A Complete Checklist on How to Implement FHIR

Key Takeaways

• A Restful resource ensures data access through an endpoint, by using specific structures and formats. FHIR uses REST as the base for data exchange in its API.
• FHIR implementation can help to link EHR and wearables such as blood glucose monitors, diet apps, Bluetooth scales, and fitness trackers. Apps built on FHIR API can help to analyze this patient data for further care and treatment.
• The right FHIR implementation helps to simplify data exchange and tasks related to it. HL7 FHIR has undergone four major evolutions and has grown from 49 Resources to 145, and continues to expand.

FHIR (Fast Healthcare Interoperability Resources) is a standard that was created by the HL7 and it determines how health information can be exchanged between systems. It ensures that all healthcare data is accessible and available over a secure network. Additionally, there is widespread adoption of API-enabled FHIR. In 2019, around 84 percent of the hospitals adopted and implemented API technology enabled with FHIR. Unlike the previous standard HL7, FHIR is made especially for web applications and it uses resources such as JSON, XML, OAuth, and AToM structures. This helps to improve the interoperability of healthcare data.

Critical Checklist on How to Implement FHIR

1. FHIR Restful API

HL7 FHIR consists of specifications for APIs, based on modern information exchange and web standards. Several applications that run on web browsers and mobile use REST (Representational State Transfer), which is an information exchange standard. It is a way of exchanging information by using WWW standard transfer protocol HTTP.

The exchange of data by using REST is named Restful. A Restful resource uses specific structures and formats to ensure data access through an endpoint. FHIR uses REST as the base for data exchange in its API.

Furthermore, healthcare data such as medications, patients’ personal information, or treatment observations fall under resources. These resources can be requested through a RESTful HTTP command. FHIR APIs can be grouped with third-party applications, integrated into EHR, and fed directly into the healthcare providers’ workflow.

Apart from this, APIs give users more power, for example with a REST API, users can build a ‘new interface’ and they become active participants. Also, REST APIs offer tools to interact with data sources. It enables interactions with HTTP methods such as POST, DELETE, and PUT.

2. Ensure Interoperability

The volume of patient-generated data is constantly rising, mainly through wearables. So, it would be meaningless if this data isn’t put to good use by healthcare providers. FHIR implementation can help to link EHR and wearables such as blood glucose monitors, diet apps, Bluetooth scales, and fitness trackers.

Apps built on the FHIR platform can be used to analyze patient-generated data and present a summary related to patient wellness, chronic disease management, etc. Further, patients with multiple healthcare providers no longer have to worry about having three to four different portals.

FHIR implementation can ensure that all data is integrated to deliver a comprehensive view of allergies, problems, medications, etc. Apart from this, FHIR’s inclusion in the 21st Century Cures Act encourages providers and HeathTech companies to access data using third-party APIs and apps.

3. Choose a Suitable FHIR Version

Technology is continuously evolving and newer advanced versions of FHIR are coming up in the market. So, it’s necessary to decide which one suits you best. The right FHIR implementation helps to simplify data exchange and tasks related to it. Healthcare providers can easily gain access to patient data for giving care and treatment.

Further, the right FHIR version reduces risks associated with the systems such as data errors, application downtime, bugs in software, and glitches in system operations. These aspects decrease the productivity of healthcare facilities, hence choosing the right FHIR for implementation is vital.

To date, HL7 FHIR has undergone four major evolutions and has grown from 49 Resources to 145, and continues to expand. In 2019, FHIR Release 4 was introduced. Along with it, patient and observation and two key clinical resources were released as normative. Additionally, RESTful API, JSON, and XML formats, and nine additional resources were released too.

The FHIR Release 5 will be introduced soon. It will have massive normative content and over 30 Resources. The HL7 will continue to develop supportive specifications for FHIR such as CDS Hooks (Clinical Decision Support), SMART, and bulk data transfer specification.

Barriers to FHIR Implementation

Healthcare facilities are still struggling from the impact of the Covid-19 pandemic, which resulted in staffing shortages, and compliance. Managing these aspects is likely to stall FHIR implementation. However, if facilities undergo structural changes to handle data exchange, FHIR can be implemented more quickly.

Additionally, security is another barrier for FHIR as there are concerns that patient data can be exposed to unauthorized parties while using FHIR APIs. So, it is necessary to take measures to counter these concerns. Some of them could be incorporating limited authorization for patient data, installing firewalls around data systems, and transferring encrypted data between providers and patients.

As per an article published in HealthTech, the cost is another barrier to FHIR API implementation. Investment is required for building infrastructure to support security measures such as data encryption. The article also highlights that there is a huge cost associated with data sharing. Healthcare systems have been trying to reduce costs and manage data exchange and storage.

Any healthcare technology built with FHIR standards can work with any EHR database. As a result, healthcare technology becomes interchangeable, allowing patients and providers to access data on apps that best suit them, rather than those that work with the EHR system they use.

Arkenea offers interoperable EHR/EMR software for your healthcare organizations. It is created with a focus to work seamlessly with practice management solutions that your facility uses. To know more, get in touch with Arkenea.