HL7 releases FHIR 4

Fast Healthcare Interoperability Resources is now normative, and the new edition brings thousands of other updates.
By Tom Sullivan
11:47 AM

Health Level Seven announced on Wednesday that a new version of its interoperability specification is now available.


Many in the healthcare industry have been eagerly awaiting the fourth iteration of FHIR 4 because future changes will now be backward compatible.

"Applications that implement the normative parts of R4 no longer risk being non-conformant to the standard," said FHIR Product Director Grahame Grieve on the FHIR blog.

Grieve also noted that in addition of the base platform several key piece of FHIR are also now normative, including the RESTful API, the XML and JSON formats, the terminology layer, the conformance framework as well as Patient and Observation resources.


FHIR and open APIs are widely considered to be critical to making health data more interoperable. The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT have both said as much. When Apple launched its Health Records a year ago, it incorporated FHIR – and nearly 150 hospitals have signed on to support the tool.

At the same time, EHR makers such as Allscripts, athenahealth, Cerner, eClinicalWorks, Epic and Meditech have developer programs that use FHIR and open APIs to enable third-parties to write software that uses their electronic health record platforms. (The 21st Century Cures Act requires certified EHRs to have open APIs.)

Some of those developers have been calling for a single version of FHIR and while R4 does not solve that entirely, it is a step in the right direction.


"R4 is the culmination of 18 months of extensive work to finalize the base parts of the specification, and incorporate changes and enhancement requests received from implementation partners across the world," said Grieve.

Twitter: @SullyHIT
Email the writer: tom.sullivan@himssmedia.com

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