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This Might Be A Useful Paper For The ADHA Secure Messaging Task Force To Review.

This appeared a few days ago:

Using both Direct and FHIR standards could improve data exchange

Experts from HL7 and DirectTrust say hospitals can benefit from combining the two interoperability specs.

By Mike Miliard

August 14, 2017 03:34 PM

As HL7's FHIR standard continues to catch on across healthcare, there are ways it can be leveraged to work in tandem with the Direct protocol for better information exchange, a new report from DirectTrust shows.

Hospitals and medical practices could make progress in their interoperability initiatives by availing themselves of both approaches, according to the report, coauthored by DirectTrust CEO David Kibbe, MD, members of the DirectTrust Policy Committee and FHIR architect Grahame Grieve of HL7.

The two approaches are different, but offer synergies that bear exploration. FHIR is a standards framework created by HL7; Direct is an exchange network for easy and exchange of personal health information between providers and between provider and patients.

The white paper, "Direct, DirectTrust, and FHIR: A Value Proposition," explores different ways  FHIR's web APIs can complement the Direct standard for more seamlessly exchanging healthcare data.

"The FHIR community’s current focus is 'perimeter interoperability' – that is, exchange of data outside the institution, either with patients/consumer directly, or between institutions," according to the report. "In the USA, most of the focus around FHIR has been consumer to business (C2B) rather than business to business (B2B). This focus is because institutions have their internal integrations and some external exchanges already in place, whereas C2B is where immediate value can be extracted and may lead to a marketplace for apps."

Meanwhile, "the primary use of the Direct protocol is for exchanging data between clinicians and support staff in institutions," the authors said. "Today, as a result of the meaningful use Program, Direct is commonly used to carry C-CDA formatted data between many institutions using version R2.1 of the C-CDA. There were over 98 million such exchanges via Direct in the DirectTrust network during 2016, and approximately 150 million transactions are expected in 2017."

Despite those very different origins and uses, however, there's big potential for harnessing the two specs together, especially across the DirectTrust network, which expect to host 150 million transitions in 2017.

"There is a perceived conflict between the current use and growth of Direct and the future use of FHIR," according to the study, "even though Direct is content agnostic, and FHIR as a resource is transport agnostic."

There are challenges to making the two standards work together – but also, potentially, big advantages.

There are two primary avenues through which Direct/DirectTrust and FHIR could work well together, the study shows. 1) FHIR resources can be pushed in Direct Messages; 2) DirectTrust framework and certificates can support FHIR’s RESTful API

More here:

http://www.healthcareitnews.com/news/using-both-direct-and-fhir-standards-could-improve-data-exchange

You can download the paper direct from this link:

http://healthintersections.com.au/direct-fhir-paper.pdf

As usual comments are welcome.

David.

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