As I work on #BlueButton on #FHIR I find people struggling to understand how FHIR works. I am still learning myself. This was a short introductory session I gave to colleagues at CMS about the underlying mechanics of FHIR and how it can benefit Healthcare interoperability.

1. A Baptism of FHIR
@ekivemark
Mark Scrimshire
HHS/CMS Entrepreneur-In-Residence

2. @ekivemark

3. What is
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• A Standards Developing Organization
• Accredited by the American National
Standards Institute (ANSI)
• Author of consensus-based standards
• Representing a broad view from healthcare
system stakeholders
• HL7 compiled a collection of message formats
and related clinical standards that loosely
define an ideal presentation of clinical
information
• Adoption of version 3.0 since 2005
drove a “reset” in the HL7 Community
• FHIR is the result of that “reset”
http://www.corepointhealth.com/
whitepapers/evolution-hl7

4. What is the Industry doing with FHIR?
athenahealth
Beth Israel Deaconess Medical Center
Cerner
Epic
Intermountain Healthcare
Mayo Clinic
MEDITECH
McKesson
Partners HealthCare System
SMART
(Boston Children's Hospital
Informatics Program)
The Advisory Board Company
@ekivemark http://hl7.org/implement/standards/fhir/2
015Jan/argonauts.html

5. What is FHIR?
Secure
Transport
Developer
Friendly
Structured
Data
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6. FHIR
Think of it as an International
common Language for Health
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7. FHIR Can Publish and Consume Data
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8. What can a FHIR Server Do?
• Its all in the Conformance Statement
http://fhir.bbonfhir.com:8080/f
hir-p/
baseDstu2/metadata/
$everything
?_format=json
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9. {
"resourceType":"Conformance",
"publisher":"Not provided",
"date":"2015-09-02T15:19:48-04:00",
"software":{
"name":"HAPI FHIR Server",
"version":"1.0-SNAPSHOT"
},
"implementation":{
"description":"UHN Test Server (DSTU2 Resources)"
},
"fhirVersion":"0.5.0",
"acceptUnknown":false,
"format":[
"application/xml+fhir",
"application/json+fhir"
Conformance: What and How
• JSON or XML Description of the Data Profiles
and the Actions each profile supports
interaction":[
{"code":"vread”},
{"code":"update”},
{"code":"delete”},
{"code":"history-instance”},
{"code":"validate”},
{"code":"history-type”},
{"code":"create”},
{"code":"search-type” }]
GET http://localhost:8080/fhir-
p/baseDstu2/Practitioner/32768
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10. Building Blocks
Primitives
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11. @ekivemark
Constructing
Resources
• Identifier
• HumanName
• Address
• ContactPoint
• CodeableConcept

12. Resources: Define what you use
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13. Codes within Codes
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14. Cardinality
0..0 Not used
0..1 Optional
0..* Optional
multiple
1..1 Required
1..* At least one
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[{ Address} ,]
“String”
Boolean
Integer
{ CodeableConcept }

15. Building a FHIR Request
https://fhir.bbonfhir.com:8080/
fhir-p/
Patient/
{123456}
?parameters
[_id=123456]&
[date=>2015-02-14&date=<2015-06-30]&
[name:exact=Eve]&
[_format=json|xml]
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Base-url
resourceType
id
https://www.hl7.org/fhi
r/search.html

16. FHIR Interactions
• Read
– GET https://example.com/path/{resourceType}/{id}
• Search
– GET https://example.com/path/{resourceType}?search parameters...
• History
– GET https://example.com/path/{resourceType}/{id}/_history
• Operation
– GET https://example.com/path/{resourceType}/{id}/${opname}
• Create
– POST https://example.com/path/{resourceType}
• Update
– PUT https://example.com/path/{resourceType}/{id}
• Delete
– DELETE https://example.com/path/{resourceType}/{id}
• Transaction
– POST https://example.com/path/
• (POST a transaction bundle to the system)
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17. Implementing FHIR
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• Identify code sets
• Publish codeable concepts
• Map fields to Profile/Resource elements
• Define Legacy-FHIR Integration
– Real time query
– Batch ETL

18. DEMO/TOUR@ekivemark

19. Links to know…
• http://hl7-fhir.github.io/index.html
• https://github.com/jamesagnew/hapi-fhir
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