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Blog: Sparks fly when FHIR meets generative AI

22 March 2024
By Kate McDonald
Image: iStock

There was a great turnout for the healthcare standards gang this week as HL7 New Zealand and HL7 Australia jointly hosted a simultaneously live-streamed symposium on interoperability that got everyone FHIRed up.

The symposium provided a super update on progress implementing FHIR into the real world, and also gave us a glimpse of what may lie in the near future during a live demonstration by former Telstra Health and now Microsoft senior software engineer Brian Postlethwaite using GPT-4 prompts to create a bespoke clinical form using the FHIR questionnaire structure in a matter of minutes.

We also heard from Health New Zealand Te Whatu Ora about the early iteration of what New Zealand has – perhaps unwisely, considering Australia’s experience – chosen to call My Health Record. This has grown out of the My COVID Record immunisation record set up during the pandemic and the plan is to slowly add more information for consumers so they have access to their health information, including their dispensed medications, allergies and alerts.

The record will be fed using the FHIR APIs that the Hira program is developing and will be aligned with the New Zealand Patient Summary that Te Whatu Ora is very excited about. The NZ PS is a localisation of the International Patient Summary (IPS) and is being built to allow healthcare providers to access a core set of standardised data no matter where they are in the world.

It’s great stuff and was demonstrated at the symposium during a terrific presentation by James Agnew, CTO of Canada’s Smile Digital Health, a health information exchange (HIE) vendor that has built its platform on FHIR and has also developed an open source implementation of the FHIR standard in Java called HAPI. Healthcare providers can access his personal IPS just by scanning a QR code on his phone. Mr Agnew gave an enthusiastic presentation on the some of the big ideas to link health information across Ontario over the years, which he happily described as failures. They are trying again now, building HIEs on a firmer foundation than in the past through FHIR.

Interestingly, earlier this year Telstra Health announced that it was partnering with Smile to bring some of its ideas to Australia and New Zealand. With the Australian Digital Health Agency planning a series of health information exchanges, this will be an interesting area to watch.

Also fascinating was a stunning presentation by Google Health senior product manager Fred Hersch about Open Health Stack, a suite of open source tools that Google Health has built on FHIR. Dr Hersch is an Australian medical doctor who also trained as an engineer and has spent the last six years with Google Health, working on open source standards that can be used around the world.

Google has been kindling a lot of new products in AI for healthcare, including its Healthcare API, Apigee, BigQuery and Vertex AI products, but the Open Health Stack has flown a bit under the radar. It is there for all developers to use to build next generation healthcare apps, including FHIR-native Android apps, and with the help of WHO and organisations like the Bill and Melinda Gates Foundation, is making its mark in particular in low resource countries.

The symposium also heard about the announcement of a new Australian FHIR Coordination Committee that has been set up as an independent watchdog to oversee the development and implementation of FHIR in Australia. We’ll have more on this next week, and in the meantime we sincerely hope that more joint gatherings will be scheduled by the Australian and New Zealand HL7 communities. Clinical software vendors marketing to both countries will benefit too.

Also a great success this week was Australian Healthcare Week in Sydney, which was absolutely buzzing, particularly over new areas such as the digital transformation of aged care, the explosion of AI in healthcare and Healthcare 2040.

Next week, Pulse+IT will be at the ITAC conference on the Gold Coast. Formerly known as information technology in aged care and now rebadged as innovation and technology across care, ITAC skipped a year last year what with the huge goings on in the sector, but it has been resurrected and provided with a bumper program this year. Themes include star ratings in residential aged care, digital maturity and how it can actually affect the quality of care, a new healthy ageing innovation ecosystem recently launched, as well as a couple of presentations by local innovators.

Some amazing work – most of it voluntary – has been done by the aged care standards community to lay the foundations for an interoperable aged care system. The sector wouldn’t be where it is now without the dedicated long term persistence of legends such as George Margelis, Anne Livingstone, Isobel Freane and Len Gray, who will all be out in force at ITAC, as well as international innovators like Greg Alexander and Jon Warner, who we’ll have interviews with next week.

In the meantime, back to interoperability and our poll question for the week.

Are you confident of real progress on interoperability?

Vote here and leave your comments below.

Last week we asked: is the future of AI in healthcare in good hands? Unfortunately no, 80 per cent of our readers said. From the comments, it seems that Big Tech and the tech bros are not to be trusted. Here’s what you said.

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6 comments on “Blog: Sparks fly when FHIR meets generative AI”

  1. Attendances and participation levels in the Sparked Accelerator design forums is a significant indication that we have a willing community will to invest time and money in better interoperability. Ultimately, a willing community is the key to real progress on interoperability.

    • Now that Healthlink has bought out Argus, and Argus is interoperable with ReferralNet, it just leaves out Medical Objects, which has been the main sticking point to secure messaging interoperability, if those 3 become interoperable, Medical Objects will have to fall in line or become irrelevant. Medical objects is way more expensive, doesn’t offer practice subscriptions, only individual subscriptions which does not work with shared address book in a practice, and doesn’t routinely have generic practice identifiers unlike the other 3, at last I am optimistic about secure messaging interoperability.What will stuff it up is using NASH certificates with a short expiry date, so messaging will recurrently go offline.

      • Vendors still not providing open APIs for their customers to use. They would rather waffle on about AI fantasies than provide access to their still closed systems.

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