Healthcare IT experts believe that clinical interoperability is a clinical practice problem and not an Information Technology or Information Management problem.
There are two aspects to Fast Healthcare Interoperability Resources (FHIR) – it is a technical standard, and also a community. Healthcare integration within institutions traditionally focused on a push-based messaging model – using HL7 messaging standard along with routing and transformation services. Later, a cross-enterprise integration that was based on a shared repository using documents (XDS/CDA) arrived. There is a need to integrate these two separate frameworks. People are increasingly looking for integration. There is a demand for a single framework using a combination of push messages and subscription for institutions and countries to manage their data with more flexibility and build integrated workflows. Every node in that framework must link up with both repositories and messaging – integration spans over time and place.
Experts stress that FHIR is a community as well as a technical standard that is founded on the basis that openness allows for new possibilities that cannot arise in a closed system, and the possibilities can transform health outcomes. This applies to both the standards process, as well as the health data management process. FHIR is also the web, but for healthcare. Everything that the web has achieved in other industries, FHIR can make it happen in healthcare.
It is crucial to understand, however, that FHIR is just a small part of the overall picture. All the technical standards are only helpful only if they are used, which is a cultural or business or the governance decision. As a standard, FHIR is maturing. This standard is increasingly becoming stable and ready for large scale adoption. At the technical level, as per the updates, the work is building out the eco-system and allowing large-scale data extraction for research and analysis. This is helping to stabilize the clinical summary content.
In terms of community, the set of participants is expanding and the focus is shifting to scale the community processes. Many experts are not sure on when FHIR be widely deployed on a large scale, but what they are sure of is that it will grow. In many countries, that pace at which it happens depends on key decisions made because of political or business reasons. This makes it difficult to predict how far the technology and the standards will go in the next 3-5 years.
It will be interesting to see how the healthcare community comes together to understand that clinical interoperability, including the ability to switch teams, patients, and algorithms or AI between different care providers. This will be driven by wider cultural and business considerations that sponsor of the changes that will assume clinical interoperability exists.
Keeping up the optimism, experts believe that the next 3-5 years are expected to be very busy for people working in healthcare interoperability.