A new initiative launched by Health Level Seven International (HL7) and jointly supported by the Centers for Disease Control and Prevention (CDC) and the Office of the National Coordinator for Health IT (ONC) seeks to use widely recognized data exchange standards to help advance public health. The effort, called Helios, intends to strengthen the capacity and streamline data sharing across all levels of public health using the HL7 Fast Healthcare Interoperability (FHIR) standard.
“Public health has risen in urgency and importance over the last 18 months,” said the ONC’s National Coordinator for Health IT Micky Tripathi, Ph.D., M.P.P., “FHIR accelerators have had great success in engaging implementers as early as possible to help identify and overcome longstanding barriers to interoperability. The Helios alliance is a market-based implementation collaboration that will help to ensure FHIR development is coordinated and focused on real world public health needs.”
The initiative is the latest to use HL7’s FHIR Accelerator program, which seeks to speed the development and availability of FHIR to deliver better data that leads to better health outcomes. The Helios alliance represents an ambitious new use of the FHIR Accelerator Program, pulling together a diverse group of state, tribal, local, territorial, and Federal public health agencies, private and philanthropic sector partners, and other groups interested in the equitable and effective use of data for the advancement of public health.
“Helios is expected to become an integral component of the HL7 FHIR Accelerator Program and comprise a cornerstone to the newly announced HL7 Implementation Division,” said Charles Jaffe, M.D., Ph.D., the CEO of Health Level Seven International. “The Helios Public Health Accelerator will provide a critical step toward the direct access to data needed for public health.”
As the FHIR standard matures, there is a clear path to utilize FHIR and other existing standards to execute the interoperable exchange of data for public health. Helios members will help demonstrate the utility of FHIR and ensure public health needs are at the forefront as FHIR-based implementations evolve and rollout nationwide.
As the FHIR standard matures, there is a clear path to utilize FHIR and other existing standards to execute the interoperable exchange of data for public health. Helios members will help demonstrate the utility of FHIR and ensure public health needs are at the forefront as FHIR-based implementations evolve and rollout nationwide.
“Standardizing and automating our data flows will help us accelerate data into action,” said Daniel Jernigan, M.D., M.P.H., CDC’s deputy director for public health science and surveillance. “Organizing in this way will help ensure FHIR-based solutions are integrated, aligned, and are a complement to everything else that’s going on in the public health community.”
Organizers of Helios are encouraging other entities to participate in the effort. More information about Helios and the project’s goals can be found on HL7’s website, www.hl7.org/helios/.
Health Level Seven International (HL7), announces the launch of the HL7 FHIR Accelerator Program. The program is based on a model piloted by the HL7 Argonaut Project and, more recently, the HL7 Da Vinci Project. The goal is to strengthen the FHIR (Fast Healthcare Interoperability Resources) standard and enhance market adoption through a programmatic approach available to myriad stakeholders.
Charles Jaffe, MD, PhD
“HL7 FHIR has achieved remarkable adoption on a global scale,” said Dr. Charles Jaffe, CEO of HL7. “An ever-growing community of implementers has emerged across a broad spectrum of health care, eager to participate in an agile onramp for FHIR adoption and implementation. The HL7 FHIR Accelerator Program provides the framework for that community to leverage the technical capability, management expertise and experience gained during the creation and growth of the Argonaut and Da Vinci Projects.”
Building on the success of current projects – Argonaut (provider-provider and provider-patient) and Da Vinci (payer-provider) – The CARIN Alliance has recently been approved as an HL7 FHIR accelerator project (payer-patient). The three projects are complementary initiatives.
“On behalf of the CARIN Alliance, its board and membership, we are grateful for the opportunity to work more closely with HL7 as part of the FHIR Accelerator Program as we work to develop additional FHIR implementation guides so consumers can get access to more of their health information,” said Ryan Howells, CARIN Alliance Project Manager and Principal at Leavitt Partners. “Consumers and their authorized caregivers are requesting more access to health care data with less friction to empower them to become more informed, shared decision-makers in the care they receive.”
The original concept behind accelerating HL7 FHIR began approximately four years ago with the advent of the Argonaut Project.
Health Level Seven International (HL7), the global authority for interoperability in healthcare information technology with affiliates in 35 countries, announced that it has published release 4 of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard. This new version is the culmination of 18 months of extensive work to finalize the base parts of the specification and incorporates changes and enhancement requests received from implementation partners around the world.
HL7 FHIR is a standards framework that leverages the latest web standards and applies a tight focus on implementation. FHIR includes a RESTful API, which is an approach based on modern internet conventions and widely used in other industries. The standard represents a significant advance in accessing and delivering data while offering enormous flexibility and ease of development. For patients and providers, its versatility can be applied to mobile devices, web-based applications, cloud communications and EHR data-sharing using modular components. FHIR is already widely used in hundreds of applications across the globe for the benefit of providers, patients and payers.
