What Bulk FHIR can do for quality measurement and more

For the past decade or so, HL7’s Fast Healthcare Interoperability Resources standard has been enabling more widespread and intuitive data exchange across the healthcare ecosystem for a variety of mission-critical use cases.

The FHIR innovation has only increased in recent years. At HIMSS23 this month, former National Coordinator for Health IT Dr. Donald Rucker, along with longtime clinical informatics leader Dr. Kenneth Mandl, will offer a discussion on how the SMART/HL7 Bulk FHIR Access programming interface can help healthcare organizations of all shapes and sizes better manage their data and track their performance across an array of key metrics.

Rucker, who’s now chief strategy officer at 1upHealth, and Mandl, who directs the Computational Health Informatics Program at Boston Children’s Hospital and is a professor of biomedical informatics at Harvard Medical School, were leaders in the development and standardization of the Bulk FHIR specification.

They’ll explain how it will describe how Bulk FHIR is enabling new approaches to quality measurement, allowing for more thoroughgoing assessments of provider performance. They’ll also explore its uses as artificial intelligence continues to evolve and will discuss other implications for reimbursement and policy making.  

“We would love to see, at our session, innovators of all stripes, who use population data in their work,” said Mandl of the HIMSS23 talk – which is scheduled for April 19 and aims to help attendees better understand how to access the Bulk FHIR API made available thanks to ONC rulemaking, use Bulk FHIR data in their improvement efforts and evaluate its implications for quality measurement and more.

The SMART/HL7 FHIR Bulk Data Access API “enables push-button access to patient-level data across a patient population,” Mandl explains, noting that the data is made available and defined by the U.S. Core for Data Interoperability, or USCDI, the standardized set of data classes created through the ONC’s interoperability work under the 21st Century Cures Act.

Because the data are made available everywhere via standardized FHIR, he added, “reproducible analytic pipelines and processes can be used universally without the complex and expensive task of mapping data to a common format.”

The Bulk FHIR API has been used by the Centers for Medicare and Medicaid Services “from the earliest days of the project,” said Mandl.

“Physicians and ACOs can access claims data on their populations for use in treatment,” he explained, since, under the Cures Act, Bulk FHIR Access APIs “must also be accessible in all certified health IT” – meaning any organization using an electronic health record can access the full USCDI dataset on their populations.

With that in mind, “quality metrics can become ‘digital’ composites of EHR and claims data and be readily produced with automated processes,” Mandl explained.

“The same data used in quality may be useful for multiple use cases, such as public health surveillance, monitoring the safety of post-market pharmaceuticals, standing up multisystem research networks or training AI algorithms.”

Mandl and Rucker will explain more in their HIMSS23 presentation, “Bulk FHIR: Measuring Global Organizational Performance.” It’s scheduled for Wednesday, April 19, from 2:30 -3:30 p.m. CT in room S504, South Building, Level 5.

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