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Interoperability on FHIR

Posted on October 6, 2020 by Joel Francis

Doctor sitting at deskWhether you’re a physician sending diagnostic imaging across the country or a patient checking lab results on a smartphone, it’s essential that different health information systems and devices can talk to each other. This mutually intelligible flow of information between systems is interoperability, and it is essential to effective digital health, especially in Canada, where different provinces and territories look after their own systems.

One of our main tools for achieving interoperability is FHIR®. FHIR (Fast Healthcare Interoperability Resources) is the latest standard from HL7® that combines the best aspects of HL7’s v2, v3 and Clinical Document Architecture (CDA) specifications and is built on the underlying web stack. FHIR is a free-to-share and free-to-use specification under the Creative Commons license.

FHIR elements are modular building blocks that — when assembled collectively — solve real world clinical and administrative use-cases. On the clinical side, they enable solutions such as remote patient monitoring on a patient’s personal device. In administration, a common use-case is pre-populating forms — cutting down on administrative burden and transcription errors.

At its heart, FHIR focuses on doing, rather than modelling; its flexibility and design principles prioritize standardization via implementation. As a result, there has been a high international uptake of FHIR in recent years. In Canada, the Canadian FHIR Registry sponsored by Canada Health Infoway serves as the pan-Canadian showcase for all FHIR-related projects, promoting sharing and re-use of artifacts.

Of course, interoperability doesn’t just affect health care providers. It’s essential for patients, too. In March 2020, the Office of the National Coordinator for Health Information Technology (ONC) in the U.S. rolled out the Final Rule of the 21st Century Cures Act. It aims to ensure that patients can access their health information, and it primarily concentrates on interoperability and information blocking (i.e., with some specific exceptions, the Final Rule prohibits health information practices that interfere with/discourage the sharing of data).

Facilitating patients’ access to their health information through their device of choice helps empower them to manage their care. To implement the Final Rule, the ONC proposed to adopt the HL7 FHIR standard as a foundational standard and ultimately adopted FHIR Release 4.

Fired up about FHIR and looking to learn more? FHIR North is the only Canadian conference focused on building awareness, knowledge and experience around HL7 FHIR in Canada. It was established in 2014 by Mohawk MEDICGevitySmile CDR and Canada Health Infoway. FHIR North is also recognized by Digital Health Canada as an official source of educational and training programs; attendees can earn Continuing Education (CE) hours to be used towards CPHIMS-CA certification renewal.

FHIR North 2020 will take place virtually on October 14 and 15. This year’s theme is “FHIR Without Borders: Accelerating Change During a Global Pandemic.” If you would like to be a speaker, learn more about FHIR, or network with individuals looking to ensure the best outcomes for patients in Canada and around the world, please join the conference by visiting FHIR North 2020.


Joel Francis

Joel Francis is a certified HL7 Proficient FHIR subject matter expert who influences and advises Infoway's jurisdictional representatives on the creation of semantically interoperable APIs. He has extensive experience in software development and architecture having worked on many Java Enterprise implementations. He is also a certified IBM MobileFirst application developer with experience in building hybrid and Android applications.

*originally published on October 6, 2020.

Interested in continuing the discussion? Learn more and take part in the FHIR Implementations Working Group to share your experience with interoperable data in EHR systems.

The FHIR Implementations Working Group has five different workstreams that meet monthly, all with the objective to develop pan-Canadian approaches to constraining and extending FHIR. Join the FHIR Working Group to learn, share and collaborate, whether you are new to FHIR or are already have deep FHIR experience.

Do you have an idea or question that you want to share with this diverse range of professionals? Post it in the FHIR Implementations Working Group forum and get the conversation started.

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