One of the things that is happening to FHIR is that as it grows in maturity, it is starting to attract more Clinicians and Business Analysts who are less interested in the technology, and more interested in how it can be used to represent the clinical information they want to share – both inside and between organizations.
Indeed, the chair of HL7 – Stan Huff – referred to this explicitly at the last Working Group Meeting when he referred to the importance of the clinical community getting together to develop the profiles of use that take the core FHIR specification, and make it work for the clinical community. There is a very real risk of developing multiple different profiles that actually mean the same thing and thus harming interoperability. FHIR offers mechanisms to avoid this, but it does mean that people – especially clinical and analysts –need to have a good idea of how FHIR in general – and these mechanisms in particular – work.
In the past year we’ve started to hold ‘Clinical Connectathons’ at the Working Group meetings. Similar in concept to the technical connectathons we’re held since the beginning, these events are aimed at clinicians to help them understand FHIR, and to guide it’s development in the clinical space. To facilitate these events we’ve developed tooling – an application that lets someone actually use FHIR resources and profiles to represent clinical data, thus both educating people in its use and testing the standard against real-world scenarios. It hasn’t been the easiest thing to develop these tools, but we think we’re now on the right track so it seems appropriate to talk about them and to expose them to a wider audience for comment and review.
First some important caveats.
- The tool is an online resource and accessed through a browser (which needs to be a modern one – we use Google Chrome to develop it). It is in a state of rapid development which means that the interface will change over time – though hopefully will be straightforward to use (but you’ll appreciate that the author is not a User Interface expert!).
- It’s not intended to be like an EHR or EMR. It’s all about understanding how FHIR is organized at the base level. You’d never create an interface like this for an EHR (though you certainly could create an EHR using FHIR).
- There are known limitations and doubtless many bugs.
- All data entered is saved in a publically available test server (currently Grahames server) so don’t put any real data in it!
- Also, because of the moving nature of FHIR at the moment, you can’t assume that any data you enter on one day is going to be there the next. This will eventually improve, but right now regard your data as ephemeral. (If there is a special reason why you might want to keep stuff there for a short while, drop me a line and we’ll see what we can do).
The tool (which we’ll refer to as ‘clinFHIR’) currently has 2 main components:
- A Resource builder that takes the definition of a resource (actually a profile – or StructureDefinition resource to be precise) and allows the user to create a resource instance using the resource definition that is saved on the server. It also allowsa user to ‘browse’ the resources for a patient to explore their relationships.
- A profile builder that allows a resource definition to be customized to a specific use case (This is still a bit flaky, but we’re working on it).
These are not intended to be comprehensive applications that cover all aspects of FHIR profiling (there are other tools being built for that like forge from furore) – but enough to show how FHIR works to record clinical data – especially aimed at non-technical folk, and also to help uncover the areas that require further work.
There is documentation here (again, under construction!) and a Google Group for user feedback.
Feel free to have a play with the application, and feed back any comments/suggestions through the group.