There are 2 standards that are widely used for ensuring interoperability between different healthcare information systems:
HL7
Fast Healthcare Interoperability Resources (FHIR)
In 80s, the HL7 standard was created to help exchange information within systems in hospitals.
HL7 focuses on enabling interoperability between health IT systems, ensuring that patient data can be shared seamlessly.
It was a great achievement for that era, but nowadays, information is consumed and interpreted into a variety of devices, by a multitude of users.
There is a growing amount of data from an increasing variety of sources, and more stakeholders—such as payers—need access to it to make important decisions. Over time, these decisions have also become more complex.
William Stead, a Professor of Medicine at Vanderbilt University, notes that in the past, healthcare decisions involved around 10 key facts. Today, that number has risen to about 1,000 facts per decision, and it continues to grow (source).
FHIR is a newer standard created by HL7 to address modern healthcare challenges, emphasizing ease of implementation, particularly using web technologies (like RESTful APIs, JSON, and XML).
One key element in FHIR are the "Resources" -- which are building blocks that represent key entities in healthcare (source).
Each resource is a modular piece of information that describes a specific aspect of a healthcare interaction or process. These resources are designed to be flexible and reusable, making it easier to share and exchange data between systems.
Some examples of FHIR resources include:
Patient – Contains basic patient information (e.g., name, address, age).
Observation – Records clinical observations, such as lab results or vital signs.
Encounter – Represents an interaction between a patient and healthcare provider (e.g., a visit or consultation).
Medication – Details about a specific medication prescribed or administered to a patient.
Practitioner – Information about a healthcare provider (e.g., doctor or nurse).
Condition – Describes a patient's medical condition or diagnosis.
Each resource is structured in a standardized way, so different systems can understand and interpret the data consistently. By using these resources, FHIR enables easier data exchange and integration across different healthcare platforms and systems.
Another important component are "Profiles" -- which are a customized set of rules or constraints that specify how a Resource should be used in a particular context.
Profiles allow organizations or systems to adapt standard FHIR resources to meet specific requirements, ensuring consistency in how data is exchanged and interpreted.
The ICD-10 codes are a standardized coding system for diagnoses and health conditions. They’re maintained by the World Health Organization (WHO) and are used globally for health reporting, billing, and tracking of diseases.
These codes provide a uniform way to describe diseases, symptoms, and other health conditions, which is essential for healthcare interoperability.
Both HL7 and FHIR are making use of ICD-10 codes, so these ensure a common language from diagnosis and throughout the treatment, which ultimately enables interoperability.
In summary, ICD-10 codes are used within both FHIR and HL7 standards to ensure a common language for diagnosis and treatment information, enhancing interoperability across healthcare systems.
Examples of ICD-10 for Diagnosis
J45.909 – Unspecified asthma, uncomplicated.
E11.9 – Type 2 diabetes mellitus without complications.
I10 – Essential (primary) hypertension.
F32.9 – Major depressive disorder, single episode, unspecified.
M54.5 – Low back pain.
Examples of ICD-10 for Procedures
0FT44ZZ – Resection of liver, percutaneous endoscopic approach.
3E0A3GC – Introduction of chemotherapy into peripheral vein, percutaneous approach.
5A1D70Z – Performance of cardiac output monitoring.
0Y6J0ZZ – Drainage of knee joint, open approach.
8E0H30Z – Chiropractic manipulation of thoracic region, indirect approach.