FHIR for Technical Architects

Are you the technical or solution architect working on a project that uses FHIR?

Much of what you need to know is not in the FHIR documentation and won’t be found on the FHIR chat forums.

In the posts below I answer some of the key questions you should be asking. And I walk you through some of the “hidden features” of FHIR that you can use to address specific architectural problems.

When it comes to FHIR it’s easy to go off-track or invest time in dead ends. My goal here is to make your FHIR journey more streamlined and to help you avoid many of the mistakes that are common to FHIR projects.

1. Should your Project use FHIR?
FHIR is all about Interoperability. If the project you’re building is not sharing data outside your organization, you need to ask if FHIR is the right choice. Don’t use it blindly. Understand why you’re using it.
https://darrendevitt.com/should-your-project-use-fhir/

2. Building a FHIR Server Proxy
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. This adds a significant workload to most FHIR project and is almost always necessary in one form or another.
https://darrendevitt.com/building-a-fhir-intercept-layer/

3. FHIR Workflows using the Task Resource
FHIR’s Task resource often lies undiscovered until a project is well into development. Understanding this resource type early enables you to leverage FHIR’s “workflow” capability from the start instead of restructuring code and projects later.
https://darrendevitt.com/are-you-using-fhirs-task-resource-type/

4. Analytical Queries and FHIR Servers
FHIR is not a database. You cannot run heavy duty analytical queries against a FHIR API. If the product or business has a “dashboard” or analytical requirement you are expected to build, you need to look into how this can be achieved as early as possible. Different server providers offer different ways of doing this, but all require a lot of work.
https://darrendevitt.com/how-do-you-run-labor-intensive-queries-on-your-fhir-server-in-real-time/

5. Microsoft Open Source FHIR projects
Microsoft maintain a number of OS projects that interact with their FHIR servers. They can all be adapted for use with other server providers. Of particular interest are the “Toolkit”, which demonstrates how to build a proxy, a data anonymization project that applies anonymization rules to FHIR resources, and a customizable HL7 to FHIR convertor.
https://darrendevitt.com/theres-a-gap-in-the-fhir-documentation/

6. FHIR Security Labels
There are two aspects to security labels that you need to understand. How to deal with them when they arrive in incoming FHIR resources, and how to use them for your own internal purposes to tag resources in specific ways.
https://darrendevitt.com/do-you-know-what-security-labels-are-in-fhir/

7. FHIR Server Security: AuditEvent and Provenance
The AuditEvent resource in FHIR can be used to capture “Who did what and when” information. Provenance is primarily used to identify the source of incoming data — who has ownership of a specific data element in a resource or of an entire resource. Every resource in a properly structured and maintained FHIR server should have one or more connected Provenance resources.
https://darrendevitt.com/ask-yourself-these-questions-about-your-fhir-server/

8. Managing Patient Consent in FHIR
The HL7 working groups and projects dealing with Patient consent are new, but have already done solid work on how to properly document the various aspects of consent. If you’re storing consent information in your FHIR server you should dig deeper into the articles mentioned in this post.
https://darrendevitt.com/managing-patient-consent-in-fhir/

9. How to Create a New FHIR Extension
There’s no escaping FHIR extensions. Your project will need to create them and use them. But you should ensure you’re doing so properly and for the right reasons, otherwise you run the risk of breaking your project’s “interoperability”.
https://darrendevitt.com/10-steps-to-create-a-new-fhir-extension/

10. FHIR Notes for Technical Architects
A checklist of FHIR features and issues that you need to be aware of. You may use some or all of these, but don’t discount any and ensure that you can “sign off” on each one: “covered”, “not applicable”, “needs investigation”.
https://darrendevitt.com/fhir-notes-for-technical-architects/

If you have questions about bringing FHIR into your organization or projects, reach out and and we’ll talk: fhir@darrendevitt.com.