My first trip to the FHIR Connectathon in Orlando, Florida, last month was everything I'd been told to expect. It was filled with HL7®, masterminds, brilliant developers, exceptional healthcare speakers, and a slew of erudite Connectathon participants. While my primary objective was to test-drive FHIR, I'd like to share three unexpected and exciting discoveries that made my Connectathon experience unique.
1. A FHIR-Y COOL CROWD
I only became aware of the diverse crowd components because I stayed after the Connectathon to attend the HL7 Working Group Meetings. The working groups were comprised mainly of HL7 denizens that included general counsel, industry experts, nurses, doctors, and the like. The primary topic of discussion centered on workflow and process, along with a spirited comparison of the old standards, V2 and C-CDA®, and the new standards, including FHIR. Conversely, the FHIR crowd I spent the week with was more casual and consisted mostly of developers and implementers, the folks who will ultimately code or create functionality in the standards, leading to the creation of original apps and tools. The two distinctive crowd characteristics represented the difference in interaction in the FHIR application and, in essence, what the two groups were trying to achieve with the standard. The HL7 experts wanted to analyze the process, flow, and use, and the developers wanted to test and create in a search for new applications.
2. FHIR IS USER-FRIENDLY, MORE ACCESSIBLE
FHIR is extraordinarily developer-friendly, which makes it uniquely accessible to a larger crowd of participants. Many in the Connectathon room, with no clinical background and no prior exposure to HL7 languages, were immediately able to develop to the FHIR standards and test one another's FHIR servers. Because FHIR is easy to understand out-of-the-box, it allowed a developer, not necessarily inside the health care arena, to immediately participate, which wasn't always the case with older standards. The industry maxim, "Once you know one HL7 V2 implementation, you know one HL7 V2 implementation," underlines the disparity between the two V2 implementations, making it a challenge to call HL7 V2 an interoperable language. The complexity of the HL7 CCD model is underlined by the fact that it took us at RelayHealth almost a full year to build our first CCD C32 implementation. In sum, FHIR's ease-of-use is outstanding news for the standard as it will broaden the user-base, and, simultaneously, FHIR's reach out into the world.
3. RING OF FHIR ATTRACTS
In the past, most of the brilliant developers flocked to companies like Google, Facebook, and Twitter, perhaps because those skill-sets have never before been able to translate as well into the health care development arena. With its foundation in widely utilized REST-based technology, FHIR is accessible to techies from non-traditional healthcare backgrounds. As FHIR draws in a younger, more creative demographic, experts enticed into the ring of FHIR will expand beyond healthcare wizards to include computer science experts and more. And, with the creation of a new talent pool testing FHIR and its applications, the possibility of FHIR expanding beyond traditional "health information exchange" is immense. The opportunity to utilize FHIR will move beyond the conventional back-end of the healthcare exchange model to include front-end purposes. Boston Children's Hospital SMART Cardiac Risk app, which calculates cardiac risk scores and is plugged into a FHIR server on the back end, is an excellent example of the possible innovation. FHIR will further differentiate itself not simply via large-scale data aggregation and analytics but also by its ability to further break down interoperability barriers between EMRs, HIEs, and information silos (clinical, financial, administrative, and operational). Today, everyone is attempting to create the next app, and with its ability to open new doors, FHIR has the opportunity to create life-changing and life-saving apps. Healthcare technology is in a period of transition, and as we continue to grow fast and furious, we seem poised to meet our new HIT challenges by creating new, exciting ways to start a FHIR.
Elisabeth Berger is a data platform product manager with RelayHealth, a healthcare information technology business unit of McKesson. Elisabeth is a C-CDA and FHIR expert, as well as a biomedical engineer and an ice cream-making enthusiast.