Wednesday, May 20, 2015

Interoperability in Action Post #2: A Tale of Two Connectathons

HL7 International held Connectathon 9 in Paris on May 10 and followed up with a FHIR Clinician
Connect-a-thon on May 15. Both events came at the challenge of interoperability from different angles.
Credit: Yann Caradec
Connectathon 9 had 4 separate themes:
·         Basic patient management
·         Version 2 mapping to FHIR messages
·         Financial Resources
·         Terminology Services
Clinician Connect-a-thon, meanwhile, featured two streams:
·         A “Clinician challenge stream” that tackled the “clinical adequacy, validity, accuracy and reliability of the FHIR clinical resources,” using different test scenarios
·         Testing of FHIR clinical resources through the following environment:
There were plenty of threads to pick up in the discussion around these events. One of the most interesting was a comment from Grahame Grieve (the ‘man of FHIR’), as captured on the FHIRplace blog:
The FHIR registry is on top of my most-important, damn-if-I-don’t task list.
Users of FHIR need to know if profiles and extensions exist already for the standard to be truly interoperable. It will be fascinating to see how this unfolds – including where this registry (or registries) ultimately lives and who will be its overseer.

Real-world scenarios
A registry is vitally important to the standardization of FHIR, but so is the real-world clinical perspective.

In an effort to ground FHIR testing in real-world clinical scenarios, Clinical Connectathon participants worked from clinical storyboards and scripts. These scenarios were provided in plain-language prose and rooted in common occurrences – through a range of clinical settings – that would make demands on FHIR resources or databases.

These storyboards are highly instructive, serving as a window into how interoperability might play out practically through the use of FHIR and also a more generally instructive testing tool. As we test interoperability in our development work, DHIT strives to simulate common use cases that affect patients and physicians. Particularly relevant to our recent work is the immunization storyboard.

The more we can return to the question of “What do physicians and patients need from this technology?” the closer we get to meaningful interoperability. As the Connectathon demonstrates, we should bake this right into our design and testing.

Extensibility in action
FHIR’s extensibility, at least in theory, allows it to accommodate a wide variety of real-world clinical situations. David Hay, part of the Connectaton planning team, writes over at the ‘Hay on FHIR’ blog: “FHIR has a built-in extension mechanism that allows specific implementations to add the properties they need that are missing from the resources.”

The Registry is the killer app to make these connections. When FHIR knows what to look for, it can rapidly address the demands the clinical world can make on data at rest.

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