ETSU is on FHIR

Fast Healthcare Interoperability Resources

Jalaj NautiyalMark Buckner

HIT Independent Study Goals

Objectives• Become more familiar

with FHIR• Modify HIT course

project– Include patient search

constraints• Participate in

HealthCamp Code-a-thon

Plan A• SMART on FHIR app

Plan B• Pending & lapsed patient

immunization app• (Create ETSU FHIR endpoint)

Plan C• Patient immunization app

– Fetch immunization information based on patient

What is FHIR?

Fast Healthcare Interoperability Resources– New standard from HL7• Result of Argonaut Project• Currently in trial-use phase

– Facilitates efficient information transfer between EHR systems

– Modular & flexible• Easier to implement than previous HL7 standards• EHR-agnostic

Resources

Clinical– Medication– RiskAssessment– Immunization

Identification– Patient– Practitioner– Organization

Workflow– Encounter– Appointment

Financial– Claim– PaymentNotice

The Patient Resource

Code-a-thon Preparations

• FHIR research• Presentation at MSHA• Formation of team

– Team WoodStove– First collaborationbetween MSHA IS team

& ETSU Computing Dept.

Team WoodStove

"O, captain! My captain!"– Dr. Jay Jarman

MSHA representatives– Wes Combs– Ian Williams– Dustin Trent

ETSU graduates– Jalaj Nautiyal– Mark Buckner

Code-a-thon Event

Locations– Washington, D.C.• Day 1: Hubert H. Humphrey Building (Dept. of HHS)• Day 2: 1776 (startup incubator)

Competition– 80+ participants– 12 teams

Objective– Create app to put a beneficiary’s claims data to use for

the betterment of their health

Use-cases– Helping beneficiaries manage their health– Allowing beneficiaries to share their data with their

providers or caregivers– Allowing beneficiaries to donate their data for research

purposes (e.g., for patient-centered comparative effectiveness research)

Highest score out of all academic teams!!!

…only academic team...

Our solution– Desktop C# app– Wrapped .NET FHIR API– Split team between UI &

middleware– Alternatives

• Microsoft Azure• Xamarin• iPhone deception!

Other teams' solutions– @Point of Care (1st place)

• Leveraged IBM Watson• Complex health information visualizations

– NavHealth (tied 2nd place)

• Patient decision support system– Uses recurring neural network algorithm

– UBeWell (tied 2nd place)

• App to improve hypertension via Medicare data

Lessons Learned

• Ad hoc team experience• Exposure to new technologies– Postman

• FHIR data-handling structure– FHIR endpoints

• Communicated with several key FHIR evangelists

FHIR's Future?

• Vendor buy-in– Lack of incentives

• Competition• Universal Medical ID number problem?

FHIR Resources

Documentation & information– Official HL7 FHIR Documentation– FHIR Wiki– Official FHIR .NET API– Health Intersections• FHIR project leader’s site

Public endpoints– FHIR Sandboxes

Demonstrations

Thanks!

Please, direct all questionsto Jalaj Nautiyal. :)