FHIR takes center stage for healthcare with Microsoft Azure

Throughout the past year, Azure FHIR capabilities have played an increasingly prominent role in Microsoft's healthcare industry effirts, particularly with the announcement of the Azure API for FHIR in February and its general availability at the end of October. But what is FHIR all about?

MSDW spoke with healthcare IT professionals for more perspective on the recent API announcement for Azure.

The race to standardize

In the US, healthcare providers have often struggled with interoperability and data sharing due to a large number of proprietary systems that don't "talk" with one another. FHIR, short for Fast Healthcare Interoperability Resources is an emerging, federally-devised standard to boost the exchange of healthcare data, leveraging APIs, XML, and JSON.

But why change the way healthcare data works? When electronic health records (EHRs) first arrived on the scene in 1980s and 1990s, they were little more than basic data-entry and database systems. Although the market has added intelligence, it has lacked many higher level analytical capabilities that healthcare providers need to drive both quality of care and revenues. With EHRs more central to the patient health and many patients going to different clinics and specialists with non-interoperable systems, FHIR's interoperability has become increasingly imperative.

Healthcare watchers are currently waiting to see if the Office of the National Coordinator for Health IT will fully implement the combination of US Core Data for Interoperability delivered with the FHIR API.

Although Microsoft has increasingly positioned Azure for this more standardized approach, true standardization may be a ways off, according to Dr. Dave Levin, chief medical officer of Datica Health.

In terms of barriers to integration, FHIR capabilities are still quite limited and lack support for population/cohort level queries. However, they will continue to evolve for many years. As a consensus-based standard, evolution will likely be slow. There are also no "teeth" for enforcing the standards. EHR vendors, for example, are currently implementing different "flavors" of FHIR, or piece-meal approaches. This ultimately diminishes the value and portability of the standard.

Dr. José Morey, chief medical innovation officer for Liberty BioSecurity told MSDW that the advent of the Azure API for FHIR is boosting Azure's position in the market: