Fast Healthcare Interoperability Resources (FHIR, pronounced “fire”) is poised to dramatically change how the healthcare industry exchanges data, and not just for EMRs. All HIT products—from lab systems to HIEs, and even population health management tools—will have the opportunity to leverage the new framework. With the advent of FHIR, the healthcare industry is closer than ever to catching up to other industries in regard to integration.
FHIR is a specification from HL7.org that outlines how to support an API for the purpose of exchanging data among HIT systems. The specification itself is still in DSTU 2 phase and, therefore, still evolving. The premise of FHIR is that HIT vendors will expose the API endpoints detailed in the specification, which can then be accessed by anyone who is properly authenticated and authorized. There are numerous API functions that FHIR supports, including both putting data into and getting data out of vendors who support the API. For example, FHIR provides endpoints for lab results, procedures, medications, and documents, among others.
How FHIR will play out in the population health arena remains to be seen. However, there are certain use cases that Wellcentive believes will feature prominently in the near future. One such case is the scenario of providers using an EMR as their main workflow tool, but needing population health alerts for their patients. Because accurate alerts require a complete and precise longitudinal chart, EMRs simply do not have the data to offer that functionality. Tools used for population health management should inherently offer such a complete longitudinal chart.
The difficulty in this instance for providers is one of workflow; specifically, having to use two separate tools. Furthermore, having to leave the EMR, log in to a separate application, search for a patient again, and adjust one’s mindset to a completely new screen layout is difficult, and makes an already cumbersome EMR process even more onerous. Fortunately, the FHIR specification provides for an Alert API. This means that rather than leaving their EMR, providers can have their EMR call the Alert API of their population health management tool, get the alert data on the fly, and have the EMR render it in real time in the patient’s chart.
A second use case for FHIR and population health revolves around care plans and care management. Because population health management tools generally have more complete and accurate data, they serve as better tools for care managers who need the complete picture of a patient’s health in order to make informed decisions about care plans. Providers, however, generally use their EMR as the primary point of data entry. This discrepancy in workflow creates an information barrier between the care managers who update care plans and the providers who enter data into the EMR. To remedy this, FHIR allows for a care plan API which can be leveraged to bridge the potential gap in tools. Specifically, if the EMR supports the care plan API, the population health management tool can push updated care plans to the EMR for the provider’s use.
These are just two potential occurrences where FHIR will directly affect the population health management space. As the specification is completed and gains popularity, more possibilities are sure to arise. Wellcentive plans to support these two scenarios, as well as any others that will help to further the agenda of improving patient outcomes, reducing costs and improving workflows.