September 08, 2015 / by Jasmine Lam

Trailblazing with FHIR

Imagine at your behest, with a simple press of a button, you download your childhood medical records from your hometown clinic in Moncton, your last lab results from your current laboratory in Toronto, and records from that one time you travelled to Vancouver and needed medical attention at a hospital.

Although this concept seems simple enough to have in place in healthcare systems, the reality is that we are far from achieving this. Healthcare organizations are often reluctant to share health data for a variety of reasons. Sometimes it’s policy: Does the law let us share data? Do we risk losing customers if we open up our data? Are there privacy risks? Other times, the problem is technical: Did we build the systems as “silos of data” or can they communicate with the outside world? If we make data available, who’s looking at it and will people be able to make use of it?

The world is changing though. Healthcare consumers are increasingly expecting to access and manage their records electronically, and receive care with devices and applications both connected to the Internet and their records. Healthcare providers now have incentives, including financial ones, to improve the exchange of data between disparate systems. By making health data available, patients can receive better care. By offering patients what they want, providers can attract more patients.

FHIR Stepping In

FHIR (Fast Healthcare Interoperability Resources) is an emerging standard that makes it easy to move health data from point A to point B, even if A and B are using different electronic health record (EHR) systems. FHIR makes it easy for an application to choose exactly what data they want to fetch, and makes it available in a format that is easy to understand. Developed by the healthcare standards organization Health Level 7 International (HL7), the specification is built around modelling health data in a way that is easy to use and understand. As health data can be exchanged in XML and JSON, it is accessible to the majority of developers.


In the United States, there is already traction in integrating FHIR with the Meaningful Use policy. In Canada, the rise of FHIR is coinciding with the growing momentum to make health records available online. In August, our own James Agnew shared with a crowd of enthusiastic caregivers and executives at the QuadraMed conference on the standards work that University Health Network is adopting in Toronto.

Our Work with FHIR

Here at the Centre, we have begun to integrate FHIR into our app development. Ned, a survivorship mobile platform for prostate cancer, is the first app that allows patients’ prostate specific antigen (PSA) results to be transmitted seamlessly from a provincial laboratory to an outside mobile application through the use of FHIR. Other apps, iCanCope with Pain and the Medly platform are up next. Oh, and of course, bant, and our diabetes standard project.

James and the Centre have been active in his work to promote FHIR. Our HAPI-FHIR project on GitHub is a reference implementation of the specification, and provides a free open source implementation of FHIR in Java. As a member of HL7, James contributes towards continued development and refinement of FHIR, in particular on its infrastructure, including message and data exchange formats.

The goal now is to keep people talking and get more people to talk about FHIR. Webinars, workshops, conferences, are ways to engage the public, regulators, and caregivers on FHIR’s benefits. Keep the name in mind, as FHIR will continue to forge ahead to make medical records exchangeable and accessible.

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