One of the biggest problems I encounter with FHIR projects has nothing to do with FHIR.
It’s about missing expertise.
Not FHIR expertise. Not even healthcare data expertise.
Clinical expertise.
Developers and product people making decisions about what to build and how to build it without a single clinical viewpoint in the room.
It doesn’t matter how polished your FHIR profiles are if you’re storing the wrong data.
It doesn’t matter how sophisticated and scalable your hybrid architecture is if doctors won’t use it.
It doesn’t matter how slick your terminology server is if it’s the wrong terminology.
There’s something about FHIR that makes management rub their hands together almost gleefully and say: “This time we can do things differently”.
Differently often means new people. Lots and lots of new people with zero healthcare data experience.
Differently often means fresh new teams with none of the old “expertise” that got your business to where it is today.
Differently often means building a wall between your technical teams and the outside world, all in the aid of being agile and modern and fast-moving.
Guess which side of that wall the clinical experience is on?
Doctors and nurses and lab technicians, all on the outside. Only looking in briefly on “Demo Day” every 6 or 9 months.
Not contributing to what’s being built or to how it’s being built.
Not providing sanity checks as screens are designed and data starts flowing.
This happens more often that we’d like to admit. And it happens inside businesses and organizations that should know better.
Don’t throw the baby out with the bath water.
Adopting FHIR should not be seen as a license to abandon everything else.
You need clinical insight at the heart of your FHIR project.
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