Examines the role of architecture and standards in NZ Digital Health Strategy and how interoperability, based on FHIR APIs and SNOMED CT concepts, will help to achieve the objectives of that strategy.

1. HL7New Zealand
New ZealandActivities
WhyHL7® FHIR® isHOT…
&SNOMED CT® isCOOL
ForHealthcareCIOs
PHOCIOForum, March20,2018
PeterJordan,ChairHL7NewZealand

2. Page 2
The Context

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• Legacy Practice Management Systems – late 90s
• Data Ownership/custodianship and quality issues
• Data held on-premises at L1 Healthcare Facilities
• Point to point messaging via privately-owned services
• 3rd Party applications tightly-coupled to PMS schemas
• Patient Portals with NO API
WHERE ARE WE NOW IN PRIMARY CARE?

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Where Are We Heading?
Who is already there? Google, Microsoft, Amazon, Apple,
Epic, Cerner, InterSystems, DXC, Orion Health, etc.

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Why Are Platform Providers In Healthcare?
The World’s most valuable resource is no longer oil, but data…
The Economist, 6 May, 2017.

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How Do We Get There? INTEROPERABILITY
NZ Interoperability Charter…
“the ability of different information technology systems and software applications to
communicate, exchange data, and use the information that has been exchanged.”
(HIMSS Board of Directors, 5 April 2013).
• International Standards
• Terminologies – SNOMED CT
• Information Models Bound to Terminologies
• APIs with Common Models of Exchange - FHIR
• Aggregation of data from Multiple sources (Patient, CDS, Analytics)
• GOAL = Semantic Interoperability – exchange data with no loss of
meaning

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Dissect Interoperability

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10 Hot Facts About HL7® FHIR®
• Fast Healthcare Interoperability Resources
• Latest Interoperability Standard from HL7
• Built using Web Standards (HTTP, REST, JSON,
XML, oAuth, etc.)
• Open and free to use with no restrictions
• Implementer-focused - easy to develop (multiple libraries) & test
• Supported by large worldwide community
• Platform Specification for building APIs – can be extended & constrained
• FHIR is not a Draft Standard. It has been widely adopted for patient care
and research around the world and R4 will contain normative content
• FHIR has a maturity model (FMM) that provides end-users with real data
for implementation decisions
• Compliance testing via Independent Cloud-Based services.

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CHIME CIO Member Survey

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10 Cool Things to Know About SNOMED CT®
• Systemized Nomenclature of Medicine Clinical Terms
• Comprehensive clinical ontology from SNOMED International for use in
digital healthcare
• More than a classification or ‘coding’ system – e.g. language features
• Contains 400k Concepts each with multiple descriptions & relationships
to other concepts
• Represents clinical information accurately
• Facilitates meaningful communication, sharing and reuse of healthcare
data
• Essential to the big picture of healthcare – aggregation & analytics
• Contains Mappings to other ‘code’ systems (Read, ICD, etc.)
• Updated six-monthly and extensible
• Used in over 55 countries (35 members) and growing.

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The Problem

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Further Information
• Any Questions?
• HL7® FHIR®… http://hl7.org/fhir/
• SNOMED ® International…
https://www.snomed.org/