HL7 FHIR

HL7’s standard of Fast Healthcare Interoperability Resources, Release 4, aids in collaborating medical data between healthcare practitioners, patients, and other involved members. Its two primary sections include a content prototype and stipulations on sharing these resources within real-time RESTful applications and other communication flows. In connection with the FHIR standard is the FHIRcast specification for context synchronisation. FHIRcast enables a subscriber to receive notifications either through a webhook or over a WebSocket connection. FHIRcast recommends the HL7 SMART on FHIR launch protocol for both session discovery and API authentication.

SMART on FHIR

The SMART App Launch Framework allows browser-based apps to be launched from an Electronic Health Record system. The framework implements a protocol in which certain data and contextual information can be handed over from the starting application to the new application, thus enabling the newly started application to start in the correct context. SMART is proposed by SMART Health IT as an API (application programming interface) to transform EHRs into platforms. By combining elements from SMART and FHIR, the SMART on FHIR solution presents a possible solution for browser-based apps on standard FHIR interfaces.

SMART on FHIR and FHIRcast applications

FHIRcast and SMART on FHIR’s real-time healthcare interoperability enable access to the same clinical data without a separate context management system. Although FHIRcast, SMART on FHIR, and CCOW address many of the same concerns, FHIRcast and SMART on FHIR can’t substitute CCOW as its design is more rudimentary and technologically constrained.  

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Since HL7 started promoting the FHIR standard, its use has become increasingly widespread. FHIRcast and SMART on FHIR solutions are likely to develop for browser-based applications. SMART on FHIR based applications are already running in a range of settings.

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FHIRcast and SMART on FHIR are not substitutions for CCOW, but are emerging solutions for a subset of the use cases a CCOW Context Manager handles. It is, however, important that a CCOW Context Manager does not hinder the deployment of FHIRcast and SMART on FHIR applications in the complete IT portfolio.

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