The National Institutes of Health issued a request for information earlier this fall, seeking to learn more about how HL7's Fast Healthcare Interoperability Resources specification can be better used for clinical research. The American Medical Informatics Association has responded with some suggestions for how NIH can help develop and promote the FHIR standard.

WHY IT MATTERS
AMIA notes that the data exchange standard – as well as the larger issue of interoperability across the healthcare world – is in need of funding and research. And the informatics group has asked NIH to directly support FHIR research in three different ways: through investment, education and product support.

"Given the direction of ONC and CMS rulemaking, and the standards development infrastructure established and maintained by HL7, it is likely that FHIR will become the standard for exchange of most common categories of clinical data over the next two to three years," said AMIA officials. 

"However," they added, "we note that this vision for the use of FHIR is distant and in need of federal support."

The fractured EHR landscape across the nation means many health organizations have data of varying degrees of consistency and compatibility. Under these circumstances, AMIA warns that  "data will need a high degree of additional, potentially manual, curation" in order to be used for research purposes.

THE LARGER TREND
While the FHIR standard is not a cure-all for interoperability challenges, the protocol has seen big momentum in recent years, and is seen as an important bridge between newer mobile devices and hospital networks.

As a web-based spec that has seen a significant amount of buy-in, the standard could have a large impact on the ability of researchers to access better data.

AMIA is proposing several kinds of government investment for FHIR: direct R&D grants to pay for advances in the standard, product requirements that will favor FHIR use and education of the healthcare research community about the standard.

"Given the size and reach of the NIH, it could be a prominent stakeholder to educate the research community on the benefits and known limitations of FHIR," said AMIA President and CEO Dr. Douglas B. Fridsma, in the group's Nov. 21 letter to Dr. Susan Gregurick, director of the NIH Office of Data Science Strategy.

ON THE RECORD
"The development of FHIR has revolutionized how clinical data are accessed, used, and exchanged," Fridsma added in a separate statement.

"NIH is uniquely positioned to further support the standard to advance biomedical research. We look forward to working with them as they develop their strategy."