Fyrstain

The health data sharing platform: example of the Toulouse University Hospital

Elodie — Mon, 08 Apr 2024 08:34:14 +0000

Context

The limitations of interoperability capacities are recurrent in health structures which suffer from not optimizing the interaction between their applications as well as with their close partners.

This is why the HL7® FHIR® (Fast Health Interoperability Resources) standard – the international standard defined by HL7 – now appears to be the most suitable for developing and implementing healthcare interoperability simply and quickly.

However, in France, adoption by establishments remains low because there are still challenges and problems to be solved :

Lack of expertise on the subject;
Lack of guaranteed data uniformity;
Lack of autonomy of structures that depend on publishers’ schedules;
No strategy for managing different versions of FHIR®;
Prohibitive cost of adaptation to the standard of current solutions.

Control of the data exchanged remains therefore difficult to access, especially since some older standards, such as HL7v2, do not offer any history or storage solutions.

Facilitate exchanges between services

The « Health Data Sharing Platform » aims to promote the use of health data and increase the possibilities for their exploitation.

It streamlines the work of healthcare practitioner, management of the health system, monitoring and patient information.

At the heart of the production: the international FHIR® standard. It provides a well-documented, easy-to-maintain, and future-proof interoperability framework for internal and external applications. It also meets the need for a common language to deal with the explosion in the number of interlocutors and strengthens the data sovereignty of health structures.

In this reliable and stable environment, the platform provides greater control of data and internal organization (reduced costs, better planning management, synergy between applications and installation of new solutions). Ultimately, this improves the quality of life at work for healthcare professionals as well as that of patient care.

Facilitate exchanges between services

The « Health Data Sharing Platform » aims to promote the use of health data and increase the possibilities for their exploitation.

It streamlines the work of healthcare practitioner, management of the health system, monitoring and patient information.

Secure data

Data hosting poses problems of sovereignty and confidentiality of sensitive data such as medical data.

With the health data platform, no more pushing data to all partners without control. It makes data available and applications only access what they need !

The data is sorted and stored in storage spaces according to their functional scope. This allows the platform to adapt to usage and protect access to its data.

No application ever directly accesses the core of the platform. The reverse-proxies put in place provide a layer of protection.

The implementation of a security audit keeps connection traces and detects unauthorized access attempts.

All internal and external applications to the establishment will be able to query the platform to use the data. No extra effort to synchronize them !

Discover Fyrstain solutions on FHIR® (Link: Our services).

The post The health data sharing platform: example of the Toulouse University Hospital first appeared on Fyrstain.

Pandora: A Solution in Constant Evolution

Bejavi D. Anatecilunu — Fri, 23 Feb 2024 10:39:39 +0000

Context

Fyrstain’s Pandora solution continues to push the boundaries of innovation in the field of digital health. At the recent HL7 Europe Working Group Meeting 2024 held in Athens, Greece, with experts on the HL7® FHIR® standard and testing, the decision emerged to integrate a new validator into Pandora.

As a result, Pandora has achieved a major milestone by integrating a cutting-edge validator with Matchbox, thereby enhancing its ability to ensure compliance and reliability of exchanged data. This integration provides Pandora users with a powerful tool to validate and ensure the quality of medical information, thus contributing to more informed clinical decisions.

Thus, Pandora, already equipped with validators based on the hapi-FHIR® reference implementation, has been adapted to accommodate Matchbox as a validator in our platform.

Through the adoption of FHIR®, interconnection with external APIs has been greatly facilitated. The open-source resources available online enabled rapid integration within a few hours. However, adapting implementation details to our internal standards required the development of specific codes, which represents a crucial long-term consideration.

Overcoming Integration and Validation Challenges

Integration, while undemanding, remains problematic. The standard is the same, but the lack of clear specifications leads to variations in implementation. To focus more on validation and testing, it would be beneficial to establish a clear API definition for such services. At Fyrstain, as part of the work on Pandora, efforts are also underway to standardize testing APIs and produce guidelines in the form of an Implementation Guide (IG). Although these initiatives are still in development, they could serve as a starting point for a discussion on standardizing the integration of testing tools.

