My introduction to FHIR came as a technical architect working a short contract for a US health insurance company. I was tasked with designing some middleware that sat between the consumer and a Microsoft Azure FHIR server.
It was many years ago and no one on the team had any FHIR experience. It was most definitely a baptism of fire.
The official FHIR documentation was great for the detail on each resource type and element. But what I felt then and still feel now was that key guidance was missing.
What do we need to build and how should we build it?
I no longer work as an architect. I no longer write code. But I’ve seen enough mistakes on projects that use FHIR to know that this is a gap that needs to be filled.
Here are 6 short pieces I wrote over the past couple of years that I would have benefited from reading way back on that first FHIR project.
1. Should your project use FHIR?
It’s almost sacrilege to ask this question but not every healthcare data project needs a FHIR server. Don’t use FHIR blindly. Understand why you’re using it.
2. Building a FHIR server proxy
Commercial and open source FHIR servers are not “production ready.” You will almost certainly have to build a proxy of some sort in front of your FHIR server to intercept requests going in and responses going out. I’ve written about this many times and gave a presentation on it at DevDays earlier in the year.
3. FHIR workflows using the Task resource
The Task resource is one of FHIR’s hidden and underused gems. If you’re considering creating an extension to manage extra resource statuses, chances are you’re trying to build something that already exists.
4. Managing patient consent in FHIR
Capturing patient consent can be a nightmare, especially if your application is used internationally or even across different states and regions. There is real work being done in this space that you might not be aware of.
5. FHIR security labels and their uses
Along with the Task resource, I consider security labels to be one of FHIR’s most under-used features. The documentation provides a solid introduction with examples of how to use them, but you should be thinking outside that clearly defined box and looking at how you can use them to fit your own specific use case.
6. The importance of provenance
I’m talking about more than just the Provenance resource type here. “Who did what and when?” A critical question you should be able to answer for every resource and element in your FHIR server.
In a couple of weeks I release an early copy of my new eBook “Approaching FHIR: A practical guide to choosing the right FHIR implementation strategy”.
You can sign up to be notified about it here: https://darrendevitt.com/books-about-fhir/
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