HL7 FHIR Adoption In New Zealand

HL7 AustraliaPlenary WGM Sydney, July 2016

FHIR Adoption in New Zealand

Peter Jordan MSc LLB MCPD

Vice-Chair HL7 New Zealand

• HL7 New Zealand

House Rules

National Health IT Plan 2010

National / Regional / Local

Systems Our Year of the

Portal 2014

Deloitte Report 2015

• HL7 New Zealand

Standards Journey

• Reference Architecture for Interoperability...– Detailed Clinical Modelling – openEHR Archetypes– Clinical Data Repositories - IHE XDS– Exchange – HL7 CDA

• Up and Running…– HL7 v2 messaging (Labs, RSD, Service Fee Claiming, ADT, CDA packages)– HL7 v3 CDA (GP2GP, NZePS, interRAI, Maternity, Ambulatory Care)– Clinical Data Repositories (TestSafe)

• Speed Bumps– Varying, and often non-compliant, v2 implementations– CDA hard to consume and no transport standard– Record Locator Service - slow progress– 100k Users of Patient Portals by March 2016

Then came ...

• HL7 New Zealand

FHIR Roots, New Routes

• 2011 – West Island - Resources for Healthcare

• 2012 – HL7 NZ Chair at FHIR Connectathon #1

• 2013 – Presentation at Health Informatics NZ Conference

• 2014 – HL7 NZ Key Focus

• 2015 - Heath Information Standards Organisation (HISO) endorsed FHIR as an approved HL7 Standard

• 2016 – APIs for National & Regional Systems

• HL7 New Zealand

Trailblazers

Community Participation (FMG)

Vendor Uptake (Orion Rhapsody, Sysmex, HealthOne)

NZ Inc. (Appointments)

Patients First Terminology Server

HL7 NZ Registry Server

ClinFHIR Profiling Tool for Clinicians

• HL7 New Zealand

clinFHIR tooling (clinFHIR.com)

• Developed to support clinicians understand FHIR– Educational

• Supports:– Building resources– Show resource references– Simple profiling– Simple ValueSet editor

• Will use to engage clinicians– Working Group Meetings

– NZ Seminar

– Available on line

– DevDays(November)

– UK NHS Digital

• HL7 New Zealand

NZ Inc.

– Project to create single data repository from multiple source systems

• Data aggregator

– Predominantly read-only

– FHIR interfaces

– Orion, CSC, MedTech, Sysmexmain partners

• About 15 others

– Starting with appointments

– Iterative development

• HL7 New Zealand

Reality Checks

Doesn’t solve or change fundamentals…• EHR Systems must reflect business strategy & operational

models.

• Successful projects derive working solutions from well-defined business needs.

• Within healthcare, IT is an enabler – not the driver.

• Hype v Reality – FHIR will not solve interoperability – but will make it easier and cheaper to achieve!

• FHIR cannot standardise clinical practice.

• FHIR won’t force unwilling partners to collaborate…

• HL7 New Zealand

FHIR Extinguishers - Barriers to Adoption

Classic Project “Iron Triangle” 2/3 mapped to Primary Care IT

• Ministry of Health (Governance)

• Software Vendors (Applications)

• General Practices / PHOs (Providers)

• HL7 New Zealand

2016: A Transformational Year

New Health Strategy…live well, stay well, get well

1. people-powered

2. closer to home

3. value & high performance

4. one team

5. smart system

NZ Electronic Health Record– “Single” EHR…probably

– Design Stage – widespread engagement

– Build, Buy or Adapt?

– HL7 NZ – key input to standards

– FHIR-based APIs & SNOMED CT clinical coding

– Seeking overseas success stories?

• HL7 New Zealand

…but we kept the old flag!

• HL7 New Zealand

A Smart EcoSystem With FHIR

• HL7 New Zealand13

Wellington, New Zealand

SNOMED CT Expo Host

27-28 October 2016

HL7 FHIR Adoption In New Zealand

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