Published on December 20, 2014 by Pavel Smirnov
Whether you work in a healthcare organization, a hospital, a medical center or are a member of a physician group, you most likely are working with an electronic health record (EHR). While there’s no doubt that there have been many benefits of healthcare data becoming digitized and captured by EHRs, the inability to customize and personalize vendor software has been a major hurdle to healthcare innovation. Nowadays there is a new healthcare data standard called FHIR (Fast Healthcare Interoperability Resources) that is bringing technological disruption to healthcare. Starting a health IT project with the new HL7 FHIR standard and modern web technologies will bring you the flexibility and customization that legacy health information systems and EHR vendors don’t offer and were previously unimaginable.
Innovating at your organization
As a provider, you want to improve efficiency, cut costs for your healthcare organization, and deliver optimal care for your patients. So you get an idea about what you want to change in your current organization’s workflows to make them better, and you decide to act.
First, you call your EHR vendor, and you quickly realize how expensive even a small change in the system would cost. Then you try discussing the changes with your own health IT department and get the classic response that they are overwhelmed with ten other more urgent issues, and that they’re not going to be able to help. So now what?
You’re not a quitter and you don’t want to give up. You also can’t start building a new system from scratch - that would be too expensive and take too long. To complete a successful healthcare IT project you need a good foundation to start with, so you begin to look at the different available health technology solutions you can build with. To create great software you need to have a solid backend, a server with standardized storage for clinical health information and an ability to build robust healthcare solutions on top of it. There are many technological frameworks and programming languages you can choose from, but there are only a few choices out there to work with when it comes to standards for storing your health data. The current medical standards providing data models for storing health data are HL7 v3, HL7 FHIR, and OpenEHR. But there is only one real choice — HL7 FHIR  ( Fast Healthcare Interoperability Resources). It’s the most promising, modern and developer-friendly amongst all of the existing healthcare data standards.
Combining FHIR with Modern Web Technologies
The HL7 FHIR standard is distributed under a licence similar to the Creative Common License for software. You can do pretty much anything you want with it, as long as you give credit back to the HL7 organization. When you combine the HL7 FHIR standard with modern web technologies that fills the infrastructure gaps of the HL7 FHIR specification, you end up with comprehensive solutions that can be used to build new health IT projects right away. Plenty of free, open source solutions already exist with this emerging standard. For example, our team developed FHIRbase — a relational storage for HL7 FHIR resources. FHIRbase is based on the open and free relational database PostgreSQL. We worked closely with core PostgreSQL developers to build this database to combine the main advantages of relational databases: the powerful SQL query language, transactions and data integrity with easy-to-use document database API. FHIRbase is distributed under the open source MIT license and you can use it without any restrictions in all commercial and non-commercial software products. Feel free to let us know in the chat or contact us here if you have any questions!
After you’ve chosen a FHIR storage for your clinical data, can you integrate it with other legacy healthcare software that your organization uses, such as electronic health records and laboratory systems? Luckily, the HL7 FHIR standard is an interoperability standard with well-documented data mappings to other medical standards such as HL7 v2, HL7 v3 or CDA. So that means you can get clinical data from other vendors’ software into the FHIR storage of your choice with minimal efforts. A standardized storage integrated with other software within your healthcare organization is amazing, but can it get even better? I’m here to tell you that it can! Yes you’ve got a solid backend, but you can get help with your healthcare application frontend as well. If you’re going to build a web application (which nowadays is the way to go), you can use a free frontend API for working with the server — FHIR.js and a set of widgets for creating nice interfaces — formstamp. Don’t waste time on buying tools for building software solutions. Get the best tools for free and concentrate on your workflows and business cases you want to implement!
Find a FHIR Partner and Start Building!
For the icing on the cake, I have to mention the Health Samurai team which develops and maintains these free, open source solutions. Our engineers are always available to help, receptive and always seem to be right around the corner whenever you need them most. We’re fanatics about producing quality healthcare solutions and working hard to make our products better. We have over a decade of experience building custom health information technology products, such as an ONC-certified cloud electronic health record system for Choice Hospital Systems. We do all our commercial development around the suite of FHIR solutions and have been using FHIR successfully in real projects since 2012.
