® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered with the United States Patent and Trademark Office.

FHIR Transforms the Business of Healthcare for Clinicians

Russell B. Leftwich, MD

2 | © 2016 InterSystems Corporation. All Rights Reserved.

FHIR Applications Roundtable Harvard, July 2016

3 | © 2016 InterSystems Corporation. All Rights Reserved.

Interoperability: The meaning of the data is

understood, and data is usable in the workflow of the receiver

4 | © 2016 InterSystems Corporation. All Rights Reserved.

All clinical domains have data that is important to them and

usually their workflow dictates how that information is best

presented

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Usability: Data views that fit the workflow

6 | © 2016 InterSystems Corporation. All Rights Reserved.

Pediatric Growth Table

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Pediatric Growth Chart

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Context: The app knows about the patient

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VisualDx uses the FHIR standard to obtain:

• patient’s age • gender • problem list (conditions encoded with SNOMED-

CT) • medication list (medications encoded with RxNorm)

Result: provides the user with VisualDx data and images matching their specific conditions or drug eruption/reaction differentials.

VisualDx and FHIR for Decision Support

Differential Builder Image Results in VisualDx

11 | © 2016 InterSystems Corporation. All Rights Reserved.

FHIR Genomics: Data from heterogeneous sources

API Resource oriented, everything a URL

Data Model Context (container, user, patient) Medical (problems, allergies, … )

Authentication Consistent delegation, web standards (OAuth)

UI Standards-based integration (HTML5)

SMART: Substitutable Medical Applications, Reusable Technology

SMART Architecture

SMART on FHIR Genomics Clinico-Genomic Apps

SMART on FHIR Clinico-Genomics Apps

SMART Precision Cancer Medicine App

(Warner & Alterovitz, JAMIA, 2016)

® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered with the United States Patent and Trademark Office.

What next for FHIR apps?

The ability to access data for an individual across systems and

across organizations.

® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered with the United States Patent and Trademark Office.

• Acknowledgements

• Dr. Scott Narus • Dr. Art Papier • Dr. Gil Alterovitz

® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered with the United States Patent and Trademark Office.

THANK YOU!

Russell.Leftwich@InterSystems.com Twitter: @DocOnFHIR