Pavel Smirnov, CEO of Health Samurai, organized the inaugural FHIR meetup at UC San Diego to discuss developing FHIR-first applications. Health Samurai's Aidbox is a FHIR development platform that allows building applications using the FHIR standard and data model. Aidbox provides tools like a FHIR API and storage, as well as the ability to extend the FHIR model to support custom use cases. Lessons from using FHIR include benefits like standardized data models and an active community, as well as challenges in migrating between versions and complexity of extensions.

1. Pavel Smirnov, CEO, Health Samurai pavel@health-samurai.io
FHIR-first application development.
Inaugural FHIR meetup at the UC San Diego

2. Organizations struggle to innovate
https://www.mobihealthnews.com/content/mobile-health-app-development-costs-425000-average-likely-continuing-rise

3. FHIR
2012 2013 20152005
Cloud EHR
is a FHIR company
2019
Fhirbase Aidbox

4. FHIR-first
applications
• FHIR Model
• FHIR API
• FHIR Community
• FHIR tooling
Built with FHIR inside

5. 5
FHIR data
model
FHIR RESOURCES

6. 6
What is
different?
MAPPING YOUR DATA TO FHIR

7. 7
FHIR API
FHIR API - demo with Postman

8. 8
FHIR
community
FHIR COMMUNITY
CHAT.FHIR.ORG

9. 9
FHIR tooling
FHIR TOOLING - SERVERS
Health Samurai’s Aidbox
Azure API for FHIR
Google Healthcare API
Firely Vonk
SmileCDR
HAPI FHIR
Publicly available FHIR servers from HL7

10. 1
0
FHIR:
Lessons
learned
WHAT IS GREAT ABOUT FHIR
• Quality data models for common medical and financial data
• The FHIR community is incredible – chat.fhir.org
• API and tools that are easy to learn and use for web and mobile
apps
• FHIR facilitates interoperability with legacy standards
• The FHIR specification describes an easy way to use terminology
services

11. 1
1
FHIR:
Lessons
learned
WHAT IS NOT SO GOOD
• Migration between FHIR versions can be painful
• FHIR Extensions and profiles can be complicated to use

12. 1
2
FHIR:
Lessons
learned
WHAT FHIR IS NOT
• FHIR does not address technological concerns such as your
system architecture
• FHIR API is limited might be not enough for your real app
• FHIR is not a security protocol
• FHIR doesn’t address infrastructure

13. is a development platform
for FHIR-first applications

14. FHIR Storage
REST API & SQL
Terminology Server
Security & Access Control
Custom Resources
Ecosystem of Add-ons
Cloud Infrastructure
Aidbox
Platform
for FHIR-first Apps

15. 1
5
FHIR data
model
extensibility
What if there is no FHIR resource for your use case?
{
resourceType: “User”,
email: “niquola@health-samurai.io",
relationships: [
{
type: “Patient”,
reference: “Patient/pt-1”
},
{
type: “Patient”,
reference: “Patient/pt-1”
},
]
…
}

16. 1
6
FIRST-class
extensions
FIRST-CLASS EXTENSIONS
Patient.race
vs
Patient.extension.where(system=“http://…
/race”).value
Developer-friendly
Database-friendly

17. 1
7
API extensibility
Aidbox API is extensible to support business logic of your
applications
● Custom Operations
● Plugins/Modules
● Subscriptions
For your tech developed with
Node.js
Python
Java
.NET
Golang
etc

18. 1
8
SQL API
Postgres
SQL
ACID
SQL is Aidbox second API
with e as (
SELECT resource#>>'{period,start}' as visit_date,
resource#>>'{subject,id}' as patient
FROM encounter ),
p as ( SELECT id, resource->'name' as
name, age(DATE(resource->>'birthDate'))::text as
age, DATE(resource->>'birthDate') as birthdate
FROM patient )
SELECT p.id as patient, p.name as name,
e.visit_date as visit_date, p.age as age
FROM e JOIN p on p.id = e.patient
WHERE DATE(e.visit_date) >= (NOW()-(interval '2
years')) AND p.birthdate <= DATE('1976-01-01');

19. 1
9
Demo
Demo

21. Nursing Care Workflow
Personalized Care Plans
Patient Medical Records
Secure Messaging
Mobile Apps for Patients
Data Analytics and Reporting
Case Study
Care Coordination
Platform

22. Front-desk Workflow
SMS Notifications
Billing workflow
Eligibility Checks
Claims Submission
Online Payments
BI reporting
Case Study
Dermatology EHR

23. Tableau
Power BI
Jupyter
Integration
Data Analytics plugins

24. Case Study
Workflow and Form Builder
Data First Approach
Reusable Components
Runtime Flexibility
Self-Service Analytics
Self-Service Digital forms
Extensible Architecture
Collaboration
platform

25. Case Study
RK 360 - Mobile App
Personal Medical Record
Apple HealthKit integration
Data sharing with providers
Data import from providers
Integration with NPI

26. 2
6
Apple
HealthKit
example
Example of the FHIR-first mobile app integrated with
Apple HealthKit
https://github.com/aidbox/example

27. Let’s implement
your ideas on FHIR

28. Contacts
Pavel Smirnov, CEO, Health Samurai
Phone: (818) 731-1279
Email: pavel@health-samurai.io
Website: https://health-samurai.io
3415 S Sepulveda Blvd Ste 1000
Los Angeles, CA 90034 USA