Is FHIR Adoption At A Turning Point, Or Is This Just More Hype?

Posted on October 8, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Over the last few years, healthcare industry players have continued to experiment with the use of HL7 FHIR to solve key interoperability problems.

Perhaps the most recent efforts to do so is the Da Vinci Project, which brings together a group of payers, health IT vendors, and providers dedicated to fostering value-based care with FHIR. The group has begun work on two test cases, one addressing 30-day medication reconciliation and the other coverage requirements discovery.

This wasn’t big news, as it doesn’t seem to be doing anything that new. In fact, few if any of these projects — of which there have been many — have come close to establishing FHIR firmly established as a standard, much less fostering major change in the healthcare industry.

Now, a new analysis by the ONC suggests that we may finally be on the verge of a FHIR breakthrough.

According to ONC’s research, which looked at how health IT developers used FHIR to meet 2015 Edition certification requirements, roughly 32% of the health IT developers certified are using FHIR Release 2, and nearly 51% of health IT developers seem to be using a version of FHIR combined with OAuth 2.0.

While this may not sound very impressive (and at first glance, it didn’t to me), the certified products issued by the top 10 certified health IT developers serve about 82% of hospitals and 64% of clinicians.

Not only that, big tech companies staking out an expanded position in healthcare are leveraging FHIR 2, the ONC notes. For example, Apple is using a FHIR-based client app as part of its healthcare deployment.  Amazon, Alphabet, and Microsoft are working to establish themselves in the healthcare industry as well, and it seems likely that FHIR-based interoperability will come to play a part in their efforts.

In addition, CMS has shown faith in FHIR as well, investing in FHIR through its Blue Button 2.0,  a standards-based API allowing Medicare beneficiaries to connect their claims data to applications, services, and research programs.

That being said, after citing this progress, the agency concedes that FHIR still has a way to go, from standards development implementation, before it becomes the lingua franca of the industry. In other words, ONC’s definition of “turning point” may be a little different than yours or mine. Have I missed something here?

Look, I don’t like being “that guy,” but how encouraging is this really? By my standards at least, FHIR uptake is relatively modest for such a hot idea. For example, compare FHIR adoption of AI technology or blockchain. In some ways, interoperability may be a harder “get” than blockchain or AI in some ways, but one would think it would be further along if it were completely practical. Maybe I’m just a cynic.