FHIR

See the following -

Navigating between Heavy-weight and Light-weight Standardization

Andy Oram | EMR & HIPAA | August 25, 2016

Andy Oram

FHIR is large and far-reaching but deliberately open-ended. Many details are expected tovary from country to country and industry to industry, and thus are left up to extensions that various players will design later. It is precisely in the extensions that the risk lurks of reproducing the Tower of Babel that exists in other health care standards. The reason the industry have good hopes for success this time is the unusual way in which the Argonaut project was limited in both time and scope. It was not supposed to cover the entire health field, as standards such as the International Classification of Diseases (ICD) try to do. It would instead harmonize the 90% of cases seen most often in the US. For instance, instead of specifying a standard of 10,000 codes, it might pick out the 500 that the doctor is most likely to see. 

Read More »

Navigation Between Heavy-weight and Light-weight Standardization (Part 2)

Andy Oram | EMR & HIPPA | August 26, 2016

The previous section of this article laid out the context for HL7 FHIR standard and the Argonaut project; now we can look at the current status.Tripathi portrays the Argonaut process as radically different from HL7 norms. HL7 hasestablished its leading role in health standards by following the rules of the American National Standards Institute (ANSI) in the US, and similar bodies set up in other countries where HL7 operates. These come from the pre-Internet era and emphasize ponderous, procedure-laden formalities. Meetings must be held, drafts circulated, comments explicitly reconciled, ballots taken. Historically this has ensured that large industries play fair and hear through all objections, but the process is slow and frustrates smaller actors who may have good ideas but lack the resources to participate.

Read More »

ONC Releases New NPRM on Interoperability: How Might it Affect Public Health?

On February 11, 2019, the Office of the National Coordinator for Health Information Technology (ONC) released its latest Notice of Proposed Rulemaking (NPRM) to Improve the Interoperability of Health Information. Referred to by some people as the "Information Blocking NPRM," since this was the primary topic anticipated, the document actually covers a host of other topics related to interoperability driven primarily by requirements of the 21st Century Cures Act. Besides the initial text of the NPRM, ONC also released a set of summary slides and fact sheets to help explain the document.

Read More »

ONC's 3rd Interoperability Forum: Not Much to Report

On August 21 and 22, 2019 the Office of the National Coordinator for Health Information Technology (ONC) held its third Interoperability Forum in Washington, DC. More than 600 individuals participated in person with many others viewing the general sessions via webinar. The conference began and ended with half-day plenary sessions while providing five tracks with smaller sessions in between. I attended the Health Information Exchange (HIE)/Community-based Information Exchange (CIE) breakout session on both days. The plenaries...focused on the current state and the future state of interoperability.

Read More »

Open Health Guide to HIMSS19

The annual gargantuan HIMSS conference is back in Orlando with over 45,000 participants from more than 90 countries. There will be more than 1,300 vendors at the exhibit floor and more than 300 educational sessions. As with the last several conferences, the focus on open source as the key underlying technologies of health information technologies continues to increase. In previous conferences, we have seen the rise of open source technologies, in particular, those related to interoperability such as FHIR and Blockchain. A large number of sessions at HIMSS19 will be focused on another set of technologies powered largely by open source software and design principles such as artificial intelligence (AI), machine learning, and natural language processing.

Read More »

Open mHealth Popular Standard (Part 3)

Andy Oram | EMR & EHR | December 3, 2015

The first section of this article introduced the common schemas for mobile healthdesigned by Open mHealth, and the second section covered the first two design principles driving their schemas. We’ll finish off the design principles in this section. Here, the ideal is to get accurate measurements to the precision needed by users and researchers. But many devices are known to give fuzzy results, or results that are internally consistent but out of line with absolute measurements. The goal adopted by Open mHealth is to firm up the things that are simple to get right and also critical to accuracy, such as units of measurement discussed earlier. They also require care in reporting the time interval that a measurement covers: day, week, month. There’s no excuse if you add up the walks recorded for the day and the sum doesn’t match the total steps that the device reports for that day...

Read More »

Open Source EHRs: Will They Support Clinical Data Needs of the Future? (Part 2 of 2)

Andy Oram | EMR & EHR | November 18, 2014

The first part of this article provided a view of the current data needs in health care and asked whether open source electronic health records could solve those needs. I’ll pick up here with a look at how some open source products deal with the two main requirements I identified: interoperability and analytics. Interoperability, in health care as in other areas of software, is supported better by open source products than by proprietary ones. Read More »

openEHR: A Game Changer Comes of Age

I’ve been watching openEHR over more than fifteen years and have always been impressed by its potential to enable us to do things differently, but it’s been a slow burn, with limited take up, particularly in the United Kingdom (UK) where it was invented. However, recent developments mean that I think this is about to change and that openEHR is going to take off in a big way which is going to revolutionize how we think about and do digital health and increase the speed at which we can do it by at least two orders of magnitude. Why do I say this and what evidence is there to support my assertion?

