Health Level Seven International’s Fast Healthcare Interoperability Resources (FHIR) application programming interface is moving closer to becoming a mature standard, with the “normative” version slated for release sometime in 2017.

Standards are widely perceived as providing the greatest potential for achieving national health IT interoperability in the near future. In particular, FHIR is seen by industry stakeholders as a promising solution to the complex interoperability challenges that are confronting healthcare organizations.

Standard for Trial Use (STU) 3 is the next release of the FHIR specification before it reaches a normative level, which is defined by HL7 as content that has been subject to review/production implementation in a wide variety of environments, has been “frozen” and is considered to be stable.

“Release 3 is a Standard for Trial Use, and it contains many artifacts which will be frozen and will be part of the normative release,” says HL7 CEO Chuck Jaffe, MD. “The normative release formally will be Release 4. We expect that in 2017, although there is no promised date. We talk to ANSI all the time. It’s just that we’re not committed to a month yet, but 2017 is our expectation.”

Chuck Jaffe, MD
Chuck Jaffe, MD

While implementation of STU 3 is occurring, development will be progressing on the normative release that is expected later this year. According to HL7, only content that has been successfully implemented in a wide variety of implementation environments with minimal divergence from the STU specification will be candidates for the normative version of FHIR.

Conceivably, it is at this normative point that FHIR will be stable enough for electronic health record vendors to incorporate it into their product offerings.

Also See: FHIR’s normative stage only months away; EHR vendors planning to use it

“Once FHIR has reached normative status, subsequent publications will continue on the 18 to 24 month schedule with subsequent releases introducing additional resources, capabilities and other content as well as migrating existing content from draft to STU and STU to normative, based on the level of implementation,” states HL7’s FHIR STU 3 website. “While changes are possible, they are expected to be infrequent and are tightly constrained.”

Last month, the Office of the National Coordinator for Health IT issued its 2017 Interoperability Standards Advisory (ISA), providing the healthcare industry with a listing of standards and implementation specifications meant to enhance the flow of electronic health information. As a document, the ISA represents ONC’s current assessment of the HIT standards landscape.

Also See: FHIR—Things HIT Execs Need to Know

Steve Posnack, director of ONC’s Office of Standards and Technology, says FHIR is listed in many parts of the 2017 ISA as an emerging standard.

“FHIR is still going through its improvements as a standard overall,” adds Posnack. “Last year, there was STU 2, and this year coming out very soon will be STU 3.”

Micky Tripathi, CEO of the Massachusetts eHealth Collaborative and manager of the Argonaut Project, an industry-wide effort to accelerate the development and adoption of FHIR, notes that STU 3 is targeted for the February/March timeframe with the normative version to follow.

The normative version of FHIR will be “backward-compatible” with all the existing trial use standards and at the same time “has to be sufficiently stable so we can confirm for the stakeholders that interoperability will be preserved,” according to Jaffe.

“There will be advances in Release 4, even when it’s a normative standard, so that we can incorporate new ideas, technologies and use cases,” Jaffe concludes. “Interoperability is a journey, not a destination.”

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