Health Informatics on FHIR

A brief history of the healthcare informatics field emphasizing long recognized key capabilities and the reasons for their slow adoption. An introduction to the Fast Healthcare Interoperability (FHIR) standard and its transformative potential. This is illustrated by an interview with the clinical team developing a FHIR based tool for use in an ICU environment. A survey of the problems and challenges facing healthcare systems around the world and in the US in particular. An introduction of chronic disease and its key role in rising healthcare costs. Alternate care models that show promise of improving healthcare outcomes while lowering cost and their dependency on the use of information technology. The concept of a Learning Healthcare System that continuously improves using informatics to glean new knowledge from actual patient care and feed it back to providers as they take care of future patients. An interview with a team of Emory researchers that are using a FHIR-based tool to help lower the cost of hospital care while improving outcomes. A discussion of electronic medical records, the federal programs to stimulate their adoption and the challenges physicians have in using them. An interview with the lead of the FHIR effort at the major health IT vendor Cerner. A detailed discussion of the rich array of patient-facing informatics tools and approaches used in the past and being increasingly deployed at present. An activity using Microsoft’s Personal Health Record system for patients. A detailed discussion of the complex technical and policy issues surrounding the sharing and exchange of confidential health information. An interview with a Blockchain expert and with an expert on data models for sharing of healthcare information for research,

Once electronic health records and other clinical systems used in patient care are digital, the focus turns to how this health information can be represented and shared using standards. Developing standards that are both sufficiently comprehensive and also implementable in practice is one of the long-standing health informatics challenges in part because of the complexity of the human body and the resultant complexity of patient care. We discuss data and data sharing (interoperability) standards separately but they are inevitably intertwined since the information being shared using interoperability standards is often represented using data standards.