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1.9 Getting Started with FHIR

FHIR Infrastructure Work Group

Maturity Level: N/A

Standards Status: Informative

FHIR is a platform specification that defines a set of capabilities for use across the healthcare process, in all jurisdictions, and in lots of different contexts. While the basics of the FHIR specification are relatively straight-forward (see the Overviews: General, Developers, Clinical, and Architects), it can still be difficult to know where to start when implementing a solution based on FHIR.

This page provides some guidance to help get new implementers started on their path to successful implementation. Beyond reading the overviews (previous paragraph), where should an implementer start? Generally, an implementer needs to resolve:

• How will information be exchanged? (see Foundation Module)
• How are terminologies being used? (see Terminology Module)
• How will the information be secured? (see Security and Privacy Module)
• When is information exchanged? (see Workflow Module)
• What information is going to be exchanged?
• How the information conforms to the FHIR specification and implementation guides? (see Conformance Module)

The remaining sections provide guidance on specific areas (Foundation, Implementer Support, Security and Privacy, Conformance, Terminology, Administration, Clinical, Diagnostics, Medications, Workflow, Financial and Clinical Reasoning).

All implementers should be aware of how versioning works in the FHIR specification. See both:

• Managing Multiple FHIR Versions
• Specification Version Management Policy

1.9.1 Modules

In order to help implementers find their way around the specification and answer these questions, it is organized into a set of "modules". Each module represents a different functional area of the specification, and contains:

• Scope and Index: A description of the content covered by the module, and an index of the important content
• Use cases: Guidance for common uses of the module, and how to approach them. This is a key resource for implementers familiarizing themselves with the FHIR specification
• Security / Privacy: The Security and Privacy Module describes how to protect a FHIR server, how to document what permissions a user has granted, and how to keep records about what events have been performed.
• Roadmap: Where the content covered by the module is in terms of overall progress (see also, for general information: FHIR Timelines)

Broadly, the modules are organized into 3 groups:

• Infrastructure (Level 1 and Level 2)
• Content (Level 3 and Level 4)
• Reasoning (Level 5)

Dependencies between the modules are mainly downwards, with some horizontal dependencies. Implementers should choose the content modules to engage with based on their requirements, and should only engage with the reasoning module if they need to do clinical decision support, and/or Quality Measures.

In addition to the use case based assistance in the modules, these additional documentation pages may be useful:

• Common Use Cases: Personal Health Record, Document Sharing (XDS) and Decision Support
• Resource Guide: Further information about the resources and the relationship between them

Finally, one important place to look is the registry of implementation guides , to see whether similar (or identical) requirements have been met.