Sessions 0 And 1 - Introduction To HL7 FHIR And FHIR Principles Flashcards
What does FHIR stand for?
Fast Healthcare Interoperability Resources
What is FHIR based on?
Modern web tools like XML, JSON, RESTful APIs, and modular resources.
What does FHIR focus on?
The 20% of resources that cover 80% of use cases (e.g. Patient). For remaining use cases, extensions can be created.
What were previous versions of FHIR
HL7 v2, then v3, then CDA, then FHIR, now FHIR R4B.
How long should implementation of FHIR take?
Days or weeks. Not months or years, like previous versions.
Who was FHIR created for?
For implementers and developers. Not for clinicians.
What security measures are available?
HTTPS and OAuth
Every FHIR resource has
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.
FHIR supports multiple exchange paradigms, including:
RESTful APIs
Documents
Messaging
Services
Databases
What does RESTful stand for?
REpresentational State Transfer protocol
What is CRUD?
Create
Read
Update
Delete
How does CRUD relate to HTTP actions?
Create = Post
Read = Get
Update = Put
Delete = Delete
Is gender a resource?
No. It is a property of the Patient resource.
What is HTTP used for?
For transporting data across the web. RESTful API uses HTTP.
What are XML and JSON?
Formats for data transfers.
What is FHIR similar to?
It is similar to a language. Don’t have to have FHIR server. Just need to be able to understand / interpret it.
What are FHIR identifiers?
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
What is FHIR?
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)
What types of clinical data are involved?
Clinical data, Financials, public health and research, quality reporting, and conformance/profiles and terminology
What does FHIR not do?
It does not attempt to define good or best clinical practices, nor does it provide guidance on user interfaces or workflows.
What are the key inbuilt features of FHIR?
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
What is common for FHIR APIs?
Signature and format used in all FHIR compliant systems. Standard API signature and outcome format will always be the same.
What is a FHIR Server?
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
What is the official FHIR validator?
A Java jar file that can be used to validate resources. Included in FHIR. Other options include HAPI FHIR, Forge, Implementation Guide publisher, etc.
How is FHIR organized?
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
How are the modules associated with each other?
Downward dependencies with some horizontal
What architectural principles does FHIR have?
Reuse and composability
Scalability
Performance
Usability - used by experts and non-technical users alike
Data Fidelity
Implementability
What are the 5 versions of FHIR?
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.
What is the FHIR Maturity Model (FMM)?
For determining how advanced or stable the FHIR content is?
Draft (0)
FMM 1 - FMM5
Normative
What is the FHIR versioning format?
Publication.major.minor.revision
Example: 4.0.1
What are forward and backward compatibility?
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
What is main difference between HL7 v2 and FHIR?
V2 had no web-based options or ways to exchange data. It emphasized standard format.
FHIR has standard format + web + exchange mechanisms
What is an implementation guide (IG)?
A group of profiles.
What is FHIR validator made of?
Schema, scheme draw, profile = validation
What is a FHIR client?
The entity requesting data. Could be EMR, mobile phone app, a database, etc
What are the layers of FHIR?
Foundation
Base
Clinical
Financial
Specialized (clinical reasoning)
Content (Profiles)
