True interoperability has been an elusive goal for over four decades. Interoperability is a component of most of the topics for this conference. Over the years, we have come to understand that interoperability requires many stakeholders to work together to achieve universal interoperability. The positive aspect of the COVID-19 pandemic has been the forced change on the healthcare industry. These changes include data aggregation across multiple sites of care; tracking persons and data over time; extending the collection of data to many sources and types of data beyond just clinical data; and tracking of resources, supplies, and health actions at national and international levels. From a technical perspective, we require semantic interoperability – not only the data elements and value sets, but consistency in what data is collected. Clinical research increasingly requires the aggregation of data across multiple sites. Big data is a desirable resource for machine learning and developing artificial intelligence applications. Is it unreasonable to assume that it is time for the world to adapt to global and consistent standards to support the exchange of data, the acquisition of data, the patient-centric patient record, and the development of knowledge, the sharing of knowledge, and the effective use of knowledge.
The Fast Healthcare Interoperability Resources (FHIR®) developed by Health Level 7 International (HL7®) is viewed by most as the best opportunity thus far to achieve true interoperability. Many government agencies in the United States, including ONC, CMS, HHS, FDA, CDC, and others, have endorsed its use or required it through regulation. FHIR itself is a tool, and effective and committed use of that tool is essential to optimize FHIR’s contribution to the health and healthcare setting. Special groups, known as Accelerator Groups, have been formed around FHIR. These ‘birds of a feather” have and are developing Implementation Guides (IG) addressing a particular health related industry such as reimbursement.
This panel is comprised of four individuals who address one component of the items discussed above. Charles Jaffe will give a brief overture to FHIR and an update on the growing FHIR Accelerator program. Paula Braun with present the perspective of the CDC and public health interoperability. Russ Leftwich will discuss the clinical use of FHIR, and Ed Hammond will present the role of FHIR in Clinical Research.