ONC’s FHIR Mandate- The New Face of Healthcare Interoperability
Avakash Dekavadiya
A mandate or a facilitation? It is all about freedom to access information and tools:
Included in the Cures Act Final Rule by ONC, Fast Healthcare Interoperability Resource’s #4 Release (FHIR R4) has been made a mandate to improve the Electronic Health Information (EHI) exchange. The mandate has 2 basic principles, access to information and freedom of choice.
The motive behind making FHIR a mandate was to allow patients to retrieve their electronic medical records at any given time without incurring extra expenses. Another major reason for the FHIR mandate was to provide Healthcare Providers the freedom to select appropriate IT tools that facilitate them in delivering optimal patient care, without encountering undue expenses or technical obstacles.
To ensure that all the healthcare systems can make the most from the FHIR mandate, ONC has divided the practice of FHIR implementation into 4 major provisions:
4 major provisions of FHIR implementation:
Negate Information Blockage- Healthcare providers must not set up any Health Systems or information exchange practices that prevent providers and patients from accessing their health information.
Data Interoperability- FHIR has already standardized all the healthcare communications including the ones with 3rd party applications and thus, providers and developers must set FHIR data exchange protocols in their IT systems to ensure seamless and secure sharing of EHI.
API Setup- Healthcare IT teams of hospitals and medical clinics must provide authorized third-party apps with secure API access to the relevant EHI that are used by patients and providers.
ONC-ACB Certification- To ensure that healthcare systems adhere to the FHIR mandate rules, all the HealthTech and MedTech software products used in the hospitals must be Certified by ONC’s Authorized Certification Body.
But, is setting up a FHIR server enough to get certified?
Just setting up a FHIR server and APIs will not work! The idea is to ensure that Healthcare Systems must enable their users to create single export files containing all of the EHI produced and/or managed on the platform at will. Health IT Developers must also be able to export this information for their entire database.
Another essential requirement is the need for standardized APIs for patient and population services. This means patients must be able to access their own health information and share it with other healthcare providers and applications securely and easily. It also means Providers must be able to access the information of their patient population in a standardized manner for effective clinical decision-making.
What does this implicate?
This implicates 3 major things:
- All EHI Data Must be cleaned and processed in a manner that it can be set in FHIR standardized formatsAll EHI Data Must be cleaned and processed in a manner that it can be set in FHIR standardized formats
- Hospitals must set FHIR favorable workflows for data interoperability
- For proper visualization and effective data pulling, hospitals will need relevant SMART on FHIR applications, especially for 3rd party applications
It takes the right partner for FHIR implementation:
To ensure that a third-party technology solution/platform or a hospital can make the most from its FHIR resources and implementation, it requires the right partner with relevant experience and expertise to ensure beyond compliant personalized FHIR implementation.
Benefits of right FHIR implementation:
- Best for modernized products as all the communications are already standardized so integration setup with hospitals and EHRs becomes seamless
- FHIR not only supports the microservices and product upgrades, but it also has the fundamental compliances set for the US making SaaS upgrades possible with minimal changes
- Data processing speed can be optimized and querying issues or bottlenecks can be solved with FHIR
- Due to its transactional nature and API-based transfers, FHIR also maintains all the data versions and sources ensuring there is no data loss and it also helps with data audits with audit logs and provenance
- Optimum data field coverage and its standardization make interoperability easy and seamless
- Flexibility of FHIR allows SaaS platforms to integrate with hospitals based on their preferred file formats to make customer onboarding seamless and easier for Hospital clients to set up
- With its modular and dynamic nature, FHIR makes your SaaS platform EHR agnostic or rather Future-proof to all the technical advancements and upgrades