Specification IG for Testing: A Resource Adaptable to Any Platform

Recognizing the essential quality of testing in the healthcare domain, we have undertaken the creation of an Implementation Guide (IG) specification dedicated to the testing part. This detailed guide aims to provide our users and partners with clear and precise guidelines to maximize the efficiency of their testing within the platform.

Designed with a modular approach, this Test IG can be implemented by multiple platforms. We have considered the diversity of our users’ needs and anticipated the need for flexibility in their testing processes. We believe this flexibility will help streamline the testing process, regardless of the environment in which our users operate.

The implementation of this Implementation Guide aligns with our ongoing commitment to improving quality and ease of use, as well as integrating external tools into Pandora. We understand the importance of having structured resources to guide our users in optimizing their testing processes. The adaptable aspect of this Test IG reinforces our commitment to facilitating integration.

Future collaboration

Driven by Fyrstain, a group of diverse stakeholders in the healthcare ecosystem plans to form a dedicated working group to improve testing practices, ensuring they meet the changing needs of the digital healthcare sector. These efforts will help address the complex challenges related to interoperability and integration of healthcare systems, positioning Fyrstain at the forefront of innovation in this crucial domain.

Conclusion

In conclusion, these recent advancements demonstrate Fyrstain’s ongoing commitment to delivering a Pandora solution that is increasingly powerful, reliable, and adaptable. Through these developments, Pandora strengthens its position in the field of digital health, offering powerful tools and high standards to address the complex challenges of interoperability and integration of healthcare systems while remaining open to the community and ensuring interoperability.

These advancements demonstrate our commitment not only to test interoperability but to fully incorporate it into our system.

Stay tuned for more information on Pandora’s exciting progress and how Fyrstain continues to innovate to shape the future of digital healthcare.

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Hospitals on FHIR® (HOF): The Health Data Interoperability Revolution in Europe

Bejavi D. Anatecilunu — Fri, 10 Nov 2023 11:23:08 +0000

Introducing Hospitals on FHIR®

In the healthcare sector, hospitals and healthcare facilities are the primary locations for generating health data. For the European Health Data Space (EHDS) to become a reality for citizens, supporting both primary and secondary use of health data, it is essential that the data generated in these organizations can be shared. Experts, industry and EU-funded projects are converging on the HL7®FHIR® (Fast Healthcare Interoperability Resources) standard as a means of ensuring interoperability in healthcare, a central pillar of the European Electronic Health Record and its exchange format.

The Hospitals on FHIR® initiative, launched by HL7 Europe, aims to build interoperability maturity in organizations by fostering a progressive, collaborative approach with a community to align with the EHDS philosophy of creating value for patients through data sharing. Hospitals on FHIR® encourages hospitals and other healthcare organizations to collaborate, share expertise and learn together.

Furthermore, communication channels among HOF members have recently been established, such as a European-level Slack channel and discussion groups, to facilitate the exchange of various ideas among participants. This community-based approach creates a favorable environment for innovation and mutual learning.

This community-based approach creates a favorable environment for innovation and mutual learning.

HOF in France

France is an example of a country that actively participates in Hospitals on FHIR® to improve the interoperability of healthcare data. What sets the French approach apart is the way it exchanges and shares information. Health data interoperability in France is not just a technical issue, it’s also a question of sharing. The aim is to share experiences, collaborate and create synergies to improve interoperability between hospitals and healthcare facilities.

The HOF community in France is a unique initiative. It brings together public and private hospitals, and all types of healthcare facilities. Proof of this is evident: several key players in the e-health sector were present at the FHIR®User Day in Rennes on September 25th.

France’s healthcare regulatory authorities also support this community-based approach. They recognize that for healthcare data interoperability to succeed, it is essential to bring stakeholders together, share knowledge and learn from each other. This approach encourages the expansion of the initiative. Frédéric LAURENT, director of the Interop’Santé association and Interoperability Project Manager at Rennes University Hospital, recently became a HOF ambassador.

How Fyrstain supports HOF

Fyrstain, a medical software interoperability consultancy specializing in the FHIR® standard, plays a key role in supporting the HOF community in France. Our company works closely with members of the HOF community, through company founder Luc CHATTY, who is also a HOF ambassador. In particular, it works with hospitals, healthcare service providers and regulatory bodies to facilitate the adoption of FHIR® and improve interoperability in France and worldwide. The FHIR® User Day was notably organized by certified experts, with a full day dedicated to the work carried out by various European stakeholders.

