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and tools of digital health, lack of interoperability between systems – siloed and only connecting to their partners, outdated infrastructure, non-operable databases…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.
