By Paul Sinclair,
Partner - Healthcare, Clarity Insights


When it comes to the exchange of data, application interoperability is crucial. That’s why 2019's debut of FHIR 4 – announced by the Health Level 7 board and advisory council – is an important milestone in the evolution of healthcare data exchange.

With heightened data privacy concerns top of mind, interoperability in healthcare has been slower moving than other industries. It’s more important than ever to be methodical and conscientious stewards of patient information, and the announcement of FHIR 4 is a welcome development to support the emergence of new applications that will ensure innovation can continue to open new doors for patient data — both within care centers and outside their four walls. 

1. “Normative” status is a signal of maturity. For investors, providers, payers, and IT practitioners alike, a “ready for use and stable” specification means a certain expectation for future consistency that helps in planning and moved the needle for greater adoption. The fact that this level has finally been reached helps make the business case for investments in healthcare interoperability that are much-needed, but often met with skepticism for systemwide change.

2. Standards will hold for FHIR 4-compatible code from this point forward, even with new updates. Developers can issue a sigh of relief at this news, affecting their work now and in the future when considering code updates to keep applications viable for the market. When you think of planned obsolescence, you might immediately think of your mobile phone. I could use my iPhone charger from just a few years ago for decoration or perhaps as a hipster belt, but for not much else. While it may work as a product strategy, for healthcare apps it’s far from desirable. And without backward compatibility for developers in the healthcare sector, developers had cause for concern that their painstakingly belabored code would become irrelevant as new standards emerged. Knowing the demand for skilled developers in this space and across IT, any motivators that show forward momentum provide a clear advantage…and a compelling case for greater application investment as new ideas enter the scene.

3. New levels of flexibility are a welcome shift. An important component of the new standard, new guidance allows for bi-directional, read or write functionality at the individual data element level or for entire documents. Paired with the future-compatible assurance that FHIR delivers, this stands out as noteworthy.

4. It supports pluggable apps. Amidst a wave of consumerization, patient empowerment is creating demand for new apps that can be downloaded directly from the Apple App Store or Google Play. Health tools at your fingertips is powerful but limited, if information cannot be shared with healthcare providers or insurers in order to bring impact full circle. These connections will be easier with FHIR 4 implementation, without worry that compatibility will be short-lived when the next update comes along.

5. Newly compatible data sources create new opportunity. “The addition of imaging resources, financial resources and decision support resources opens the door for more precise data analytics and precision medicine, further the pushing of normative approach for the underlying layer of the API will allow easier and more standardized adoption of FHIR,” said Dr. Shafiq Rab, board chair of the College of Healthcare Information Management Executives and senior vice president and CIO at Rush University Medical Center in an interview with Healthcare IT News. This means smarter, faster decisions that affect patient outcomes, and that’s a benefit that providers can agree on. As physicians begin to see the need for greater interoperability – even at the macro level – they are yet another stakeholder who can advocate for the importance of these standards to be upheld as new technology becomes available for adoption, too.

Of course, organizations need to have shared investment to exchange data in the first place: something that has hindered the advancement of interoperability through lack of incentive, enforcement and business reality. Other drivers need forward momentum in tandem with the advancements of FHIR 4 to be effective with widespread adoption. Even still, the developments here show that when other factors align, healthcare IT – leadership, developers, and software engineers alike – will be ready.  

Want an in-depth look at how Clarity Insights can make you a pioneer of your clinical data by capitalizing on FHIR 4 standards? Download our whitepaper here.

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