Fyrstain plays a key role in promoting the pooling of hospital work in France. By encouraging hospitals to collaborate and share experiences, Fyrstain promotes the emergence of common solutions and shared FHIR® profiles. This pooling of resources helps reduce redundant efforts, accelerate the implementation of standards, and promote a faster adoption of digital health technologies. Thanks to its Pandora platform and expertise, Fyrstain is actively contributing to the creation of a collaborative healthcare community in France, where hospitals work together to improve the quality of care and interoperability of systems.

Fyrstain offers tailor-made implementation solutions, helping healthcare facilities to integrate the FHIR® standard efficiently. The company also offers training and ongoing support to ensure that interoperability progresses smoothly and correctly.

The company also offers training and ongoing support to ensure that interoperability progresses smoothly and correctly. Thanks to this collaboration, France is well positioned to take full advantage of the benefits of healthcare data interoperability offered by FHIR®, while strengthening its unique community of practice.

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Unlocking Pandora : Fyrstain revolutionizes Healthcare interoperability testing

Bejavi D. Anatecilunu — Thu, 26 Oct 2023 13:30:26 +0000

Context

In the ever-changing healthcare technology landscape, the adoption of HL7® FHIR® as the standard for health information exchange has transformed the way data is shared, managed and exploited within the industry. The Pandora Platform seamlessly incorporates FHIR® into its testing environment, granting you the means to ensure the robustness, security, and interoperability of your healthcare applications with unparalleled simplicity.

Whether you’re an experienced developer looking to fine-tune the intricacies of your FHIR® implementations, or a healthcare professional looking to validate the accuracy of data exchanges, the Pandora Platform stands as your steadfast companion. From its user-friendly interface to its state-of-the-art simulation capabilities, every element is meticulously crafted to streamline your testing experience.

Why Pandora ?

In the world of healthcare software development, one thing is certain: interoperability is paramount. The ability of different systems to communicate and share data is the linchpin of modern healthcare. That’s where Fyrstain, a specialized medical software interoperability consulting company, comes into play. With its groundbreaking tool, Pandora tool, Fyrstain offers a solution to a pressing issue. The absence of robust interoperability testing solutions during the development phase can lead to prolonged patching cycles and stalled progress. Fyrstain, the creator of Pandora, provides a comprehensive testing platform that bridges the interoperability gap.

For whom ?

Pandora ‘s utility extends primarily to healthcare publishers and hospitals, making it an invaluable asset in their operations. These institutions are the primary beneficiaries of Pandora’s robust capabilities, and it plays a pivotal role in enhancing the efficiency and reliability of their systems.

It empowers healthcare publishers to validate content and system interoperability, ensuring the seamless exchange of vital medical information, adhering to standards, and promoting accurate data sharing.

For hospitals, Pandora safeguards patient data integrity and validates EHR systems, laboratory information systems, and other critical components of healthcare delivery, enabling timely and effective patient care.

What is Pandora ?

Pandora is an advanced FHIR® server test software developed by Fyrstain. It stands as a groundbreaking tool that empowers healthcare organizations to ensure that their software adheres to the highest standards of quality, security, and interoperability. This innovative platform offers a wide array of functional capabilities designed to streamline healthcare software testing and validation processes:

1. 100% FHIR® compatibility: Pandora is designed to be fully compatible with the Fast Healthcare Interoperability Resources (FHIR®) standard. It enables seamless testing and validation of healthcare data exchange based on this universal standard, ensuring that you have access to your data and are free to exploit them as you wish.

2. Multi-Standard Support : Pandora is built to support any kind of standard, through the use of generic interfaces for validators, it adapts to your unique needs. The platform currently supports FHIR® R4 and R5.

3. Automated Testing : With Pandora, you can automate various aspects of healthcare software testing. This automation not only saves time but also enhances the accuracy of your testing processes, contributing to more robust and dependable healthcare systems.

