Sequoia Project

The original vision for nationwide health information exchange was a “network of networks” model where local HIEs would interact HIE-to-HIE to form a virtual national network. But notice that many of the new initiatives are essentially solving a different problem: they are enabling point-to-point connections across a wider geography and set of clinical sites. This seems more like a large, single national network rather than leverage of more distributed organizations or implementations. Only time will tell if these private sector initiatives will collaborate, converge or compete. And only time will tell of the limitations of ONC’s ability to influence and provide leadership will creates gaps or provide new opportunities for innovation.

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It has been several years since we reviewed the progress of the HL7 FHIR standards adoption rate. Health Level Seven's (HL7) Fast Healthcare Interoperability Resources (FHIR) is an emerging standard that has rapidly captured the mind-share of the Health Information Technology (HIT) standards community. FHIR is a standard that enables healthcare data sharing between systems in a manner that is more easily implemented and more expressive than previous HL7 standards such as HL7 Version 2, 3 and Clinical Document Architecture (CDA). Regardless of the version of HL7 standard used, the purpose of these standards is to send clinical data in messages, whether to a party inside or outside your organization. HL7 devises flexible message formats so the receiver of the message can open it up, know who sent it and why, and break it down into understandable segments and data fields.

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