Lecture on FHIR (Fast Healthcare Interoperability Resources)

Introduction to FHIR

• Created by HL7 International.
• Addresses interoperability needs of the current healthcare data environment.
• Federally mandated in many countries for healthcare IT systems.
• Allows data integration from various sources: pharmacies, home devices, mobile devices.
• Provides real-time data visibility in one place.

Key Considerations

• Designed to transition data from offline to online.
• Ensures data transparency.
• Handles both narrative and coded data.

Technical Aspects

• FHIR is a REST API.
• Specifies how to request/receive data and agree on data meaning.

Components of FHIR

FHIR Resources

• Logically discrete data concepts (e.g., patient, medication, document).
• Defined meaning and server location.
• Example: Patient resource includes given name, family name, birth date.

FHIR Profiles

• Implementations of clinical information models for specific use cases (e.g., procedure).
• Contain rules, relationships, value sets, and extensions.
• Enables use across different interoperability paradigms without transformation.

Data Usage

• Expressed in messages, documents, and REST APIs.
• Machine-readable, applicable in decision support services.

Interoperability

• Requires shared FHIR profiles across systems.
• Ensures consistent data interpretation across different platforms.
• Clinical information models provide data descriptions, usage rules, terminology bindings, and data relationships.

Importance of Profiles

• Provide context to data elements and their interrelationships.
• Use a FHIR terminology server for codes and value sets.
• Ensures uniform terminology across systems.

Example

• Printed medical history report with separate data elements.
• Profiles add context to elements, ensuring accurate interpretation and relationship definition.

FHIR Extensions

• Allow representation of data elements not part of the standard.
• Example: Adding nationality to patient resource for medical tourism.
• Published to a publicly accessible URL for discoverability.

FHIR Implementation Guides

• Contain profiles, extensions, terminology bindings, and value sets for specific use cases.
• Provide documentation and usage examples.
• Published online using HL7 International's web publishing tool.
• Machine-readable, useful for validating FHIR applications.

Conclusion

• Critical for integrating healthcare data from diverse sources.
• Standardized approach ensures effective data sharing and usage.
• Further learning resources available on the InterSystems learning site.