Sessions 0 And 1 - Introduction To HL7 FHIR And FHIR Principles

Question 1

What does FHIR stand for?

Answer 1

Fast Healthcare Interoperability Resources

Question 2

What is FHIR based on?

Answer 2

Modern web tools like XML, JSON, RESTful APIs, and modular resources.

Question 3

What does FHIR focus on?

Answer 3

The 20% of resources that cover 80% of use cases (e.g. Patient). For remaining use cases, extensions can be created.

Question 4

What were previous versions of FHIR

Answer 4

HL7 v2, then v3, then CDA, then FHIR, now FHIR R4B.

Question 5

How long should implementation of FHIR take?

Answer 5

Days or weeks. Not months or years, like previous versions.

Question 6

Who was FHIR created for?

Answer 6

For implementers and developers. Not for clinicians.

Question 7

What security measures are available?

Answer 7

HTTPS and OAuth

Question 8

Every FHIR resource has

Answer 8

URL that identifies the resource
ID and metadata
Human readable XHTML summary
Defined data elements
Extensibility

every resource instance represented as either XML, JSON, or RDF. Currently 145 different Resource types.

Question 9

FHIR supports multiple exchange paradigms, including:

Answer 9

RESTful APIs
Documents
Messaging
Services
Databases

Question 10

What does RESTful stand for?

Answer 10

REpresentational State Transfer protocol

Question 11

What is CRUD?

Answer 11

Create
Read
Update
Delete

Question 12

How does CRUD relate to HTTP actions?

Answer 12

Create = Post
Read = Get
Update = Put
Delete = Delete

Question 13

Is gender a resource?

Answer 13

No. It is a property of the Patient resource.

Question 14

What is HTTP used for?

Answer 14

For transporting data across the web. RESTful API uses HTTP.

Question 15

What are XML and JSON?

Answer 15

Formats for data transfers.

Question 16

What is FHIR similar to?

Answer 16

It is similar to a language. Don’t have to have FHIR server. Just need to be able to understand / interpret it.

Question 17

What are FHIR identifiers?

Answer 17

There are 2 types: business IDs like SSN, MRN, etc from real world. And ID, relating to server and meta data for finding a data bit on a server / URL

Question 18

What is FHIR?

Answer 18

An HL7 interoperability standard for sharing clinical data. 2 main parts are Content Model (resources) to represent clinical data and Exchange Specification (Rest API, messaging, services, services documents, databases)

Question 19

What types of clinical data are involved?

Answer 19

Clinical data, Financials, public health and research, quality reporting, and conformance/profiles and terminology

Question 20

What does FHIR not do?

Answer 20

It does not attempt to define good or best clinical practices, nor does it provide guidance on user interfaces or workflows.

Question 21

What are the key inbuilt features of FHIR?

Answer 21

Structure Definitions - describe FHIR constructs themselves (meta)
Search Parameters
Capability Statement - advertises what server is capable of
Healthcare Domain Model - focus on resources with wide applicability in healthcare
Extensions - for extending or adding resources or elements
Profiles - for conformance
Rest API - for exchange

Question 22

What is common for FHIR APIs?

Answer 22

Signature and format used in all FHIR compliant systems. Standard API signature and outcome format will always be the same.

Question 23

What is a FHIR Server?

Answer 23

Ability to understand and validate FHIR query from client.
Convert the FHIR query to business query
Get the data desired from backend and convert to FHIR resources.
Send the resources to client.
FHIR repository

Don’t to replace existing servers, but make it FHIR enabled.

Understand, convert, and validate query
Get resources and send them
Repository

Question 24

What is the official FHIR validator?

Answer 24

A Java jar file that can be used to validate resources. Included in FHIR. Other options include HAPI FHIR, Forge, Implementation Guide publisher, etc.

Question 25

How is FHIR organized?

Answer 25

In sets of modules.
Level 1 Foundation = base documentation, XML, JSON, Data types, extensions
Level 2 Supporting Implementation = Implementer Support, Security, Privacy, Conformance, Terminology, Exchange
Level 3 Administration = linking to real world concepts
Level 4 record keeping healthcare process = clinical, diagnostics, medications, financials
Level 5 reasoning = clinical reasoning

Question 26

How are the modules associated with each other?

Answer 26

Downward dependencies with some horizontal

Question 27

What architectural principles does FHIR have?

Answer 27

Reuse and composability
Scalability
Performance
Usability - used by experts and non-technical users alike
Data Fidelity
Implementability

Question 28

What are the 5 versions of FHIR?

Answer 28

Draft
Trial Use
Normative
Informative
Deprecated

Note: Normative resources can have non-normative elements. Mixed content is allowed
Note: R4 is first version of FHIR with some normative content.

Question 29

What is the FHIR Maturity Model (FMM)?

Answer 29

For determining how advanced or stable the FHIR content is?
Draft (0)
FMM 1 - FMM5
Normative

Question 30

What is the FHIR versioning format?

Answer 30

Publication.major.minor.revision
Example: 4.0.1

Question 31

What are forward and backward compatibility?

Answer 31

Forward means that content that is conformant in old release will remain conformant in new release.
Backward means that content that is conformant in new release will work with old releases.
To maximize backward compatibility you should ignore, ignore, ignore unexpected or unrecognized

Question 32

What is main difference between HL7 v2 and FHIR?

Answer 32

V2 had no web-based options or ways to exchange data. It emphasized standard format.
FHIR has standard format + web + exchange mechanisms

Question 33

What is an implementation guide (IG)?

Answer 33

A group of profiles.

Question 34

What is FHIR validator made of?

Answer 34

Schema, scheme draw, profile = validation

Question 35

What is a FHIR client?

Answer 35

The entity requesting data. Could be EMR, mobile phone app, a database, etc

Question 36

What are the layers of FHIR?

Answer 36

Foundation
Base
Clinical
Financial
Specialized (clinical reasoning)
Content (Profiles)