HL7 FHIR: What is it, Really? — Transcript

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1. 0:03fire or fast Health Care
2. 0:05interoperability resources is a
3. 0:07healthcare data standard created by hl7
4. 0:10International to meet the
5. 0:11interoperability needs of the current
6. 0:13Healthcare data environment over the
7. 0:16past few decades more and more systems
8. 0:18need to be connected so a data standard
9. 0:20of this kind has become essential
10. 0:22in fact compatibility with the fire
11. 0:25standard is now federally mandated for
12. 0:27healthcare I.T systems in many countries
13. 0:30with data now stored in many places such
14. 0:33as pharmacies home devices and mobile
15. 0:35devices interoperability and the fire
16. 0:37standard make it possible to see all
17. 0:40this data in one place in real time
18. 0:42fire was designed with key
19. 0:44considerations in mind including the
20. 0:46need to move data from offline to online
21. 0:48as well as data transparency
22. 0:51requirements
23. 0:52as a standard fire can also handle both
24. 0:54narrative and coded data to put it
25. 0:57simply fire is a representational state
26. 1:00or rest API fire encompasses the
27. 1:03specification for requesting and
28. 1:04receiving data as well as an agreement
29. 1:07on the meaning of the data in healthcare
30. 1:09let's take a look at the elements that
31. 1:11make up fire
32. 1:13first fire resources are logically
33. 1:15discrete data Concepts such as a patient
34. 1:18medication or document which have a
35. 1:20defined meaning and a known location on
36. 1:22a server
37. 1:24A Fire Resource includes all the data
38. 1:26elements necessary to define the data
39. 1:28concept
40. 1:30for example the patient resource
41. 1:32includes elements such as given name
42. 1:33family name and birth date
43. 1:36the fire specification also includes
44. 1:38profiles which are implementations of
45. 1:41clinical information models defined for
46. 1:43specific use cases such as a procedure
47. 1:47fire profiles exist for each resource
48. 1:49required for the use case
49. 1:51and they consist of all the necessary
50. 1:53rules and relationships value sets and
51. 1:56fire extensions
52. 1:58we'll discuss fire extensions in more
53. 2:00detail later
54. 2:01by using shared profiles Healthcare
55. 2:03applications can use fire across
56. 2:05different interoperability paradigms
57. 2:07without any transformation required
58. 2:10data expressed as fire can be used in
59. 2:13messages documents and rest apis
60. 2:16since fire is machine readable it can
61. 2:19also be used in services such as
62. 2:21decision Support Services
63. 2:23interoperability comes from using the
64. 2:25same fire profiles in each system
65. 2:27true interoperability comes from
66. 2:29exchanging information and having the
67. 2:31intended meeting come across
68. 2:33while humans are very good at
69. 2:35interpreting meaning computers can only
70. 2:37understand exactly what the data says
71. 2:41for example two people describing a
72. 2:43zebra is either a white horse with black
73. 2:45stripes or a black horse with white
74. 2:47stripes would quickly figure out that
75. 2:49these mean the same animal however these
76. 2:52descriptions are completely different to
77. 2:54a computer
78. 2:55to ensure that the same descriptions are
79. 2:57used across systems and Health Care a
80. 2:59clinical information model must be used
81. 3:01this includes the descriptions of
82. 3:03healthcare data concepts for a
83. 3:05particular use case rules of how the
84. 3:08data is used vocabulary or terminology
85. 3:10bindings and the relationships between
86. 3:12data
87. 3:14a fire profile is the implementation of
88. 3:17a clinical information model
89. 3:19to understand the importance of a
90. 3:21profile consider a patient's medical
91. 3:22history report from an EHR system that
92. 3:25you print out and cut into individual
93. 3:27data elements on one of these strips of
94. 3:30paper is the phrase diabetes type 2.
95. 3:34while we know what this phrase is the
96. 3:36context is missing diabetes could be a
97. 3:39condition the patient has a condition
98. 3:41they used to have or even a condition
99. 3:43their mother had based on family history
100. 3:46fire profiles provide context by
101. 3:48defining the relationships between data
102. 3:50elements and resources
103. 3:53the terminology binding in these
104. 3:55profiles uses a fire terminology server
105. 3:58which contains all of the codes and
106. 4:00value sets needed for a fire profile
107. 4:04the codes used for a particular element
108. 4:06make up a value set all applications
109. 4:09systems and operations using the profile
110. 4:12can access the server ensuring that the
111. 4:14same codes are used to refer to the same
112. 4:16data elements within resources across
113. 4:18systems
114. 4:20the fire standard includes data elements
115. 4:22that are used in 80 percent of systems
116. 4:24but it also defines how to create a fire
117. 4:27extension as part of a profile to
118. 4:29represent data elements for a specific
119. 4:31use case that are not already part of
120. 4:34the standard
121. 4:35for example a clinic that does medical
122. 4:37tourism may want to record a patient's
123. 4:39nationality which is not part of the
124. 4:42standard patient resource
125. 4:43they can simply extend the patient
126. 4:45resource to add a nationality extension
127. 4:49when fire extensions are created they
128. 4:51are published to a publicly available
129. 4:52URL meaning anyone who receives data
130. 4:56that uses the extension can discover
131. 4:57what it means
132. 4:59finally when it comes to putting the
133. 5:01fire standard into use for a specific
134. 5:03purpose you can refer to fire
135. 5:05implementation guides which contain the
136. 5:08profile resources including extensions
137. 5:11terminology bindings and value sets
138. 5:13needed for a particular use case Beyond
139. 5:16these technical details fire
140. 5:18implementation guides provide
141. 5:19documentation and examples of how they
142. 5:21might be used
143. 5:23these guides are published to a publicly
144. 5:25available URL using a web publishing
145. 5:28tool made by hl7 International as part
146. 5:31of the fire specification
147. 5:33since they are machine readable fire
148. 5:35implementation guides can be used to
149. 5:36validate fire applications developed by
150. 5:39using them to learn more about the fire
151. 5:41standard refer to the other content on
152. 5:44the intersystems learning site