Interoperability allows different applications, devices, and healthcare information systems (HIS) to exchange and access important health data without the risk of compromising its structure or security. Health data interoperability standards not only provide a common language to make data exchanges between disparate systems simpler, but they also provide an information infrastructure that maintains the meaning and security of the the important data elements.

Now, are you asking yourself, “Where do HL7 FHIR standards come in”? If you answered yes to that question, you’ve come to the right place!

Let’s take a closer look at why interoperability is so important, what the new FHIR standards are, why payers are struggling to meet new standards, and how they can solve those challenges.

What is HL7 FHIR?

HL7 FHIR is the Fast Healthcare Interoperability Resources framework developed and housed within the HL7 system. The HL7 FHIR standard defines healthcare information exchange processes between different computer systems in the healthcare industry, regardless of how that information is stored in each system.

Main Principles of FHIR

FHIR allows users to seamlessly share data through open application programing interfaces (APIs), improving the visibility of patient records and acting as a main connector between all systems, applications, and users that need access to the same patient data.

Here are a few of the main principles of FHIR as outlined by HL7:

  • Provide a flexible interoperability framework for users.
  • Prioritize implementation practices and standards.
  • Simplify data exchange processes.
  • Offer guided support (not strict mandates and specifications).

Key Benefits of HL7 FHIR

  1. Improved Data Management Practices: Because real-time data is collected from multiple sources across applications, systems, and even organizations, connections provided by FHIR resources allow for better data management. And, with improved data management, the organizational structure and accuracy of your data will also improve as a result.
  2. Automated Data Structuring: FHIR enhances organizational approaches to data exchange, and it leads the way for better care management practices, improved patient care experiences, and reduced costs for patients and providers. With automated data structure and exchange, organizations can save valuable time while continuing to maintain compliance and data security.
  3. Better Treatment Conditions: Interoperability between systems and organizations not only provides better access to important patient information and electronic medical records (EMRs), but it also helps improve system efficiency and treatment conditions as a whole. FHIR data sharing standards also allow for increased safety, speed, and reliability of data, therefore improving system standards for determining and maintaining patient treatment conditions.
  4. Increased Engagement: FHIR not only enhances data management processes for physicians and other staff members of healthcare organizations, but it also increases patient engagement opportunities by providing a way to track their own medical records and history through any approved healthcare software or applications. This way, patients have better visibility into their own health data, allowing them to make better decisions about their own treatment or care plans.
  5. Improved Patient Experience: In addition to allowing patients to manage their own data and medical records within the system, FHIR also provides simple integrations that make it easier for patients to share necessary data with their healthcare providers. With FHIR resources, patients are given a bigger voice in their own treatment and care coordination decisions.
  6. Easy Integrations: Most healthcare organizations use a variety of systems, applications, and integrations to optimize their operations. HL7 understands that third-party systems and tools are important to the success of many organizations, so FHIR standards not only work well with such tools, but they also provide easy integration capabilities between separate systems.

Breaking Down Interoperability Standards

While building and maintaining interoperability plans is an important step in optimizing system efficiency, organizations will also need to establish a secure and trusted connection with third-party applications.

These reliable connections offer better opportunities for patient data to comply with the ONC’s implementation specifications for OAuth and OpenID. The access has to include authorization and authentication for API users with tokens for accessing healthcare data for a single patient, verifying the patient, and revoking access, all at the patient’s discretion. 

The key requirements for standardizing data access include: 

  • Giving patients access to their data through a patient access API
  • Sharing provider data more broadly with third-parties through a Provider Directory API
  • Facilitating patient information transfer between payers (through a payer-to-payer exchange)
  • Complying with information blocking and federal/state data exchange and event notifications 

Why Is Interoperability So Important?

The global healthcare interoperability market has been in an extended period of rapid explosion. Market research firm Frost & Sullivan projects the market will reach $8 billion by 2024, (up almost 14% from $4.2 billion in 2019). A lot of that has to do with the exponential growth in clinical data over the past five years, but the more data you have, the more potential problems lurk within it. And the biggest issue? Much of that data is inaccurate. 

For example, medical data company, Diameter Health, found that 80 percent of allergies aren’t coded correctly, and 40 percent of medications don’t have the right coding to apply for quality purposes. On top of that, most of this healthcare data is sitting in silos, making it a herculean task to run simple analysis and get insights. 

Why Are Payers Struggling to Meet Deadlines?

According to Terry Boch, chief commercial officer for Diameter Health, many payers don’t have a plan to deploy new technical systems and make decisions with vendor partners in time to meet these standards. Stats from a poll conducted by Diameter Health reveal that 58 percent of health plans said they were behind or didn’t know where they were when it comes to plan readiness, and 71 percent said the quality of their clinical data needed work. 

Rising to meet the challenge of new healthcare interoperability mandates can be a struggle, so it’s understandable that organizations are at a loss for how they’re going to meet requirements and deadlines set by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) for Health Information Technology’s 21st Century Cures Act Final Rule.

Getting Started with Interoperability Standards 

Changing CMS policies continually put healthcare interoperability in the spotlight, but a lack of effective data exchange continues to be a problem for payers. Fortunately, Surety Systems has been assisting healthcare providers with their HL7 engine challenges for years, and we’re here to help with any of your FHIR issues.

Our senior-level healthcare integration consulting team has the HL7 experience and skills you need to assist you in meeting these new interoperability standards.

How Can We Help?

Need an extra hand navigating third-party apps and APIs to support the FHIR Release 4 standard? Our consultants have you covered. Just need an extra hand understanding how FHIR APIs work in your organization? They can help with that too.

No matter where your HL7 needs lie, our consultants have what it takes to lead your team to success. And, to give you a better idea of what to expect when partnering with us, we’ve included a sample profile of one of our HL7 FHIR consultants:

Surety Senior HL7 FHIR Consultant

  • 6+ years Rhapsody Interface consultant
  • Rhapsody Expert Certification
  • Experience with RESTful and SOAP web services including FHIR and IHE frameworks
  • Build interfaces using Rhapsody Integration Engine for HIEs, health clinics, hospitals, and health  organizations
  • Extensive experience with JavaScript, HL7, JSON, and XML
  • Responsible for all route development, troubleshooting  and support across multiple environments across multiple HL7, FHIR, and IHE  frameworks.

Contact us today to learn more and take your mind off the tick-tock of the countdown clock.