FHIR Holds Big Promise for Interoperability, but Will Need to Coexist with Other Standards for the Foreseeable Future

Russell Leftwich, MD, senior clinical advisor of interoperability at InterSystems and member of the HL7 board of directors, says IT professionals need to have a strategy for integrating the spec with existing standards into a hybrid model.

Once again this year, HL7's FHIR specification was a hot topic at HIMSS17, a burning issue discussed ardently across the show floor. (Our apologies, but heat- and flame-related puns seem to be required when writing about FHIR. Thankfully, we've gotten them out of the way early.) But while many vendors were touting their embrace of the interoperability spec, and while the promise it holds for enabling faster and easier exchange of data is very real, the open API isn't going to supplant existing HL7 standards such as Version 2 and CDA any time soon. 

That means the industry will be taking a hybrid approach to interoperability standards for the foreseeable future.  We recently spoke with HL7 board member Russell Leftwich, MD, senior clinical advisor of interoperability at InterSystems and co-chair of both HL7's Learning Health Systems Workgroup and its Clinical Interoperability Council, for his perspective on FHIRs place in healthcare now and prospects for the future.

Q. How do you see FHIR's place right now in the larger ecosystem of interoperability standards?

A. Number one, it will be the preferred technology for new development, particularly when it involves accessing data across many servers. That's one of the driving forces for developing FHIR – that the existing standard are based on technology of a previous era. Really, interoperability in the '80s, when those standards were first developed, meant connecting two systems together. And then we managed to extend those standards to connect one system to multiple systems. But the reality of today is that there's data across many systems, for an individual or a population – and that's happened steadily over the past decades. The amount of data has grown, and so has the number of places where it exists...