The creation of electronic medical records opened a number of doors for the healthcare and research community to explore. Over time, this has led to EHR integration that has vastly improved communication between healthcare providers and patients. Healthcare data is now easier than ever to recall and digest, streamlining the lengthy medical history and communication process that clinicians once faced while providing care.
Another door opened included the ease of access to numerous electronic health records for research purposes. This access to potentially millions of health records could drive innumerable amounts of research that could improve the quality of care clinicians are able to provide.
However, a problem exists in EHR integration in its current state that has slowed R&D progress. FHIR - a next-generation standards framework created by HL7 describing data formats within an interoperable EHR - lacks the consistency needed to make this research a reality. What’s there to do regarding this issue? The team at Iron Bridge is here to break down the latest news regard FHIR research and development.
The Current State of FHIR and EHR Integration
Existing Dilemmas in the Consistency of HL7 FHIR Standards
HL7, as the governing organization for healthcare standards, created FHIR: the next generation standards framework for describing data formats, elements, and the application programming interface for the exchange of disparate EHRs. FHIR combines the best features of HL7 V2, HL7 V3, and CDA while leveraging the latest web service technologies. FHIR, in essence, is what makes EHR integration and interoperability possible for modern multi-tenant Software as a Service (SaaS) EHRs. FHIR’s long-term goal is to eventually replace HL7 2.x which has widespread adoption. Even with this widespread adoption, HL7 2.x has many shortcomings that FHIR intended to fix. During HL7 2.x creation, HL7 defined 80% of this standard, leaving 20% of the integration up to the two parties being integrated.
While this freedom allowed HL7 2.x adoption and EHR integration to really take off, it proved to create limitations preventing plug and play integration thus requiring data integrators to help facilitate EHR data exchange. FHIR should have solved these problems by eliminating the 20% standards negotiation experienced with HL7 2.x. Unfortunately, several factors have pushed FHIR to fall short in this area including various EHR vendor FHIR version implementations and varying FHIR standard consistency by EHR vendors.
This has not only made utilizing FHIR for basic healthcare transactions difficult, but it’s also increased the difficulty to acquire data for research purposes. When completing clinical research, researchers often look upon existing health records to find patterns in treatment, outcomes, and reactions among patients. However, the various and inconsistent EHR vendor FHIR implementations have turned consistency into a backseat issue. Researchers find it difficult to extract clinical data, transform it, and make it usable for research in a timely manner as current EHR formats only allow for data extractions from a single patient at a time and overall lower quality of data able to be extracted.
Tackling Issues with FHIR and Data Consistency
Calls to Create Uniform Data Formats for EHR Integration
The American Medical Informatics Association, or the AMIA, recently called upon to NIH to fund research and development into FHIR standards through a series of grants. The AMIA is far from alone in this notion, with researchers consistently looking for ways to use electronic medical records to their greatest ability. Additionally, many sources believe Google’s Nightingale project is looking for ways to make EHRs more accessible for research purposes.
All initiatives converge at the need for more uniformity in the way in which EHRs generate clinical data using FHIR. Currently, researchers are slowed by the curation of data - many times completed manually - that can be used from biomedical research purposes.
Once EHRs and HL7 can consistently implement the same FHIR standard for the creation and communication of medical information, the healthcare industry and the world of clinical research will be able to move forward with larger initiatives.
To further exacerbate these issues, FHIR is designed around single patient data extraction, making bulk data extraction extremely difficult. HL7 as an organization is aware of this issue. Currently in development is a new set of capabilities from HL7 called ‘bulk FHIR:’ an FHIR that could potentially allow researchers to examine hundreds of thousands of pieces of data at once. Once adopted by the EHR vendor community, the democratization of clinical data for research purposes will finally open the doors for medical research and advancements that EHRs as a whole have put on a back burner for some time now.
Tackling Interoperability with Poor FHIR Data Consistency
How Iron Bridge - a Leader in EHR Integration - Solves these Interoperability Issues
FHIR standards are designed to support healthcare interoperability, decreased costs, and shorten implementation times of EHR integration. However, the implementation of slightly-varying standards keeps healthcare interoperability and data communication from reaching its full potential.
What’s there to do about this lack of consistency? While HL7 and larger corporations like Google continue their efforts at making health record data more consistent and transferable, Iron Bridge puts the power back in vendors’ hands regarding interoperability. Essentially acting as the Rosetta Stone of data exchange between varying EHRs, Iron Bridge steps in with managed EHR integration services at a monthly rate only a percentage of what you’d pay for in-house implementation. With the help of Iron Bridge, the healthcare industry can begin making proper use of (currently inconsistently formatted) data for research purposes, finally embracing the capabilities of electronic medical records as a whole.
Think it’s time to set your FHIR standards straight? Reach out to the team at Iron Bridge to take your first steps toward affordable managed EHR integration today.
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