Bring technologists together to discuss interoperability, and you\u2019re going to hear a lot of acronyms, some words of wisdom, and a considerable amount of dissent.<\/p>\n\n\n\n
That was the case at the\u00a04th<\/sup>\u00a0Annual Current and Future State of Interoperability, a panel discussion sponsored by eFax Corporate\u00ae and hosted by HealthcareNOW Radio.<\/p>\n\n\n\n Indeed, there was little consensus on the first question asked by moderator Matt Fisher, an attorney with Mirick O\u2019Connell. Fisher asked where APIs fit into current and future healthcare interoperability. \u201cConnectivity is a big plus for APIs, giving healthcare organization the opportunity to expand their ecosystems,\u201d said John Nebergall, vice president of Consensus. \u201cBut APIs are not going to solve your integration problems.\u201d<\/p>\n\n\n\n Chris Muir, director in the Standards Division of ONC, agreed. \u201cIt\u2019s not a full solution, but it\u2019s helpful when patients need to access data from an ERHs or providers are using more than one EHR,\u201d he said.<\/p>\n\n\n\n Dave Cassel, executive director of Carequality, saw things differently. \u201cAPIs are useful across the board,\u201d he said. \u201cThere are challenges on the patient-access side, but they\u2019re solvable. And giving patients more control over data access has benefits, including fewer HIPAA problems.\u201d<\/p>\n\n\n\n Shifting the discussion slightly, Nebergall said the real issue is creating a way for patients to gather and exchange information in a way that\u2019s useful to them. This is where technology other than APIs can be useful, providing a way to deliver information directly to patients rather than making them go from place to place to find it, he said.<\/p>\n\n\n\n Asked about the Fast Healthcare Interoperability Resources (FHIR) standard, Cassel said while there are always arguments about any given standard, there\u2019s a lot of support in the industry for it. ONC\u2019s Muir concurred, saying that people are supporting it and talking about trying to use it. \u201cWe\u2019re seeing a lot of adoption of open APIs based on FHIR,\u201d he said.<\/p>\n\n\n\n But Nebergall said there are serious issues on what he called the semantic side of FHIR. \u201cFHIR holds great promise, but there\u2019s not full consensus,\u201d he said. \u201cWe see the use of different coding systems with prior data normalization.\u201d<\/p>\n\n\n\n Jeff Coughlin, senior director of federal and state affairs for HIMSS noted that ONC is asking what version of FHIR should be used and that he expects to see version specification in ONC\u2019s Final Rule.<\/p>\n\n\n\n Cassel pointed out that version specification is not sufficient, that users must take a further step. \u201cFHIR is, more or less, a transport standard, telling you how to get information from point A to point B. It doesn\u2019t say how to define the payload in terms of the data set,\u201d he said. \u201cFHIR can<\/em> do semantic, but the user has to specify. He or she has to go into Resources and say \u2018Thou shalt use Terminology X.\u2019 You can\u2019t leave it unspecified, for example just saying \u2018Send medication.\u2019\u201d<\/p>\n\n\n\n
\n\n\n\nFHIR\u2019s semantic side<\/h2>\n\n\n\n