A brand new report describes the educational curve concerned in efforts to speed up FHIR maturity throughout the public well being group. Pilot mission individuals mentioned that preliminary initiatives require time to construct familiarity with the FHIR customary and implementation processes, resembling information mapping, translation, use of particular file codecs, and preliminary setup of FHIR servers and infrastructure.
The Affiliation of State and Territorial Well being Officers (ASTHO) report, co-authored by Ankur Jain, Ashley Ottewell, and Elizabeth Ruebush, notes that adopting FHIR for information trade can equip public well being businesses with a contemporary, interoperable framework to effectively share data with suppliers, laboratories, and authorities businesses.
The pilot websites had been comprised of state/native well being departments and information trade companions. Every pilot concerned an information trade pair, together with:
• Minnesota Division of Well being and Hennepin County Public Well being
• Virginia Division of Well being and Fairfax County Well being Division
• Washington State Division of Well being and Public Well being — Seattle & King County
• Philadelphia Division of Public Well being and the HealthShare Alternate HIE
A number of different organizations offered technical assist. Because the report describes, in 2022 the Public Well being FHIR Implementation Collaborative (PHFIC) kick-started a group that targeted on bettering public well being information trade by way of use of the FHIR customary. Convened by the CDC, PHFIC brings stakeholders collectively to check FHIR-based options in real-world settings. It has suggested three phases of public well being FHIR pilot initiatives.
By way of these pilots, PHFIC recognized classes discovered, and developed assets to assist different well being businesses in adopting FHIR, such because the Public Well being FHIR Playbook, launched in 2023.
Within the pilot involving the Washington State Division of Well being (DOH) and Public Well being Seattle & King County (PHSKC), the organizations had been looking for to cut back information silos throughout packages throughout the DOH, between the state and native well being jurisdictions, and between public well being and well being care techniques. DOH and PHSKC started with one-way information sharing of dying document information, adopted by advancing to bi-directional trade, and at last integrating immunization information into the trade.
Aiming to cut back the burden related to manually accessing particular person immunization data, DOH and PHSKC are working to assist bulk FHIR transmission of immunization information from the state immunization registry to the county. This effort aligns with actions of the HL7 Helios Venture Bulk Knowledge Precedence Space.
Listed below are just some of the challenges recognized by the pilots:
• A number of pilot websites reported having restricted or various ranges of FHIR information and expertise on the outset of their initiatives. Time and coaching are essential to constructing a “FHIR-savvy” public well being workforce, and to upskill the mission workforce.
• Pilot websites additionally famous that many well being departments usually are not but engaged on FHIR implementation and/or could also be prioritizing different information modernization efforts. This dynamic might restrict the provision of prepared trade companions, peer studying alternatives, and colleagues engaged on refining implementation guides and different implementation instruments.
• Obtainable funding didn’t all the time cowl complete FHIR-associated implementation prices since annual funding cycles usually are not nicely aligned with the time and assets wanted to plan and implement FHIR initiatives, or to supply contract deliverables.
Pilot individuals really helpful creating an agency-level FHIR roadmap to assist information infrastructure growth over time and assist groups in prioritizing use circumstances. On the mission stage, an implementation plan with key milestones, deliverables, and timelines is necessary for guiding work and aligning workforce expectations.
They emphasised considering longer-term and constructing a reusable FHIR-based infrastructure. When implementing new applied sciences or approaches for a selected use case, you will need to think about their applicability to broader company and public well being capabilities, the report mentioned. Establishing reusable FHIR-based infrastructure requires early and sustained planning, starting with the preliminary implementation. Emphasis needs to be positioned on scalable, standards-based options that may be tailored throughout a number of use circumstances to assist long-term interoperability and effectivity.
The ASTHO report says that the momentum from these pilots affords a path ahead, and that ongoing pilot initiatives ought to discover and refine new use circumstances and that implementation guides can present replicable fashions and technical documentation that different jurisdictions can undertake and adapt.
Pilots can function peer mentors and incubators for brand spanking new use circumstances, additional advancing the event and adoption of FHIR-based information requirements.
Well being departments may also combine FHIR implementation efforts into different initiatives, such because the Public Well being Knowledge Modernization Implementation Heart Program, to make sure continued momentum.
The report says that future initiatives ought to assist strategic planning for sustainable FHIR infrastructure that aligns with nationwide priorities such because the Public Well being Knowledge Technique, and frameworks such because the Trusted Alternate Framework and Frequent Settlement (TEFCA).
