HL7 Argonaut Project Aims to Enable Health Care Interoperability

Health Level Seven International (HL7), a nonprofit health care information interoperability and standards organization, has announced the launch of the Argonaut Project, an initiative dedicated to accelerating the development and adoption of HL7's Fast Healthcare Interoperability Resources. FHIR is a standards framework featuring a RESTful API designed to enable the exchange of health care information between applications and systems. The FHIR framework is designed to allow implementation of health care standards across all systems, devices and applications, regardless of the variability caused by diverse health care processes.

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The Argonaut Project comprises both health care IT industry provider organizations and electronic health records vendors, including Mayo Clinic, Intermountain Healthcare, Partners HealthCare, Epic Systems and Athenahealth. Argonaut Project participants are working together to modernize nationwide health care interoperability through the increased adoption and development of the HL7 FHIR framework and API. Enabling nationwide health care interoperability is an extremely difficult goal to achieve as there are hundreds of EHR systems available today and thousands of EHR system implementations.

ProgrammableWeb reached out to Daniel Kivatinos, COO and co-founder of drchrono, who explained that one of the factors that makes enabling nationwide health care interoperability a difficult prospect is that there are multiple competing health care industry data-sharing/EHR standards. The Meaningful Use regulation, Blue Button initiative and HL7 are just a few of the health care industry data-sharing standards competing for nationwide adoption.

Meaningful Use is a set of regulations required under the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Meaningful Use includes Medicare and Medicaid EHR incentive programs, EHR technology certification criteria, and guidelines for the use of electronic health records and certified EHR technology.

The Blue Button initiative was launched in 2010 by the U.S. Department of Veteran Affairs and was created so that veterans would have a way to securely access and download their health records. The Blue Button initiative has expanded well beyond the VA, making health records available through participating health care providers, health insurance companies and other health care industry organizations. The Blue Button Connector site features bulk downloads, a Blue Button toolkit and the Blue Button Connector API, which developers can use for implementing Blue Button-recommended standards in applications.

HL7 provides a set of standards for "the exchange, integration, sharing and retrieval of electronic health information." The organization also provides the FHIR standards framework to use for implementing HL7 standards. The Argonaut Project aims to accelerate FHIR development efforts and to develop "a first-generation FHIR-based API and Core Data Services specification" based on modern API design standards and architectural styles.

Another factor hindering nationwide health care interoperability is the difficulty of implementing data-sharing/EHR standards in existing health care systems, Kivatinos said. Instead of having to implement one or two industry-accepted EHR sharing standards, developers find that they have to implement multiple standards using several APIs and have to build custom integrations based on each specific health care system implementation (a recent VentureBeat article highlights these difficulties). In addition, the APIs provided by some health care standards organizations are not easy for developers to use and in some cases do not follow modern API design practices.

"An API needs to work for the developer community," Kivatinos told ProgrammableWeb. "HL7's Argonaut Project is a good starting point. As I see it, we all have the same end goal: making the transfer of health care data easier. If the majority of health care institutions and EHR vendors agree to implement this standard and it does become widely adopted, drchrono would love to jump on board, support and leverage the API."

With all of the organizations competing for the adoption of their specific health care industry data sharing standards, there may never be one de facto standard for enabling nationwide health care interoperability. However, it will be interesting to see how the Argonaut Project develops.

For more information about HL7 and the Argonaut Project, visit HL7.org.

Janet Wagner is a freelance technical writer and contributor to ProgrammableWeb covering breaking news, in-depth analysis, and product reviews. She specializes in creating well-researched, in-depth content about APIs, machine learning, deep learning, computer vision, analytics, GIS/maps, and other advanced technologies.

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PCP_care

Good article. This is exactly the reason you should pick an EMR/EHR vendor for your practice internal workflows ONLY: i.e. scheduling, billing and your personal SOAP notes. For everything external (i.e. peer communications, test results, messaging with vendors and patients) - don’t hold your breath that your EMR vendor will EVER exchange data with other EMRs or HIE. Ain’t going to happen. Why? It’s quite simple: doctors hate EMRs; the moment they unlock the data and release the "hostage" - doctors would immediately consider switching to another EMR provider, perceived as "better" or having a better sales pitch (or free).  Interoperability is a victim of the wrong business strategies (or right business strategies designed to maintain the revenue, depending who you ask) designed by EMR vendors. The only way to ensure any interoperability – an EMR agnostic platform must be created and adopted by physicians (and not enforced: HIEs!) It also must be a physician agnostic platform. SureScripts is a good example, with the only caveat that a conglomerate of the pharmacies owns it. CoverMyMeds is perfect in that respect (for now). Health Gorilla is perfect for the diagnostics tests aggregation and ordering. EMRs were the first wave of software evolution in medicine. We learned to tolerate them, and cannot practice without them. We are at the beginning of the next turn of the ubiquitous market evolution S curve (economics 101), and the healthcare software industry is ripe for incoming disruptors to become the next "salesforce" of the healthcare software. But it must be an EMR agnostic and patient centric strategy; this is the only key to achieve meaningful savings and population management through operability.