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I already have one proposal for the transition from the current Federated Health Information Exchange to supporting FHIR, that is based on a transition from CDA to FHIR-Documents. Note that just because the content being published is a "Document" does not mean that it must be consumed as a document.
This profile shows how to build a Document Sharing Exchange using IHE profiled FHIR® standard, rather than the legacy IHE profiles that is dominated by XDS and HL7® v2. This profile will assemble profiles and define a Document Registry. The actor that is specific to this profile is a Document Registry. 3 - Section 4.0
He detailed how API users are facing onerous fees, incomplete documentation, and general difficulty connecting with providers. Another ASTP/ONC post found only 20% of HIE organizations are using HL7 FHIR APIs to send and receive data. About 90% still use a mix of CDAs, HL7 v2 messages, and ADT transfers.
Documents have a bad perception, they are big, unfocused, and hard to process or view. I'm going to propose something that is counter to the perception, driven by current healthcare use of CDA documents and the HL7 Principles of a Document. When is a Document a Document? When is a Document a Document?
In the USA and elsewhere, there are Document Sharing based Health Information Exchanges. The solution is to leverage this existing solution, and just add FHIR. My point in this article is that this does not need to be a restriction on those that do want to move on to FHIR. Just add FHIRFHIR is a content format.
The IHE IT-Infrastructure committee continues to produce new and improved specifications for HIE interoperability. Document Sharing Across Network Topologies- Rev. It is intended to be read by HIE and Healthcare IT Executives and Architects, Standards Development Architects, and health data exchange stakeholders in academia.
I think the most useful value-add that an HIE can add is an API that is based on FHIR. This is true of an XDS based HIE, Regional Exchange (XCA), Vendor based EHR, nationwide Exchange, and Direct HISP. At an HIE level: Initially I would focus on enabling Apps to query for and read the data available in the HIE.
This article is where I muse about getting to that beautiful future based on #FHIR. Break Everything One possibly that some advocate is turn off what we have today, and everyone and everything switch to using http RESTful FHIR. This pair of transports now has a third FHIR mode, so Karen's Cross is now three dimensional.
Does that mean we don't move to nationwide http RESTful FHIR? I expect, as I have said before, that the green-fields will/should use http RESTful FHIR. I expect, as I have said before, that the green-fields will/should use http RESTful FHIR. The use of http RESTful FHIR at the edges or point-to-point make good sense.
How does one put a FHIRDocument into XDS? How does one find a FHIRDocument in XDS? XDS, more broadly the whole Document Sharing family, including XDS , XCA , XDR , XDM , and MHD. Initially Document Sharing was about 'historic' documents. Thus the Document is "Shared". Let me explain.
Today on the FHIR Consent call we had a very useful discussion of how one would use FHIR Consent to do the same thing that BPPC does in XDS. Said another way, what is the degenerate form of FHIR Consent that is equal-to the functionality of BPPC, and what is the degenerate form of FHIR Consent that is compatible with BPPC.
The IHE-MHDS does not define a Document Repository Actor but does include architecture support for distributed FHIR Servers and thus the concept of a Document Repository is included in MHDS. For example: XCA also does not make a distinction between a Document Registry or Document Repository, having a Responding Gateway Actor.
Mostly they keep trying because the most basic query is just asking for all documents available for a given Patient. These are useful, just not very primary for a general purpose Document Consumer. Where these classifications are useful to a Document Consumer. Thus one can ask for documents covering treatment prior to 1998.
The last time I did a year-end report was at the end of 2017 - HIE Future is Bright - stepping into 2018. 1.6k) Agile improvements toward #FHIR (1.5k) Security of #FHIR implementations concerns (1k) It is good to see that the Alisa Knight cybersecurity attacks on #FHIR were not a big reason for visitors to my blog.
It happens that the framework for explaining why the future is bright for HIE comes from the Wisconsin HIE (WISHIN) fall summit. They used the following diagram to show what they viewed as the HIE future. These historic events need to have the full context of them, which is what a Document model provides.
This winter quarter will be a lighter load, recognizing the holidays: Patient Scheduling, prospective look at FHIR R5/6, and evaluating impact of Gender Harmony. The Document Subscription for Mobile (DSUBm) profile describes the use of document subscription and notification mechanisms for RESTful applications.
The IHE IT Infrastructure Technical Committee has published a new Handbook as of August 20, 2018: Document Sharing Metadata The above document is available for download at [link] or at User Handbooks. This is described in the Enabling Document Sharing through IHE Profiles white paper (HIE using IHE).
The Integrating the Healthcare Enterprise (IHE) standards profiling organization has developed a collection of profiles which can be leveraged for use by healthcare communities for the purposes of document sharing. There is also a model in MHDS for those that have no legacy environment that builds the full infrastructure using FHIR services.
I still remember being with a New York State HIE at the time, on the HIMSS13 floor, and being asked by a reporter to speculate about what it meant. billion documents to date. Today, we facilitate the exchange of 30-40 million documents each week across the nation.
