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Expectations and prospects on FHIR and
Interoperability
(Gemini and GCeHI collaboration)
IHE Työkokous12.05.2020
Jürgen BrandstätterGemini Steering Committee
Member, IHE International Board
Deputy Co-chair, IHE Europe
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Director Standards Development, x-tention GmbH
CodeWerk Software Services and Development GmbH
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First
Creation of an HIE
is not „the“
problem anymore
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HIE
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First
Creation of an HIE
is not „the“
problem anymore
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HIE
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Second
Standards and
Blueprints
are available
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What is a „global“ blueprint?
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Blueprint
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eHealth Landscape
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Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Use-case
Blueprint Blueprint
Blueprint
Blueprint
Blueprint
Blueprint Blueprint
Blueprint Blueprint
Patient
Identification
Audit and
Logging
Document-
sharing
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Governance needs blueprints
• EC Recommendation on EHRxformat− eHDSI cross-border of …
• Patient Summary
• ePrescription / eDispense
• Medical Imaging and Reports
• Laboratory Results
• Hospital Discharge Reports
− Based on • Established IHE Profiles
• HL7 CDA content
− Future developments: FHIR• -> Blueprints need yet to crystallize first!
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ITI PCC QRPH
PHARM
FHIR-based IHE profiles
12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration)
MHD
PIXmPDQm
mACM mXDE
QEDm
MMAUPB
QORE
8
FHIR ATNA
mCSD
SOLE NPFSm
PMDTPCS
RIPTACDC
RECON
GAO
CMAPDCTM
DCP
BFDE-EmRFD
mADXPRQ
VRDR
Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )
FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry
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ITI PCC QRPH
PHARM
FHIR-based IHE profiles
12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration)
MHD
PIXmPDQm
mACM mXDE
QEDm
MMAUPB
QORE
9
FHIR ATNA
mCSD
SOLE NPFSm
PMDTPCS
RIPTACDC
RECON
GAO
CMAPDCTM
DCP
BFDE-EmRFD
mADXPRQ
VRDR
Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )
FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry
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How it should be orchestrated
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Requirements Implementation
Developing thebase standards
Profiling the standard for particular communities
Driving Solutions intoproduction in the market
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International collaborations …
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• Governmental bodies start engaging
• Global Digital Health Partnership (GDHP)− 30 countries + WHO
− Informal gov-gov collaboration
• Gemini - A Joint Initiative of IHE and HL7 toAdvance Use of FHIR for Interoperability
• Global Consortium for eHealth Interoperability− HIMSS / IHE / HL7
www.gdhp.org
globalhealthinterop.org
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Gemini
A Joint Initiative of IHE and HL7
to Advance Use of FHIR for
Interoperability
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In the special case of FHIR
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Projectathon
Standards
Profiles
Interoperability
Specifications
IHE Conformity
Assessment
eHealth Projects
Product
Test ReportISO17025
Product
Transactions
Actors
Workflow
Use-case
Content
Re
s
Re
s
Pro
file
d
FH
IR r
es
Re
sR
es
Re
s
Wo
rkfl
ow
sF
HIR
IG
s
:
Path from Standard to Tested Interoperable Product
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Mandate, Mission, Parity
• Mandate− Project GEMINI operates under the Statement of
Understanding between IHE and HL7
• Mission− Tighten collaboration between IHE and HL7 in the
context of FHIR
• Parity− GEMINI is a „Joint“ IHE / HL7 project
− Joint ownership and steering under equal parity
• Main work− Coordinate! Establish connections!
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About Gemini
• Area 1: Development and Tooling of „FHIR-based IHE profiles“− FHIR-based IHE profiles remain under IHE governance, but participation and
contribution of HL7 shall be encouraged (as well as participation of IHE in HL7)
− This includes collaborative work, alignment of tooling, mutual notification of new work-items, etc.