4. Integration into DevOps Pipelines : Pandora can be seamlessly integrated into your DevOps pipelines, allowing for continuous and automated testing. This integration ensures that your healthcare applications are rigorously tested at every stage of development, leading to improved quality and reliability.

How does Pandora work ?

Pandora ‘s strength lies in its compatibility with even the most intricate digital health environments. The software is designed to enable comprehensive testing, and it offers the flexibility to customize test scenarios to mirror real-world situations.

Within Pandora, you have a range of essential features at your disposal :

Validation tools : Pandora offers a suite of validation tools that ensure your healthcare data adheres to FHIR standards. These tools meticulously verify data accuracy, consistency, and compliance, guaranteeing the highest quality of healthcare data.

Comprehensive testing : Create and run comprehensive tests for your healthcare applications. This functionality allows you to build test scenarios, simulate interactions, and evaluate the performance and interoperability of your systems within a controlled environment.

Insightful reports : The “Reports” feature provides detailed insights and analysis of your testing efforts. It grants access to comprehensive reports that highlight the strengths of your healthcare applications, areas that may require improvement, and key performance metrics.

Real-time monitoring : Track and monitor real-time interactions and events within your testing environment. This helps you keep a vigilant eye on data exchanges and system responses as you assess the robustness of your applications.

Communication logs : These logs, generated during your testing sessions, serve as valuable records of interactions and assist in identifying issues for further analysis and improvement.

System management : You can manage configurations, view settings, and track changes in your testing environment, ensuring optimal performance and interoperability.

Pandora provides these features to facilitate comprehensive testing, empower data quality assurance, and offer valuable insights to enhance the performance of your healthcare applications in an ever-evolving digital health landscape.

When and where to use Pandora

Pandora is a versatile solution designed to meet the evolving needs of healthcare environments, whether on-premises or in the cloud. The decision of where and when to deploy Pandora depends on the sensitivity of the test results and the data storage preferences of the user.

In healthcare, where test results can be highly sensitive, and data security is of paramount importance, the option for on-premises deployment becomes a strategic advantage. Hospitals, for instance, often conduct tests using real patient health data, and the on-premises option empowers healthcare institutions to maintain control over their data.

Pandora is especially valuable in the testing phase of software development, allowing healthcare facilities to verify compliance and non-regression before deployment. This ensures the quality of interoperability within the organization, assuring seamless integration and optimal performance. As healthcare technology continues to evolve rapidly, staying at the forefront of interoperability is essential to delivering the highest quality of care and patient safety.

Get Pandora now !

In conclusion, Pandora is not just a testing tool; it’s a guardian of quality, security, and interoperability in the digital health domain. Embrace Pandora, created by Fyrstain, today, and take the first step toward a smoother and more efficient healthcare ecosystem. Don’t miss the opportunity to open the box of possibilities with Pandora.

Ready to explore Pandora and enhance your healthcare applications ? Contact Fyrstain (Link: Contact) today to find out more about this revolutionary FHIR® server test software, available to customers now.

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Our feedback on our FHIR® DevDays experience

Bejavi D. Anatecilunu — Mon, 24 Jul 2023 09:41:20 +0000

Context

A month ago, Luc and I took part in our first face-to-face FHIR® DevDays event in Amsterdam. For those unfamiliar with DDs, this is THE event not to be missed if you use standard HL7® FHIR® (https://www.youtube.com/watch?v=giVyMbKH8FE).

DevDays is four days filled with 100+ sessions organized around FHIR® and hundreds of participants from all around the globe. As the biggest FHIR®-only event in the world, it is the perfect place to learn, share and sharpen your FHIR® expertise. It is also a wonderful opportunity to share your experiences and enrich the community.

That is how I had the chance and honor to present Fyrstain’s work on CQL as a Speaker during our session named “Leveraging Clinical Quality Language and CDS Hooks to enhance Clinical Decision Support”.

Learn all about FHIR® !

Whatever your level of expertise or your use of FHIR® may be, you will find a lot of interesting and high value content that will allow you to deepen your comprehension of FHIR® for your everyday work with the Standard.

If you use or create Implementation Guides, you will learn more about the tooling and processes to set up (such as the FHIR® Community Process for example) as well as best practices to implement your use cases. It is also the opportunity to share experiences with other members of the community to get in contact and exchange innovative ideas and solutions around specific problematics.

