Thread by @andrewsjourney

I have found most non-technical explanations of FHIR (🔥) to be unsatisfactory. Key things to know are as follows… 1/🧵

FHIR (Fast Healthcare Interoperability Resources) defines a standard way to organize health data. By having a standard, a computer programmer can write an application (app) that requests data from a source location without having to ask anyone how the data are organized. 2/

This means that a computer application can be written once and work the same no matter which source (e.g., hospital) it requests data from. This is called interoperability. 3/

You might be thinking, “don’t computer systems already share health data.” Well, they do to an extent, but it requires massive amounts of customization. Upfront costs and maintenance are expensive, and the work must be repeated for each data source. 4/

FHIR also defines how to request (i.e., query) data. FHIR querying uses the same standards as the internet. REST (representational state transfer) is the standard you use when entering a URL into a web browser, interacting with a website, or using a smartphone app. 5/

“RESTful” standards have huge benefits, including being scalable (many users at the same time), cacheable (storing past results to speed up a current query), and human-readable (helps when developing and fixing errors (debugging)). 6/

So far, we have only addressed syntactic interoperability (organizing & querying of data). Semantic interoperability (understanding the meaning of data) is also required. E.g., does the value of a “sodium measurement” mean sodium measured in serum, plasma, urine, CSF, etc. 7/

For semantic interoperability, FHIR uses existing medical terminologies such as ICD-10 (for diagnoses), LOINC (for laboratory tests), RxNorm (for medications), etc. 8/

What is SMART on FHIR? SMART (substitutable medical applications, reusable technologies) is another standard that sits on top of FHIR to handle security (authentication & authorization). 9/

What is CDS Hooks? #CDS (clinical decision support) Hooks is a way of defining trigger events within the electronic health record (#EHR) that cause a FHIR app to run and return a result (information, a suggestion, or a link to view a FHIR app). 10/

What is Bulk FHIR? The FHIR standard was initially imagined to center around the context of a single patient. It was not designed to handle transfers of large amounts of data. Bulk FHIR was developed to allow the bulk transfer of health data. 11/

TLDR: #FHIR is a standard for organizing and querying health data. It and the #SMARTonFHIR standard are catalyzing the development of an ecosystem of health care apps. The apps serve patients, clinicians, researchers, public health officials, and more. 12/🏁

Let me know what I missed and what questions someone might have.