FAST Implementation Guides: Making HL7 FHIR a Lifeguard for Health Data Exchange

The FAST pursues the FHIR versatility task as a revamped HL7 accelerator.

The FAST implementation guides include data security and the in-between health data exchange within the HL7 FHIR ecosystem.

What is FAST?

The FHIR at Scale Taskforce (FAST), convened by the Office of the National Coordinator for Health IT (ONC), brings together a highly representative group of motivated healthcare industry stakeholders and health information technology experts.

The group is set to identify HL7® Fast Healthcare Interoperability Resources (FHIR®) scalability gaps and possible solutions, analysis that will address current barriers and will accelerate FHIR adoption at scale.

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FAST Implementation Guides

The FAST has issued its two implementation guides (IGs) as an HL7 FHI Accelerator for health data exchange. Duncan Weatherston, CEO of Smile Digital Health and co-chair of FAST’s Steering Committee, said in a press release that FASt is proud to be a part of the vibrant FHIR ecosystem to support the development and implementation of much-needed data standards”.

They said that their role is to identify and foster the common scalability approaches to support the real-world use cases for HL7 FHIR across multiple domains. They are also thrilled to promote the work of their colleagues and publish the initial Implementation Guides (IGs) around security and intermediary data exchange.

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1. The first Implementation Guide (IG): Scalable Security for Registration, Authentication, and Authorization (STU 1)

• It narrates how to enlarge or expand OAuth 2.0 utilizing Unified Data Access Profiles (UDAP) workflows for customer-facing applications that apply the authorization code flow or client credentials flow.
• It also envelops how to expand OAuth 2.0 using UDAP workflows for as business-to-business (B2B) applications that apply the client credentials flow or authorization code flow.

2. The second Implementation Guide (IG): Hybrid/Intermediary Exchange (STU 1)

• It inscribes the process of integrating mediatory entities like HIEs and clearinghouses, into the HL7 FHIR-enables data exchange ecosystem.
• It also offers guidance for authorizing HL7 FHIR REST interactions across one or more mediators using a passive approach. 
• The mediator acts as just a “transit”, and the asked-for person isn’t certainly aware that the request will go through a mediatory entity like HIE.
• The possible implementation of this initial IG incorporates the Da Vinci value-based care use case, in which mediators may form connectivity between stakeholders.
• Other HL7 FHIR accelerators like Gravity, CARIN, etc., are operating to build use cases that may incorporate mediators.

Bonus points

• FAST has contributed to three CMS-supported guides narrating technical and architectural thoughts for a national healthcare directory.
• These guides not only provide implementation points but also addresses challenges involving the query, exchange, attestation, and verification of data elements needed for a verified, consolidated directory.
• Recently, CMS released an RFI to gather feedback from the sector as an approach to developing the system. FAST has responded as they will lead a coordinated team to create a response to this RFI.

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