HL7 FHIR is rewriting the Interoperability Paradigm · Happy Birthday FHIR. * HL7 Roadmap * Making...
Transcript of HL7 FHIR is rewriting the Interoperability Paradigm · Happy Birthday FHIR. * HL7 Roadmap * Making...
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HL7 FHIR is rewriting the
Interoperability Paradigm
Partners in Interoperability
Charles Jaffe, MD, PhD
CEO HL7
18 October 2016
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* Why is Interoperability taking so long? * HL7 Fresh Look. Happy Birthday FHIR. * HL7 Roadmap * Making it all work together
Advancing Interoperability
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Is the Holy Grail of Interoperability
really Plug & Play?
Credit: Monty Python
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The Interoperability Blame Game.
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Benjamin Disraeli
“How much easier it is to be
critical than to be correct.”
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The Players
Government Agencies
& Regulators
SDOs
Healthcare Systems
& Hospitals
Clinicians
Technology Developers
& Vendors
Academicians
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The Circle
SDOs Government
Hospitals
Vendors Clinicians
Academia
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The Circle: Let the Games Begin
Government SDOs
“You develop
standards too
slowly and too
unpredictably.”
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The Circle
Government SDOS
“You don’t
provide the
support we
need.”
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The Circle
Government
Health
Systems
“You are lagging
far behind,
considering the
incentives we
provide.”
Clinicians
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The Circle
Government
Health
Systems
“The
regulations are
obtuse, vague
and
overwhelming.”
Vendors
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The Circle
Vendor
Health
Systems “We need
everything
customized,
and we need it
yesterday.”
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The Circle
Vendor
Health
Systems “Best of breed?
That’s not a
coherent
strategy.”
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The Circle
Vendor Nurses
“Work flow?
You call that
work flow?”
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The Circle
Vendor Surgeons
“You put
3 surgeons in a
room, you get
4 (strong) opinions.”
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The Circle
Vendor Pediatricians
“If is doesn’t
have head
circumference,
it’s not an EHR.”
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The Circle
Government SDOS
“Charging for
standards is an
impediment to
adoption.” Academicians
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The Circle
Government SDOS
“Can we get a
grant for that?”
Academicians
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The Circle
Government SDOS
“Corollary: You
pay for SNOMED.”
Academicians
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The Circle
SDOS
“Do we really
need a license?
What happened
to Open
Source?” Academicians
Vendors
Hospitals
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The Circle
SDOs
“Standards are
an impediment
to innovation.” Academicians
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The Circle
SDOs
“What are
standards?”
Clinicians
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The Circle
“Can that be
postponed
until 2020?”
Vendors
Government
Hospitals
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The Circle
“Can that be
accelerated to
next month?”
Government
SDOs
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The Circle
Fraud & Abuse:
“If you’re not
cheating, you’re
not trying.”
Clinicians
Government
Hospitals
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If you’re not guilty of any of these
elements of the Blame Game, you shouldn’t be in the room.
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The principles underlying FHIR development
are meant to address the challenges learned in
30 years of open standards development.
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Here are several principles we learned the hard way.
I think they are the best kind of lessons.
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It’s not architecture; it’s city planning.
Principle #1
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Remaining relevant.
…not just interesting.
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A standard is not used because we created it.
It is a standard because people use it.
Principle #2
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“I can’t understand why people
are frightened of new ideas. I’m frightened of the old ones.”
John Cage
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Government regulation only codifies standards. Standards bring value
when they are adopted in the marketplace.
Principle #3
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For information models, one size never
fits all.
Principle #4
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The only standard that never changes
is the standard you never use.
Principle #5
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“Knowledge is knowing that a
tomato is a fruit.
Wisdom is not putting tomatoes in a
fruit salad.”
Peter Kay
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There is an inherent Standards Life Cycle,
either stated or implied.
The entire community of stakeholders
rely upon that knowledge.
Principle #6
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Emerging standards require a Maturity Model.
Mature standards need a timeline
for enhancement or sunsetting.
Principle #7
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“Perfection is achieved,
not when there is nothing more to add,
but when there is nothing left to take away.”
Antoine de Saint-Exupery
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The HL7 Roadmap
must be visionary and keep promises.
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FHIR enables an evolutionary
development path with
other HL7 standards*
* Many are embedded in Federal regulation
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* Consolidated-CDA is embedded in Meaningful Use * Inconsistent implementation of C-CDA has been an impediment to interoperability * CDA on FHIR project has been developed to overcome that challenge
CDA on FHIR
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Collaboration
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JASON Task Force
& the Argonauts
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* SMART is a 6-year project at Boston Children’s Hospital, funded by ONC,
based upon an API model to enhance health data interoperability * SMART has adopted FHIR as its standards- based API model * The goal of SMART is the creation of an “App Store” for healthcare
SMART on FHIR
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* Joint project of ONC, Harvard Medical School, EHR vendors and NIH * Leverages patient-donated genomic data for clinical research and Precision Medicine * Relies upon open APIs and FHIR
Sync for Science
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openFDA Initiative
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CMS is coordinating a diverse ecosystem of
developers for creation of the Blue
Button on FHIR
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Public Health Reporting
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Mobile Health is…
…more than clinical data on a smart phone.
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More than three hundred clinical organizations, IT
developers, government agencies and healthcare systems worldwide are now committed to developing
FHIR applications
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Clinical Professional Societies
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Payer Summit Implementing FHIR
July 11-12, 2016
AHIP Innovation Center
Chicago
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HL7 International Genomics Summits
Next Summit: October 26-28, Washington
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* Showcase for FHIR Apps & Development tools * Platform for best practices & collaboration * Apps & tools in demonstration environment * Harvard Medical School, July 27-28 Duke University, March 8-9, 2017
FHIR Applications Roundtable
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HL7 FHIR Foundation
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FHIR.ORG
• Non-profit community for Implementers
• Implementation Registry
• Reference implementations & task tracking
• Community Forum & Help Desk
• Resources for conformance testing and public reference implementations
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Albert Einstein
“We can’t solve problems with
the same kind of thinking when we created them.”
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“It’s not enough to show up.
You’ve got to have a Business Plan.”
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Analytics may be the answer, but
you can’t get there with bad data.