{"id":2037,"date":"2023-03-31T13:48:42","date_gmt":"2023-03-31T11:48:42","guid":{"rendered":"https:\/\/fyrstain.com\/?p=2037"},"modified":"2024-04-08T11:08:13","modified_gmt":"2024-04-08T09:08:13","slug":"issues-surrounding-fhir","status":"publish","type":"post","link":"https:\/\/fyrstain.com\/en\/issues-surrounding-fhir\/","title":{"rendered":"Issues surrounding FHIR\u00ae"},"content":{"rendered":"<section class=\"gb-container gb-container-f5182e37 gb-container-conteneurPrincipal\">\n<div class=\"gb-container gb-container-1321efaf gb-container-conteneurMedium\">\n<div class=\"gb-grid-wrapper gb-grid-wrapper-d3307bde\">\n<div class=\"gb-grid-column gb-grid-column-2bccbbb8\"><div class=\"gb-container gb-container-2bccbbb8\">\n\n<h2 class=\"wp-block-heading\">Context<\/h2>\n\n\n\n<p><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-accent-color\">FHIR\u00ae<\/mark> (Fast Health Interoperability Resources), is not the guarantee of interoperability even if it remains a great tool for exchanging or modeling health objects.<\/p>\n\n\n\n<p>It is essential that the modeling and the data respect certain rules in order to ensure their interoperability. <\/p>\n\n\n\n<p>Various issues around FHIR\u00ae need to be resolved in order to correctly exploit this standard. <\/p>\n\n<\/div><\/div>\n\n<div class=\"gb-grid-column gb-grid-column-4a92a894\"><div class=\"gb-container gb-container-4a92a894\" data-aos=\"fade-left\">\n\n<figure class=\"gb-block-image gb-block-image-6d0641b1\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"320\" class=\"gb-image gb-image-6d0641b1 gb-image-illustration\" src=\"https:\/\/fyrstain.com\/wp-content\/uploads\/2022\/10\/anim_obsolete.svg\" alt=\"Fhir background\"><\/figure>\n\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/section><section class=\"gb-container gb-container-ee8c3d1d gb-container-conteneurPrincipal_fond\">\n<div class=\"gb-container gb-container-704f14ac gb-container-conteneurMedium\">\n<div class=\"gb-grid-wrapper gb-grid-wrapper-9c72e5e3\">\n<div class=\"gb-grid-column gb-grid-column-43c244ab\"><div class=\"gb-container gb-container-43c244ab\" data-aos=\"fade-right\">\n\n<figure class=\"gb-block-image gb-block-image-8e227cc6\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"320\" class=\"gb-image gb-image-8e227cc6 gb-image-illustration\" src=\"https:\/\/fyrstain.com\/wp-content\/uploads\/2022\/10\/anim_solution.svg\" alt=\"FHIR Solutions\"><\/figure>\n\n<\/div><\/div>\n\n<div class=\"gb-grid-column gb-grid-column-ea852f3e\"><div class=\"gb-container gb-container-ea852f3e\">\n\n<h2 class=\"wp-block-heading\">FHIR\u00ae, the assurance of semantic interoperability ?<\/h2>\n\n\n\n<p>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\u00ae Condition resource (for a personal history) if one healthcare facility models cancer by a code &#8220;CAN&#8221; and another by &#8220;Cancer&#8221;, what should I look for if I want the history of Cancer ? <\/p>\n\n\n\n<p>Although FHIR\u00ae makes it possible to define sets of values \u200b\u200bfor 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. <\/p>\n\n\n\n<p>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. <\/p>\n\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/section><section class=\"gb-container gb-container-af5f63f9 gb-container-conteneurPrincipal\">\n<div class=\"gb-container gb-container-523797f5 gb-container-conteneurMedium\">\n<div class=\"gb-grid-wrapper gb-grid-wrapper-1c7042ef\">\n<div class=\"gb-grid-column gb-grid-column-4db6e311\"><div class=\"gb-container gb-container-4db6e311\">\n\n<h2 class=\"wp-block-heading\">FHIR\u00ae profiling or adaptation to specific solutions. <\/h2>\n\n\n\n<p>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&#8217;s and a patient in the emergency department are both modeled by the Patient FHIR\u00ae resource, so is nothing without profiling: &#8220;Profiling FHIR\u00ae&#8221; (https:\/\/www.hl7.org\/<a href=\"https:\/\/www.hl7.org\/fhir\/profiling.html\" target=\"_blank\" rel=\"noopener\" title=\"https:\/\/www.hl7.org\/fhir\/profiling.html\">fhir<\/a>\/profiling.html <\/p>\n\n\n\n<p>Profiling consists of adapting FHIR\u00ae 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. <\/p>\n\n\n\n<p>Creating profiles requires specific skills and tools. We can accompany you on these tasks or train you. <\/p>\n\n<\/div><\/div>\n\n<div class=\"gb-grid-column gb-grid-column-75f7e57c\"><div class=\"gb-container gb-container-75f7e57c\" data-aos=\"fade-left\">\n\n<figure class=\"gb-block-image gb-block-image-0162b693\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"320\" class=\"gb-image gb-image-0162b693 gb-image-illustration\" src=\"https:\/\/fyrstain.com\/wp-content\/uploads\/2022\/10\/anim_defi-1.svg\" alt=\"Fhir Standard Challenges\"><\/figure>\n\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/section><section class=\"gb-container gb-container-36c3c5e8 gb-container-conteneurPrincipal_fond\">\n<div class=\"gb-container gb-container-c965c224 gb-container-conteneurMedium\">\n<div class=\"gb-grid-wrapper gb-grid-wrapper-807cfd08\">\n<div class=\"gb-grid-column gb-grid-column-e80c5504\"><div class=\"gb-container gb-container-e80c5504\" data-aos=\"fade-right\">\n\n<figure class=\"gb-block-image gb-block-image-f220a394\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"320\" class=\"gb-image gb-image-f220a394 gb-image-illustration\" src=\"https:\/\/fyrstain.com\/wp-content\/uploads\/2022\/10\/anim_dev.svg\" alt=\"Fhir development\" title=\"anim_dev\"><\/figure>\n\n<\/div><\/div>\n\n<div class=\"gb-grid-column gb-grid-column-daa608c4\"><div class=\"gb-container gb-container-daa608c4\">\n\n<h2 class=\"wp-block-heading\">Difficulty finding efficient FHIR\u00ae servers <\/h2>\n\n\n\n<p>A FHIR\u00ae server implements the <mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-accent-color\">HL7\u00ae FHIR\u00ae standard<\/mark>, using FHIR\u00ae resources to exchange, store and access data. <\/p>\n\n\n\n<p>3TB (terabyte) is the storage capacity required by a FHIR\u00ae 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\u00ae resources per patient, or 5 billion FHIR\u00ae resources per year. Without substantial storage capacity and massive resource production, the FHIR\u00ae server will not be able to handle such large amounts of data. <\/p>\n\n\n\n<p>A system sending 8 million HL7 messages per day, or 15 FHIR\u00ae resources produced per message, means that the system is ingesting approximately 2000 FHIR\u00ae resources per second. A FHIR\u00ae server should therefore be able to ingest\/create thousands of resources per second. <\/p>\n\n\n\n<p>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. <\/p>\n\n\n\n<p>Discover Fyrstain solutions on <mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-accent-color\">FHIR\u00ae<\/mark> (Link: <a href=\"https:\/\/fyrstain.com\/en\/fhir-services\/\" target=\"_blank\" rel=\"noopener\" title=\"https:\/\/fyrstain.com\/prestations-fhir\/\">Our services<\/a>).<\/p>\n\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/section>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":1852,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-2037","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-what-is-fhir","infinite-scroll-item","masonry-post","generate-columns","tablet-grid-50","mobile-grid-100","grid-parent","grid-50"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/posts\/2037","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/comments?post=2037"}],"version-history":[{"count":23,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/posts\/2037\/revisions"}],"predecessor-version":[{"id":3342,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/posts\/2037\/revisions\/3342"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/media\/1852"}],"wp:attachment":[{"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/media?parent=2037"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/categories?post=2037"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fyrstain.com\/en\/wp-json\/wp\/v2\/tags?post=2037"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}