What is FHIR? Fast Healthcare Interoperability Resources

Fast Healthcare Interoperability Resources is a standard describing data formats and elements and an API (application programming interface) for exchanging health information on electronic health records. The standard was created by the Health Level Seven International (HL7) health-care standards organization.

FHIR is easier to implement because it uses a modern web-based suite of API technology and leverages on previous data format standards from HL7. FHIR including a HTTP-based RESTful protocol, HTML and CSS for user interface integration, with an option of JSON, XML or RDF for data representation, and Atom for results.

One of FHIR’s goals is to aid interoperation between legacy health care systems, to make it easy to administer health care information to health care providers and individuals on a wide variety of devices from computers to tablets to cell phones, and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.

FHIR provides an alternative to document-centric approaches by directly exposing discrete data elements as services. For example, basic elements of healthcare like patients, admissions, diagnostic reports and medications can each be retrieved and manipulated via their own resource URLs.

Standardization

The HL7 International published FHIR as a “Draft Standard for Trial Use” in 2014. Shortly after a broad cross-section of stakeholders committed to the Argonaut Project which provided accelerated funding and political will to publish FHIR implementation guides and profiles for query/response interoperability and document retrieval by May 2015. It would then be possible for medical records systems to migrate from the current practice of exchanging complex Clinical Document Architecture (CDA) documents, and instead exchange sets of simpler, more modular and interoperable FHIR JSON objects.

FHIR Release 3 was published in mid-2017, as the first STU (Standards for Trial Use) release. It included coverage of a variety of clinical workflows, a Resource Description Framework format amongst other updates.

Apple & FHIR

In January, 2018, Apple announced that its iPhone Health App would allow viewing a user’s FHIR-compliant medical records when providers choose to make them available. Johns Hopkins Medicine, Cedars-Sinai, Penn Medicine, NYU-Langone Medical Center, and other large hospital systems participated at launch.

Read more on FHIR Standard