Exago on FHIR

Sep 17, 2019

Kasey Tveit

The healthcare industry is on FHIR. Or, it will be soon. FHIR (pronounced “fire”) protocol is the future of health data interoperability.  Some in the healthcare IT industry have even claimed that FHIR “has the potential to be as ubiquitous and useful as the internet itself.”

For those unfamiliar with FHIR protocol, it isn’t a Jason Bourne or Mission Impossible sequel, as much as it sounds like one. It’s actually something much, much cooler than Tom Cruise. It is an open standard and application programming interface by Health Level Seven International (HL7) that simplifies the electronic exchange of healthcare information. 

fhir logo

The FHIR initiative, supported by The U.S. Department of Health and Human Services along with tech giants like Amazon, Google, Microsoft, and Oracle, promises a slew of palpable benefits to every entity dealing with or affected by health data. Everyone from healthcare IT providers, hospital administrators, and caregivers down to the patients themselves should expect to see “reduced costs, increased access to data, and improved health outcomes” as a result of FHIR’s standards for how health data is stored and shared. 

FHIR’s benefits come from its move away from SOAP web services toward RESTful APIs and standard data formats. FHIR data objects, called Resources, must be built, defined, and represented in common, reusable formats containing a common set of metadata as well as a human readable element.

 

fhir diagram

FHIR data transfer diagram.

 

Some healthcare systems, such as Northwell Health, the largest employer in New York state with 23 hospitals and 700 practices, have already implemented FHIR. Northwell Health “is using [Microsoft’s] Azure API for FHIR to build interoperability into its data flow solution to reduce excess days for patients,” according to Josh Mandel, the Chief Architect at Microsoft Healthcare.

For developers responsible for implementing FHIR: not to fear! FHIR and the other H7 standards simply define the format the data must take for it to be FHIR-ready, and it can be stored in a variety of databases. So, odds are you won’t have to make any major overhauls to your existing environments, especially if you already meet H7 standards.

 

"Odds are you won’t have to make any major overhauls to your existing environments, especially if you already meet H7 standards."

 

Plus, there are all kinds of open-source FHIR servers and toolkits with built-in developer communities around them to make transitioning your organization’s data to FHIR format as smooth and painless as possible. Microsoft’s Azure API for FHIR, for example, is a “Platform as a Service (PaaS) FHIR server backed by the open source project” that “offers a turn key solution to provisioning a compliant, secure FHIR service.” And the Azure API for FHIR is just one option. There are also other open-source FHIR toolkits like SMART on FHIR and Fhirbase, which “store FHIR data in JSON columns while keeping all resource IDs and timestamps as regular columns in a relational database” to enable SQL queries to the data.

So far, this is all good news. But healthcare IT providers who have or are looking to add embedded analytics to their application might be wondering where a third-party BI solution, which adds yet another layer, fits in with FHIR protocol.

It’s not as complicated as you may think. Take Exago BI as an example. As the healthcare software provider, all you have to worry about is handling and storing data according to FHIR standards with help from the toolkits above. Since the open-source FHIR toolkits like Fhirbase do the work of converting FHIR API calls into digestible forms for SQL querying (without restricting you to a SQL database), connecting Exago BI to FHIR data and securing that data for reporting is no different from connecting to non-FHIR data. 

And here’s a shameless plug: connecting data sources to Exago BI is super easy, and it accepts just about any source you like— Aurora, .Net Assemblies, Web Services, MySQL, you name it. Even common NoSQL databases are easily reportable for Exago BI through the use of CDATA drivers, which lets Exago BI make calls to NoSQL DBs in SQL. CDATA has drivers for all the NoSQL databases supported by H7 and FHIR, including MongoDB, Couch, Hadoop, and Big Query, so there’s no need to stress about connecting to embedded BI, regardless of your environment.

Software exists to make people’s lives and work more manageable—even the people who build software in the first place! With a combination of FHIR toolkits and embedded analytics, data — even sensitive health data — is kept safe and made more accessible to stakeholders without overcomplicating healthtech providers’ role in the transmission of that data.

So, healthcare software providers, rejoice! You can feel free to pursue the dream of embedded analytics while working toward FHIR.  

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