS released the much-awaited Interoperability & Patient Access Rule in early March this year. This rule establishes policies that aim to break down barriers in the health system across the US for better patient engagement.

CMS had proposed the Interoperability & Patient Access Rule to support regulations of the MyHealthEData initiative and 21st Century Cures Act with an implementation timeline. This resulted in numerous requests from the healthcare industry, especially from the payer community, which demanded for the rule to be implemented in a phased manner. This was well received by CMS and timelines have been set accordingly given that technological advancements and security of data exchange need to be taken into consideration.

The rule promises to enable better patient access to their health information, improve interoperability and drive innovation, while reducing burden on payers and providers. Patients can now be aware of their health information for better care and improved patient outcomes. With data being available conveniently and securely among payers, providers and patients, CMS hopes to achieve real coordinated care, improved health outcomes and reduced costs.

Keeping Us Together While Apart

During this time of global crisis, it’s worth remembering the critical importance of what we at HL7 are doing to improve global health by making health information more available and useful. While so many are struggling with social distancing, we already have a culture that long ago learned to work together remotely on our common goals. But now with fewer opportunities to meet together in person, we need to move ahead to finish much of the work we’ve been doing over the past few years – so we’re better prepared to work together even more effectively, while knowing we must be further apart geographically.

Seqster has developed a platform that allows patients and their caregivers to collect, visualize, manage and share all of their health data in one app. We aggregate clinical data points across providers chronologically using the industry-standard coding systems that the HL7 community knows all too well.