Though there are many challenges in utilizing FHIR fully, there are several specifications which will support workflows and provider experience between healthcare organizations and multiple EHRs.

There are three instances of Epic along with three varied versions of Meditech, Athena health and Cerner. Lahey Health, Beth Israel Deaconess Medical Center along with three other hospitals, are currently involved in merging the organizations under one roof, as they are operating with varied EHR vendors and versions.

John Halamka, MD, Beth Israel Deaconess CIO at HL7’s DevDays said, “That might be true if I had $2 or $3 billion or if I had the nerve to uproot the current EHR workflows, but I don’t want to do that. So instead, what we’ve said is FHIR. Why don’t we just create a suite of apps, device neutral, then enable providers to have the appropriate workflow and experience, regardless of the transaction in the EHR.”

Though FHIR utilization is user-friendly, cost-effective and fuels interoperability, there are few challenges in the United States to utilize it fully.

One of the issues is the lack of patient matching system, where they are assigned a unique identifier. Halamka said, “We need to see some kind of service to track patient identity -- demographics alone aren’t sufficient; we’ve created ways of saving that data and taking it place-to-place, but we’ve never had a way to get there.”

Another issue is the variation in state wise data sharing policies. Halamka said, “As we move from fee-for-service we have an imperative to improve care quality. But today, we can’t survive in a risk-based environment unless we share data.”

Halamka finally concluded, “All of the underlying data you work with will have its flaws; there needs to be a solution to this mismatch problem because you can’t update everyone simultaneously. We need to accept the fact we’re going to have a lot of variation; the government used to drive the agenda -- but I really think the private sector economy is where the action is … the change is going to come from you.”