Cleveland to test interoperability between their devices using IHE defined profiles. What was new this year were the recently published profiles facilitating exchange of information using mobile communications based on the new FHIR standard, which is based on standard web protocols.
The FHIR testing emphasized querying for patient
information, corresponding documents, and uploading and retrieving them. In
addition, we tested the audit trails using FHIR, which is important from a
security and privacy perspective.
There are still relatively few FHIR based implementations in
the field due to the immaturity of the standard (most of it is still a draft),
the lack of critical mass (implementing FHIR for just one application such as
scheduling does not make sense), and its steep learning curve as it is
sufficiently different from what healthcare IT is accustomed to. Therefore, the
more that can be verified and tested in a neutral environment such as the
connectathon the better it is. Speaking with the participants, they uncovered
quite a few issues in their early FHIR implementations, which again is good as
it is better to solve these issues beforehand than during an actual deployment.
The attendance at this year’s event seemed to be lower than
previous years, which could be due to the fact that there are several local
connectathons happening during the year on other continents, which draw from
the same crowd, and that implementations are starting to mature (except for
FHIR of course) and therefore, there is less need for debugging.
There could also be somewhat of a “standards overkill” in
place if one considers the fact that for radiology alone, which is one of the
11 domains, there are 22 defined profiles and another 27 published as draft. It
is hard to keep up with all of these and for vendors to deploy all of these new
requirements.
As FHIR matures, which will take several years as its
typical release cycle is 12-18 months, there will be a need to test these new
releases between the vendors providing the medical devices and software
products. There were a few new vendors present but most of them consist of the
same “crowd,” which is somewhat disappointing because I believe that the real
FHIR implementation breakthrough will come from outsiders such as Apple,
Amazon, Microsoft and/or Google, all of which were notably absent.
In conclusion, another very successful event, giving a boost
to interoperability, something we very badly need as patients, especially in
the US where we are still struggling to get access to our medical records,
including images, and where healthcare institutions continue to have difficulty
exchanging information among themselves and other providers. In many
departments and medical offices, the fax machine still is an important tool,
hopefully not for long.