We Didn’t Start the FHIR…

With sincere apologies to Billy Joel, the title for this blog is actually very accurate. We didn’t start the FHIR. Modern interoperability is all about standing on the shoulders of giants and the work that comes before you. And that is what FHIR does – it takes many good things that have impacted healthcare interoperability in a positive manner and modernizes the concepts from a transactional and infrastructure standpoint, and from a content standpoint, to enable interoperability to achieve better scalability. You can read how CommonWell has enabled use of the FHIR standard within the CommonWell services in Andrew Wright’s, Change Healthcare, blog post.

Why did we at Brightree embrace FHIR for our connectivity with CommonWell and other portions of our interoperability solutions sets? We are writing today to help folks understand how we view FHIR fitting into the post-acute interoperability world and our interoperability commitment.

FHIR, or Fast Healthcare Interoperability Resources, has gained much attention in the past several years. Emerging out of HL7 and put to practical use by such initiatives as the Argonaut Project, FHIR is certainly a hot and emerging technology. But what does it do in practical terms? Why should clinicians and healthcare organizations care?

In short, what FHIR enables is innovation and scalability. While there have been multiple innovation and evolutionary steps on the road to more widespread interoperability, FHIR helps grease the skids in a few key areas.

First, it is a more simple approach to technology behind interoperability. Instead of needing massive infrastructure and heavy-coded integration engines, FHIR enables vendors with modern infrastructure to connect more quickly and seamlessly. Built for a web-based world, it allows developers to quickly connect and solve interoperability problems.

FHIR also enables scalability. By embracing modern architecture, FHIR allows technical connections to scale across networks more readily. Scalability lowers cost and improves speed to implementation. This means you can impact your patient’s lives and your organization’s operations more rapidly than you would have been able to with the last few generations of technical approaches to interoperability. Speed to implementation should also serve to drive cost out of connectivity. As we all know, post-acute care has a lot of catching up to do to deliver connectivity to the rest of the care continuum and FHIR will help us enable this for our providers.

And last but not least, FHIR enables us in the Health IT world to innovate more readily. Because it is a modern architecture solution, and because it scales well, the next generation of disruptive technologies and applications can utilize FHIR to bring their solutions to market faster, and with greater impact.

We chose to embrace FHIR for our connections to CommonWell (and for some of our external APIs) for these reasons. Does FHIR solve for every interoperability challenge? No, not in and of itself. You still need to solve for other historic, patient-centric challenges such as patient identity across domains, record locator services, security and governance models, etc. (Hello CommonWell network!!) to reap the benefits and have data truly follow a patient, but FHIR does a wonderful job lifting a lot of the technical challenges and allowing us to focus on addressing other issues that have hindered interoperability in the past.

We didn’t start the FHIR, but we are thrilled to leverage its capabilities and proud to display it in partnership with the other CommonWell members at the Nationwide Care Transitions HIMSS Interoperability Showcase in March.

About the Author
Nick Knowlton is the vice president of strategic initiatives for Brightree, a CommonWell Contributor Member since 2014.

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