Health Informatics On Fhir

This extensively revised textbook describes and defines the US healthcare delivery system, its many systemic challenges and the prior efforts to develop and deploy informatics tools to help overcome these problems. Now that electronic health record systems are widely deployed, the HL7 Fast Healthcare Interoperability standard is being rapidly accepted as the means to access and share the data stored in those systems and analytics is increasing being used to gain new knowledge from that aggregated clinical data, this book goes on to discuss health informatics from an historical perspective, its current state and likely future state. It then turns to some of the important and evolving areas of informatics including electronic healt\h records, clinical decision support,. population and public health, mHealth and analytics. Numerous use cases and case studies are employed in all of these discussions to help readers connect the technologies to real world challenges. Health Informatics on FHIR: How HL7's API is Transforming Healthcare is for introductory health informatics courses for health sciences students (e.g., doctors, nurses, PhDs), the current health informatics community, computer science and IT professionals interested in learning about the field and practicing healthcare providers. Though this textbook covers an important new technology, it is accessible to non-technical readers including healthcare providers, their patients or anyone interested in the use of healthcare data for improved care, public/population health or research.

This textbook begins with an introduction to the US healthcare delivery system, its many systemic challenges and the prior efforts to develop and deploy informatics tools to help overcome those problems. It goes on to discuss health informatics from an historical perspective, its current state and its likely future state now that electronic health record systems are widely deployed, the HL7 Fast Healthcare Interoperability standard is being rapidly accepted as the means to access the data stored in those systems and analytics is increasing being used to gain new knowledge from that aggregated clinical data. It then turns to some of the important and evolving areas of informatics including population and public health, mHealth and big data and analytics. Use cases and case studies are used in all of these discussions to help readers connect the technologies to real world challenges. Effective use of informatics systems and tools by providers and their patients is key to improving the quality, safety and cost of healthcare. With health records now digital, no effective means has existed for sharing them with patients, among the multiple providers who may care for them and for important secondary uses such as public/population health and research. This problem is a topic of congressional discussion and is addressed by the 21st Century Cures Act of 2016 that mandates that electronic health record (EHR) systems offer a patient-facing API. HL7’s Fast Healthcare Interoperability Resources (FHIR) is that API and this is the first comprehensive treatment of the technology and the many ways it is already being used. FHIR is based on web technologies and is thus a far more facile, easy to implement approach that is rapidly gaining acceptance. It is also the basis for a ‘universal health app platform’ that literally has the potential to foster innovation around the data in patient records similar to the app ecosystems smartphones created around the data they store. FHIR app stores have already been opened by Epic and Cerner, the two largest enterprise EHR vendors. Provider facing apps are already being explored to improve EHR usability and support personalized medicine. Medicare and the Veteran’s Administration have announced FHIR app platforms for their patients. Apple’s new IOS 11.3 features the ability for consumers to aggregate their health records on their iPhone using FHIR. Health insurance companies are exploring applications of FHIR to improve service and communication with their providers and patients. SureScripts, the national e-Prescribing network, is using FHIR to help doctors know if their patients are complying with prescriptions. This textbook is for introductory health informatics courses for computer science and health sciences students (e.g. doctors, nurses, PhDs), the current health informatics community, IT professionals interested in learning about the field and practicing healthcare providers. Though this textbook covers an important new technology, it is accessible to non-technical readers including healthcare providers, their patients or anyone interested in the use of healthcare data for improved care, public/population health or research.

This book provides an introduction to health interoperability and the main standards used. Health interoperability delivers health information where and when it is needed. Everybody stands to gain from safer more soundly based decisions and less duplication, delays, waste and errors. The third edition of Principles of Health Interoperability includes a new part on FHIR (Fast Health Interoperability Resources), the most important new health interoperability standard for a generation. FHIR combines the best features of HL7’s v2, v3 and CDA while leveraging the latest web standards and a tight focus on implementability. FHIR can be implemented at a fraction of the price of existing alternatives and is well suited for use in mobile phone apps, cloud communications and EHRs. The book is organised into four parts. The first part covers the principles of health interoperability, why it matters, why it is hard and why models are an important part of the solution. The second part covers clinical terminology and SNOMED CT. The third part covers the main HL7 standards: v2, v3, CDA and IHE XDS. The new fourth part covers FHIR and has been contributed by Grahame Grieve, the original FHIR chief.

