Something wonderful will happen this year. It will be a bumpy ride (like the Wright brothers’ first flight), but it’s the start of a new era that will take us further than we can imagine.This is the start of real interoperability that finally includes us – the patient. Including us in health information exchange will have an impact on healthcare in the same way that smartphones has had an impact on communication.
In January 2019, a new law takes effect that gives us the right to download our medical records using any app of our choice – as long as that app is using specific technology standards to interact with their physician’s electronic health record (EHR). Most EHR vendors have chosen to implement FHIR® to make this possible. FHIR (Fast Healthcare Interoperability Resources) is a new Application Programming Interface (API) standard that can be used to allow us to gather our data locked within our physician’s EHR. You can think of it like an electrical socket. It doesn’t matter if you plug in a toaster, an iron, or a drill…as long as these items are built according to the socket’s requirements, electricity will flow into them. If a software application is built using FHIR and your doctor’s health organization has the “FHIR socket”, your health data will flow into your software application. It’s a beautiful thing!
This wonderful new ability is the result of many organizations and people working together to plan, build, and implement new technologies (and mandates for physicians to use the new technologies) to make sure our health data can flow unhindered all the way into our hands. (Thank you HL7®, Argonauts, and ONC!)
The ability for all EHRs to use a single common API has never been available before FHIR. In the past, each EHR vendor had their own requirements for applications to connect to them, making it impossible for one application to interact with all of them without special coding. The EHR vendors who truly care about patients having their own data will implement FHIR this year.
In this age of “Interoperability”, it is really important to remember to include the most important person – the patient. Historically, organizations talked about interoperability as the ability to share information between organizations. We are trying to change that perception. As an industry, we cannot reach true interoperability until the patient can gather and send their records to anyone they choose. We will be participating in two use cases in the HIMSS Interoperability Showcase™ to demonstrate real interoperability that includes the patient: Opioid Addiction Care and Telehealth & Stroke Continuum of Care.
I said this year will be a bumpy ride because the mandate takes effect in January 2019. Most of the larger EHR vendors will be implementing FHIR sometime this year and some smaller EHR vendors seem to be waiting to see if they can simply offer their own proprietary API to meet the mandate. (I think they will be sorry…)
Patients having all their health data at their fingertips will change healthcare. Studies have shown that patients who read their health records are able to better understand their conditions and are more adherent in taking their medications to improve their health. The ability to gather and share our records will help us to coordinate our care and manage the care of our loved ones. No more standing in lines to get our records and bringing them to the next doctor. Our records will travel with us and we can share them with anyone at any time.
Consumers will really be the driving force behind the success of FHIR and this new law. I have already changed my PCP because my old one did not have an EHR that is FHIR-enabled. The health organizations who see the value to me owning my own records will get me as a patient.
Once patients begin to learn about this new law, they will make choices based on this capability. We want our records…in our own application, fully under our own control. This isn’t only about convenience, it is about safety – making sure my doctors have complete and correct information about me. (More on that in a future blog).
If your doctors have never heard of FHIR, tell them to check it out and contact their EHR vendor to make sure it’s coming their way. If they think FHIR is not important, ask them if they think their cell phone is important.
Debi Willis is a HIMSS member and CEO / Founder of PatientLink Enterprises in Oklahoma City, OK. PatientLink’s newest innovation is MyLinks®, a multiple award-winning patient facing app that uses FHIR to allow patients to collect and send their health data to providers, researchers and others.
