For anyone involved in management of health IT, the collection, storage and safe sharing of healthcare information has always been one of the most important \u2013 yet difficult to achieve - parts of their job.\nPart of the problem is that information is not only collected from many different systems, but the way data is represented and shared is often specific to each system.\nAnd increasingly there are demands beyond the simple sharing of data within a facility. We are seeing:\n\u2022\tAn increasing need for patients to be involved in their own care. They need access to their own information, and are expected to contribute to it.\n\u2022\tA big shift to the use of mobile devices as the means of access.\n\u2022\tDecision support, requiring highly structured \u2013 and consistently represented \u2013 information.\n\u2022\tPopulation health analytics.\n\u2022\tA vast increase in the range and quantity of data, driven largely by the increasing availability of devices that can collect this information, plus the increasing use of genetic information.\nThis means:\n\u2022\tThere is an increasing range of organisations and developers who need to access health information \u2013 and often they are not experts in the healthcare domain.\n\u2022\tA requirement to use real-time Internet based protocols to access that data. Information needs to be delivered right now!\n\u2022\tA need to be consistent in the representation of health data, especially as the same \u2018type\u2019 of information can come from multiple sources.\nFundamentally there need to be standards in the way health information is represented, and made available to those who need it.\nWhile there are existing standards designed for healthcare exchange, they were developed many years ago, are no longer really \u2018fit for purpose\u2019 for these new requirements.\nHL7 version 2 is very widely used \u2013 and very successful in what it aims to do - yet uses technology almost 30 years old, and has not been implemented consistently. HL7 CDA is excellent at sharing documents for human use, but is only really applicable to the document paradigm, and is complex when attempting to extract coded information from them. Specialised standards such as DICOM remain important \u2013 but only within their specialised areas.\nIHE \u2013 a profiling organisation rather than a Standards Development Organisation remains very relevant, but the standards they use are also in need of a refresh.\n FHIR (Fast Healthcare Interoperability Resources) has been designed from the ground up to make it easy for implementers to develop and deploy solutions across the globe.\nThe result of these factors is that new implementations involving the manipulation of healthcare care:\n\u2022\tAre time consuming and expensive.\n\u2022\tRequire highly qualified (and costly and scarce) people to design and implement.\n\u2022\tOften result in fragile implementations that are difficult to support and upgrade.\nRelated:The hybrid team leader: David Kennedy of Orion Health\nThe latest standard from HL7 \u2013 FHIR \u2013 promises to change that.\nFHIR (Fast Healthcare Interoperability Resources) has been designed from the ground up to make it easy for implementers to develop and deploy solutions across the globe. In fact, it came about in the first place in response to the question from the HL7 Board: \u201cIf we were designing a health care interoperability standard today, what would it look like?\u201d\nBased on commonly used Internet standards as used by organisations like Google, Facebook and Amazon, it is designed with the Implementer in mind \u2013 and an Implementer who is not familiar with the healthcare domain.\nIt is based around the concept of Resources \u2013 small pieces of information that \u2018make sense\u2019 in the health IT world such as patient, encounter, medication, allergy and condition. Each resource is effectively a best-practice model of how the majority of systems think about \u2013 and exchange - healthcare data. Each resource is small \u2013 up to 20 or so individual elements, yet is capable of being extended to accommodate any required information in a manner that promotes discoverability.\nResources can then be combined in a \u2018web\u2019 of relationships, allowing the most complex of requirements to be represented. They can be exchanged in real-time (so-called RESTful exchanges), packaged in a document (like CDA) or a message (like HL7 V2).\nWhile each resource is compact, there are profiling and extension mechanisms built into FHIR that allow them to be extended to represent any conceivable requirement in a manner that is understandable to others.\nSo a FHIR based implementation will be cheaper and faster than existing standards because:\n\u2022\tThere are already resources defined for most of the commonly needed requirements;\n\u2022\tImplementation can be performed by a much wider range of implementers;\n\u2022\tThere is wide interest from the existing vendor community, with many of them announcing support and providing test interfaces. It is very likely that FHIR interfaces will be supported by them within months rather than years;\n\u2022\tThere is a world wide community of experts to give advice, using social media as a mechanism;\n\u2022\tThe specification is available on-line, is fully hyperlinked and contains numerous examples;\n\u2022\tOpen source libraries are available to kick start any development;\n\u2022\t\u2018Connectathons\u2019 \u2013 where application developers meet to learn and test the standard are regularly held around the globe;\n\u2022\tTest servers are available 24x7.\n\nDrawbacks and deficiencies\nBut nothing is perfect \u2013 so where is FHIR deficient? Well, the biggest drawback is FHIR\u2019s relative immaturity, it is yet to be \u2018battle tested in real implementations over a period of time. And much of the focus of the developers has been on the real-time \u2018RESTful\u2019 capabilities to support mobile and browser based applications \u2013 while the standard has been designed to support messaging and documents, these capabilities are less developed and exercised.\nSo what should a prudent CIO do about FHIR? The first is to ensure that technical staff are familiar with FHIR, and ideally participating in the different practical events and forums being hosted around the world.\nIf current standards are meeting requirements, or there is such a heavy commitment that change is difficult, then a \u2018watching game\u2019 is probably best. But for developments that hit the \u2018sweet spot\u2019 of FHIR \u2013 mobile, device and real-time interactions \u2013 then give it a go! You will be surprised how easy and intuitive it is. (And the amount of support available when needed \u2013 answers are often received within minutes of asking)\nAt the time of writing, FHIR is approaching its second trial version. While it will not be \u2018finished\u2019 for another couple of years, there are already trial implementations in every continent in the globe (apart from Antarctica), and by almost every significant healthcare vendor globally.\nIt is no surprise then, that FHIR is taking the healthcare world by storm.\n\nDavid Hay, is a medical doctor and product strategist at Orion Health. He is chair of HL7 New Zealand and a member of the international FHIR Management Group and the National Health IT Board's Health Information Standards Organisation (HISO). He is the author of a blog on FHIR. \nSend news tips and comments to firstname.lastname@example.org\nFollow Divina Paredes on Twitter: @divinap\nFollow CIO New Zealand on Twitter:@cio_nz\nSign up for CIO newsletters for regular updates on CIO news, views and events.\nJoin us on Facebook.