Read More »

OSEHRA 2017: Open Source Becomes Mainstream in the Healthcare Industry

One of the most exciting things about the OSEHRA 2017 Open Source Summit was to see so many leading edge open source health IT solutions, and to hear reports of the major strides they are making around the world. Our very own Editor-in-Chief, Roger A. Maduro gave a presentation on the state of open health IT. The room was absolutely packed, with standing room only. Maduro started his presentation by pointing out that during the recent HIMSS17 conference in Orlando, Florida, more than half of of the 300 sessions of the conference were based on open source solutions such as FHIR, Blockchain, Interoperability and the open/modular IT strategy being followed by Medicaid.

Read More »

OSEHRA's Synthetic Patient Data Project Group Releases End-to-End Open Source Patient Data Software Package

Press Release | OSEHRA, Perspecta, MITRE | July 1, 2019

OSEHRA's Synthetic Patient Data Open Source Project Group is proud to announce the release of their end-to-end open source patient data software package. Sponsored by Perspecta Inc., an OSEHRA Organizational Member, this group has worked for more than a year to make it possible for users to generate, visualize, and ingest synthetic patient data with a single command. "The lack of realistic clinical data that mimics the volume, velocity, and variety of real-world patient records has been an impediment to health IT development, testing, and simulation," said Bo Dagnall, chair of the Project Group and Chief Technologist and Strategist for Perspecta's Health Business Group. 

Read More »

Problems with Health Information Exchange Resist Cures (Part 1)

Andy Oram | EMR & EHR | March 22, 2016

Given that Office of the National Coordinator for Health Information Technology (ONC) received 564 million dollars in the 2009 HITECH act to promote health information exchange, one has to give them credit for carrying out a thorough evaluation of progress in that area. The results? You don’t want to know. There are certainly glass-full as well as glass-empty indications in the 98-page report that the ONC just released. But I feel that failure dominated. Basically, there has been a lot of relative growth in the use of HIE, but the starting point was so low that huge swaths of the industry remain untouched by HIE...

Read More »

Regarding Open Source, Security, and Cloud Migration, Old Prejudices Die Hard in Health Care

Although the health care industry has made great strides in health IT, large numbers of providers remain slow to reap the benefits of a “digital transformation”. Health care organizations focus on what they get paid for and neglect other practices that would improve care and security. At conferences and meetings year and after year, I have to listen to health care leaders tediously explode the same myths and explain the same principles over and over. In this article I'll concentrate on the recent EXPO.health conference, put on in Boston by John Lynn's Healthcare Scene, where the topics of free and open source EHRs, security, and cloud migration got mired down in rather elementary discussions.

Read More »

Report on the ONC 2017 Technical Interoperability Forum

Last week I attended with my colleague Mike Berry the ONC 2017 Technical Interoperability Forum. This meeting was convened under the 21st Century Cures Act passed by Congress in late 2016. Several hundred participants attended a series of panel presentations and discussions. The forum took place over one-and-a-half-days. The forum covered a variety of topics related to interoperability, including discussion of the business case for interoperability, semantics, national networks, and application programming interfaces (APIs). In many ways the speakers were “the usual suspects” involved in national networks, standards development, and HIE planning and implementation.

Read More »

Sansoro Health Record API Will Unite Them All

Andy Oram | EMR & HIPPA | June 20, 2016

After some seven years of watching the US government push interoperability among health records, and hearing how far we are from achieving it, I assumed that fundamental divergences among electronic health records at different sites posed problems of staggering complexity. I pricked up my ears, therefore, when John Orosco, CTO of Sansoro Health, said that they could get EHRs to expose real-time web services in a few hours, or at most a couple days.

Read More »

Tech Industry Pledges to Improve Healthcare Through Open Source Health IT

Press Release | Information Technology Industry Council (ITI) | August 13, 2018

Today, ITI President and CEO Dean Garfield and several ITI member companies participated in the Blue Button 2.0 Developer Conference at the White House where they announced their commitment to removing barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI...“Today’s announcement will be a catalyst to creating better health outcomes for patients at a lower cost,” said ITI president and CEO Dean Garfield. “As transformative technologies like cloud computing and artificial intelligence continue to advance, it is important that we work towards creating partnerships that embrace open standards and interoperability.

Read More »