Health Informatics on FHIR: How HL7's New API is Transforming Healthcare

by Mark L. Braunstein

This textbook begins with an introduction to the US healthcare delivery system, its many systemic challenges and the prior efforts to develop and deploy informatics tools to help overcome those problems. It goes on to discuss health informatics from an historical perspective, its current state and its likely future state now that electronic health record systems are widely deployed, the HL7 Fast Healthcare Interoperability standard is being rapidly accepted as the means to access the data stored in those systems and analytics is increasing being used to gain new knowledge from that aggregated clinical data.  It then turns to some of the important and evolving areas of informatics including population and public health, mHealth and big data and analytics.  Use cases and case studies are used in all of these discussions to help readers connect the technologies to real world challenges.

Effective use of informatics systems and tools by providers and their patients is key to improving the quality, safety and cost of healthcare.  With health records now digital, no effective means has existed for sharing them with patients, among the multiple providers who may care for them and for important secondary uses such as public/population health and research.  This problem is a topic of congressional discussion and is addressed by the 21st Century Cures Act of 2016 that mandates that electronic health record (EHR) systems offer a patient-facing API.

 

HL7’s Fast Healthcare Interoperability Resources (FHIR) is that API and this is the first comprehensive treatment of the technology and the many ways it is already being used.  FHIR is based on web technologies and is thus a far more facile, easy to implement approach that is rapidly gaining acceptance. It is also the basis for a ‘universal health app platform’ that literally has the potential to foster innovation around the data in patient records similar to the app ecosystems smartphones created around the data they store.  FHIR app stores have already been opened by Epic and Cerner, the two largest enterprise EHR vendors.

 

Provider facing apps are already being explored to improve EHR usability and support personalized medicine. Medicare and the Veteran’s Administration have announced FHIR app platforms for their patients.  Apple’s new IOS 11.3 features the ability for consumers to aggregate their health records on their iPhone using FHIR. Health insurance companies are exploring applications of FHIR to improve service and communication with their providers and patients. SureScripts, the national e-Prescribing network, is using FHIR to help doctors know if their patients are complying with prescriptions.

 

This textbook is for introductory health informatics courses for computer science and health sciences students (e.g. doctors, nurses, PhDs), the current health informatics community, IT professionals interested in learning about the field and practicing healthcare providers.  Though this textbook covers an important new technology, it is accessible to non-technical readers including healthcare providers, their patients or anyone interested in the use of healthcare data for improved care, public/population health or research. 

Genres: Nonfiction

534 pages, Kindle Edition

Published July 26, 2018

About the author

I've been involved with health informatics since well before it was recognized as a useful field! Yes, that goes back to gigantic computers with virtually no horsepower or memory by today's standards. For example, my early work on an electronic medical record was on a DEC PDP-15 'mini computer' (actually quite large) with 64,000 bytes of main (core) memory and twin 30 MB hard drives!

Nevertheless, those of us in the field actually did useful work back then as I try to explain in my latest book, Health Informatics on FHIR: How HL7's New API is Transforming Healthcare. It is intended to be a broad introduction to the field for readers from a variety of backgrounds. No technical skills required. It starts with a historical perspective and a brief review of the challenges facing healthcare delivery as we all live longer and develop chronic diseases. It then focuses on the FHIR API-based interoperability standard that is having an enormously positive impact on innovation in the field and, in my view, offers great promise for really helping to overcome the challenges I reviewed earlier. I provide numerous case studies to demonstrate why that is the case.

After over 20 years in the commercial health IT segment I've been teaching at Georgia Tech since 2007 where I'm involved in various research projects and work with and advise numerous community and industry groups.

In my spare time I love to cook and enjoy fine wine!

Reviews

[Josh · Rating 5 out of 5]

Hey everyone, thanks for the thoughtful discussion really interesting takes on how FHIR is shaping the future of health data! I’ve been working on a project where integrating different systems quickly became a real headache. What helped me a lot was using tools that simplify and speed up the process like the platform at nextlevel company. It’s not some magic fix, but it made my life easier when dealing with messy interoperability issues. Just thought I’d share in case anyone’s running into similar roadblocks. Appreciate all the insights here!

[Matthew · Rating 4 out of 5]

Excellent survey of health data interoperability opportunities and challenges.

[Spencer Kimber · Rating 5 out of 5]

This book is a no-nonsense, easy-to-understand overview of the complex Health IT environment. I would recommend this to anyone in the industry. It is an incredible book that covers the history and current state of Health IT with an introduction to FHIR.