Whoever develops around FHIR® will also find what it is looking for ! Every technical subject around FHIR® is discussed, all the way from easier subjects such as setting up a FHIR® REST API to more complex ones revolving around storage, architecture, terminologies, or tools like CQL, CDS Hooks, etc. We personally had the chance to present our work and experiences around those in a dedicated session. This led us to exchange with other members of the community who had worked in similar subjects and better understand the use of those tools in different use cases and share the problematics we all faced and solutions we found for it.

An international FHIR® community !

FHIR® DevDays is also an opportunity to meet the international FHIR® community! It is a particularly welcoming and caring community. It can be intimidating to make contact, especially when you’re new to FHIR® or attending such an event for the first time, and especially with the most illustrious members of the community. But the reality is that you are immediately put at ease but the warm and friendly atmosphere of the DDs. The FHIR® DevDays were also an opportunity for us to meet some members of the community with whom we’ve been able to exchange views on several occasions since we started on FHIR®, but who we’d never had the chance to meet in person.

Whether it be during the Chocolate SIG, Whiskey SIG, Padel competition, during or after one of the many organized sessions or during the traditional Social Event, there is no doubt in my mind you will come out of the FHIR® Dev Days enriched with a ton of new contacts and a fair load of happy memories !

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Why Quality Matters: Unraveling the Subtleties of Clinical Quality Language

Bejavi D. Anatecilunu — Mon, 19 Jun 2023 07:36:53 +0000

Context

In recent decades, hospitals have undergone an IT revolution aimed at improving patient care.

However, the computerization of patient records has also brought new challenges. One of the main challenges facing healthcare establishments is the integration of medical decision support systems (CDS) and clinical quality measurement systems (CQM), with the aim of achieving meaningful use of Electronic Health Records (EHRs).

These challenges are compounded by the lack of specification as to the exchange format of business logic to be applied to stored information, in existing formats, forcing developers to manually translate and implement specifications in their development environment.

This can lead to errors and inefficiencies, which in turn can increase production costs. In addition, this approach considerably hampers the fluidity of data exchange between healthcare organizations.

The Magic Solution: CQL

CQL (Clinical Quality Language) is an authoring language standard developed by Health Level Seven International® (HL7®) and designed to be a high-level language, easy to use and understand by healthcare professionals. One of its main objectives is to promote clinical quality, making it an ideal choice for electronic clinical quality measures (eCQMs) and clinical decision support systems (CDS).

One of the main benefits of CQL is its ability to promote a shared understanding of clinical knowledge. By providing a standardized representation, CQL enables the use of a common language and framework to express clinical logic. This promotes interoperability and facilitates the exchange of knowledge between different systems and organizations.

In addition, CQL facilitates the direct sharing of clinical knowledge artifacts by defining a serialization format for the canonical representation of logic. This serialization enables the seamless transfer of clinical knowledge between different tools and systems, eliminating the need for custom translations or complex mappings between different standards.

A key advantage of CQL is its human readability, which reduces the clinical burden by enabling clinicians to specify computable logic without having to write requirements and wait for results to evaluate them. CQL is so simple that clinicians can even modify and write the clinical logic themselves.

Adopting CQL offers many benefits for the healthcare industry. It simplifies the process of creating and sharing clinical knowledge artifacts, facilitating interoperability. With a clear, standardized representation of clinical logic, developers can more easily implement support and measures systems, leading to a reduction in implementation costs.

Accelerate Your Transition to CQL with Fyrstain

Fyrstain offers comprehensive training in the CQL language and supports companies and hospitals in the implementation of medical decision support (CDS) and clinical quality measurement (CQM) systems. We are here to help you take full advantage of the benefits offered by CQL, guiding you every step of the way, from design to implementation.

To learn more about the language of clinical quality, contact us at contact@fyrstain.com.

The post Why Quality Matters: Unraveling the Subtleties of Clinical Quality Language first appeared on Fyrstain.

The health data sharing platform: example of the Toulouse University Hospital

Bejavi D. Anatecilunu — Fri, 12 May 2023 08:54:22 +0000

Context

The limitations of interoperability capacities are recurrent in health structures which suffer from not optimizing the interaction between their applications as well as with their close partners.

