The Genesis of FHIR

The need for interoperability was first highlighted back in the 1980s when payer organizations had to expand to working with data from more than one system. They needed a foolproof method of exchanging data from one system to another, where both systems could understand and process the data as per requirement.

Today, however, the number of systems within a payer organization has surpassed two. There are numerous IT systems, with their unique architecture and data formats – which exacerbate the complexity of data exchange for health plans w Furthermore, to support business intelligence, analytics, clinical decision support, and other machine-based processing, the data must be structured and standardized to support healthcare digitization. This has led to a growing pressure to broaden the scope of interoperability across organizations, handheld devices, mobile & cloud-based applications; to enable faster integration and workflow customization.

That’s where Health Level Seven (HL7) International comes in. It is a non-profit organization with members from all over the world dedicated to developing standards to exchange electronic health care data with ease. The latest interoperability standard is FHIR – Fast Health Interoperability Resource. In the simplest of terms, FHIR is a standard, describing data formats and elements, in which healthcare data can be exchanged and understood across organizations and applications using an API.

The need for FHIR – shortcomings of HL7 V2 and V3 

  • Almost 20 years old, HL7 V2 does not provide support to modern platforms for internal processing and manipulation of healthcare data. The flat file approach is too old school, hard to customize and extend as needed by the healthcare industry today.
  • The implementation required for HL7 V3 is more time-consuming and complex due to many customized tools. It has a very steep learning curve and as of now, has limited market adoption.
  • A standard that emerged with EHR Incentive Program – CDA implementation was mandatory but it requires extensive knowledge of RIM. Extensibility was offered but it required a lot of pre-processing. Every vendor in the market has its own style for extensions leading to errors while incorporating CDA from a different EHR vendor.

FHIR in a Nutshell  

It all began back in 2012 when the HL7 community began developing FHIR, combining the best features of HL7 v2 and HL7 v3. With the swiftly growing amount of healthcare data being shared across health plans and providers and with the boom of the apps being used for everyday purposes, the ecosystem needed to share data in a lightweight, real-time fashion using modern internet technologies and standards.

The concept of FHIR is to make healthcare information, be it administrative or clinical, available to those who have the right to access it, to ensure improved patient care. It is based on internet standards – such as the REST approach, which describes how individual packets of information or rather, resources can be shared easily. Adopting familiar technologies and standards that aligned with the latest and upcoming technologies, lowered the barriers of entry for software developers to support healthcare needs.

The Interoperability and Patient Access rule, as well as the Reducing Provider and Patient Burden proposal call for the mandatory implementation of certain FHIR APIs to ease administrative burden and further interoperability and enable fast access to healthcare data at the point of care.

Get In Touch 

Integrating FHIR into existing systems and enabling the exchange of information through the mandated APIs is no piece of cake. Software developers need a clear understanding of the healthcare ecosystem, the revenue cycle, as well as the heightened security protocols when it comes to dealing with healthcare data.

Thankfully Nalashaa comes equipped with it all. Connect with our experienced healthcare IT experts at and set your systems on FHIR.

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Shireen Noushad

Shireen Noushad

Currently, trying to navigate through the ocean of Healthcare IT systems, processes, and workflows. Passionate about writing, and stringing together words in the simplest of ways for a better reading experience and easier comprehension.

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