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HL7 FHIR: The New Language of Health Data

Duration: 55 min · Level: Intermediate · Module: 8. Interoperability & Data Exchange · Focus: FHIR, HL7, interoperability, APIs, information-blocking

Learning objectives

By the end of this lesson you will be able to explain and apply:

  • FHIR R4
  • SMART on FHIR
  • ONC Cures Act Final Rule (2020)
  • Information blocking
  • FHIR vs HL7 v2

Why this matters​

HL7 FHIR (Fast Healthcare Interoperability Resources) is the modern standard for exchanging health data via RESTful APIs.

Overview​

HL7 FHIR (Fast Healthcare Interoperability Resources) is the modern standard for exchanging health data via RESTful APIs. Unlike the older HL7 v2 standard, FHIR uses web-standard formats (JSON, XML) and enables patient-facing apps to access health data directly. Since April 2021, certified EHRs must expose FHIR R4 APIs.

Key concepts​

Key idea

FHIR R4: current stable version of HL7 FHIR; defines "resources" (Patient, Observation, Condition, MedicationRequest, DiagnosticReport) that map to specific data elements

  • SMART on FHIR: authorization framework built on OAuth 2.0 that allows third-party apps to securely access EHR data with patient consent; enables Apple Health, patient portals, and care coordination apps
  • ONC Cures Act Final Rule (2020): requires EHR vendors to publish FHIR R4 APIs; prohibits information blocking; empowers patients to access their data via third-party apps without paying for it
  • Information blocking: any practice by a health IT developer, health network, or healthcare provider that interferes with access, exchange, or use of electronic health information (EHI); ONC can impose civil monetary penalties up to $1M per violation
  • FHIR vs HL7 v2: HL7 v2 is pipe-delimited text (MSH|^~&|...) used in hospital messaging (ADT, lab results, orders); FHIR is JSON/XML via REST API used for patient-facing and cross-organization exchange; both are used simultaneously
  • CDS Hooks: FHIR-based standard for delivering clinical decision support into EHR workflow; a third-party CDS service can display alerts and recommendations inside the EHR via standardized hooks

Check your understanding​

Try to recall each answer before expanding it.

Q1. What do you know about FHIR R4?

current stable version of HL7 FHIR; defines "resources" (Patient, Observation, Condition, MedicationRequest, DiagnosticReport) that map to specific data elements

Q2. What do you know about SMART on FHIR?

authorization framework built on OAuth 2.0 that allows third-party apps to securely access EHR data with patient consent; enables Apple Health, patient portals, and care coordination apps

Q3. What do you know about ONC Cures Act Final Rule (2020)?

requires EHR vendors to publish FHIR R4 APIs; prohibits information blocking; empowers patients to access their data via third-party apps without paying for it

Q4. What do you know about Information blocking?

any practice by a health IT developer, health network, or healthcare provider that interferes with access, exchange, or use of electronic health information (EHI); ONC can impose civil monetary penalties up to $1M per violation

Q5. What do you know about FHIR vs HL7 v2?

HL7 v2 is pipe-delimited text (MSH|^~&|...) used in hospital messaging (ADT, lab results, orders); FHIR is JSON/XML via REST API used for patient-facing and cross-organization exchange; both are used simultaneously

Next: C8.2 HIEs, Carequality & CommonWell — Networks for Health Data →

Part of Module 8: Interoperability & Data Exchange.