Foundation
This page is part of the FHIR Specification (v1.6.0:
STU
3 Ballot 4). The current version which supercedes this version is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
. For a full list of available versions, see the
Directory of published versions 
.
Page
versions:
. Page versions:
R5
R4B
R4
R3
R2
|
|
|
|
FHIR offers more than a standard solving existing problems in interoperability, it provides a platform for the future. Interoperability is "all about the people"; to get past the peak of inflated expectations to the plateau of productivity on
the hype cycle
it
is
imperative
that
there
is
a
shared
vision
of
what
is
trying
to
be
achieved.
Healthcare
is
in
the
midst
of
a
transformation
driven
by
the
convergence
of
biological
and
information
revolutions
and
by
economic
imperative
and
social
change..
FHIR's
strength
lies
in
it
being
grounded
in
the
real
world
which
is
changing
rapidly.
This
appendix
offers
a
high-level
view
of
the
disruption
underway
and
helps
place
FHIR
into
a
wider
context.
Just
as
John
Snow
used
a
branch
of
informatics
and
geospatial
analysis
to
identify
the
source
of
cholera
in
London
and
so
prove
the
germ
theory
and
revolutionize
medicine
in
1854,
so
too
will
the
application
of
informatics
and
associated
technology
be
instrumental
in
the
next
big
change
in
healthcare.
In
countries
with
advanced
economies,
health
systems
are
facing
increased
demand
from
aging
populations
and
increased
incidence
of
chronic
disease.
In
many
of
these
countries,
there
is
also
a
shortage
of
skilled
workers.
Mounting
evidence
points
to
avoidable
errors
causing
serious
harm
to
patients.
Indeed
optimal
care
only
occurs
about
half
the
time
in
even
the
best
performing
health
systems
(1).
Small
incremental
improvements
will
not
be
enough
to
address
the
looming
crisis
in
sustainable
healthcare.
Convergence
of
trends
in
health
care,
biology,
informatics
and
technology
together
with
the
associated
social
changes
and
economic
imperative
is
driving
a
paradigm
shift
(2)
that
may
be
the
answer.
Informatics
has
a
role
in
most
aspects
of
this.
The
figure
below
provides
a
summary
of
the
convergence
of
these
trends
and
the
likely
results
of
disruption
that
will
move
us
from
reactive
to
proactive
healthcare.
In
terms
of
our
understanding
of
physiological
pathways,
informatics
is
now
the
major
tool
of
molecular
biology.
For
example,
the
time
spent
computing
exceeds
chemical
analysis
for
gene
sequencing
by
3
to
1.
Informatics
is
being
used
to
map
neural
networks
and
to
build
the
models
of
systems
biology
(3)
with
ever
increasing
levels
of
precision
and
complexity
that
can't
be
done
without
the
help
of
machines.
Our
understanding
has
changed
so
much
in
recent
times
that
the
American
Academy
of
Science
is
now
arguing
that
it
is
time
for
a
new
taxonomy
(4).
Personalization
is
occurring
both
because
of
social
change
and
increased
biological
knowledge
and
is
being
facilitated
by
cheap
mobile
computing,
sensors
and
devices.
These
social
forces
and
the
enabling
technologies
are
allowing
greater
participation
by
'non-experts'
in
decision
making,
treatment,
discovery
and
knowledge
management.
Greater
knowledge
about
how
we
think
(5),
advances
in
the
information
sciences
and
the
increased
availability
of
computing
power
means
that
our
capacity
to
acquire
knowledge
and
use
it
to
predict
the
course
of
pathology
has
increased
enormously,
and
that
is
fortuitous,
because
the
explosion
of
information
is
impossible
to
deal
with
otherwise.
These
new
capabilities
can
be
used
to
provide
better
advice
and
to
better
prevent
disease
through
discovery,
monitoring
and
treatment.
The
health
system
itself
can
also
benefit
from
what
looks
like
a
second
phase
of
utilization
of
information
technology
through
on-line
care
provision,
real
integrated
measurement
of
quality
and
integration
of
knowledge
in
work-flow.
With
openness
and
transparency
there
is
also
the
prospect
of
co-opetition
(cooperative
competition)
and
with
integrated
outcome
measures
that
pay-for-success
contracting
can
be
used
as
an
economic
lever.
Large
scale
change
in
the
way
healthcare
is
done
is
both
essential
and
inevitable.
