Evaluation of FHIR in the Field of Electronic HIE System

Running Head: EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM
EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM
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EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM1
Executive Summary:
The objective of this writing is to critically examine and evaluate the Fast Healthcare
Interoperability Resources (FIHR) standard as a means of exchanging healthcare information
electronically. The analysis has also thrown light on the present scenario of health
information exchange and its challenges. In case of addressing those challenges, there are
many ways to encounter the problems, but the most effective way is applying FIHR-based
technology. The justification of using FIHR has been critically analyzed with the citation of
proper pieces of evidence. The parts and components of FIHR have also described, and the
effectiveness in managing the database enhances the acceptability of FIHR in the field of
HIE.

EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM2
Table of Contents
Introduction:...............................................................................................................................3
Discussion:.................................................................................................................................3
The Current Scenario and Challenges of the e-HIE system:..................................................3
Briefing about Recent Scenario of HIE:............................................................................4
Classifications and Way of Functioning of HIE:...............................................................4
Models Using in HIE Currently:........................................................................................5
Detailing on Current Environment of e-HIE and its usage to improve Patient Care:........6
Challenges and Issues regarding the use of HIE:...............................................................8
Description of Components and Application of FHIR-Based Technology:..........................8
Components and Structure of FHIR:..................................................................................9
Application of FHIR Technology in HIE:.......................................................................10
Application of FHIR in Health IT:...................................................................................11
Analysis of Suitability of FHIR Technology in Meeting the Upcoming Challenges:.........12
Advantages and Suitability of FHIR Based technology:.................................................12
Future Challenges in Case of Interoperability and Suitability of Using FHIR:...............13
Conclusion:..............................................................................................................................14
Reflection on Regarding the Knowledge and Experience I Gained During Research:...........15
References:...............................................................................................................................16
Journals:...............................................................................................................................16

EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM3
Introduction:
According to Downing et al. (2016) Electronic Healthcare Information Exchange (e-
HIE) permits the medical practitioners and patients to access and exchange health data
securely. There are many technical interfaces or strategies to exchange and share important
data and FIHR (Fast Healthcare Interoperability Resources) technology is one of them. FHIR
is a proactive interoperability standard that was developed by the Health Level Seven
International (HL7), a non-profit organization, which is dedicated to developing solutions and
standards for the global empowerment of health data interoperability (Bender & Sartipi,
2013). Thus the objective of the project is to critically examine the HIE on the basis of
present scenario and the challenges encountered. The assignment will also compare and
contrast the suitability of applying the FHIR based technology to counter the forthcoming
challenges.
Discussion:
In this discussion, the evaluation of FIHR system is done on the basis of electronic
Healthcare information exchange. The way of working of e-HIE, the recent environment and
its importance to manage and exchange the data is healthcare organization is very significant
to provide a quality service to patients. The importance of FHIR in this e-HIE field and how
FHIR manages and exchanges data successfully is described here.
The Current Scenario and Challenges of the e-HIE system:
According to Carr et al., (2013) Healthcare Information Exchange (HIE) is the
electronic development of healthcare related data among associations, as per broadly
perceived norms, with the objective of encouraging access to and recovery of clinical
information by doctors, medical attendants, drug specialists, other human services suppliers,
and patients. In other words, HIE encompasses the mobilization of healthcare related data

EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM4
electronically, across different organizations that are located within a hospital or community
system. The primary objective of using the HIE is to ease the entry to, and extraction of
pertinent clinical information, with the aim of delivering more timely, safer, equitable, and
effective patient-centered care services (Groves et al., 2016). This in turn proves beneficial to
the health authorities and also assists them while analyzing the population health.
The benefits of HIE are as follows:
 Reducing medical errors decreases paperwork.
 In case of proper treatment facility, it aids the doctors and nurses to deliver quality
treatment.
 It augments the quality of monitoring and testing.
 Effective cost management regarding Healthcare.
 Engage social insurance purchasers concerning their very own healthcare data
Briefing about Recent Scenario of HIE:
It has been postulated by researchers that Australian-formulated open source FHIR
might be soon standardized for exchange of health information by the government of USA,
such that it would push the huge EHR businesses and healthcare benefactors in the direction
of data sharing. It was also mentioned to the Healthcare IT News Australia that some
progress has been made, regarding health information networks (Minion, 2018). However,
future research will be done on interoperability and the standards for FHIR in Australia.
The process of enhancing interoperability function regarding HIE is quite critical. With the
evolution of technology, the scope for receiving the information and transferring the data has
also improved. By applying Multivariate logistic Regression on the data during 2009 to 2013
it was found that acceptability of HIE in case of EHR has increased (Furukawa et al., 2014).

EVALUATION OF FHIR IN THE FIELD OF ELECTRONIC HIE SYSTEM5
Nowadays, the acceptance and the usability of HIE has augmented globally, as it is
quite successful in giving benefits regarding patient care. For instance, it was found that
SHIN-NY (statewide health information network) became successful in using HIE in the field
of ADT (admission, discharge, transfer). During the period of 2016 to 2017, it achieved 95%
growth ("What are Potential Benefits, Challenges of HIE Use?", 2019). Thus it is evident
from the examples of Charles, Gabriel and Searcy (2013) that the benefits and applicability of
HIE in a healthcare organization is needed to understand otherwise it would be difficult for
employees to provide continuous quality service.
Classifications and Way of Functioning of HIE:
Health Information Exchange mainly provides three classified services those are
Directed Exchange Method, Query-based Exchange method and the last one is the Consumer
mediated exchange Method. Directed information exchange mainly deals with transferring
and receiving data between care providers. The query-based system performs its activity to
manage the requests from patients. Consumer mediated exchange provides support to the
patients to use and also control their health information among health service providers
(Cimino et al., 2014).
The directed exchange helps providers to send data or the information securely and
directly to the other health professionals. In the case of delivering unplanned medical support,
the medical service providers use the query-based health information exchange. For instance,
physicians in case of emergency services utilize the query exchange in accessing the
information regarding medications, images of X-ray and radiology (Shy et al., 2016).
Consumer exchange type allows the Consumer to manipulate, access and manage their
information online just similar to online banking.