The most significant change in HL7 FHIR Release 4 (R4) is that the base platform of the standard has passed a normative ballot and will be submitted to the American National Standards Institute (ANSI) as a normative standard. This means that future changes should be backward compatible so applications that implement the normative sections of R4 no longer risk being nonconformant to the standard. The following portions of the standard are now normative:
The RESTful API, the XML and JSON formats, and the basic datatypes
The Terminology Layer (CodeSystem and ValueSet)
The Conformance Framework (StructureDefinition and CapabilityStatement)
The key resources Patient and Observation
Thousands of other R4 updates and changes have been made in response to implementation experience and quality review processes.
Guest post by Joanna Gorovoy, senior director product and solutions marketing, Axway.
Joanna Gorovoy, MBA
The healthcare industry is in the midst of digital transformation. At the same time, heightened government regulation, evolving healthcare policies and a rise in healthcare consumerism are driving a shift toward value-based, outcome-driven care models.
The focus on maximizing value and outcomes requires organizations across the healthcare ecosystem to work together, especially across a variety of different, and often unaffiliated organizations, including hospitals, health insurance companies, pharmacies and wearable health tech companies. Additionally, data silos and interoperability issues make it difficult to derive value from health data across ecosystems, provide quality patient care and optimize health outcomes.
Healthcare IT leaders in today’s digital era face a great opportunity and a daunting challenge: deriving value from massive volumes of healthcare data while meeting heightened demands for data privacy and security. In 2016 alone there were 106 major healthcare data breaches, exposing 13.5 million individuals’ records. As healthcare data breaches continue to rise in numbers, healthcare IT leaders must reevaluate how they approach key initiatives across patient engagement, population health management and care coordination.
They need to provide secure and innovative digital experiences by implementing application program interfaces (APIs), which are a set of routines, protocols and tools for building software applications, and increase awareness of industry standards, such as Health Level Seven International’s (HL7) Fast Healthcare Interoperability Resources (FHIR). Doing these two things will provide assistance in addressing interoperability issues and simplify the exchange of health information across the ecosystem.
But it doesn’t stop there. Moving toward a future where healthcare data is more widely accessible will require greater security management across all organizations that have access to patient data. To create a more secure and scalable foundation for digital innovation in healthcare you must follow these three steps:
For decades, the use of paper medical records was the “norm” and the sharing of those records with another provider typically involved a photocopier and a briefcase for the patient to carry them to the next doctor. Today, electronic medical records are becoming the standard, but the exchange of health data between disparate networks and software systems has remained elusive.
While some data exchange is taking place in health care today, it’s only occurring in isolated pockets, typically within one region or health system, making it largely ineffective. Solving this challenge requires transparency, collaboration and innovation for continued success–attributes CommonWell Health Alliance embodies.
Transparency across the Industry
Competition in almost every sector thrives on keeping information separate and technologies proprietary. However, for many industries – like banking, telecom and internet, working across competitor lines to exchange data has enriched and expanded their reach. Health care needs to take a lesson from these industries.
Working in data silos will not improve the exchange of health data; rather, it will create friction in the industry. Patients expect their doctors to have the information they need to provide them with the best treatment. Doctors struggle to access this important data outside their four walls. The industry has an opportunity to step up and make it possible for providers to access a three-dimensional view of the patient’s health history, and in turn, create a new wave of opportunities for the health IT industry.
Collaboration among Health IT Industry Players
Collaboration throughout the IT industry is essential to creating a ubiquitous nationwide interoperable Health IT Infrastructure. This focus on infrastructure will drive standard adoption and open up the gates to national record sharing. Electronic health record (EHR) vendors offering services across the healthcare continuum are a key piece of this puzzle, which is why CommonWell formed to join forces with all health IT stakeholders dedicated to the vision that patient data should be accessible no matter where care occurs.
Collaboration with the public sector is also crucial. The government plays a strong role in narrowing the technical standards in health IT, but the bar must be raised on leveraging real-world data exchange. Additional ONC activities are complementary to the existing Federal Advisory Committees (FACAs) as noted below:
Bipartisan legislation known as the 21st Century Cures Act—which passed in the U.S. House of Representatives this past July—includes mandates that systems be interoperable by the end of 2017 or face reimbursement penalties.
In early October, the Office of the National Coordinator for Health IT (ONC) released its final draft of “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap.” The three overarching themes of the roadmap including:
Giving consumers the ability to access and share their health data
Ceasing all intentional or inadvertent information blocking
Adopting federally-recognized national interoperability standards.
The ONC has also formed a Health IT Policy Committee and Health IT Standards Committee which each include smaller workgroups that meet to ensure ongoing collaboration among the private and public sector. In fact, many members of CommonWell and other private-sector interoperability initiatives participate and/or lead these committees and workgroups.
Health Level Seven International (HL7), the global authority for interoperability in healthcare information technology with affiliates in 35 countries, announced that it has published release 4 of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard. This new version is the culmination of 18 months of extensive work to finalize the base parts of the specification and incorporates changes and enhancement requests received from implementation partners around the world.