Despite its high cost, the US healthcare system produces relatively short life spans, and is wasteful, inefficient and has serious safety and quality issues. While other industries have surmounted similar challenges by transforming themselves through information technology, healthcare lags behind. Major reasons are that our approaches to care delivery and financial incentives were designed for a bygone era. Beyond that the technology offered to practitioners has often been overly expensive, poorly designed, overly proprietary, hard to implement and difficult to use. Spurred by a unique, one-time Federal stimulus and the new mobile, wireless and cloud technologies now available, this landscape is rapidly changing. To succeed going forward practitioners, and those interested in entering the field, need to understand the new driving forces and have a basic understanding of contemporary clinical informatics. Practitioners, in particular, need to understand the alternative technologies and approaches available for their use in individual patient care and more continuous management of their chronic disease patients. To efficiently meet these needs, this book provides an introduction to the rationale for care transformation through clinical informatics; its application to patient care outside of hospitals; and a look at its future. Key points are illustrated throughout by actual examples of open source and commercial health IT products and services. While written with practitioners and students entering the field of clinical informatics in mind, the book eschews technical terminology and is easily accessible by the lay reader not proficient in clinical medicine or information technology.

The aims and scope of the second edition are unchanged from the first edition. The major market is in health informatics education. The three part format, which covers principles of health interoperability, HL7 and interchange formats, and SNOMED CT and clinical terminology, works well. In the US, The ONC (Office of the National Coordinator for Health Information Technology) has estimated that the HITECH stimulus will create more than 50,000 new jobs for health informatics professionals, who need to be educated.

"This book will be a terrific introduction to the field of clinical IT and clinical informatics" -- Kevin Johnson "Dr. Braunstein has done a wonderful job of exploring a number of key trends in technology in the context of the transformations that are occurring in our health care system" -- Bob Greenes "This insightful book is a perfect primer for technologists entering the health tech field." -- Deb Estrin "This book should be read by everyone.​" -- David Kibbe This book provides care providers and other non-technical readers with a broad, practical overview of the changing US healthcare system and the contemporary health informatics systems and tools that are increasingly critical to its new financial and clinical care paradigms. US healthcare delivery is dramatically transforming and informatics is at the center of the changes. Increasingly care providers must be skilled users of informatics tools to meet federal mandates and succeed under value-based contracts that demand higher quality and increased patient satisfaction but at lower cost. Yet, most have little formal training in these systems and technologies. Providers face system selection issues with little unbiased and insightful information to guide them. Patient engagement to promote wellness, prevention and improved outcomes is a requirement of Meaningful Use Stage 2 and is increasingly supported by mobile devices, apps, sensors and other technologies. Care providers need to provide guidance and advice to their patients and know how to incorporated as they generate into their care. The one-patient-at-a-time care model is being rapidly supplemented by new team-, population- and public health-based models of care. As digital data becomes ubiquitous, medicine is changing as research based on that data reveals new methods for earlier diagnosis, improved treatment and disease management and prevention. This book is clearly written, up-to-date and uses real world examples extensively to explain the tools and technologies and illustrate their practical role and potential impact on providers, patients, researchers, and society as a whole.

This extensively updated fourth edition expands the discussion of FHIR (Fast Health Interoperability Resources), which has rapidly become the most important health interoperability standard globally. FHIR can be implemented at a fraction of the price of existing alternatives and is well suited for use in mobile phone apps, cloud communications and electronic health records. FHIR combines the best features of HL7’s v2, v3 and CDA while leveraging the latest web standards and clinical terminologies, with a tight focus on implementation. Principles of Health Interoperability has been completely re-organised into five sections. The first part covers the core principles of health interoperability, while the second extensively reviews FHIR. The third part includes older HL7 standards that are still widely used, which leads on to a section dedicated to clinical terminology including SNOMED CT and LOINC. The final part of the book covers privacy, models, XML and JSON, standards development organizations and HL7 v3. This vital new edition therefore is essential reading for all involved in the use of these technologies in medical informatics.

This book focuses on the development and use of interoperability standards related to healthcare information technology (HIT) and provides in-depth discussion of the associated essential aspects. The book explains the principles of conformance, examining how to improve the content of healthcare data exchange standards (including HL7 v2.x, V3/CDA, FHIR, CTS2, DICOM, EDIFACT, and ebXML), the rigor of conformance testing, and the interoperability capabilities of healthcare applications for the benefit of healthcare professionals who use HIT, developers of HIT applications, and healthcare consumers who aspire to be recipients of safe and effective health services facilitated through meaningful use of well-designed HIT. Readers will understand the common terms interoperability, conformance, compliance and compatibility, and be prepared to design and implement their own complex interoperable healthcare information system. Chapters address the practical aspects of the subject matter to enable application of previously theoretical concepts. The book provides real-world, concrete examples to explain how to apply the information, and includes many diagrams to illustrate relationships of entities and concepts described in the text. Designed for professionals and practitioners, this book is appropriate for implementers and developers of HIT, technical staff of information technology vendors participating in the development of standards and profiling initiatives, informatics professionals who design conformance testing tools, staff of information technology departments in healthcare institutions, and experts involved in standards development. Healthcare providers and leadership of provider organizations seeking a better understanding of conformance, interoperability, and IT certification processes will benefit from this book, as will students studying healthcare information technology.