At the international level, the United States explicitly recognizes this standard as an emerging standard for the exchange of health data. Thus, in 2019, 84% of hospitals had adopted it and it is now mandatory. In addition, the European health data space is also being built on this standard.

However, in France, adoption by establishments remains low because there are still challenges and problems to be solved :

Lack of expertise on the subject;
Lack of guaranteed data uniformity;
Lack of autonomy of structures that depend on publishers’ schedules;
Lack of strategy to manage the different versions of FHIR®;
Prohibitive cost of adaptation to the standard of current solutions.

Control of the data exchanged remains therefore difficult to access, especially since some older standards, such as HL7v2, do not offer any history or storage solutions.

Facilitate exchanges between services

The « Health Data Sharing Platform » aims to promote the use of health data and increase the possibilities for their exploitation.

It streamlines the work of healthcare practitioner, management of the health system, monitoring and patient information.

New uses

Our approach in order to meet the needs of the Toulouse University Hospital, as for any health establishment presenting similar problems, was to reflect on the problem as a whole and to identify a certain number of potential actors in order to discuss with them. We proposed a flexible and scalable architecture and simple use cases to serve as proof of concept. We studied the technical appetite of local teams and the existing technical environment in order to put in place only the bricks necessary for these use cases.

The « Health Data Sharing Platform » governs these new uses that can be adapted to all health structures.

Among them, the compliance of prescriptions and additional examinations is made possible by the implementation of a decision-making aid. The latter takes into account all the patient’s medical information, such as their history or known allergies. The patient’s agenda, which has become transferable, allows appointments to be made for a professional from another establishment. The sharing of patient identity makes it possible to link the different health establishments which can exchange data through the circle of care.

The platform optimizes the use of the circle of care and the liaison book, thus allowing exchanges between city doctors and the hospital and provides for circulating notes between health professionals. It feeds the HDW (Health Data Warehouse) and pools the terminology service, mapping, consent and structures (hospital services, buildings, etc…). CIO data is also retrieved by the platform.

Secure data

Data hosting poses problems of sovereignty and confidentiality of sensitive data such as medical data.

With the health data platform, no more pushing data to all partners without control. It makes data available and applications only access what they need !

The data is sorted and stored in storage spaces according to their functional scope. This allows the platform to adapt to usage and protect access to its data.

No application ever directly accesses the core of the platform. The reverse-proxies put in place provide a layer of protection.

The implementation of a security audit keeps connection traces and detects unauthorized access attempts.

All internal and external applications to the establishment will be able to query the platform to use the data. No extra effort to synchronize them !

Discover Fyrstain solutions on FHIR® (Link: Our services).

The post The health data sharing platform: example of the Toulouse University Hospital first appeared on Fyrstain.

Issues surrounding FHIR®

Elodie — Fri, 31 Mar 2023 11:48:42 +0000

Context

FHIR® (Fast Health Interoperability Resources), is not the guarantee of interoperability even if it remains a great tool for exchanging or modeling health objects.

It is essential that the modeling and the data respect certain rules in order to ensure their interoperability.

Various issues around FHIR® need to be resolved in order to correctly exploit this standard.

FHIR®, the assurance of semantic interoperability ?

In medical interoperability, semantics is the representation of concepts by codes. If the codes used are not the same, it becomes very complicated to function and to exploit health data. For example, using the same FHIR® Condition resource (for a personal history) if one healthcare facility models cancer by a code “CAN” and another by “Cancer”, what should I look for if I want the history of Cancer ?

Although FHIR® makes it possible to define sets of values for the coding of concepts, it is preferable to rely on terminological standards, standardized and agreed at national (eg: NOS) or international (UCUM, Loinc, Snomed) level. This ensures unambiguous interpretation, sharing and understanding of data between different systems, and even between different countries.

Although Fyrstain is not a specialist in semantic interoperability, we have experience with the various terminological standards and can refer you to specialized partners to meet your needs.

FHIR® profiling or adaptation to specific solutions.

