In February I attended the HL7 International meeting in Sydney. Despite being openly aligned with openEHR AND a clinician, a classic double whammy, I was universally welcomed. It was a treat to catch up with some long term colleagues and renew acquaintances whom I hadn’t seen for some years.
I dropped in on some working group meetings to observe and soak in the ambience, particularly Patient Care, Vocabulary and the Genomics groups. An unexpected treat was to participate in the BPM+ Health workshop where I was able to learn to use some online OMG tooling to build clinical workflows, and it was super exciting to see where high quality atomic data has the potential to trigger initiation of care pathways, which could have a massive impact on health outcomes.
However the main reason for my attendance was to participate in the ‘Clinicians on FHIR’ day, initiated by Kate Ebrill from AeHRC. The ubiquitous Prof Ed Hammond, regarded by many as the father of HL7, and I jointly presented on clinical data modelling and standards.
Still pinching myself, but if it is on Twitter, it must be true!
A couple of moments from Ed’s talk stood out for me - ones that I’d like to share. The first was his slide, below. With apologies to Pieter Brueget the Elder, he described the current state of interoperability…
And the health professionals said “Let everybody choose their own data elements and terminologies, and we can map it all together.” And the result was interoperability-breaking chaos.
Per Prof Ed Hammond, with permission.
Without a doubt FHIR is a realistic and achievable way for our diverse silos of clinical data to share selected data. It’s international momentum and growing community bear witness to it successfully meeting an immediate digital health need in 2020.
I had asked Ed to speak about his vision for the future in healthIT, especially in the context of his announcement at Medinfo 2019, in Lyon, for a HL7 universal health language. Unfortunately Ed wasn’t able to share anything more about this new HL7 vision but I captured one of his quotable quotes on twitter instead…
Ed Hammond: “If you’re solving today’s problems, you’re out of date!”
It is no secret that I view FHIR as a great interim solution for today, but essentially as a patch to create opportunistic interoperability between systems, but I have also expressed concern about it’s governance of models, coordination and sustainability.
I’ve also publicly stated many times that we need a universal health data foundation, a major leap forward where all systems based on common information models can share data natively. So you can understand how exciting it was to hear Ed declare a similar vision publicly at Medinfo. Now, my particular flavour of that lingua franca is no secret - it’s obviously openEHR. Ed and I agree on the vision, but differ on the the flavour of solution. I can live with that :)
Reading between the lines here (so please don’t quote either Ed or I on this), I suspect that Ed is also recognising that FHIR alone is not enough as the ‘final solution’. Without a doubt it is kicking major goals in the short term, patching between systems to start to create some limited order in Ed’s Tower of Interoperability chaos, but for a long term solution for digital health Ed and I seem to agree that we need a universal lingua franca as a digital health foundation.