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Carequality Seeks Health System Input to FHIR Governance Model

By Mandy Roth  
   October 11, 2018

As FHIR adoption accelerates, the nonprofit organization hopes to create a framework for sustainable growth.

As the healthcare industry accelerates adoption of FHIR (Fast Healthcare Interoperability Resources), which is already being widely used by healthcare organizations and vendors developing healthcare IT applications, the nonprofit organization Carequality is seeking input to develop a governance model and unified standards. Involvement from health systems is welcomed.

"We're hoping to bring the healthcare community together and establish answers to the core policy and operational questions," says Dave Cassel, executive director of Carequality. "Ultimately, we're trying to achieve a single onramp to FHIR-based exchange, so that health systems and others can operate under the Carequality framework, whether they're exchanging with other providers, patients, or payers."

Technical and Policy Workgroups Are Forming

Carequality encourages any interested party, including those who aren't members of the organization, to participate in the new FHIR Implementation Guide technical and/or policy workgroups. The former will focus on specifications and security; the latter on developing “rules of the road.” Individuals interested in participating in either or both workgroups can email, and indicate which workgroup is of interest.

The groups are expected to work in concert with other organizations also addressing FHIR issues, and will not duplicate efforts already underway. For example, they will not address FHIR resource specs and associated use case workflows. The focus will be on operational and policy elements needed to support use of these resources across an organized ecosystem.

While some industry groups address convening, and others address operations, Cassel explains that there are "relatively few that do both. That's where Carequality comes in. We can take the work that's being done by others and enforce it legally through our operational governance approach."

“Carequality has demonstrated the power of a nationwide governance framework in connecting health IT networks and services for clinical document exchange,” Cassel said in a news release. “We believe that the FHIR exchange community will ultimately encounter some similar challenges to those that Carequality has helped to address with document exchange, and likely some new ones as well."

Rapid Adoption Drives Need for Standards

FHIR is at a stage of rapid adoption, and stakeholders are investing a lot of time addressing issues related to individual connections. When older technologies were at a similar maturation point, the individual connections gradually became unsustainable, Cassel says.

The input process will address "how we can create a standardized ecosystem that answers the operational questions," says Cassel. Security, directory services, and patient matching are likely to be key topics.

“The overarching goal of all healthcare interoperability project is to improve outcomes, lower costs, and broadly improve overall population health,” said Cassel. “We believe that adoption of FHIR in the Carequality interoperability framework can advance all of these goals by improving the availability of useable clinical information, expanding the scope of exchange, and significantly lowering the costs of participating in interoperable exchange.”

Mandy Roth is the innovations editor at HealthLeaders.

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