With the launch of the Transfer of Care initiative by the HSCIC and NHS England, interoperability is becoming one of the leading IT issues for NHS organisations. Yet many organisations are struggling to understand how the technical pieces fit together.
HL7 UKs latest series of Interoperability Roadshows provide an ideal opportunity for NHS IT and integration teams to gain valuable knowledge around the use of HL7 and IHE standards, including V2, XDS, CDA and FHIR, and understand how these support Transfer of Care and other integration projects.
Delegates will also have the opportunity to engage with healthcare IT solution suppliers such as InterSystems, CSC, Orion Health and Qvera.
Attendance at these events is FREE. Also, please do feel free to forward this on to any of your colleagues who may also wish to attend. To see the full agenda, venue details and to register your attendance, please view the roadshow website: http://www.hl7.org.uk/marketing/roadshow/2016.asp
Thanks Kev. Nice to know that the event is being held at UCLH (where I work) but I sadly I cannot make it.
Kev, how do you see FHIR taking off in the NHS. How does it fit in the the GP appointment APIs? FHIR won’t cover those. I guess perhaps for extraction of structures data it does help but that’s predicated on underlying systems exposing FHIR APIs. Which bit of FHIR do you then is most helpful? The resources (data models) or the fact the it is a RESTful API? Or both??
Clearly the resources is never going to cover everything the NHS needs as they will be england/ NHS specific use cases.
FHIR is really just standardising what has been around for a good many years. The resources are very similar to most PAS and EPR’s internal data structures (EMIS LV/PCS, Trak, RiO, Cerner, Lorenzo, etc) and most of the API’s these systems make available are very similar to FHIR (many have had these for over 15 years including one GP supplier).
From a technical point of view FHIR works with REST, OAuth2 & JSON things a modern developer already knows. It also provides provides a resource API which has a number of IG (Confidentiality, concurrency & Security) advantages over SQL or messaging systems (ie HL7v2).
[This was really why I started looking at FHIR - working on a portal dealing with confidential data in social services]
[SMART on FHIR] For an app developer you can write a app using FHIR and it will work with Cerner or Epic (and HAPI FHIR Server). For Cerner or Epic it allows extra features to be added to the application without minimal cost to them, which adds value.
Against. It’s only suitable to (Enterprise) API work at the moment but it is currently being extended to support workflow. It’s support for complex interactions/models or service API’s is limited but you have HL7v3/CDA or openEHR for that and you could normalise them into FHIR like resources for storage.
Enterprise = NHS Trust or local health economy (NHS trust, social services, CCG, GP, etc)
In short if I was going to write an app from scratch I would build the api using FHIR.
It’s a no brainer. It’s the only standard that covers this, it follows modern practices and it saves me from building/documenting one myself. The model is very good and it helps you to avoid mistakes (difference between what you actually must do and what you’re asked to do).
Second reason (main long term reason). It’s good practice in an ESB/SOA environment to adopt a canonical model (https://en.wikipedia.org/wiki/Canonical_model). We’re using HL7 FHIR for this and HL7v2 for messaging.
Please clarify - is this a data model or a business model for developing apps
(I get angry when people waffle on about pathways without being more specific
e.g care pathway or PATIENT pathway)
Wonder how many terms or ways we can use to describe the same thing (I’d probably call a pathway a set of Referral Requests - matching terminology I’d use as a developer. FHIR is also developer driven, it describes how we see the health domain)
Re Pathways and definitions, clinically and operationally there are different types of pathway and further sub types with different functions and content. If we do wish to define these terms then @karen.j.green happens to be the Pathways and outcomes lead in trust and has done a lot on classifying pathways. She attended the openEHR training and has great insight into this stuff, (including mapping things like data points on pathways) we may wish to utilise her knowledge.
I would call a referral request an activity, an activity that sets a person of
on a patient pathway, 'appy to expand if you are interested?
However you are right about developers,
they must take all the bullshit and make IT real e.g. a person’s health journey
Again 'appy to expand if you are interested?
Integration of care relies on integration of data …
That is good, Karen understands pathway templates or care pathways
I use data to make every patient pathway unique just like every patient is
unique
A patient pathway is of type care pathway I.e. it is based on a template, but
once the activity starts being allocaredto it it becomes unique, the ACTIVITY
DATA is what makes it unique, just like every person (which includes clinicians,
patients, service users …) is unique
(Best not to put patients into boxes)
Indeed the patient pathway is unique as you describe, despite the all too common discrepancies in defining pathways it sounds like you have similar understanding to mine.
In overly simplistic terms the patient pathway is comprised of the implemented component parts of clinical, service and intervention pathways. The data that falls out of these can be used to describe the unique patient pathway.
The separate pathways can be seen as driving what goes into the patient pathway (so long as there are mechanisms to deliver this to the clinician and SU, pathways are like medicines they don’t work in the bottle!) Some are seen as particularly linear and have more affinity to templates whereas others have more breadth and decision points with words like “Consider” and lend themselves well to advanced decision support.
My understanding around this is forming well however it pails into insignificance when compared to Karens, she is a member of the ECPA (European Care Pathways Association) and presents internationally on the subject, she delivered a fantastic presentation in Italy last year which completely blew my mind!
Hello, I am a student at the end of study during internship for this I work on a
project named the transformation of messages hl7 on FHIR, but the
problem
is that I have no idea how I will start and By what started, you have
to khnow that I have to use the java language for messages hl7, please
help me to start the work…