Interoperability in Action Post #2: A Tale of Two Connectathons

HL7 International held Connectathon 9 in Paris on May 10 and
followed up with a FHIR Clinician

Connect-a-thon on May 15. Both events came at the challenge of interoperability from different angles.

Credit: Yann Caradec
Connectathon 9 had 4 separate
themes:
·        
Basic patient management
·        
Version 2 mapping to FHIR messages
·        
Financial Resources
·        
Terminology Services
Clinician Connect-a-thon, meanwhile, featured
two streams:
·        
A “Clinician challenge stream” that
tackled the “clinical adequacy, validity, accuracy and reliability of the FHIR
clinical resources,” using different test scenarios
·        
Testing of FHIR clinical resources
through the following environment: http://clinfhir.com/
There were plenty of threads to pick up in the discussion
around these events. One of the most interesting was a comment from Grahame
Grieve (the ‘man of FHIR’), as captured on the FHIRplace
blog
:

The FHIR registry is on top of my
most-important, damn-if-I-don’t task list.

Users of FHIR need to know if profiles and extensions exist
already for the standard to be truly interoperable. It will be fascinating to see
how this unfolds – including where this registry (or registries) ultimately
lives and who will be its overseer.
Real-world scenarios
A registry is vitally important to the standardization of
FHIR, but so is the real-world clinical perspective.
In an effort to ground FHIR testing in real-world clinical
scenarios, Clinical Connectathon participants worked from clinical
storyboards and scripts
. These scenarios were provided in plain-language
prose and rooted in common occurrences – through a range of clinical settings –
that would make demands on FHIR resources or databases.
These storyboards are highly instructive, serving as a
window into how interoperability might play out practically through the use of
FHIR and also a more generally instructive testing tool. As we test
interoperability in our development work, DHIT strives to simulate common use
cases that affect patients and physicians. Particularly relevant to our recent
work is the immunization
storyboard
.
The more we can return to the question of “What do
physicians and patients need from this technology?” the closer we get to
meaningful interoperability. As the Connectathon demonstrates, we should bake
this right into our design and
testing.
Extensibility in
action
FHIR’s extensibility, at least in theory, allows it to accommodate
a wide variety of real-world clinical situations. David Hay, part of the
Connectaton planning team, writes over at the
‘Hay on FHIR’ blog
: “FHIR has a built-in extension mechanism that allows
specific implementations to add the properties they need that are missing from
the resources.”
The Registry is the killer app to make these connections. When
FHIR knows what to look for, it can rapidly address the demands the clinical
world can make on data at rest.