1. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. ONC FHIR status update Lloyd McKenzie June 6, 2013

2. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. FHIR INTRO (Really fast)

3. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Healthcare Standards Complex…. Slow… Hard to use and understand Require specialist skills, tools Costly 3 What if it didn’t have to be like that?

4. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Introducing FHIR Fast Health Interoperability Resources  Pronounced “Fire” Based on industry best practices, with a focus on simplicity and implementability Leverage web technologies Human readability as base level of interoperability One syntax – documents, messages, services, REST  Computable templates/profiles that work in all architectures 4

5. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Resources “Resources” are:  Small logically discrete units of exchange  Defined behaviour and meaning  Known identity / location  Smallest unit of transaction  “of interest” to healthcare  E.g. Patient, Provider, Specimen, Drug, Lab Result, Allergy, Care Plan, Study, Adverse Reaction 5

6. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Resources have 3 parts Defined Structured Data  The logical, common contents of the resource  Mapped to formal definitions/RIM & other formats Extensions  Local requirements, but everyone can use  Published and managed (w/ formal definitions) Narrative  Human readable (fall back) 6

7. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. FHIR STATUS 7

8. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Organizational penetration Broad support from board and TSC Significant uptake within main HL7 Work Groups  Redirecting energy from v3  50 FHIR-related quarters at last WGM Leading effort on enhanced governance processes 8

9. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Ballots First DSTU (Jan 2014 latest)  48 resources in scope 10 Infrastructure 25 for CCDA support 6 for IHE (ATNA, XDS) & DICOM 7 other sources  Significant up-front QA  Will pass after one, possibly two ballots  No guarantee of backward compatibility 9

10. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Ballots Second DSTU (~Jan 2015)  Additional “key” resources Referral, Appointment, Diet, Radiation  Additional domains Financial, Public Health, Clinical Studies, etc.  Resource Profiles  ‘Standard’ extensions? Possibility of 3rd DSTU 10

11. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Ballots Normative ballot not likely until 2016  Want significant (and broad) implementation experience  Promising wire-format compatibility, don’t want the overhead of workarounds for many years  Some resources may not go normative if they haven’t been sufficiently exercised  Will evaluate providing transforms for DSTU Normative depending on need, resources 11

12. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Implementer supports Multiple reference implementations Auto-generated interfaces in 4+ languages Public test servers Automated test tools Draft tooling to convert CCDA -> FHIR Tooling in progress for Profile development/maintenance 12

13. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Implementer experience 3 connectathons so far (30+ implementers)  Increasing attendance, including EMR vendors for first time At least 20 companies/projects looking at/working on FHIR with intention of production use  (Possibly in limited environments)  Significant interface engine interest 13

14. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Long range plans Most resource development complete within 3 years  For some Work Groups, even sooner Focus will change from resource development to:  Profile/extension development & maintenance  Vetting external profiles/extensions  Implementer support 14

15. © 2013 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Follow Up Read the spec: hl7.org/fhirhl7.org/fhir Follow #FHIR on Twitter Implementation questions on stackoverflow  Tag hl7_fhir Shape the specification:  Make comments online (wiki linked to spec)  Try implementing it  Come to the next Connectathon and/or HL7 meeting Sept. in Cambridge Contact me  lloyd@lmckenzie.com 15