FHIR

FHIR, which stands for Fast Healthcare Interoperability Resources, is a standard for exchanging healthcare information electronically. It was developed by Health Level Seven International (HL7), a not-for-profit standards organization accredited by the American National Standards Institute (ANSI).

History

The development of FHIR began in 2011 when HL7 recognized the need for a more flexible, developer-friendly standard to facilitate the exchange of healthcare data. Here's a brief timeline:

• 2011: HL7 started the FHIR project, aiming to create a new standard that would be easier to implement, more flexible, and web-friendly compared to existing standards like HL7 v2, HL7 v3, and CDA.
• 2012: The first draft standard for trial use (DSTU) was released for public review.
• 2014: FHIR DSTU2 was released, introducing more resources and improving upon the initial framework.
• 2016: FHIR DSTU3 was published, which included significant enhancements and was adopted by several major healthcare IT systems.
• 2019: FHIR became a normative standard with the release of FHIR Release 4 (R4), marking its maturity and stability for broader adoption.

Core Concepts

FHIR is designed around the following key principles:

• Resource-based Architecture: Everything in FHIR is a resource, which is a modular component representing a healthcare concept like Patient, Observation, or Medication.
• Web-Based: FHIR uses standard web technologies like RESTful APIs, JSON, and XML for data exchange, making it accessible to web developers.
• Support for Multiple Serialization Formats: FHIR supports JSON, XML, and RDF for data representation, allowing flexibility in implementation.
• Extensibility: FHIR allows for extensions to accommodate local needs or variations in how data might be used or interpreted.
• Modular Design: The standard is broken into independent modules or resources, which can be combined in various ways to meet different use cases.

Benefits of FHIR

• Interoperability: FHIR aims to solve the interoperability issues in healthcare by providing a common format for data exchange.
• Usability: It is designed to be user-friendly for developers, reducing the learning curve and implementation costs.
• Scalability: The modular nature allows for incremental implementation and scaling as needed.
• Mobile Health: FHIR's RESTful API design makes it particularly suitable for mobile and web applications.

Implementation and Adoption

FHIR has been adopted by various organizations globally for different purposes:

• It's used in Electronic Health Records (EHRs), clinical decision support systems, and public health systems.
• The Office of the National Coordinator for Health IT in the U.S. has pushed for its adoption through regulations like the 21st Century Cures Act.
• International organizations like the World Health Organization (WHO) have also recognized FHIR as a standard for global health data exchange.

For more detailed information on FHIR, refer to:

• HL7 FHIR Official Website
• HealthIT.gov on FHIR
• PubMed Central Article on FHIR Adoption

Related Topics

• HL7 v2
• Clinical Document Architecture
• SMART on FHIR
• DICOM