It
is
likely
that
this
will
derive
from
the
merging
of
the
knowledge
and
machines
of
the
biological
and
information
revolutions
facilitating
a
shift
from
reactive
treatment
to
proactive
personalized
medicine.
Only
by
such
significant
changes
could
the
needed
quantum
improvement
in
the
effectiveness
and
efficiency
of
healthcare
be
made.
The
development
of
digital
technology
has
disrupted
other
sectors,
notably
media,
retail
and
manufacturing,
and
the
health
sector
is
unlikely
to
remain
immune
(6).
Digitization
of
biology
and
health
will
allow
machines
to
help,
lead
to
a
demystification
of
disease,
the
democratization
of
healthcare,
and
a
move
from
the
treatment
of
disease
to
the
promotion
and
maintenance
of
wellness.
it is imperative that there is a shared vision of what is trying to be achieved. Healthcare is in the midst of a transformation driven by the convergence of biological and information revolutions and by economic imperative and social change.. FHIR's strength lies in it being grounded in the real world which is changing rapidly. This appendix offers a high-level view of the disruption underway and helps place FHIR into a wider context.
Just as John Snow used a branch of informatics and geospatial analysis to identify the source of cholera in London and so prove the germ theory and revolutionize medicine in 1854, so too will the application of informatics and associated technology be instrumental in the next big change in healthcare.
In countries with advanced economies, health systems are facing increased demand from aging populations and increased incidence of chronic disease. In many of these countries, there is also a shortage of skilled workers. Mounting evidence points to avoidable errors causing serious harm to patients. Indeed optimal care only occurs about half the time in even the best performing health systems (1). Small incremental improvements will not be enough to address the looming crisis in sustainable healthcare.
Convergence of trends in health care, biology, informatics and technology together with the associated social changes and economic imperative is driving a paradigm shift (2) that may be the answer. Informatics has a role in most aspects of this. The figure below provides a summary of the convergence of these trends and the likely results of disruption that will move us from reactive to proactive healthcare.
In terms of our understanding of physiological pathways, informatics is now the major tool of molecular biology. For example, the time spent computing exceeds chemical analysis for gene sequencing by 3 to 1. Informatics is being used to map neural networks and to build the models of systems biology (3) with ever increasing levels of precision and complexity that can't be done without the help of machines. Our understanding has changed so much in recent times that the American Academy of Science is now arguing that it is time for a new taxonomy (4).
Personalization is occurring both because of social change and increased biological knowledge and is being facilitated by cheap mobile computing, sensors and devices. These social forces and the enabling technologies are allowing greater participation by 'non-experts' in decision making, treatment, discovery and knowledge management.
Greater knowledge about how we think (5), advances in the information sciences and the increased availability of computing power means that our capacity to acquire knowledge and use it to predict the course of pathology has increased enormously, and that is fortuitous, because the explosion of information is impossible to deal with otherwise. These new capabilities can be used to provide better advice and to better prevent disease through discovery, monitoring and treatment.
The health system itself can also benefit from what looks like a second phase of utilization of information technology through on-line care provision, real integrated measurement of quality and integration of knowledge in work-flow. With openness and transparency there is also the prospect of co-opetition (cooperative competition) and with integrated outcome measures that pay-for-success contracting can be used as an economic lever.
Large scale change in the way healthcare is done is both essential and inevitable. It is likely that this will derive from the merging of the knowledge and machines of the biological and information revolutions facilitating a shift from reactive treatment to proactive personalized medicine. Only by such significant changes could the needed quantum improvement in the effectiveness and efficiency of healthcare be made.
The development of digital technology has disrupted other sectors, notably media, retail and manufacturing, and the health sector is unlikely to remain immune (6). Digitization of biology and health will allow machines to help, lead to a demystification of disease, the democratization of healthcare, and a move from the treatment of disease to the promotion and maintenance of wellness.
References
This page maintained by
Michael Legg
©
HL7.org
2011+.
FHIR
DSTU2
(v1.0.2-7202)
generated
on
Sat,
Oct
24,
2015
07:44+1100.
Links:
Search
|
Version
History
|
Table
of
Contents
|
Compare
to
DSTU1
© HL7.org 2011+. FHIR STU3 Ballot (v1.6.0-9663) generated on Thu, Aug 11, 2016 17:07+1000.
QA Page
Links:
Search
|
|
Version History
|
Table of Contents
|
Compare to DSTU2
|
|
Propose
a
change
|
Propose a change