• Area 2: Publication of „FHIR-based IHE profiles“− Align publication of FHIR Implementation Guides and FHIR-based IHE profiles by
referencing FHIR-based IHE profiles on fhir.org
• Area 3: Testing− Positioning of the current testing initiatives, such as HL7 FHIR Connectathons, IHE
Connectathons, IHE Conformity Assessment and coordination of the test tooling ecosystem across both organizations
• Area 4: Pilot projects− Identify, agree and execute joint IHE/HL7 pilot projects and demonstrations
• Area 5: Joint Messaging and Marketing− Maintain joint messaging/marketing/education on HL7 FHIR and FHIR-based IHE
profiles on fhir.org
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Gemini Projects
Medical Imaging for Cancer Care
• Gemini shall coordinate …− Specification development
− Progressively more rigorous interoperability testing
− Implementation activities
− Appropriately timed communications and public demonstrations
• Partners− SMART on FHIR/Sync for Science
− HL7 Imaging Integration WG/DICOM WG20
− FHIRcast
− Clinical Interoperability Council/Clinical Information Modeling Initiative
− ACR-RSNA Common Data Elements Steering Committee
− IHE Radiology
− IHE-USA and IHE-Europe
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Gemini Projects
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Source: QRPH Presentation on CCG Profile, Derek Ritz
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Gemini Projects
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Source: QRPH Presentation on CCG Profile, Derek Ritz
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Gemini Projects
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Source: QRPH Presentation on CCG Profile, Derek Ritz
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Gemini Projects
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Source: QRPH Presentation on CCG Profile, Derek Ritz
See detailed explanation video at
https://vimeo.com/356829962
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Gemini Projects
Device Interoperability using SDPi+FHIR
• Collaborative initiative between HL7 Devices and IHE Devices Domain
• Consolidate various device interoperability projects:− HL7 FHIR (and the Devices on FHIR Implementation Guide work)
− IHE Service-oriented Device Point-of-care Interoperability (SDPi) technical framework specifications
• Focus− High-acuity Point-of-Care, Healthcare enterprise, and home/mobile
• Goals− Simplify the device interoperability story presented by both orgs
− Gain participant efficiency and productivity
− Achieve a more tightly coupled, coherent set of specifications
• Includes collaboration with related activities in− IEEE 11073, ISO/TC 215 & IEC/SC 62A JWG 7
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Gemini Projects
Device Interoperability using SDPi+FHIR
• One set of cohesive, coordinated deliverables
− IHE SDPi Supplement – published 2020 JUL, PAT/CAT testing Q3/4 ’20
− HL7 Devices on FHIR IG supporting SDC integration & Alerting – ballot in 2020
• DoF IG (proposed) for Device Information Consumers (title TBD)
− Joint White Papers:
• “Safe, Effective & Secure MDI Using SDC/SDPi + FHIR” – Quality / Regulatory / Legal Considerations
• “What is a device?” - including AI/ML SAMD, across use context geographies
• Governance based on HL7 or IHE project home organization processes
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GCeHI
• Global Consortium for eHealth Interoperability (HIMSS / IHE / HL7)
• Launched at ONC Annual Meeting in Washington, D.C, January 27, 2020− https://www.himss.org/resource-news/announcing-
global-consortium-ehealth-interoperability
• Rapidly advance global digital health efficiency through next generation API-based interoperability
• Founded to become a global community− Collaborate to succeed!
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• Covene stakeholders to …− Support the implementation of safe, usable and
effective health data standards
− Accelerate the development and adoption of secure and open standards-based APIs
− Define an on-ramp for exchange via APIs
− Facilitate the establishment of implementation communities around the world
• Participation model (fee-based)− Government agencies / MoH / NGOs
− Provider organizations
− SDOs
− Market suppliers
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GCeHI
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GCeHI
• Current (first) activity of GCeHI: COVID-19 Listening sessions
− Session 1 Focus – Clinical Care: Clinicians and Provider Organizations on the Frontline of COVID-19
• Data exchange needs and pain points
• Wednesday, April 29th at 1:00-2:30 PM CT. Register Here.
− Session 2 Focus - Technology: HIT Professionals and Market Suppliers
• Accelerating Interoperability by Leveraging Existing Resources
• Wednesday, May 27th at 2:00-3:30 PM CT. Register Here.
− Session 3 Focus – Policy: How Governments and Ministries of Health are Working with the Industry to Respond to COVID
• Wednesday, June 24th at 2:00-3:30 PM CT. Register Here.
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GCeHI
• Future work (ideas and draft)− GCeHI Portal
− More listening sessions
− Interoperability dashboard (Info on projects)
− Global master standards list (info on established standards)
− Interoperability measurement/maturity models
− Shared use cases, best practices around implementation/deployment
• Plus: Work-items brought by participants, e.g.− Coordinated work on new standards / blueprints
Everything which is too big/complex for one of the organizations alone
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Links
• Gemini− https://confluence.hl7.org/display/GP/Project+Gemini
• Global Consortium for eHealth Interoperability (GCeHI)− http://globalhealthinterop.org
• GDHP, Global Digital Health Partnership− https://www.gdhp.org
• Interesting publications− eHealth Suisse Summary IHE / HL7 / FHIR
• https://www.e-health-suisse.ch/fileadmin/user_upload/Dokumente/E/overview-ihe-hl7-fhir.pdf
− The 3 Legs of the Health Informatics Standards Process• http://www.healthintersections.com.au/?p=2921
− The 4 aspects that change the game in eHealth Interoperability• https://www.linkedin.com/pulse/4-aspects-change-game-ehealth-interoperability-j%C3%BCrgen-
brandst%C3%A4tter
− European Commission recognizes 27 IHE profiles that should be referenced in public procurement documents
• http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:JOL_2015_199_R_0011
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Links
• IHE Homepage
− http://www.ihe.net/
− http://www.ihe-europe.net/
• IHE Wiki
− http://wiki.ihe.net/
• IHE International Social Media
− YouTube channel: https://www.youtube.com/user/IHEIntl
− IHE Webinars: http://www.ihe.net/Webinars/
− Twitter: https://twitter.com/IHEIntl
• Google groups
− https://groups.google.com/forum/#!search/ihe
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Changing the Way Healthcare CONNECTS
http://www.ihe.net
Jürgen Brandstätter
[email protected]
LinkedIn: https://www.linkedin.com/in/jbrandstaetter
Twitter: JuBrandstaetter