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Interoperability: What is FHIR? - Part 1 in a series
Jun 02, 2021
As we all continue preparations for the upcoming Cures Act deadlines, we at IQVIA would be remiss if we didn’t talk to you about Fast Healthcare Interoperability Resources — also known as FHIR. For many in the industry, FHIR standards and their underlying technologies are relatively new, so let’s walk through what they are.
What is FHIR?
Approximately six years ago, the healthcare industry collectively realized that exchanging health information was a considerable challenge, due in large part to the technology available to make those exchanges. To date, there are two predominate technology standards in the industry: HL7 and X12.1 HL7 has been leading most standards around clinical healthcare data for nearly two decades, while X12 has focused more on payer-based administrative transactions.
Experts from across the healthcare industry knew that the healthcare information exchange process needed to be updated by utilizing more modern application technology, and that new methods and standards were needed to truly achieve healthcare information interoperability.
So, the HL7 organization developed FHIR as the new set of standards for the digital exchange of healthcare information via modern technology. The technology is based on newer Representational State Transfer (REST) designs that use HTTP to enable applications to exchange information. For example, two applications that utilize these RESTful technologies adhere to the HL7-defined standards to create a “payload of healthcare data” that’s contained within the messages sent from one application to another. This “payload” helps both applications communicate the data to one another and makes it easier for the recipient application to organize and manage said data.
While this could be new information to you, HL7 is now on their fourth iteration of the standards used to define the content that should be contained within the application-to-application messages. The organization went on to further define various forms of healthcare interactions so that the information sent was more refined and easily identifiable. For example, if a provider is exchanging pharmacy and prescription data with another provider, it’s defined specifically as a “pharmacy/prescription transaction,” offering the users’ a more optimized, efficient, and specialized exchange capability.
Although the list of transaction types is extensive and makes it easier to organize datasets, healthcare information exchange continues to be a challenge within the industry. This leaves patients, providers, and payers at a distinct disadvantage when it comes to the management of their care, the care plans developed for that care, and their overall well-being.
Enter the Cures Act.
When discussing the exchange of data from application to application or organization to organization, you’ll most likely hear about Application Programming Interfaces, otherwise known as APIs. The 21st Century Cures Act stated that healthcare information must be exchanged using standard APIs, and as such, defined the Trusted Exchange Framework and Common Agreement (TEFCA) to establish the governance of these standards. Businesses that support federally funded healthcare services will have to begin using APIs that are based on the FHIR standards.
Although the Cures Act has not yet defined a date by which organizations need to adhere to and apply FHIR standards to their healthcare data exchange processes, our IQVIA experts acknowledge the importance of these new standards and encourage our customers to begin preparing for these mandates as soon as possible.
In our next blog, we’ll talk about how you can navigate the complexities of such a task — and how IQVIA can help.
1 HL7 "Health Level Seven" refers to the seventh level of the International Organization for Standardization (ISO) seven-layer communications model for Open Systems Interconnection (OSI) - the application level. The application level interfaces directly to and performs common application services for the application processes. Although other protocols have largely superseded it, the OSI model remains valuable as a place to begin the study of network architecture. Website: HL7.org
X12 defines and maintains transaction sets that establish the data content exchanged for specific business purposes. Transaction sets are identified by a numeric identifier and a name. Each transaction set is maintained by a subcommittee operating within X12’s Accredited Standards Committee. Website: X12.org
Catch up on the Cures Act
Are you ready for July 1, 2021?