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Digital Health Rewired Panel Paper: FHIR and openEHR

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We receive so many questions about FHIR and openEHR – what are they, when can you (or should you) use which or both? In preparation for our panel session at Digital Health Rewired, Ian McNicoll of openEHR Foundation, Amir Mehrkar of INTEROPen and Tony Shannon of Ripple Foundation (with a little help from friends including Grahame Grieve!) have been busy pulling together this paper on FHIR and openEHR in an attempt to answer those questions.

Setting aside personal passions, this paper is in an attempt to open minds, challenge thinking and look at ways in which the rich ecosystem of standards can be put to best use to deliver interoperability across health and social care.

This paper and all the arguments that surround it will be discussed at the INTEROPen panel session ‘INTEROPen: openEHR or FHIR’ at 16.10 in the Clinical Software stream at Digital Health Rewired on 26th March 2019.

The panel will include the following representatives from the INTEROPen Board:
Luke Readman, INTEROPen co-Chair
Amir Mehrkar, INTEROPen clinical co-chair
Ian McNicoll, openEHR Representative
David Hancock, techUK Representative
Ben McAlister, Vendor Representative
Ian Townend, NHS England
and
Mike Chapman of Allscripts (not on the INTEROPen Board)

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Co-Chair, Amir Mehrkar, to Take on New Challenge at NHS Digital

Amir Mehrkar, Clinical Co-Chair of the INTEROPen Board, has been invited to step into a new role as Chief Medical Officer for NHS Digital. Discussion of next steps and nominations for a new Co-Chair will take place at the next meeting of the INTEROPen Board on 28 March.

Amir has been leading the INTEROPen community alongside Co-Chair, Luke Readman, for over three years and his energy, determination and ability to raise a smile while pushing people out of our comfort zones will be dearly missed. Often to be seen donning pink socks and a t-shirt from our unforgettable INTEROP SUMMIT (or even a Robin Hood cap), Amir has lived the spirit of INTEROPen principles of openness and transparency since its inception.

We are very excited to see the developments that can be achieved as we look to a future with a new Co-Chair and greater focus on giving a voice to the vendor members of our community – with a firm ally at the helm of NHS Digital and an even greater emphasis on delivering interoperability across health and social care.

Below is the letter announcing this news from INTEROPen Co-Chairs, Luke and Amir:

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INTEROPen Publishes CareConnect Guidance

CareConnect Guidance for Developers and Provider Organisations

The INTEROPen CareConnect FHIR profiles and Transfer of Care specifications are now ready for First of Type implementation, with the CareConnect API following soon!

The term “CareConnect” – coined by HL7 UK – has become a recognised “brand” describing UK interoperability assets. These may be vendor-led, NHS Digital-led, or curated by members of the INTEROPen community. The INTEROPen FHIR curation process exemplifies the application of our values of openness, transparency and collaboration.

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SUCCESSFUL INTEROPen FHIR CURATION PILOT: Next Steps

Feedback has been positive on the INTEROPen FHIR curation process used to create CareConnect FHIR profiles to support UK clinical interoperability. The curation process was initially designed as a pilot for structured information sharing for Transfer of Care and GPConnect. This pilot has now come to an end and has been successful. As you will appreciate, the FHIR curation process, which underpins multiple NHS England and Digital work programmes, will need a suitable business case going forward.

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Transfer of Care BETA Technical Specifications now published

The BETA versions of the Transfer of Care message specifications are now published; these are sufficiently mature to enable suppliers to development against. There are no plans to change the specifications other than to react to defects reported by implementers. The specifications can be found here
 
The Transfer of Care FHIR messages will use the ITK3 (Interoperability Toolkit) specification available here.  

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IHE, HL7 FHIR & openEHR – a smörgåsbord of standards?

When planning information sharing between healthcare systems there is a plethora of published standards from which to choose. The most widely used are published by IHE (e.g. XDS), HL7 (e.g. FHIR) and openEHR. However, it is not always clear how these standards relate to one another – are they mutually exclusive or complementary?

These standards emerged to address different concerns:

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FHIR Engine: Using FHIR to Manage Events in Child Health

Philip Graham, Digital Programme Lead for the Lancashire and South Cumbria Sustainability and Transformation Partnership attended the May 2018 INTEROPen Board to present a paper on a prototype Events Management Service (EMS) which he and his team have been developing. This service allows systems that capture clinical data, such as maternity, GP, health visiting, school nursing, A&E, etc. to publish or send events in real-time to a middleware service, the EMS.

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