Heading Ontario in the Direction of FHIR Without Getting Burned
e-Health ePoster Library. Derman Y. Jun 5, 2017; 167125; EP02.01
Yaron Derman
Yaron Derman
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Abstract
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Purpose/Objectives: HL7 Fast Healthcare Interoperability Resources (FHIR) is an emerging approach to integrating health care information systems using modern technology standards. The designers of FHIR have made ease of adoption a cornerstone of the standard for trial use. Desirable qualities include documentation that is freely accessible and easily consumable without the need for complex custom tooling, no licensing fees, and an emphasis on implementation examples for all artifacts and reference implementations for several platforms, including live test servers available over the Internet. This has contributed to FHIR’s implementation by many projects before it has achieved normative standard status. As a result, rapid proliferation can lead to local interoperability but incompatible implementations between projects. This presentation will describe eHealth Ontario’s environmental scan which sought to understand Ontario-based health care organizations’ readiness to adopt FHIR as well as the tactics that should be pursued to minimize incompatible implementations.

Methodology/Approach: The advantages of using FHIR and current adoption challenges were researched through an online literature review. Ontario stakeholder input was gathered by survey to understand perspectives on the direction of standards selection in the future, resource effort to learn new standards, and which stakeholders influence standards adoption. Over 70 stakeholders participated in a FHIR adoption readiness workshop aimed at learning perspectives on the state of FHIR adoption in Ontario, and the opportunities and cautions that should be considered in standards selection. Further input and stakeholder feedback was gathered on the subsequent FHIR Adoption Readiness - Ontario position paper. Finally, ongoing anecdotal reports indicated that organizations are implementing FHIR to solve local interoperability needs.

Finding/Results: FHIR appears to be in the early adopters phase in Ontario. Attributes from Rogers’ Diffusion of Innovations theory are applied to interpret the process of FHIR adoption within Ontario. What is less clear is whether all implementations of FHIR are using the same FHIR build and/or how significant these differences are in terms of achieving long-term interoperability.

Conclusion/Implication/Recommendations: FHIR, in some capacity, will likely continue to be adopted by the majority of Ontario health system organizations. The findings of this project indicate that Ontario should invest in efforts to influence standardization across FHIR implementations so that it is aligned with the broader North American health IT market’s use of FHIR to minimize Ontario-specific customization.

140 Character Summary: Exploring Ontario’s readiness to embrace HL7 Fast Healthcare Interoperability Resources (FHIR), as well as its benefits and pitfalls.
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