“VHS”. “No; Betamax”. “No! VHS”. “No! I said Betamax”! “Idiots!! You’re both idiots! V2000 is the correct format”. And now we need three different types of recorder/players and three different types of tape because the content cannot be played across systems. And… Healthcare systems across the globe have historically suffered from the same lack of standardization, making the sharing of patient data across different platforms agonizingly challenging . The complexities and inefficiencies associated with proprietary systems have long been obstacles for developers and clinicians alike. However, just as digitisation in the realm of video playback took us first to the LD, then the VCD and finally the DVD before arriving at live streaming (oh come on; you know I’m talking about Netflix), with the introduction of FHIR (Fast Healthcare Interoperability Resources), we are beginning to have hopes of a more integrated and seamless healthcare IT ecosystem. So let’s make a pot of tea, put our feet on the table, and slide in a cassette to watch a documentary about  why FHIR is a game-changer for healthcare developers. But which cassette? VHS. No, Betamax; No! V2000. Shucks!! 

What is FHIR?

Motivated by an urgent need felt in the industry to simplify the integration and interoperability of healthcare information systems, Health Level Seven International (HL7) developed Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) as a standard for health data exchange. FHIR provides developers with a set of resources along with an API to represent and exchange digitized health data, making it easier for healthcare providers and developers to work across competing systems.

Why FHIR is Revolutionary:

Modularity and Flexibility: Legacy  standards for health data exchange were monolithic, in that they required the developer to upload the entire data set without any ability to differentiate according to need specifications. In comparison, FHIR is modular and resource-based. Each “resource” is just one small “chunk” of health data, like a patient’s name or a lab result. Developers therefore have the flexibility to choose only the “chunks” they really need for their work, making the development and subsequent adaptation of applications a much of convenient experience. 

Modern Web Standards: FHIR is based on web technologies for data representation and exchange such as JSON, XML and RESTful APIs, with which developers are usually quite familiar and comfortable. Access to tools and libraries they are already familiar with improves the efficiency of the developers, ultimately expediting the development process.

Extensibility: Any data resource that cannot be augmented will very quickly lose its utility and become more of a liability than something to benefit from. In  order to overcome this constraint,  FHIR has been designed to accommodate extensibility. If healthcare providers need to include data not originally included by the standard FHIR resources, the platform allows them to conveniently extend the data set or even create custom resources specific to their requirements.

Interoperability: FHIR has been designed primarily with the intention of  ensuring seamless data exchange across user platforms; a bit like sticking a V2000 tape into a Betamax player and still be able to watch the movie. That’s obviously not possible on physical playback systems, but FHIR achieves this as it is designed around the principles of robustness and compatibility, ensuring that different systems can communicate with each other without data loss or corruption.

Open and Community-Driven: Three decades ago, Open Source came forward as a revolutionary concept that challenged the hegemony of proprietary software systems. Its greatest strength in all these years has been that it is responsive to the needs of the end-users, who are directly able to contribute to its improvement, as long as they allow those developments to be shared.  In much the same manner, The development and evolution of FHIR is a community-driven activity, where  all stakeholders including developers, clinicians, and others  actively contribute to its constantly ongoing improvement and refinement.

Benefits for Healthcare Developers:

Simplified Development: On the strength of FHIR’s modular approach and adherence to modern web standards, developers can create applications more quickly and efficiently.

Enhanced Data Access: The basic purpose of FHIR is to enable patient data to be seamlessly accessed and shared across different platforms without loss or corruption. Data integrity strengthens the developers in their endeavours to create applications that provide holistic views of patient information.

Greater Innovation: It should come as no surprise, then, that the standardized and open nature of FHIR development encourages innovation. Developers can focus their efforts towards creating unique applications without having to worry about the nuances of data integration.

Reduced Costs: The ease of integration reduces the time and resources needed for development, ultimately leading to cost savings.

Improved Patient Care: With seamless data exchange, clinicians are able to collect information from a diversity of patient related sources, allowing them to   develop a more comprehensive understanding of patient history, and the ability to make  better-informed decisions, thereby enhancing the quality of patient care.

The Road Ahead:

Despite having made significant contributions to  improving healthcare IT, FIHR is still an evolving discipline. As the number of healthcare organizations that are climbing on to the FHIR bandwagon is growing, the increased activity and interest in its capabilities and benefits will spur further development. The future looks promising, and we can expect an explosion of applications offering  enhanced data exchange, interoperability, and innovative healthcare.