Catherine CHRONAKI
Secretary General
HL7 Foundation
euoffice@HL7.org
Innovation pre-empts Standardization –
The FHIR Experience

A standard is not used because
we created it.
It is a standard because
people use it.
Charles Jaffe, CEO HL7 International

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Patient summaries in the health ecosystem
Can HL7 FHIR help unlock data, facilitate
decision support, navigate the system?
Bring the Power of Platforms to Health Care
[Bush & Fox, HBR November 2016]
administrative automation
networked knowledge
resource orchestration
Uber Health in 2015: one-day pilot to deliver
2,000 flu shots over four hours in 35 cities.
Patient summary is a window to a person’s health,
a personal dashboard with a lens allowing to look
more closely:
problems and procedures, medications and
implantable devices, vaccinations, allergies,
labs, images, encounters
Oslo, November 16, 2016EHTEL 2017 Symposium
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Ed Hammond’s patient summary of the 90’s: what has changed?
Oslo, November 16, 2016EHTEL 2017 Symposium
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HL7 v3 Reference Information Model

What is the eHDSI?
eHDSI funded MS
PS eP
Austria
Croatia
Cyprus
Czech Republic
Estonia
Finland
France
Germany
Greece
Hungary
Ireland
Italy
Luxembourg
Malta
Portugal
Sweden
Switzerland
• Tools and services using ICTs that can improve
cross border Healthcare services.
• Use Cases:
• Patient Summary, provides access for health
professionals to verified key health data of a patient
during an unplanned care encounter while abroad
• ePrescription, enables patients to receive
equivalent medication treatment while abroad to
what they would receive in their home country

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Digitization brings disruptive innovation in eHealth
Standards
Complex  simple
Costly  free
Specialized  generic
Comprehensive  simple and tools-driven
EHTEL 2017 Symposium
F– Fast (design & implement)
H – Healthcare
I – Interoperable
R – Resources (Building blocks)
Oslo, November 16, 2016
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What is FHIR?
Based on a set of modular components - “Resources”
Resources refer to each other using URLs
Small discrete units of exchange with defined behaviour and
meaning
Have known identity and behaviour
Extensions permit adding data not part of core
Resources are combined into “Profiles” to solve clinical and
administrative problems
Parties exchanging data define the specifics of using resources
and their relations using Profiles.
Profiles are the framework for defining services.
Test data and servers are available
Exchange resources between systems
Using a RESTful API (e.g. web approach)
As a Bundle of resources (messages, documents)
Positives
Service driven - composition
Modify components with changing need
Portability of components by moving code with the data
Oslo, November 16,
2016EHTEL 2017 Symposium
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Modified from: Ed Hammond
2016
Let’s have a look: https://www.hl7.org/fhir/

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www.estandards-project.eu
ClinFHIR: clinicians on FHIR
web based training and development:
View resources for a patient
Create resource instance from profile
Can be a base type or a profiled type
Create simple profiles
Specific server roles for clinFHIR
Data/patient – patient related (clinical) and
‘reference’ (Practitioner, Organization)
Conformance – profile, extensionDefinition (both
StructureDefinition)
Terminology – ValueSet & Terminology operations
Important to be STU consistent!
Hapi STU-3 for Data, Grahame for Conformance,
Terminology
http://clinfhir.com/
Oslo, November 16,
2016
EHTEL 2017 Symposium
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clinFHIR
Patient
and Data
Profiles
(Conformance
)
Terminology
1
2
3
4
5
Connectathon
The international FHIR Maturity Model was envisioned
to ensure developers of the value and stability of FHIR
International
Adoption

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Patient History: Resource explorer
Click on instance to see details
Source from David Hay
Oslo, November 16,
2016EHTEL 2017 Symposium
Implementation
Global
Free

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www.estandards-project.eu
Bimodal IT by Gartner
Bimodal is the practice of
managing two separate but
coherent styles of work one
focused on predictability
(improving in well-understood
areas) and one focused on
exploration (solve new
problems)
Oslo, November 16, 2016
EHTEL 2017 Symposium
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Can Patient summaries leverage HL7 FHIR
to unlock the power of data and drive our digital future?
YES, HL7 FHIR is part of the solution
It opens a window, but It takes a village…
Oslo, November 16, 2016EHTEL 2017 Symposium
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Shaping a new HIGH eStandards culture
in large scale eHealth deployment
Come join us to debate eStandards in Venice April 5, 2017
Please register:
http://www.estandards-
project.eu/index.cfm/registration-estandards-
workshop-5-april-2017-venice/
EHTEL 2017 Symposium
Oslo, November 16,
2016
eHealth
DSI
EU-US MoU