As health data interoperability becomes an increasingly pressing concern for providers, developers and vendors are paying a great deal more attention to the data standards that will enable seamless, on-demand information exchange.
What is FHIR?
Fast Healthcare Interoperability Resources (FHIR) is an interoperability standard for the electronic exchange of healthcare information. FHIR was developed by Health Level Seven International (HL7), a not-for-profit organization accredited by the American National Standards Institute that develops and provides frameworks and standards for the sharing, integration, and retrieval of clinical health data and other electronic health information.
Why FHIR is important?
As health IT and electronic health records continued to be plagued by interoperability problems, FHIR emerged in 2014 as a draft standard for trial use to enable health IT developers to more quickly and easily build applications for EHRs and to exchange and retrieve data faster from applications.
While FHIR at first was a somewhat experimental project for HL7, it quickly acquired support from even fiercely competitive for EHR vendors.
How FHIR works and what’s an FHIR resource?
- FHIR frameworks are built around the concept of resources basic units of interoperability and modular components that can be assembled into working systems to try to resolve clinical, administrative and infrastructural problems in healthcare.
- FHIR provides software development resources and tools for administrative concepts such as patients, providers, organizations and devices, as well as a variety of clinical concepts including problems, medications, diagnostics, care plans, and financial issues, among others.
Unlike HL7’s most widely used formal standard (also called HL7), FHIR is designed specifically for the web and provides resources and foundations based on XML, JSON, HTTP, Atom and OAuth structures. Tools can be reused to improve interoperability to retrieve the history of a specific resource or a specific version.
The HL7 organization
HL7 is an international organization with members in more than 50 countries. Leaders of the organization have complained that some bigger members, including vendors and healthcare providers, have failed to adequately support HL7’s standards development work, particularly in regard to FHIR.
HL7 develops new standards using a multiyear balloting system in which members vote and add commentary in successive balloting rounds until negative comments are eliminated, draft standards, draft standards for trial use and formal standards are commonly agreed upon.
FHIR is designed to do great things for health IT. Despite a few limitations around the standard, the benefits it brings will make it a standard that is here to stay. As long as you are aware of what FHIR is built to do and what it isn’t built to do, you will be able to find solutions in the marketplace that compliment FHIR to meet your data and solution needs.
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A common criticism of EMR (electronic medical records) use in medical practices is that it causes doctors to become less engaged and impersonal. This causes frustration for all parties – patients and physicians – because doctors didn’t sign up for computer duty and patients expect a doctor’s full attention during visits.
For example, an EMR allows a physician to track data over time, easily identify which patients are due for preventive screenings and vaccines, and monitor and improve the overall quality of care within the practice. Doctors use specialized software, enabling a patient’s complete history to be available immediately.
EMR Software:
EMR software has made it easier to store large amounts of PHI. When it is stored and transmitted electronically, it is referred to as ePHI. It has also changed the way that doctors are able to access ePHI. EMR software allows doctors to search by specified criteria and cross reference other doctors’ notes from one place.
Software Advice, a website that reviews medical software, recently did a survey on how to improve doctor-patient interactions in the EMR era. They listed the top seven tips received on maintaining quality relationships:
- Position your computer between you and the patient:No brainer here. Face the patient during interactions. Take the time to plan where your equipment will go so that this is possible.
- Smartphone and Tablet Apps: EMR software has other implications. Many doctors are now reporting accessing ePHI through their smart phones and tablets. A new market has emerged for apps related to management of EMR. Recent software developments have made it possible to create a doctor-patient portal in which the doctors and patient can engage in a virtual dialogue and share information without needing to be face to face. This provides care and attention in addition to the scheduled appointments.
- Invest in mobility:Whether it’s a small rolling desk, small tablets or other lightweight tools, choose equipment that helps you move around. A laptop may cost an extra buck but can be worth the investment.
- Transitioning to Virtual Platforms: Some may argue that this could lead to a dependence on technology and a reduction in actual face-to-face time between the doctor and the patient. While it is always important for patients to maintain regularly scheduled appointments with doctors, these developments in EMR software and applications allow doctors to provide care and effort without the constraint of physically being with the patient.
- Ignore the computer when you first enter the room:Chat with your patient for a few minutes before you start recording information in the digital record.
- Ask about previous complaints:If the patient information is pre-loaded, look over it before entering the room. If they have open complaints, ask them about the issues to close them out in the EMR. This reaffirms to the patient that you care.
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