Editor’s Note: The following article is a Guest Column from Edgar Wilson, an independent consultant who writes and follows health, education, and environmental policy. You can contact Edgar on Twitter @edgartwilson. To learn more about submitting a Guest Column, Click Here.
The last thing the world needs is yet another Apple-geek coming along and singing the mega-company’s praises.
But as the healthcare community continues to slouch toward interoperability, the promise of FHIR as the basis for breaking down the walls of communication is uncannily similar to the model that made the iPhone such a success.
The HTTP framework for FHIR treats disparate EHR platforms more like internet browsers; making the same content intelligible regardless of (or between) the various browsers should accommodate user preference without compromising the integrity of the data being moved.
What is exciting about this potential shift, though, is how it opens the playing field for smaller, independent application developers and designers to lend their skill and vision to the EHR field—just as the iPhone induced app developers to add value to Apple’s seminal device by way of the iTunes app store.
If you sort through all the games, gimmicks, and time-wasters this unleashed, you come to find that in the mobile app world, individuals and organizations are finding solutions in the same sandbox. Or, as Apple CEO Tim Cook put it, “What we don’t bring is we don’t have deep knowledge of all the verticals that the enterprise deals with. So to do great things we need to partner with other people.”
In the case of the iPhone, that means indie developers, as well as companies looking to promote their proprietary apps, all on the same iTunes shopping platform, “This is all about giving a suite of applications to the enterprise so we can really change how people work,” Cook explained.
Maybe that is the biggest thing FHIR can achieve: breaking through this barrier between consumers (in this case, both patients and clinicians) and enterprise clients (the hospital networks and clinical facilities who buy enterprise EHR packages). Apple has proven that the solutions that serve consumers well end up becoming enterprise solutions. What started as a new toy for tech geeks and Apple devotees became ubiquitous across the marketplace. Other companies took notice, and mobile devices all moved to integrate with an app store to add value and functionality to the devices.
We need that approach in healthcare.
It isn’t just that current systems lack broad interoperability; users regularly complain that on their own, the systems and interfaces aren’t particularly intuitive or user-friendly. Rather than the various EHR providers competing to make their all-in-one proprietary systems exclusive, opening them up to the user-centric development of extensions and applications would help bridge the divide not only between platforms, but between the enterprise and end-user level.
FHIR may not be the answer to interoperability woes that everyone is waiting for; silver bullets are far from common in the healthcare realm, after all. But what it promises is arguably more important: it opens up the EHR field for more innovation, individual and small group-led designs, app development, and generally crowd-sourced solutions to some of the operational shortcomings or nitpicks in the existing legacy systems.
By driving the platforms toward greater integration with the FHIR standard, the crowd of problem-solvers and innovators stands to grow, and that is a huge improvement.
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