FHIR

Full Title or Meme

FHIR (Fast Health Interoperability Resources) is designed to enable information exchange to support the provision of healthcare in a wide variety of settings.

• Pronounced "fire" it is primarily a data formatting and semantic set of standards.

Context

• Health Level Seven (HL7®) International standards body HL7 FHIR and their wiki
• Integrating the Healthcare Enterprise (IHE) wiki on Security
• HNS Digital GP Connect 1.2.0 on github FHIR standard for trial use (3) STU3
• FHIR can be encoded in several formats, only json and xml seems to be in current consideration, but a jsonLD version has been published.
• IHE Audit Trail and Node Authentication
• Trust Label is a discoverable and computable set of metadata to convey asserted trust attributes of an exchange partner.

Problems

• Current document exchange is focused on XDS or similar and the bulk of data is image data. There is little impetus to move quickly the HL7 FHIR.
• Healthcare data for patients has been stored on desperate networks that could not interchange data which left patients without a permanent health record as the moved across the states.

Solutions

• Privacy Consent Framework

  The Privacy Consent on FHIR (PCF) Profile provides support for patient privacy consents and access control where a FHIR API is used to access Document Sharing Health Information Exchanges. This profile includes both Consent profiling and access controls profiling of oAuth access token. Uses IUA from OAuth rev 2.2 (2022-06-17).

• Cross-Community Patient Discovery (XCPD) Health Data Locator and Revoke Option - Rev. 3.1 Trial Implementation (2023-05-04)

  The Cross-Community Patient Discovery (XCPD) Health Data Locator and Revoke Option Supplement enhances the existing IHE XCPD Integration Profile by adding two new capabilities. The first is the ability to exchange a list of health data locations, which enables Record Locator Services to interoperate with consumers wishing to discover the location of patient records within a health information exchange. The second is the ability to revoke a previously exchanged patient ID correlation, which is used in the case where patients in different health information communities were linked with XCPD, but must now be unlinked due to some circumstance such as patient merge. This update is an editorial enhancement to the existing supplement which improves the layout of the standard by separating the Revoke interaction into a separate, isolated transaction. There are no functional changes in this update. Health IT Vendors should review this supplement and determine if the capabilities within meet their interoperability needs.

• A FHIR Sandbox for InterSystems is now operational. https://www.healthit.gov/techlab/ipg/node/4/submission/2231
• A jsonLD implementation can be found here https://github.com/fhircat/fhircat/wiki

References

• FHIR, SMAT, CDS Hooks overview A good YouTube presentation from Josh Mandel to get started.