Steps to HL7® FHIR® Interoperability for Performant Data Exchange

By Justin Kaltenbach
Founder, Outcome Healthcare

FHIR® is about Improved Data Exchange

The HL7 Fast Healthcare Interoperability Resource (FHIR) standard is driving change to improve data exchange among healthcare stakeholders to improve patient care. Still, questions remain on the best steps to get started. How does HL7 FHIR work with existing content standards such as CDA / CCD and other data, and what does it mean for the future of health data interoperability? How can FHIR® benefit patients and caregivers through streamlined processes and communications? The ability to gain interoperability and data mapping throughout the care continuum provides a pathway forward, and here we’ll discuss ways to adopt best practices.

The FHIR standard has been developed and nurtured by the international HL7 community of IT, users, and leadership seeking to gain complete insight into data assets. FHIR’s ability to create standardization across the complex healthcare data variety provides a way forward, linking and tagging discrete elements.

Outcome Healthcare has experts in interoperability and data mapping, leaning on our 15 years of dedicated service to the healthcare industry. We have developed robust and highly scalable integration components to convert HL7 to FHIR, CDA / CCD to FHIR, and FHIR to CDA / CCD standards. These components run in a highly scalable architecture and can serve thousands of requests per second on moderate hardware. Understanding how to plan for the next steps in your journey to FHIR adoption is critical in developing full interoperability.

Outcome Healthcare FHIR-Ready HIE Architecture Example

Figure 1. Outcome Healthcare FHIR-Ready HIE Architecture Example

FHIR® Defining Information Content and Structure for Reuse

Healthcare organizations collect enormous amounts of data for clinical care every day, and this volume continues to rise year over year. However, challenges arise with how the industry sorts, manages and shares the data securely, slowing care, increasing costs, and making healthcare less efficient.

With the implementation of FHIR®, every piece of data is linked with a unique identifier. A FHIR resource can be an individual packet of information that includes metadata, text, or specific data elements bundled into collections to create clinical documents, like the Consolidated Clinical Document Architecture (C-CDA), the resulting content is more flexible.

Today’s health information exchange and interoperability systems are typically based on documents. While enabling organizations to communicate successfully, this is not a system designed for meaningful care coordination, decision making, or reporting on data analytics.

Moving from the static C-CDA, a standardized document format containing much critical information, a flat-file requires manual effort to show value in other forms.

Defining and structuring complete information is essential, as a document-based exchange isn’t enough to allow a provider to use the information received fully. Using standardized application programming interface (API) standards, FHIR enabled Outcome Healthcare to create applications specific to the healthcare exchanges we serve, moving beyond a document-based environment. Applications such as a Clinical Portal for FHIR, a Clinical Data Repository for FHIR, and an FHIR Data Warehouse can be plugged into a basic EHR operating system, run the FHIR Deduplication application, and feed information directly into the provider workflow.

FHIR® Specifications Are Free to Use with No Restrictions

Adoption of FHIR is building on the knowledge gained from the previous standards used in healthcare, which were customized to the industry and used technologies that were specific to its needs. Now, the industry is creating an EHR-agnostic marketplace for FHIR-ready apps that allow data to flow freely across disparate systems.

ONC engagement with health IT stakeholders created a consensus around a standard format to publish FHIR endpoint lists. This change is great news for providers. With support, these FHIR APIs enable health IT developers to publish FHIR endpoints in a standardized format, supported by the Office of the National Coordinator. As organizations seek to replace antiquated solutions, they can count on new technologies receiving data via an HL7 message or a C-CDA; the participant is given an endpoint and port for a channel in Mirth Connect to send a specific type of message in FHIR.

Preparing Patients and Providers for FHIR® Requires Standardization

Despite not seeing the interactions in IT every day, healthcare is like the other transactional industries in that information must be sent, ingested, mapped, stored, and readied for use when called. FHIR also promises to use the vast wearable devices and monitoring apparatuses we have adopted and add their value to a clinical perspective. Patients and providers benefit the most from FHIR, even if they don’t know it yet.

Here, the healthcare’s newly adopted Internet of Things can not only serve the patient with instant information but connect the patient-generated health data (PGHD) into streamlined provider workflows. This data is still an area new to technologists, and FHIR enables HIEs to create traceable linkages between their EHR and the millions of wearables and sensors needed to report on and monitor good health. The explosion of PGHD demands that this information be useful and integrated into the healthcare record. However, without structure, it cannot provide value to providers if they can’t quickly and easily access the most meaningful content from the data.

Supporting the effort to ingest and standardize data, IT experts can depend on an FHIR-ready Clinical Data Repository, designed with the strength and intelligence of the Google Cloud Healthcare API. Allowing easy and standardized data exchange between healthcare applications and solutions built on Google Cloud, a Clinical Data Repository meets requirements for healthcare data standards such as HL7® FHIR®, HL7® v2, C-CDA, and DICOM®. The Outcome Healthcare Clinical Data Repository built on the Google Cloud Healthcare API provides a fully managed, highly scalable, enterprise-grade development environment for securely building clinical and analytics solutions on Google Cloud. Leveraging cloud APIs also includes additional value-added capabilities, such as automated DICOM and FHIR de-identification, to better prepare data for these solutions.

FHIR® Supports Aggregation and Access for Outcome Analysis

FHIR has the promise to help Health Information Exchange and provider organizations to improve the clinical quality, cost, and care management outcomes that drive more patient-centric care. The guarantees of migrating to FHIR are now showing value, and the support for the data standard can be seen across the care continuum.

FHIR will become the standard for networks that share content from health applications and exchange data. Measuring the value of that exchange is meaningful in determining if internal and external KPIs are met. Outcome Healthcare enables an end-to-end FHIR® API-enabled enterprise data warehouse, combining the plethora of data flowing through an exchange into one cloud-based model. Any combination of structured and unstructured data is captured using consistent APIs and a robust data analytics infrastructure with common open standards. Leveraging FHIR will create a consistent structure for all applications that simplifies data access and interoperability.

As FHIR continues to underpin data sharing, providers and patients will have access to functions within their applications that extend their abilities and control over information. Patient data can now provide access to generate standard or custom reports on data ingested, consumed, and monitored statistics.

Ready Your Teams for FHIR® Migrations

FHIR® is the new industry standard for healthcare information exchange and focuses on patient-centricity and outcomes. Convert and migrate your data using the HL7 FHIR standard to achieve healthcare interoperability and dependable data mapping. With a dedication to ensuring your data mapping, standardization, deduplication, storage, and outcome reporting work in harmony, Outcome Healthcare is proud to work with some of the country’s most forward-thinking HIEs.

FHIR® Means Interoperability

Interoperability is more than a suite of tools, and the FHIR® standard is adaptive and easy to migrate from more complex standards. Now, health data can be shared across HIEs and organizations with results in near real-time, at a lower cost and dependency on FTEs.

Trusted. Simple. Highly Performant. Outcome Healthcare provides trusted HIE and standards migration technology and services that enable the secure transfer of health information and are easy to install. Our solutions deploy and manage data better to deliver up to 50% faster processing times than previous solutions.

Talk to Outcome Healthcare today about your Health Information Exchange conversion to FHIR® and how to ensure the most significant value from your IT time and resource investments. Reach an expert at [email protected]