What is FHIR? And How Are Apps Using It?

the FHIR logo

There’s no shortage of acronyms in healthcare, but one you will be hearing a lot more of as technological advances permeate the healthcare sector is FHIR.

An acronym for Fast Healthcare Interoperability Resources, FHIR (pronounced “fire”) is a data standard for information exchange, or as an article from Health IT Analytics puts it, a protocol for joining disparate systems together. It was built with healthcare data and all of its complexity in mind and includes a modern internet-based approach to making interoperability possible.

The Definition of Resource

You may have deduced from the name that the “Resources” part of FHIR is quite important, but how it’s defined is worth noting. Resources, as defined by Health Level 7, refers to “all exchangeable content.” Resources all share certain characteristics, such as:

  • Common definitions and representations
  • Common metadata
  • Readability
  • Made of data types that employ common reusable patterns

The goal is to create resources that can satisfy a majority of use cases, whether by themselves or combined with other resources or data elements. Why?

Think of the internet, where a user in San Francisco can have the same experience on a website as someone in South Carolina due to HTTP protocol. What we see at the top of our internet browsers is Universal Resource Locator (URL), which may look like gibberish at times, but allows a browser to pull a specific web page from anywhere, any time. In a sense, FHIR is meant to provide that level of accessibility and interoperability to healthcare providers, insurers and patients looking for specific health data, ensuring that users of different devices, applications and EHR services have access to the same information.

FHIR’s ability to enable an ecosystem in which healthcare information can be transferred with a greater level of ease than at present is important. In the current landscape, health information, though mostly digitized, is still document heavy and only includes data that providers choose to transmit. This can limit the amount of information shared and thus have an impact on decision making or the ability to perform analytics.

The information is, as the Health IT Analytics article notes, somewhat static at present. When a provider receives data it typically comes in a format similar to a .pdf, requiring special effort to extract information and deploy it in another format. FHIR is also an attempt to get away from that structure so that the entire patient story can be conveyed and developers allowed to create applications that can plug into clinical workflows to improve decision-making, care coordination and analytics efforts.

The Possibilities with FHIR

FHIR is based on the Representational State Transfer, or RESTful application programming interface (API) architecture, which means it typically uses HTTP protocol for web-based APIs. This allows for development of new applications in ways healthcare has never seen before. With that, patient generated data can be incorporated, EHRs and the health data they store made available to patients on their own devices and interoperability made simpler.

FHIR is key, for example, in an effort such as Apple’s Health Records initiative, an effort to give patients access to their electronic health records and health data on their own devices.

FHIR was the key to the creation of the Substitutable Medical Applications and Reusable Technologies (SMART) Health IT initiative, an open, standards-based technology platform that allows developers and technology innovators to create healthcare apps that can run interoperably between health IT systems.

SMART was originally a tool for building apps that work with EHRs, but EHR vendors felt that it suffered from a lack of standards. According to an article from Mobi Health News, FHIR gave the team creating SMART the standard those EHR companies were looking for.

Now, FHIR is at the core of major tech developments in healthcare, from the Google Cloud platform to clinical applications being used at specific hospitals. The challenge we face then, according to a blog post from C Vaibhav Kumar, Regional Head of healthcare data platform Innovaccer, is “developing FHIR-based APIs to help healthcare organizations enable seamless information sharing on an expanded network of electronic health records and other health information technology based on the internet and different architectures.”

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