This appeared in New Zealand and I felt it needed some OZ exposure:
My View: Interoperability is a team sport
Monday, 19 February 2024
VIEW - Grahame Grieve, FHIR product director
I started working on FHIR (Fast Healthcare Interoperability Resources) because I believe in better health outcomes and that healthcare has broken processes. As well as being a technical standard, FHIR is a name for a community of people dedicated to solving the challenge of sharing healthcare information, and who participate in an open fashion.
Together we have produced a technical specification that describes how to exchange healthcare information. That API has become transformative and is taking over the world of healthcare.
Open Solutions
Interoperability is not a technical problem, it is about building community
knowledge and building community answers at every level.
FHIR is an open community, anybody can join. You do not have to pay or register, you can just be part of the community by spending your time on FHIR. This frees up the community to focus on solving problems.
One of my mantras is that interoperability is a the team sport: people contribute to open knowledge to drive change, and it’s why FHIR being an open community is so important. One outcome of that is that open knowledge lifts the baseline, forcing everybody to get better.
The ultimate goal of FHIR is to make the platform public property, so that commercial organisations make money by providing services, not by owning the platform.
If we can solve community problems in an open way, we share the technical base at multiple levels. This solves another key problem with healthcare, which is scale.
Making interoperability worthwhile
The accepted definition of interoperability is the ability of two or more
systems to exchange data and make use of the data, so it is a very data centric
view of the world. But what if we automate our existing processes, and they are
not very good?
You can easily create worse processes with digital, so the real challenge with interoperability is to make it worthwhile.
I prefer to use this definition of clinical interoperability; ‘the ability of two or more clinical teams to transfer patients and provide seamless care’.
The idea is not to automate existing bad practices, but to build new ones that allow us to transform healthcare outcomes.
Institutions tend to keep records and share them for institutional purposes, rather than to serve the patients their families. This means the systems serve our institutions, they do not serve us – where us is either the individuals providing care, the individuals receiving care, or their families.
Our call in the FHIR community is to refocus not on interoperability that automates our existing walls and features, but on processes that break down the walls and allow us to create new kinds of workflows, as it is through those new kinds of workflows that change happens.
For example, using FHIR to provide access to fluid patient summaries that are widely available to create virtual workflows. Virtual Emergency Departments and early discharge services that keep people connected through FHIR and interoperability to hospital systems are truly transformative.
Join the community
In my experience, interoperability happens slowly and gradually and then
suddenly you realise that you now totally depend on it.
We set out to disrupt healthcare by significantly reducing the cost of data
exchange, principally through making it scalable, easy and natural to use. But
of all the things we did, it is the open community that truly changed the game.
I encourage you to join our community and build interoperability that serves clinical health outcomes and helps to build a public treasure that we all benefit from.
This View is a summary of Grieve's presentation at Digital Health Week 2023, if you attended the conference you can access his and all other presentations online.
If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.
More here:
https://www.hinz.org.nz/news/665386/My-View-Interoperability-is-a-team-sport-.htm
Some good thoughts here. Interesting to see how widely FHIR is now adopted and used. Suggests it has a lot right!
I hope at least a few might give thought to joining the FHIR community to add to its progress and success.
David.
"The accepted definition of interoperability is the ability of two or more systems to exchange data and make use of the data"
ReplyDeleteSounds a bit like Twitter (now X). Anybody can contribute data, exchange it and make use of it.
The problem is in the quality of the data - and that goes for health data and Twitter data.
It's the old garbage in garbage out syndrome. Who is working on fixing that? ADHA doesn't even realise that data quality is the bigger problem.
So, how is interoperability of consumer data going?
ReplyDeleteThe parallels are remarkable and should be worrying for proponents of FHIR. A lot of time, money and goodwill is likely to be wasted unless something different happens with health data.
Australia’s CDR-enabled digital economy has been strangled
https://www.innovationaus.com/australias-cdr-enabled-digital-economy-has-been-strangled/
Sandy Plunkett
23 February 2024
Remember the optimism around the Open Banking revolution and Australia’s new digital data economy opportunity a few years back? It was enthusiastic but fleeting, having bubbled-up somewhere after the Turnbull government’s Ideas Boom and before the Morrison government’s Robodebt bust.
It was all about leveraging the Consumer Data Right (CDR), a national government legislated policy and data standards framework for a secure online data sharing system that puts consumers’ data rights in the driving seat for trusted, competitive online commerce and services.
It was planned since 2018 under the Coalition government and enacted in 2019, first for banking and then energy (Oct 2022). Telecommunications, superannuation, and insurance were to follow before CDR-enabled digital infrastructure was to ultimately go economy wide.
etc, etc.