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Nation’s clinical informatics professionals tells NIH there are several ways to advance FHIR

In comments submitted to the National Institutes of Health (NIH), the American Medical Informatics Association (AMIA) recommended that the institutes devote substantial resources to develop a strategy and a framework for FHIR research and development (R&D) to maximize the utility and secondary use of EHR-based, clinical data for research and to encourage the development of clinical informatics innovations aimed at improving care.

In late September, NIH requested input from the scientific community and other stakeholders about the types of tools that might be needed to support use of Fast Healthcare Interoperability Resources (FHIR) in biomedical research. The RFI follows-up on a notice NIH issued over the summer encouraging researchers to explore the use of the FHIR standard to capture and integrate patient-and population-level data from clinical information systems for research purposes and to use it as common structure for sharing research data.

AMIA responded that despite some current limitations with FHIR, it is imperative that NIH both lead and coordinate R&D efforts for using FHIR for funded research. The group recommended that NIH work through established standards maturity model progressions and balloting processes of HL7, arguing that this strategy and framework for FHIR R&D should result in FHIR Resources, FHIR Profiles, and FHIR Implementation Guides (IGs) to facilitate a broad range of research using clinical data.

“Given the direction of ONC and CMS rulemaking, and the standards development infrastructure established and maintained by HL7, it is likely that FHIR will become the standard for exchange of most common categories of clinical data over the next two to three years, “ AMIA wrote.  “However,” the group continued, “we note that this vision for the use of FHIR is distant and in need of federal support.”

AMIA made three high-level recommendations for NIH to execute such a strategy: directly fund FHIR R&D through grants; indirectly fund FHIR through special emphasis notices and project requirements that favor/prioritize projects that will use FHIR; and educate the research community and help represent the research community in activities supported by ONC, HL7, and other SDOs with interest in FHIR.

 “The development of FHIR has revolutionized how clinical data are accessed, used, and exchanged,” said AMIA President and CEO Douglas B. Fridsma, MD, PhD, FACP, FACMI. “NIH is uniquely positioned to further support the standard to advance biomedical research. We look forward to working with them as they develop their strategy.”

Read AMIA’s full response to the NIH RFI on FHIR


AMIA, the leading professional association for informatics professionals, is the center of action for 5,500 informatics professionals from more than 65 countries. As the voice of the nation’s top biomedical and health informatics professionals, AMIA and its members play a leading role in assessing the effect of health innovations on health policy, and advancing the field of informatics. AMIA actively supports five domains in informatics: translational bioinformatics, clinical research informatics, clinical informatics, consumer health informatics, and public health informatics.