Fast Healthcare Interoperability Resources

Jalaj NautiyalMark Buckner

HIT Independent Study Goals

Objectives• Become more familiar

with FHIR• Modify HIT course

project– Include patient search

constraints• Participate in

HealthCamp Code-a-thon

Plan A• SMART on FHIR app

Plan B• Pending & lapsed patient

immunization app• (Create ETSU FHIR endpoint)

Plan C• Patient immunization app

– Fetch immunization information based on patient

What is FHIR?

Fast Healthcare Interoperability Resources– New standard from HL7• Result of Argonaut Project• Currently in trial-use phase

– Facilitates efficient information transfer between EHR systems

– Modular & flexible• Easier to implement than previous HL7 standards• EHR-agnostic

Resources

Clinical– Medication– RiskAssessment– Immunization

Identification– Patient– Practitioner– Organization

Workflow– Encounter– Appointment

Financial– Claim– PaymentNotice

The Patient Resource

Code-a-thon Preparations

• FHIR research• Presentation at MSHA• Formation of team

– Team WoodStove– First collaborationbetween MSHA IS team

& ETSU Computing Dept.

Team WoodStove

"O, captain! My captain!"– Dr. Jay Jarman

MSHA representatives– Wes Combs– Ian Williams– Dustin Trent

ETSU graduates– Jalaj Nautiyal– Mark Buckner

Code-a-thon Event

Locations– Washington, D.C.• Day 1: Hubert H. Humphrey Building (Dept. of HHS)• Day 2: 1776 (startup incubator)

Competition– 80+ participants– 12 teams

Objective– Create app to put a beneficiary’s claims data to use for

the betterment of their health

Use-cases– Helping beneficiaries manage their health– Allowing beneficiaries to share their data with their

providers or caregivers– Allowing beneficiaries to donate their data for research

purposes (e.g., for patient-centered comparative effectiveness research)

Highest score out of all academic teams!!!

…only academic team...

Our solution– Desktop C# app– Wrapped .NET FHIR API– Split team between UI &

middleware– Alternatives

• Microsoft Azure• Xamarin• iPhone deception!

Other teams' solutions– @Point of Care (1st place)

• Leveraged IBM Watson• Complex health information visualizations

– NavHealth (tied 2nd place)

• Patient decision support system– Uses recurring neural network algorithm

– UBeWell (tied 2nd place)

• App to improve hypertension via Medicare data

Lessons Learned

• Ad hoc team experience• Exposure to new technologies– Postman

• FHIR data-handling structure– FHIR endpoints

• Communicated with several key FHIR evangelists

FHIR's Future?

• Vendor buy-in– Lack of incentives

• Competition• Universal Medical ID number problem?

FHIR Resources

Documentation & information– Official HL7 FHIR Documentation– FHIR Wiki– Official FHIR .NET API– Health Intersections• FHIR project leader’s site

Public endpoints– FHIR Sandboxes

Demonstrations

Thanks!

Please, direct all questionsto Jalaj Nautiyal. :)