The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP) has published a draft Federal FHIR Action Plan to help guide federal investment and adoption of the FHIR standard.
FHIR Release 4 was released in 2018 and has evolved into a mature standard for federal agencies to adopt for their programs, ASTP noted. The plan is part of the larger HHS Health IT Alignment Policy, an effort to align technology standards used under HHS-funded programs.
The plan’s primary goal is to align federal agencies’ adoption and use of FHIR around a set of essential components and capabilities that agencies have implemented or are planning to implement in the next two years. Many of these components are mature and already being used in production.
The draft action plan builds off the work of a FHIR Work Group created in 2019 and provides additional direction now that FHIR is being used more broadly by federal agencies to help facilitate shared decision-making, improve care coordination, and deepen patient engagement.
Recent regulations such as ASTP’s Health, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Final Rule; the Centers for Medicare & Medicaid Services' (CMS) Interoperability and Prior Authorization Final Rule; and ASTP’s Health, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule – begin to lay out a path for the next generation of FHIR capabilities.
ASTP is working with stakeholders to identify and develop the next generation of FHIR capabilities that will power improvements in healthcare. Among the early-stage capabilities identified include a standard approach to enable writing health information from external sources into the patient health record (“FHIR Write”). For instance, the draft plan noted, as consumers leverage technology such as health-related smartphone apps and wearable devices, the data they generate can be used to improve clinical decision making if they can become part of a patient’s health record. The ability to aggregate data from external health organizations via a standard based “FHIR Write” approach would also reduce provider burden.
Another example of an early capability would be to enhance and ease data exchange between public health institutions and provider organizations. The HL7 Helios Accelerator’s initiatives such as Delivering Aggregate Information to Public Health, Making Data in Public Health Systems Accessible in Bulk, and Using Query and Response to Address Public Health Data Needs would assist in achieving these capabilities.
Still another early capability is a standardized approach to giving patients flexible options to save and share access to their health data. SMART Health Links is a FHIR-based standard that helps increase the portability and shareability of health information. SMART Health Links uses a similar approach to SMART Health Cards, in allowing an individual to maintain a limited amount of information in the form of a secure QR code, but supports larger and more dynamic records. Both enable patients to share data securely with entities of their choice using a standards-based approach.
ASTP is encouraging federal agencies and implementation partners to use the draft action plan to help:
• Identify and address common needs;
• Coordinate asks of the FHIR standards community and implementation partners; and
• Reuse and advance capabilities that have widespread adoption across industry and federal use cases to help benefit each other’s funded initiatives, avoiding redundancy and duplication of efforts.