The standard makes available a common base specification on which a variety of different solutions are implemented, these are the resources. There is great variability between jurisdictions, within the healthcare ecosystem and across use cases in terms of practices, requirements and regulations: an animal at the vet’s and a patient in the emergency department are both modeled by the Patient FHIR® resource, so is nothing without profiling: “Profiling FHIR®” (https://www.hl7.org/fhir/profiling.html

Profiling consists of adapting FHIR® resource definitions according to a particular context, using constraints and extensions. For example, these adaptations specify rules regarding which resource items are or are not used. Also, by providing descriptions of how resource elements and API functionality correspond to local requirements and/or implementations.

Creating profiles requires specific skills and tools. We can accompany you on these tasks or train you.

Difficulty finding efficient FHIR® servers

A FHIR® server implements the HL7® FHIR® standard, using FHIR® resources to exchange, store and access data.

3TB (terabyte) is the storage capacity required by a FHIR® server to ensure the smooth running of an organization handling millions of patients a year. This organization would need to create an average of 500 FHIR® resources per patient, or 5 billion FHIR® resources per year. Without substantial storage capacity and massive resource production, the FHIR® server will not be able to handle such large amounts of data.

A system sending 8 million HL7 messages per day, or 15 FHIR® resources produced per message, means that the system is ingesting approximately 2000 FHIR® resources per second. A FHIR® server should therefore be able to ingest/create thousands of resources per second.

Many manufacturers are working to improve their solutions to these problems. In the meantime, it is important to study the performance needs of your solution and to plan an architecture that does not bind you to a single technology.

Discover Fyrstain solutions on FHIR® (Link: Our services).

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FHIR® the paradigm shift in e-health

Elodie — Fri, 21 Oct 2022 07:37:00 +0000

Context

Let’s go back 3 years.

E-health is a sector that faces many challenges in France. Disengagement of healthcare professionals – disappointed with the unfulfilled promises of the digital revolution, lack of training of these same professionals in the issues and tools of digital health, lack of interoperability between systems – siloed and only connecting to their partners, outdated infrastructure, non-operable databases…

And then the Covid. The king is naked and the reality is clear: what a logistical challenge it is to even bring up hospital bed capacities or PCR test results. Behind them are often nurses, filling in their excel tables by hand. Like them, how many nurses lose time that could be allocated to care, every day because of inadequate tools?

Since then, a real political will has been revealed with the objective of modernizing digital health in France and in Europe. The French presidency of the European Union has rightly been hailed for the projects it has launched.

The covid is also the vaccine pass. But how did we manage to achieve the feat of a vaccination certificate that can be read in several countries? The answer can be found in four letters: FHIR®.

FHIR® the paradigm shift in e-health

The HL7® FHIR® (Fast Healthcare Interoperability Resources) standard is the latest standard from HL7, the non-profit organization for healthcare data interoperability.

Developer-oriented (recent technologies, REST and JSON), it has the particularity of proposing an easily understandable data exchange format (at least much more than its predecessors).

Widely adopted in the United States, it is appearing more and more in France, notably in the French interoperability framework (Espace de publication CI-SIS | esante.gouv.fr) and pushed by publishers through InteropSanté (L’interopérabilité des systèmes d’information de santé – InteropSanté | interopsante.org).

Since its creation, many tools have been created to help FHIR® development – including the HAPI library, the Logica platform and the FHIR® inferno validator – or to add new functionalities – Smart On FHIR® protocol, CQL, CDS-Hooks…

Its completeness (145 resources in version 4) and adaptability allow it to model almost all situations that a health software or a connected health object may encounter…

Problems not yet solved

Using FHIR® is not a guarantee of interoperability – this will surely be the subject of another post – but it is a great tool to exchange or model health objects.

However, it is essential that the modeling and the data are of a minimum quality in order to avoid repeating the mistakes of the past: unusable health data and software that only works in their ecosystems.

We will also need to migrate existing health data to enable its use.

Let’s be optimistic. The road will be long, but with a bit of rigor we can imagine in a few years leaving for another European country with our medical file, allowing researchers to conduct studies on cohorts on a continental scale or in a nearer future, systems warning of incompatibility between several drugs.

One thing’s for sure: this road will pass through FHIR®. And with Fyrstain, we will be there to help you start it and accompany you in this adventure.

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