This is a new FHIR specification that expresses what a International Patient Summary (IPS) would look like. This is a FHIR-Document, much like a CDA Document, but using FHIR fundamentals rather than the HL7 v3 model that is the basis of CDA. I think this approach to the question is missing a key point.
This is an alternative to SMART-on-FHIR, and not intended to be conflicting. An update to the HIE-Whitepaper , bringing in the newly build FHIR based profiles. IHE IT Infrastructure Technical Framework Documents Published. This document is available at [link]. This document is available at [link].
Two independent projects this week sent to the FHIR mailing list their diagrams of how they are using FHIR as an API to classic XDS environments. The power of using FHIR as a simplifying API to classic environments. Our project will use FHIR as an abstraction layer for the application. privacy consent). Well done!
The Mobile Health Documents (MHD) profile was born to provide a more simple API to an XDS environment. This happened to be the same timeframe that Grahame was fanning the FHIR flames. So we joined forces and brought the concepts needed for XDS into FHIR®. So now, I take those FHIR based Resources and re-write the profile.
Formal Publication -- [link] The Sharing of IPS (sIPS) IHE Profile provides for methods of exchanging the HL7 International Patient Summary (IPS) , using IHE Document Sharing Health Information Exchange but does not modify the HL7 IPS specification, nor is there any need to change IHE Document Sharing Health Information Exchange.
Some examples where BPPC are used: Connecticut HIE: For release of Privileged Care information, a consent document SHALL be registered with HITE-CT in the form of a BPPC conformant document using the Opt-in for Legally Protected Data (ALL) policy. All Opt-in documents SHALL include an expiration date. Table 10.2.3-1
HIE-Whitepaper -- the whitepaper needed to be updated to include the FHIR based models that we have published in the MHD family. This also includes the use of QEDm and mXDE to make FHIR Resource level data available from the shared documents, making consumption more easy. StructureDefinition) and inclusion of examples.
There is renewed discussion, much like back in January, around the need to go beyond testing just the FHIR Resource 'interoperability'. I think the HL7 "Implementation Guide" could be this, but I am thinking something much higher than is normally documented by HL7. This is more than just a selection of FHIR Resources.
Document Sharing Metadata Handbook IHE Document Sharing depends on document metadata, folder metadata, and submission set metadata. This Implementation Guide assembles other IHE Implementation guides (Profiles) and defines a Document Registry Actor. as the current HIE-Whitepaper contains MHD and MHDS now.
The recommendation I give here is restricted to the gross level: for Document Sharing at the XDS/XCA/DocumentReference metadata level; for FHIR REST at the returned Bundle.meta.security level, but not on each Resource in the Bundle; and for CDA at the CDA header, but not on each element. for "_confidentiality".
Is this just another HIE? Of note, the XCPD, XCA, and XDR profiles do not currently support FHIR natively. A few features of the CA DxF set it apart from traditional health information exchanges (HIEs) and networks (HINs). Required data format requirements are also notable.
Releases Four publications released from IHE IT-Infrastructure, one in Public Comment Release for Public-Comment -- Mobile access to Health Document (MHD) - Improvements changed to AuditEvent profiling leveraging Basic Audit Log Patterns (BALP) Release 1.1 Converted from PDF to a FHIR IG. was released.
Where the combined list is available in FHIR as a ValueSet of FormatCodes (updated in current build ) Important background :: Eating an Elephant -- How to approach IHE documentation on Health Information Exchange (HIE) and Healthcare Metadata The FormatCode is there to differentiate 'technical format'. is one FormatCode.
Cardiac remote monitoring company Implicity released a SMART on FHIR App that reports directly to Epic. Sales The University of Kansas Health System chose Abridge for AI-powered medical documentation. HIE framework Carequality Executive Director Alan Swenson made the Utah Business list of 40 Under 40 award winners.
Partnerships eHealth Exchange added C3HIE , a Texas-based HIE, to its network of partners under its anticipated QHIN. Products Consensus Cloud Solutions launched Clarity Clinical Documentation , which routes unstructured data into patient records. AVIA added RUSH, MUSC Health, and United Regional Health Care System to its network.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Technologies and processes to manage the steps, from documenting/administering the applicable rules to ensuring they are consistently applied to all relevant data-sharing interactions regardless of method, are starting to be explored and tested. TEFCA proposes that the adoption of FHIR access with OAuth2.0
Etienne Boshoff, Managing Director at EHR Enhancify Healthcare interoperability is advancing through the adoption of Electronic Health Records (EHRs), standardized APIs like FHIR, and emerging technologies such as blockchain. TEFCA relies on a 1990s document exchange protocol when the web was “page views” and didn’t support modern computing.
Given XDS and XCA interactions that are often used in an Health Information Exchange (HIE), or a National Health Information Exchange (NHIE); there is no standards/profiled way to enable a point-of-care consent gathering workflow. It also easy to Query for consent documents.
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