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.