Questions to manage simultaneously HL7 v2 and FHIR

Hi,
I work with Integrated Health Solutions and we normaly integrate a concrete departamental system into a Hospital Information system using Mirth and HL7v2 transformations.
I see how FHIR is being more and more implemented and maybe we have to deal with it, so I post here open questions I have with respect FHIR and if you can comment any I would be very grateful:

  • In Spain HL7 v2 is interpreted differently among Hospitals (some segments are filled differently), so we have to deal with mirth Transformations in all accounts. Will FHIR provide more standarized/mandatory structures of information? or it will continue happening the differences on interpretation because of the possibility to create profiles ad-hoc?
  • The resources are told to be located in URL, this could be also an owned server, isn’t it? it does not mean that it will run always on the cloud, isn’t it? Regulation in Spain is strict on running sensitive healthcare information in the cloud…
  • Can Mirth be used to transfrom from HL7 v2 to FHIR easily? I feel it is a complete new paradigm with different resources, but I have seen that FHIR can express data into messages… If not, would you recommend any tool?
  • Last but not least, would you recommend any tutorial to learn basis of FHIR comming from HL7 v2?

Thank you a lot in advance!
Best regards,

Rocío

FHIR is clearer about what data elements mean, so there’s slightly less wiggle-room. Also, FHIR’s “80% rule” means there are a lot fewer esoteric elements as a source for diversity in implementation. That said, FHIR doesn’t guarantee consistent business practices. For example, when is an encounter ‘done’? When do you have child encounters? etc. Also, what granularity of data is captured - do you just capture the organization, the organization + role, the organization + role + practitioner, just practitioner? Different institutions have different practices and, unless national standards dictate, you can’t count on consistency

There is no requirement that data live in the cloud, and it’s possible to use FHIR even if data isn’t web-accessible at all (though if you only use FHIR documents or FHIR messaging, then you lose much of the power) REST allows creation of interfaces that are use-case independent which is much more powerful and more scalable

Interface engines can definitely be used to support conversion, though there are complexities if you’re moving from a messaging environment to a REST environment.

Try doing a web search on “FHIR v2 video” and you’ll find some commercial sharings as well as recorded tutorials/presentations. Presume you’ve read the guidance in the core spec and the v2-to-FHIR IG?