FHIR Optimism – Is It Misplaced?

We’ve all seen the optimism around FHIR. I even wrote the cheeky post titled FHIR is on Fire. I think that observation is still accurate. If you mention the word FHIR, then people start listening. I saw a number of sessions at HIMSS on FHIR and there was a lot of interest. I actually think that many people were (and are) still trying to figure out how FHIR is different from all the previous HL7 versions, but there was a definite interest in learning about it.

Admittedly, I’m still working to understand FHIR as well. However, in all the learning I’ve done, FHIR feels like more of the same. Certainly it’s a step forward from previous HL7 iterations. I think that it has much more robust capabilities. There is a lot to like about FHIR and I don’t want to thwart people’s efforts to bring it to light.

As I’ve thought about this more though, I don’t think FHIR is the coming of interoperability. Here’s what I asked in today’s #KareoChat:

I think most would agree that the reason we don’t have healthcare data interoperability yet has almost nothing to do with the technology. It has everything to do with political and economic reasons why healthcare organizations didn’t (and many still don’t) want to share data. I’m quite sure that if there was a political and financial reason to share data it would happen very quickly.

Assuming you agree with this premise, why then do we think that a new tech standard (FHIR in this case) will change those dynamics? Will FHIR be so plug and play obvious that healthcare executives will start being embarrassed for not sharing data when it’s so easy? My past experience with healthcare standards say that won’t be the case. FHIR will be a technical improvement over what we have today, but still will require a lot of effort.

I’d love to be proven wrong on this. Do you have a different view? I’d love to learn in the comments.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • I don’t have a differing view, though I wish I did – it feels quite pessimistic. I do tend to defend the vendors in situations like this, though, because I feel like they’re the new guys invited to the record-sharing dinner party and end up taking a lot of the perhaps misdirected heat.
    But maybe I’m wrong. The internet was a game-changer, after all…
    It’s hard not to root for a catalyst!

  • Megan,
    I agree. I think most of the vendors were just delivering what the customers want. That said, I think that some vendors are in a position where they could change the game and make interoperability so easy that their customers had to adopt it.

  • I am optimistic. I believe the key is that now the EHR vendors will have a standard way to build API into their products and not be accused of blocking. I think this is really important with the CURES act, if it gets passed. Lou

  • Lou,
    My fear is that they’ll use FHIR as a scapegoat to say “I’m not blocking” when in fact FHIR will only do one small subset of their data. It’s still early in the development of FHIR, so I’d be happy if they proved me wrong and really tapped into all the EHR data that’s needed. I’m just raising the warning flag so we can avoid that disaster.

  • FHIR leverages modern tech standards and allows for finer access to clinical and administrative data. Ultimately, FHIR is another tool that allows for a greater level of interoperability between vendors. We do not believe that it supplements standards like Direct, XDS, HL7 v2 messaging or v3 CDA documents, but instead complements and augments the options to support emerging and legacy integration scenarios.

    The industry is craving a silver bullet or one size fits all solution to interoperability. I believe we should look at Interoperability similar to how we look at tools in a toolbox. You want to use the right tool for the right job, since each tool is specialized to support a specific function. Imagine using your hammer to drill a hole in a piece of wood? You may be able to get the job done – but nowhere near as efficiently or with the precision of a drill. FHIR is a tool that lends itself well to specific scenarios and integration requirements – but is not a universal tool that, at this point, will replace or consolidate other pertinent standards that exist for Interoperability.

    The question to ask vendors is: “What’s in your toolbox”?

    We are optimistic about the FHIR standard, but recognize the challenges of adoption of such standard throughout the industry. Based on the industry track record, we are very slow to universally adopt and leverage emerging standards without a push from regulators.

  • Ryan,
    You’re right that people want a silver bullet and I don’t see one out there. We’ll have to take the toolbox approach since that’s all we have right now. I’ve also wondered if the silver bullet exists in healthcare interoperability. The more I learn, the more I think there isn’t one.

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