Interoperability with FHIR: What’s your plan?

March 23, 2022 | 3 minute read
Alex Cruft
Principal Program Manager
Joseph Alymer
Principal Program Manager
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Data is the backbone for clinical decisions and claims processing, yet critical records systems like digital health records don’t always make it easy to share information between providers, labs, and payers. So, what’s getting in the way? A lack of standardization.

As health information technology systems have improved efficiencies, the need to exchange disparate types of data, such as digital health records, imaging, and claims, has only grown. This inability to share data across healthcare information systems might sound like a purely bureaucratic struggle, but it can also ultimately impact patient care.

After decades of struggling with this lack of standardization, clinicians and healthcare organizations finally have a solution: FHIR.

Different systems, different structures? No problem

FHIR, officially titled the Health Level Seven International (HL7) Fast Healthcare Interoperability Resources, is an open, developer-friendly standard that enables true interoperability between systems and empowers patients to access their clinical and claims data. With this new standard, we can improve the timeliness of critical treatment decisions, reduce cost of care, and eliminate data silos that limit patient engagement.

For this reason, FHIR is quickly making a name for itself across the healthcare industry.

Because of regulations from the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS), the healthcare industry is rapidly adopting FHIR R4 (v4.0.1) as the standard for exchanging healthcare information electronically.

So, what does this shift mean for healthcare providers and payers?

Organizations face new mandates aimed to simplify access and sharing of healthcare information, including the following examples:

  • Implementation of a secure Patient Access API allowing patients to easily view information about their claims using third-party apps

  • Publish provider directory information publicly through a Provider Directory API

  • Healthcare payers must prepare to share patient clinical data with other payers whenever patients request it.

Implementing an FHIR strategy

Failure to adhere to mandates from the ONC final rule can lead to regulatory fines and other compliance issues. For this reason, healthcare organizations need a plan to adopt and enforce the FHIR standard. Gartner Research published the following key considerations for you to think about while planning your FHIR implementation strategy:

  • Identify compliance barriers by working with regulatory experts to detail the applicable CMS Interoperability and Patient Access (CMS-9115-F) provisions and assess your organization’s readiness to meet the requirements.

  • Manage cost and timeline risks by assuming a high effort for mapping clinical and claims data to the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) specifications.

  • Anticipate and mitigate the risk that member data access will expose data quality issues by establishing member service processes to manage questions and concerns.

  • Prepare to comply with the member and third-party software application access requirements by assessing your organization’s consent management and API enablement capabilities.

  • Accelerate compliance initiatives by employing vendor partners with purpose-built solutions.

Partnering with Oracle can help you meet both your business objectives and regulatory requirements. Our cloud technology can remove barriers and data silos that have evolved over decades of healthcare product development.

Cloud technology is the answer

We offer an ever-expanding list of cloud services addressing healthcare use cases that can optimize clinical and administrative workflows and deliver economic benefits across the continuum of care. Using services like Data Lakehouse on Oracle Cloud Infrastructure (OCI), you can gain new insights across disparate data sources, such as web transactions, office visits, and phone transcriptions. To learn more, see our preconfigured Data Lakehouse architecture for health insurance analytics.

For anyone interested in AI and ML, OCI Data Science is a fully managed, serverless platform for data science teams to build, train, and manage machine learning models. The OCI Data Science reference architecture supports multiple scenarios for the application of machine learning in healthcare.

Tools like these are driving the healthcare industry toward cloud adoption. To learn more about how you can use Oracle Cloud Infrastructure for healthcare, contact one of our representatives.

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Alex Cruft

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