Turning HYPE into VALUE -- DISCUSSION THREAD

Hey David -- I think you've raised a number of really good points! As a first, most obvious observation -- I completely agree with you... the whole purpose of this blog post is to "reach out proactively to the industry beyond current committee members".

One place where I'd differ with you, though, is the degree to which FHIR is solving new problems that didn't exist before. That's perhaps true if we consider the rise of apps -- but this doesn't (in my view, at least) obviate the need to connect the digital health solutions that operationalize day-to-day care continuity (EMRs, EPRs, lab systems, pharmacy systems, DI, and the shared registries and repositories that help them interoperate). FHIR has a role to play in this, too -- today, and on into the future as the spec grows and matures. In fact, I'd argue that the true innovation is that, with FHIR, easy things are easy. (This is different from CDA over XDS, in my experience, where even easy things can be hard).

I hope you'll agree: FHIR's current market hype is not our friend. It sometimes seems the key lesson we will all have to learn, again, is that hard things are still hard. They're hard because ecosystem-wide interoperability is more of a sociotechnical problem than a technical problem. Interoperability at scale relies on consistent digital health behaviour across a whole array of disparate systems -- and the governance and operationalization of this is beyond the scope of an over-the-wire message protocol... even a really clever one.

David -- I sure hope you can attend the webinar next week. Yours is a seasoned and experienced voice that I'd love to hear in the call's Q&A. We've got a really important job to succeed at, here; this time (unlike last time), we need to turn the technology hype into actual health value.

This is an interesting blog entry. To date, IHE ITI and other Domain have mostly focused on creating Implementation Guides for using FHIR with existing Document Sharing or other established profiles. These are needed as there are many DS implementations world-wide. DS and other profiles needed to be updated to handle the FHIR resource calls and requirements

However, the FHIR community, both within and without HL7, have created IGs for many other areas that don't rely on DS or other IHE profiles but can work with them. FHIR is exciting to many in the industry because it's easy to use without need of working through the many pages of profile documentation.

IHE has a big image problem in that for the past few years, it has extended past work, rather than creating new solutions to modern problems. While extensions of past work are helpful, this doesn't bring IHE into the light as a standards organization. ITI, PCC and others need to look past small improvements and see what the big issues are for the next 10 years, now that the current problems are in hand.

FHIR has a great ability to handle many future problems because they have let go of the past limits created by HL7v2, V3 messaging and other needs. IHE needs to see where FHIR is going and what problems may arise. This means reaching out past the current community into the industry and seeing what problems they foresee, rather than waiting for use cases to be dropped on their doorstep. Document Sharing was a response to a very specific need that revolutionized the HealthCare IT industry. While that kind of revolution may not be possible again, waiting for someone else to bring it to IHE instead of the HL7 FHIR teams is a shortcut to obsolescence.

IHE needs to reach out proactively to the industry beyond current committee members into those industry players that may not be even aware that IHE exists. That's how they're going to find out what needs to be done and attract people who will appreciate the expertise that the Domain Committees have available.

I recently posted a blog entry on the Infoway site. Hopefully... it's a bit provocative.
Let's use this thread to start a discussion on the timely topic of IHE's role in a digital health market that seems to have caught on FHIR.
Comments welcome!!