HL7 Developing New Health Care Messaging Standard

A new HL7 standard, called Fast Health Interoperable Resources (FHIR), could allow clinical research organizations to extract data from patients' records.

Health Level Seven International, a standards body for health care data, is developing a new framework that will ease sharing of patients' electronic health records.

The standard, Fast Health Interoperable Resources (FHIR), consists of modular components called "resources" that allow health IT systems to read extensions using a common framework. They're used by "back-office" software, social media apps on mobile phones, cloud software, EHR data sharing and server communications, according to an HL7 document.

"These resources can easily be assembled into working systems that solve real world clinical and administrative problems at a fraction of the price of existing alternatives," HL7 stated.

A challenge in health care IT is to get multiple health care systems to be compatible. As standards bodies add fields and options to their specifications, they become more complex and costly to implement, according to HL7.

The standard provides doctors with a common format to send prescriptions, receive lab reports or share patients' clinical summaries, John Quinn, CTO for HL7, told eWEEK in an email.

"It could also be used to dynamically find structured information that needs to be queried and aggregated for purposes of measuring quality of care and reporting public health information," Quinn said.

FHIR builds on the HL7 version 2 and version 3 Clinical Document Architecture (CDA) standards for health care data exchange. They allow doctors' practices to transmit administrative and clinical data on registration, admissions, discharge, lab results, medication and headers for images, Quinn said.

Although the standard is still in development, health care organizations are already using it in HL7's "connectathons," in which application developers test FHIR to support their clinical applications, Quinn said.

In addition, FHIR offers a human-readable wire framework for systems accessing health data to be able to read the information.

FHIR is also compatible with the RESTful API architecture to allow for messages and documents to be easily exchanged in health care, according to HL7.

"[FHIR] is a very significant project for HL7, and the health IT community at large, because it takes the decades-old EDI [electronic data interchange] format and protocol and updates it to a more modern Web-oriented RESTful services architecture," Shahid Shah, CEO of IT consulting firm Netspective Communications and author of The Healthcare IT Guy blog, told eWEEK in an email. "Unlike FHIR, older versions of HL7 required programmers to know '80s-style EDI and legacy technologies, which require more training."

FHIR could increase interoperability faster than previous standards if it's adopted in a timely manner because it uses a "pull" instead of a "push" protocol, Shah noted.

"For example, instead of each system pushing data to a central system, now apps that consume and generate FHIR can connect more easily like most Internet systems do through 'pull' data models," he explained.

In addition, FHIR allows for data sharing without a central router, Shah said.

FHIR will be available as a draft standard by the end of 2013 if it passes a September vote. A published standard will follow by sometime in 2015, according to Quinn.