FHIR, open APIs and the future of healthcare interoperability

Chris Nerney
Chris Nerney, Contributing Writer |
FHIR, open APIs and the future of healthcare interoperability

It’s no secret that the key to healthcare providers being able to share electronic records is interoperability. But interoperability has remained an elusive goal because it’s been extremely difficult to get different vendor electronic health records (EHR) systems to talk to each other.
One potential solution to the interoperability barrier is application programming interfaces (APIs), which are code designed to act as an interpreter working between applications and proprietary software or web services. For example, by making open APIs available, companies such as Facebook and Twitter enable third-party developers to build apps that can communicate and interact with their services and apps.
Similarly, open APIs are viewed as a way to allow medical devices and EHRs to share data across proprietary systems. Fast Healthcare Interoperability Resources (FHIR) is a draft standard created by Health Level Seven International (HL7) that uses data formats and APIs to facilitate medical data sharing.
As promising as APIs and FHIR are to healthcare interoperability, developers need time and experience to learn how to build and integrate APIs with EHRs, medical apps, and medical devices.
Connected-care software and services provider InterSystems recently unveiled a cloud-based FHIR sandbox that offers healthcare applications developers a secure, virtual environment which allows them to test the ability of their apps to access health records from multiple provider systems. By working within the sandbox, developers can safely study FHIR apps code, become familiar with best practices, and create and test their own apps.
Over at Healthcare IT News, Editor Mike Miliard does a deep dive into the current state of open APIs and FHIR in healthcare, touching on their importance to federal healthcare initiatives such as 21st Century Cures and Stage 3 meaningful use.
He also explores the challenges preventing widespread implementation of open APIs, including the lack of familiarity among developers regarding “the complicated details of medical data and clinical workflows.”
Miliard writes: “With a lot of emerging apps, ‘either you're looking at things that don't have medical data, or you're looking at things that just have medical data,’ as Office of the National Coordinator for Health IT chief Don Rucker explained at HIMSS18. ‘You're not looking at things that synthesize knowledge about our environment and our lives and our behaviors with medical data. That is really the opportunity here.’"
Russell Leftwich is senior clinical advisor of interoperability at InterSystems, a board member of HL7, and teaches biomedical informatics at Vanderbilt University School of Medicine. He told attendees at HIMSS18 why FHIR’s previous effort at creating an interoperability standard failed.
"HL7 version 3 kind of fizzled because it broke under its own complexity – you practically had to have a PhD in it to build something simple with it,” he said. “Not that it isn't used some, but it was never going to take off like FHIR did."
And the reason FHIR will avoid that fate, Leftwich said, is because "there are hundreds of thousands of twentysomethings with web development skills who can get the idea of FHIR in a weekend. There are FHIR hackathons where somebody walks in on a Saturday morning and doesn't know anything about it, and on Sunday afternoon they've build a little app."
Click this link to read Miliard’s entire article about open APIs and FHIR.
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