guidance in FHIR implementation

Hello! Do you need guidance in your FHIR implementation?

- and make your ecosystem speak the same language?

I see a trend of interoperability and patient access spreading worldwide. New guidelines are formed to support interoperable, seamless and secure access as well as the use of electronic health information with a focus on patients and payers. The guidelines are designed to give every patient in the countries, along with their healthcare providers, secure access to see, obtain and use all electronically available health information that is relevant to their healthcare.  

 Common guidelines for interoperability aims to increase the speed of innovation and competition by fostering an ecosystem of new applications to provide patients with more choices in their healthcare. 

 To see these guidelines being implemented is so important for patient access, however fear that the complexity of implementation to its full extent is underestimated. I’m seeing challenges for many healthcare providers that comes with the urged need for implementation. But I’m positive this is doable and it is with great happiness I’m now introducing the HealthTerm on FHIR solutions. Solutions to how the implementation can be achieved rapidly in a cost-effective and resource saving way, while at the same time ensuring high data quality.

What are the risks of underestimating the complexity of implementation? 

The patient is at the center of healthcare and putting patients in charge of their health records is a key piece of patient empowerment in health care. The benefits to the patient of new guidelines such as CMS interoperability rules are: 

  1. Ease of Access to Their Records via any app of their choice implemented via API based interoperability between any payer, provider software apps 
  2. Protecting Patient Privacy and Security by allowing patient access through highly secure protocols 
  3. Promoting the Ability to Shop for Care and Manage Costs 

Likewise, there are benefits for the Providers, such as:  

  1. Making Patient Record Information Requests Easy and Inexpensive for Patients and Providers 
  2. Allowing Choice of Apps 
  3. Information Blocking 
  4. Improving Patient Safety 

The guidelines intend to support the seamless and secure access, exchange, and use of electronic health information (EHI). To meet the criteria of these guidelines the following must be available by the actors in the system. 

  • Standardized API access for patient and population health service using FHIR standards. ​ 
  • Support FHIR Release 4 standard (4.0.1)​ 
  • Respond to requests for data specified in the USCDI v1 according to the US FHIR Core implementation Guide (US FHIR Core IG) for FHIR Release 4​ 

So, does this mean that you can now comply by the rules only by start using the FHIR API’s? Will I comply by taking my data and transform it to the above mentioned formats?  

The simple answer is no! You also need to express your data with the right interoperability language. The interoperability language for healthcare is not only the large standard code sets, such as Snomed CT, RxNorm and LOINC. It is also all the small meta-data sets that defines the FHIR message sent through, and to be understood by, the recipient. Each actor in the system will also want to limit the choices for the codes defined by the guidelines to fit their internal way of working. This is what we call valuesets. These valuesets need to be defined somewhere in the system and continuously updated.  

 This is where a terminology solution comes in that supports FHIRFHIR terminology solution provides you with definitions of CodeSystemsValueSets, and ConceptMap resources and can support the operations defined for each resource utilizing the code system’s content. So basically, what you really need in order to meet the criteria of the guidelines, is a terminology server which houses content of external code systems such as SNOMEDLOINCNDCand all necessary code sets in your ecosystem.​ The terminology server should also store local code systems and standard FHIR code systems as well as HL7 code systems​. The good news though is that we can help you with that! 

We will make you speak CMS Interoperability language fluently

Jacob Boye Hansen

CareCom, a leader in Terminology Solutions and Interoperability, can help you comply by maintaining all your code systems in one single application. Our solution HealthTerm® offers you an  

interoperability solution covering all the vocabulary code sets and terminology areas you need to standardize within, all in one solution with tools for mapping and automatization and future proof updates. HealthTerm is also supporting the FHIR APIs and on top of this more than 90 APIs developed by CareCom. 

 This solution offers you the possibility of normalizing the data and mapping them to the right format. HealthTerm can be an integrated component to the ecosystem you are present in, acting as a filter on the way from source to target data to accept standard format and ensure that you are compliant with the guidelines. 


Finally, if you are a Payer or Provider facing challenges with implementing the Interoperability and Patient Access rules, please don’t hesitate to contact us or any of our partners for a discussion and demo, visit our webpage for more information or watch our video about FHIR here.  

Author: Jacob Boye Hansen 

Publish Date: 2021-03-23 


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