Mar 11 2022

ViVE 2022: Will the FHIR Standard Revolutionize Healthcare Interoperability?

The Fast Healthcare Interoperability Resources standard will expand patient access to healthcare data, but what will it take to drive adoption?

As part of the 21st Century Cures Act, the Office of the National Coordinator for Health Information Technology (ONC) has proposed the Fast Healthcare Interoperability Resources (FHIR) standard, which aims to expand patient access to personal health data and improve interoperability. This standard could replace HL7 Version 2 for interoperability use cases going forward. However, the success of FHIR relies on its adoption across the healthcare industry.

During a ViVE 2022 session titled “Setting the Future on FHIR or Setting FHIR on Fire?” moderated by EY Global Health Leader Aloha McBride, healthcare IT leaders discussed what’s needed to drive adoption of FHIR, the pain points around the standard and how FHIR enables better patient care.

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The Current Landscape for FHIR in Healthcare

David Vawdrey, chief data informatics officer at Geisinger Health, explained that, from his perspective, adoption of FHIR has been slow.

“The world is still running on HL7 Version 2,” he said. “There’s a lot of opportunity ahead, but the pace isn’t moving where a lot of us would like it to be. Regulatory framework shifts have taken place, and people are not well acquainted with the Cures Act and information blocking. We’re waiting for that watershed moment, but the policy framework is catching up.”

Jonathan Bush, CEO of Zus Health, said FHIR will be a great standard if everyone uses it, and that he believes a lot of interest could come from healthcare startups before more established healthcare organizations adopt it.

“FHIR hasn’t replaced HL7 Version 2 yet, but that was the idea. There are two use cases coming out of FHIR that HL7 never did anything about. Those are patient access to data and app building,” said Don Woodlock, head of global healthcare solutions at InterSystems. “If you have an iPhone in your pocket, you have FHIR in your pocket. There are ‘killer apps’ in terms of consumer ownership of data, and we’ve seen a lot of our customers enabling app-building teams for patient portals, mobile apps and clinical tools with FHIR on the back end.”

FHIR is a tool in the toolbox and one way data can get where it needs to go, according to Tina Joros, vice president and general manager at Allscripts. She advised healthcare IT leaders not to spend time and energy rewriting existing integration that’s already working with HL7 and instead focus on newer use cases where FHIR can add value.

“When the integration stops being relevant, stops working or needs additions, then replace HL7 with FHIR resources,” she said. “There are a lot of good use cases, but we don’t need to break what’s already out there. That’s not efficient or a good use of time.”

FHIR Pain Points and the Standard’s Longevity

Switching from a fee-for-service payment model to value-based care model can open the door for new, compelling use cases, patient participation and consumer involvement in healthcare. Vawdrey said it’s necessary to stop thinking about how to manage data for each individual encounter and move beyond that, which could be facilitated by a move to value-based care.

Another pain point in the adoption and use of FHIR is quality of data. Woodlock pointed out that FHIR has allowed healthcare organizations to see how bad their data really is.

“For population and public health, the quality standard our data needs to meet is much higher,” he said. “There’s work we need to do to get data in the form where we can go to the next level.”

Joros expressed concerns about the definition of blocking in the Cures Act and said there is a need for more clarity so healthcare organizations can comply with the standard and enable innovation.

Panelists were optimistic that FHIR will stick around for the long term, but some had caveats. Bush said that if the digital health movement ends up being a fad, then FHIR likely won’t take off as health IT leaders expect. Woodlock said that, while FHIR is here to stay, it won’t fix everything. Still, he said it’s a good step forward and has already shown its value through making it more comfortable and safer to share data.

ViVE Session

Healthcare IT experts discuss the benefits of FHIR for healthcare interoperability and how to overcome adoption barriers. (From left: Moderator Aloha McBride, Global Health Leader at EY; Don Woodlock, Head of Global Healthcare Solutions at InterSystems; David Vawdrey, Chief Data Informatics Officer at Geisinger Health; Tina Joros, Vice President and General Manager at Allscripts; and Jonathan Bush, CEO of Zus Health.)

Joros said data provenance, or documentation of where data originated, is one major benefit of FHIR. Another is how it could get healthcare organizations to speak the same data language so that they can communicate patient and demographic data to make a difference in population health.

“You can think of the FHIR standard as a data exchange and data representation standard,” said Vawdrey. “Maybe the question isn’t who’s for or against FHIR but what are the use cases and what is the right tool for the job. Like everything in health IT, it has very little to do with the technology, but more the people, process, privacy, payment and competitive interests.”

Another benefit of the FHIR standard is how it’s handed the health information key to consumers, which Vawdrey said is powerful and could lead to a philosophical change in how care is delivered.

“Do patients use that information to create healthier lives? It’s a lot of work but creating a healthier population is worth every penny and every bit of effort,” said Joros.

MORE FROM VIVE: Find out 3 takeaways on the business of healthcare.

Next Steps for Enabling FHIR and Interoperability in Healthcare

The healthcare industry and ONC can take a few steps to ensure the continued adoption and growth of FHIR and interoperability. The first is creating cleaner data that could be more useful for population health, public health, research and drug discovery, said Woodlock. He also suggested deep workflow integration. Rather than just putting data into a dashboard, it should be used at the point of decision to make a difference in patient outcomes.

Joros asked that the government not push back the attestation period for the Cures Act, since much of the industry has been preparing and is ready.

“Make it easy for people to do the right thing,” Vawdrey said, adding that organizations need to understand the problem they’re trying to solve rather than just adopting and deploying new technology. “The problem we have to universally align on is providing better, more affordable care and safer, better health outcomes. That’s easy to say but hard to do. There’s a lot of fragmentation and friction. We have to make it easy for everyone in this ecosystem to do things the right way.”

Keep this page bookmarked for our virtual coverage of ViVE 2022. Follow us on Twitter at @HealthTechMag and join the conversation at #ViVE2022.

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