Setting Healthcare Data on FHIR

We are in a period of rapid evolution in healthcare that is being driven by advances in technology and data availability that change the way patients interact with healthcare providers, services, and medical data. 

The delivery of patient care is evolving to include options like flexible provider access, urgent care centers, IoT remote monitoring, external testing options like genomic analysis, increasing home care services, and telehealth options. These options benefit the patient by providing flexible access to treatment and increased communication with providers but also complicate the process of maintaining a complete longitudinal patient medical record.

Employment trends are also increasing the mobility of patients. Recent surveys have shown that while US workers nearing retirement held an average of 11.7 jobs during their employment history, 75% of younger workers under the age of 34 view job-hopping ever few years as beneficial to career development. This job mobility results in patients who can be expected to move between health systems and geographic areas with increasing frequency.

Maintaining and sharing healthcare information has never been a simple or straightforward task, and these shifts in healthcare delivery will further complicate this. Before we can realize the full potential of healthcare data for improving patient care, the industry needs to overcome a significant roadblock: a lack of standards for how this type of data is stored and shared among different groups, including researchers, hospitals, insurance companies, and other payers.

By nature, healthcare data is often siloed and stored in varying formats in different systems. That’s not only the case when looking at separate providers but also between departments within the same organization. Adding to that complexity are the disparate types of data and information sources that organizations handle today. Much of this data didn’t exist a few years ago, before the advent of high-definition imaging, individual genomic maps, and a constant stream of inputs from wearable sensors and mobile devices. All of these are coming together with electronic health records (EHRs) containing everything from a patient’s blood pressure to written notes from a provider.

While there have been calls across the industry for standard ways to transfer and share all of that data, concerns over data security and maintaining data functionality have slowed efforts to create better and faster data transfer protocols.

That could all be changing thanks to the emergence of the Fast Healthcare Interoperability Resources (FHIR) Specification created by Health Level Seven International (HL7). HL7, a not-for-profit, ANSI-accredited, standards developing organization, is dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information.

The FHIR protocols represent a significant advancement for the entire industry in bringing down barriers that add unnecessary cost and difficulty to sharing complex health data. They have been designed collaboratively to address a wide range of issues and are independent of any single vendor, so using them won’t constrain an organization to any particular vendor’s technology. That means healthcare IT leaders and teams can focus more on processes and analysis, rather than the complexities of building their own databases.

The adoption of FHIR as a global standard could accelerate the kind of data exchange that is in demand across the industry – and even help to connect patients more directly and provide increased access and control of their medical information.

Another advantage is that the protocols are flexible and can be applied to everything from mobile phone apps and cloud communications, to EHR-based data sharing and more. In that way, they can support participants across the industry, whether it’s for researchers and regulators looking for more efficient approval processes, hospitals and insurers analyzing cost-effective outcomes, or individual practitioners seeking to improve the quality of patient interaction and care.

FHIR also includes a simple framework for extending the protocols, so that new data types can be incorporated when they appear. And, FHIR can be implemented very quickly -- for some uses, even within a day.

Oracle Health Sciences has led the industry when it comes to interoperability. With support for HL7 and Integrating the Healthcare Enterprise (IHE) standards, Oracle has enabled customers to create a single, longitudinal health record for an individual that allows any provider to collaborate on the care of a patient. In Australia, for example, Oracle has facilitated the creation of My Health Record, a national program that provides a standard health record for every person in the country and the ability to connect any provider to it. 

FHIR is a logical extension of existing protocols, and Oracle Health Sciences is closely following and implementing FHIR standards so that customers can adopt FHIR for new or existing implementations.

It will take time for this transition to occur. FHIR is still being developed and extended, and it’s likely that legacy systems won’t be modified to work with it. Those systems, however, are gradually being replaced by modern hybrid-cloud approaches that will be able to work with the FHIR protocols.

For those modern hybrid-cloud-based systems, Oracle Health Sciences expects that 2019 will be the year that the FHIR transformation takes off and anticipates that customers will be eager to get started.

For healthcare IT leaders who are looking forward, beginning to implement FHIR today offers the opportunity to move much more rapidly and cost-effectively into a powerful data management future.

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