Interoperability's 'game-changer'

'Not only is it easy to use and is fast to develop and implement, but it's also inordinately flexible.'
By Bernie Monegain
10:09 AM
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Charles Jaffe, MD

Charles Jaffe, MD, CEO of standards organization HL7, came away from the joint meeting of the federal Health IT Policy and Health IT Standards committees earlier this week, thinking that the industry could move faster on interoperability. And HL7 has just the thing to change the game.

"I don't try to denigrate the success; I try to celebrate it," he told Healthcare IT News.

He blames a stuck-in-the-past approach for the slow pace of progress.

"We embrace a lot of technology that is technology for the past and ways of doing things that were important in the past rather than understanding the ideas that fundamentally change the way we achieve interoperability."

[See also:Interoperability in 'bi-plane phase'.]

Top of mind for effecting that change is HL7's FHIR, he says. The acronym stands for Fast Healthcare Interoperability Resources. Pronounce it "fire."

According to HL7's official description, "FHIR combines the best features of HL7’s Version 2, Version 3 and CDA product lines while leveraging the latest Web standards and applying a tight focus on implementability."

As Jaffe puts it, "FHIR represents a departure from the notion of messaging and document-centric ideas."

"FHIR is such a significant advance in accessing data, delivering data and the enormous, enormous flexibility inherent in the model," he adds. FHIR doesn't specify the content; FHIR specifies what we mean by the content."

He describes FHIR as a platform and a set of rules.

"If you want to use it for consumer or patient-centric information delivery, or you want to use it for a novel idea about wellness, you can. It doesn't limit you the way messaging does. Moreover when you want to query a system, you don't have to have a registry. FHIR allows you to query systems that have FHIR capability independent of registries. Not only is it easy to use and is fast to develop and implement, but it's also inordinately flexible."

At the Oct. 15 meeting of the Health IT Policy and Health IT Standards Committee, Jaffe observed that some of the more technology savvy members were articulate and enthusiastic about FHIR. Those with little technical background, though, may have found it a hard concept to grasp.

FHIR is offered free by HL7. There is no charge for the license and users are not required to be HL7 members. FHIR is a draft standard today, with plans for HL7 to make it a normative standard by some time in 2016.

"As we move forward the government should say – or various branches of government – should say, "FHIR is where we're going."

Come 2016, "when FHIR has been rigorously tested through several iterations of draft standards, then we'll have new opportunities in interoperability that we never could achieve through the conventional tool set that we have," Jaffe says.

[See also: 'Actionable' steps to interoperability.]

FHIR is being adopted all over the world as a draft standard, he notes. "What we do in the United States should be exemplary, but I don't know if it will be. What I am certain of is that draft standard or not, there are FHIR developer meetings and FHIR implementation conferences around the world in places we never could have imagined because it is so inherently easy to develop and implement.

"The interface development when we had V.2 and the enormous heavy lifting for V 6, it doesn't exist for FHIR because all you have to do is know how to use Web technology. FHIR as a platform is really a powerful notion that potentially can change the game."