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Festive Season Greetings from HL7NZ

posted Dec 16, 2018, 2:44 AM by Ray Murakami   [ updated Dec 16, 2018, 2:45 AM ]

"And so this is Christmas
and what have you done?"

Is question posed by one of the most widely-played songs at this time of the year. In response, I could reflect upon another productive year for our Affiliate and indeed did do so in my recent Chairman's Report to the HL7 NZ Board.

Certainly, from an International viewpoint, it’s been a year of terrific progress. HL7® FHIR® continues to take the outside world by storm and its adoption by “Tech Titans” (such as Apple, Google & Microsoft), major overseas Health IT Vendors and Government Digital Health Agencies grows by the month. We now await the upcoming Release 4 which will contain the first normative content. The progress of the FHIR Project, including the significant part played by HL7NZ members, is detailed in the Reports from the International Working Group meetings that we’ve attended this year. Outside of these meetings, HL7NZ members have participated in a number of key working groups, often in co-chair positions, including a collaboration project between HL7 International and SNOMED International – not surprisingly known as ‘SNOMED on FHIR’.
 
So far, so good – but what’s this year’s key health information interoperability message from Aotearoa? Well, we’ve delivered events focussing on practical usage of these standards and attempted to engage the implementer community as best we can to facilitate the interoperable use of FHIR.   Throughout the Sector as a whole, there have been numerous analogue conversations around and about digital health issues, but very little discernible progress on interoperability – particularly in terms of creating the open APIs that might facilitate secure and appropriate access to healthcare information for the new generation of bespoke healthcare apps. O Data Portability where art thou?
 
This frustrating state of affairs was neatly encapsulated in an entertaining story told by a hospital emergency department doctor at last month’s HiNZ Conference. The punch line involved the husband of an overseas patient photographing a printed discharge summary on his mobile phone and then ripping up the paper copy having established that no digital information could flow between the FHIR API on his phone and any software application or device at the hospital. The stuff of future comedy sketches perhaps – like expectant Americans seeking international class service in 1970s Britain?
 
A further reminder of the distance between our nascent digital health strategy and cold reality came a fortnight later as I completed a four page paper form at a DHB Skin Lesion Clinic detailing everything available at the click of a button in my primary care portal.  The later would be invaluable to any clinician, although those of us without medical qualifications might prefer to download this information, via (of course) a FHIR API, to be presented, in consumer-friendly fashion, by a health and wellness app of our own choice.

At the HL7NZ events we’ve uncovered a non-trivial amount of usage of FHIR APIs, but mainly in restricted two-party exchanges and our attempts at further engagement have often met with a stony silence from the custodians of our health data silos: FHIR behind ‘closed doors’.  Let’s hope that some of these barriers will be removed in 2019 and we can utilise FHIR to make interoperability easier and cheaper to implement.
 
Finally, on a more festive, note, I’d like to extend sincere thanks to all of our members and benefactors (notably the Digital and Data Services Team at the Ministry of Health) for their support in the past year and I hope that you and your families all enjoy a well-earned Christmas and New Year break. I look forward to continuing to work together with you on the seemingly long road to interoperable health information in 2019.

Seasons’ Greetings

Peter Jordan, Chairman HL7 New Zealand
December 16, 2018

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