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Monday, November 14, 2016

Good Interoperability works like a shotgun, but with a single bullet

As an implementer these days, I don't have the luxury of building one-off solutions.  I have to be able to take components and put them together in multiple ways to solve multiple problems.  CDA was the way we used to do this in IHE Patient Care Coordination in the past, where a single section or entry could be used in multiple documents to support multiple use cases.  In fact, if I look at the number of IHE profiles that use the problems, medications and allergies sections we first created, I get at least a dozen+ CDA documents which use those.  They became the foundation of our work for many years.

The same is becoming even more true now with HL7 FHIR.  Each FHIR resource can be used for multiple use cases, and the resources can be put together in multiple ways to achieve a solution.  If I want to build a flowsheet, I can use the Observation resource.  A graph? The observation resource.  A CDS Intervenion? I might want to access the Observation resource.  And it's the same resource (though perhaps with slightly different constraints for different uses).

No longer do I have to concern myself about different models, schema, et cetera, just because how I want to use the thing has changed.

So often, we have limited resources.  We want a shotgun, but all we get is a sling with a single stone. We get one shot at this.  With FHIR, I can line all my ducks up in a row and smack them down with that single stone.  It's not just two birds (use cases), but as many as I can line up.  And in fact, I don't even have to line them up all that much.  Perhaps what I have in FHIR is a flamethrower.

   Keith

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