FHIR Webinar – reference and additional answers

This week I did a webinar on FHIR for HL7. They’ve posted the recording of it (2012 December 4 Ambassador Webinar: Fast Healthcare Interoperability Resources (FHIR) (70.26 MB)), along with my slides (PDF version of the slides here).

There were a number of questions asked that we didn’t have time to get to. Here’s some quick answers:

“Q: Is this planned to replace all v2.x and v3 standards, and if so, when?

A: Well, it might. If it it turns out to be as easy as we hope, then this will happen, slowly, and of it’s own accord. But HL7 will – as it should – be very careful about phasing out well respected widely implemented standards in favor of something new – the evidence and market selection would need be overwhelming.

“Q: When do you envision FHIR starts being commercially used in the marketplace?

A: This coming year, actually. Though as I said in the webinar, not in areas where v2, CDA, etc are already incumbent. I think XDS may well be first.

“Q: Can you show an example, end-to-end, from initiating the query, to the response?

A: Ummm, not off hand, no as a canned example. But I can do something better than that – here’s a search that returns all the persons named “peter” (as html, as xml, as json). You can fool with the parameters, or run it again from here. And use something like fiddler or proxytrace to see the actual traffic between your browser and the server, which is the same as the traffic from an application.

Q: when/where is the next connectathon?

A: Connectathon details here.

Q: At connectathon, what is scope of objects that will be considered? i.e., if we are modelling prospective orders for a particular IV set with certain additives, could that be an appropriate topic?

A: For reasons of practicality, we are focusing on XDS this time. We’d love to focus on an order scenario next time around.

“Q: How does the introduction of FHIR affects CDA implementation Guides? Will the guides be obsolete if FHIR is adopted as a standard?

A: See answer above about existing standards.

“Q: How does FHIR work together with IHE/XDS profiles?

A: That’s really worth a whole post. But the notion is that XDS.b is a transactional view of a document repository, where as FHIR will offer a RESTful view of the repository. I can imagine a true XDS.b server hosting a FHIR interface, and also a true FHIR server hosting an XDS.b interface (I’m going to be implementing a FHIR server that offers RESTful access to documents in folders, and accepts submissions by XDS.b ProvideAndRegisterDocument. The FHIR interface is closely aligned to the candidate MHD interface, but resolves some unanswered questions in the MHD profile, and is less transactional again.

“Q: is FHIR trying to be developed in android environment or is it still to early to define the software platform for implementation?

A: Not at all too early. We already have Android applications based on java code generated from the various artifacts in the specification, and we’ll be hoping for more at the next connectathon.

“Q: Specific license language/example would be great ie: GNU, Eclipse License, etc

A: see http://hl7.org/implement/standards/fhir/index.htm#license. The generated code is licensed under BSD (as the most permissive license of all that we could find). Standards are not software applications, and the licenses that are suitable for software don’t work for standards.

“Q: In an outpatient diagnostic center, we have many referring doctors that in order to send and receive orders and reports, need to implement a costly HL7 interface for up to $10,000 each. Can FHIR make this process simpler and cheaper then building an HL7 interface for up to $10,000 each?

A: I’d really like it to be much cheaper. But when it comes to ordering, much of the complexity is inherent in the problem, not the syntax or exchange paradigm, so FHIR isn’t a magic bullet.

“Q: I’m interested in understanding how you see Interface Engines making use of the FHIR standard. Is the ideal to transform it to FHIR xml over MLLP or to receive HL7V2 and then post atom to subscribers through HTTP?

A: Actually, I write an interface engine, and all my implementation is in that context. I’ll be offering bridges between v2 and CDA and XDS and FHIR/REST and also FHIR messaging with transforms between them. Of  course, the transforms will generally be custom ones, particularly for v2…

“Q: I utilize HL7 for LAB, HIPPA claims revenue cycle between insurance Payers and Healthcare facilities as well as feeding vendors and regulatory based on Trading Partner Agreements and Confidentiality guidelines. Is there a conversion chart for HL7 eExchange from the current standard use to FHIR?

A: Not yet, because we haven’t covered a lot of that ground in FHIR yet. Hopefully this will come.

Q: Data Repository feeds as well

A: Well, generally, FHIR is particularly suitable for feeds – just use pub/sub using atom

Q: Thank you for presenting…This has been very informative and I see great potential

A: –unanswered–

“Q: Seems like you are implementing ‘linked data’ concepts

A: Err, yes, we’re keeping an eye on that work as well

Q: Congratz, this seems more intuitive than HL7v3 or CDA and hopefully it will be adopted like “”FHIR”” 🙂

A:Thanks – that’s what’s driving this. If we get it right, it will be more intuitive than v2 as well

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