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A Clinician’s Perspective: The benefits of FHIR for digital health

It’s 2017. A New Year to be sure, but very likely a year in which clinicians will encounter the same challenges as in previous years with regard to interoperability of information systems in health care.

For clinicians, access to the right health information at the right time is essential for providing optimal, safe care for patients. However, in health care, sometimes it doesn’t feel like we’re in 2017. We still rely on fax. A lot.

Depending on which province you practice in, timely access to health information can be challenging. Your office-based EMR (electronic medical record) may or may not be electronically linked to other sources of your patient’s health information, such as a provincial EHR (electronic health record). As I noted in a previous blog though, we may be reaching a tipping point with regard to interoperability, i.e. the seamless, timely sharing of health information electronically between health care providers.

In October, the Cleveland Clinic announced their 11th annual list of the Top 10 Medical Innovations of 2017. This list always contains some fascinating insights into advances in medical technology. Interestingly enough, number 6 on the list was a healthcare data standard, called FHIR (Fast Healthcare Interoperability Resources). 

Yes, a health care data standard.

FHIR is the brainchild of the HL7 group, and builds upon previous HL7 standards (HL7 v2, HL7 v3, CDA, etc). It is supported by a large swathe of industry players, and makes use of the latest web standards, including Privacy and Security protocols. It supports API-based development of mobile applications, and social media applications, amongst others. 

This particular healthcare standard should help to improve the current state, in which electronic health information systems are not able to ‘speak’ to one another, sometimes even within the same hospital or clinic. Traditionally, the health care industry has proven to be a bit of a conundrum for software developers, due to the multiple medical record systems, data standards, and exchange interfaces involved. 

According to a HIMSS 2016 presentation by Dr Charles Jaffe and Dr. Stan Huff, FHIR is “faster to learn, faster to develop, faster to implement.” It may function as a kind of translator standard, a bit like a “Babel fish”; the fictional creature that “neatly crosses the language divide between any species”. 

But what does this mean for physicians and for patients? Why does FHIR matter?

Currently many physicians, particularly specialists, have to access multiple electronic systems to see relevant investigations for a patient. This can be even more challenging if they provide services in outpatient clinics that are not integrated with the local hospital information system. As a result of FHIR, we may see apps that unify or integrate pieces of data from systems that don’t normally share information. 

Similarly for patients, this may open up opportunities for the creation of new apps (or the enhancement of existing apps) that synthesize and present useful data in a consumable way. For both physicians and patients, FHIR may inspire partnerships with software developers to create novel solutions to clinical challenges and frustrations that only existed due to poor exchange of information between incompatible systems.

As with the introduction of any new technology, the risk of excessive “hype” is always a possibility for FHIR. Taking that into consideration, this new data standard appears to have a lot of promise, and should be on the radar of all clinicians in the years to come. I have a feeling that this FHIR will burn bright, well into 2017 and beyond. (Sorry - an article on FHIR wouldn’t be complete without a requisite pun).

Interested in learning more about the development of FHIR implementations in Canada? Read FHIR's Here, Get Cooking and learn more about the FHIR Implementations Working Group.


Dr. Rashaad Bhyat is a Physician Leader in the Clinical Adoption group at Canada Health Infoway. He is a family physician with a special interest in Digital Health. He currently practices in an EMR-enabled family practice in the Greater Toronto Area.

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