1. FHIR: Progress and Future
The goal of the FHIR project is to make interoperabilty an order of magnitude cheaper. Preliminary indications suggest that this might be the case. Grahame will describe existing and potential implementations and consider their likely impact on the healthcare process
Why we started FHIR
Approach – borrow the best ideas
Ethos
Timelines
Purpose / Goal
Adoption
The hype curve
The trough + clinical interoperability
Grahame Grieve
FHIR Product Director for HL7
May
Sydney
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FHIR® and the FHIR icon are trademarks of HL7, inc (

2. Status R3 published in March >2400 change proposals
Implementation Experience (Trial use is working)
Alignment with other standards
Internal Quality Review processes
Standard for Trial Use

4. Key Changes
Added support for Clinical Decision Support and Clinical Quality Measures
Broadened functionality to cover key clinical workflows
Further development of Terminology Services, and support for Financial Management
Defined an RDF format, and how FHIR relates to Linked Data
Incremental improvements and increased maturity of the RESTful API and conformance framework

5. Plans for Release 4 Normative Graph retrieval Data Analytics
RDF + Patterns
Services
Deployment FM
Standard in-process development
Read this slide, then explain that this because we needed a globally unique acronym, and that this works really well for implementers

6. Normative “Forwards Compatible”
Implementations that are conformant will continue to be so
This is aspirational
Exact meaning:

7. Timeline Conceived July 2011
1st DSTU (Draft Standard for Trial Use) Feb 3rd 2014
Widespread Community Growth and Adoption
2nd DSTU Sept 23rd 2015
Substantial changes from implementer feedback
Solid version for US adoption (clinical / event summary)
3rd STU Mar
More changes (1000s) – but starting to become stable
Preparing for normative next time

8. Maturity levels Intended to indicate level of stability
FMM1 – Resource is “done”, no build warnings
FMM2 – Tested at approved Connectathon
FMM3 – Passes QA, has passed ballot
FMM4 – Tested across scope, published, prototype implementation
FMM5 – 5 distinct production implementations, multiple countries, 2
Breaking changes at level 4 and 5 need community discussion

9. Normative FHIR
For Release 4, some portions will be balloted as ‘Normative’
Platform, terminology and conformance resources
Structural resources
Subset of other resources
Some resources won’t go normative right away
Future releases
Add more resources
Add profiles on existing resources
May add elements to resources
Time line : late 2018

10. Graph Retrieval
GraphDefinition (
GraphQL (
demonstration

11. Data Analytics: Bulk data format
Required
Billions of records - efficient encoding
ETL-able into MPP databases or analytic tools (Apache Drill, Impala, Presto, Spark, Hive, etc)
Good array of open source tools
Preferred
Self-describing file format (no external schema)
format is splittable (multiple threads or processes can process)
Candidates:
Avro – row based
Parquet - Column Based

12. RDF + Patterns RDF: http://hl7.org/fhir/rdf.html
W5:
Goals
Allow users to process the internal metadata and extract value
Allow users to share and leverage mappings with other sources of knowledge

13. Services Current Terminology Service Future: Conformance
Provider Registry
Appointment Manager
Personal Health Data Manager

14. Deployment Issues Move Smart-on-FHIR to be an HL7 standard
Prepare cds-hooks for bringing to HL7
Clarify relationship with UMA/Heart

15. Financial Management
Different development process, philosophy and architecture at play
Differences to be subject of active review

16. Standard In-Process Development
Tasks created on gForge after community discussion
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1500 tasks processed for R3 – expect the same scale again
Plans:
Migration from gForge to Jira
Migrate from Subversion on gForge to GitHub
Build more scalable work flows as the community scales

17. FHIR Foundation Support community development activities
Implementation Projects like Argonaut
Provide infrastructure to support Community:
(support from Google)
Open for membership soon
Individual membership ~$250US/year
Corporate membership … still planning

18. Certification / Credentials
HL7 will offer two levels of testing
Proficiency Certificate – demonstration of your knowledge of the overall specification
Professional Credential – deep knowledge of the specification, qualified to advise on implementation
Requires ongoing involvement/training
Testing coming this year
Heather will talk about education

19. Questions / Discussion