Posted in Standards

FHIR shows real promise, but older interoperability standards aren't going away yet

Chris Nerney
Chris Nerney, Contributing Writer |
FHIR shows real promise, but older interoperability standards aren't going away yet

Fast Healthcare Interoperability Resources, or FHIR, is an interoperability standard developed by HL7 that offers great promise for vastly improved clinical information sharing and healthcare innovation.
FHIR was a hot topic at the HIMSS17 conference earlier this year, with a number of technology vendors claiming to fully embrace the open API. But as Healthcare IT News Editor Mike Miliard points out, FHIR “isn't going to supplant existing HL7 standards such as Version 2 and CDA any time soon.”
Miliard recently spoke with HL7 board member Russell Leftwich, MD, senior clinical advisor of interoperability at InterSystems and co-chair of both HL7's Learning Health Systems Workgroup and its Clinical Interoperability Council, about the current and future role of FHIR in healthcare.
Leftwich tells Miliard that FHIR will liberate healthcare data sharing from the “technology of a previous era.”
“It will be the preferred technology for new development, particularly when it involves accessing data across many servers,” he says. “Interoperability in the '80s, when those standards were first developed, meant connecting two systems together. And then we managed to extend those standards to connect one system to multiple systems. But the reality of today is that there's data across many systems, for an individual or a population.”
However, Leftwich says, FHIR’s liberation of healthcare data from the constraints of legacy technologies will occur gradually.
“It definitely will coexist for the foreseeable future,” he says. “There is no compelling economic argument to replace the uncounted billions of dollars’ worth of existing systems that use existing standards and do what they do perfectly well with them.”
While “the change in technology is such that you probably couldn't retrofit most of those systems with FHIR,” Leftwich says, “what will happen, I think, is that FHIR will serve as a translation layer, as is the case with the InterSystems health informatics platform.”
For providers, that means developing a transition strategy that includes operating in a hybrid environment.
“You're certainly not going to replace or abandon your existing system; the average hospital today has in excess of 80 systems within their walls,” Leftwich says. “But you want to be able to get that data and aggregate it with data that comes in other forms and from other systems – some of it in FHIR, some of it in existing standards.”
Read the full interview with Leftwich.