INTRODUCTION
The Helios FHIR Accelerator for Public Health is a collaborative initiative including network organizations (QHIN, HIE, HIN), state, tribal, local, and territorial (STLT) public health agencies, health information technology (HIT) vendors, federal partners, and private sector organizations. Its primary goal is to align with the widespread standardization and transformation that is happening around digital health data today to promote more flexible and effective data exchange between healthcare, the public and other sectors beyond public health.
Helios addresses ongoing challenges in public health by ensuring that data modernization efforts incorporate market-based solutions and align with nationwide interoperability priorities. The alliance focuses on extending and adopting existing HL7 Fast Healthcare Interoperability Resources (FHIR®) specifications in ways that are flexible, accurate, scalable, sustainable, and responsive. By doing so, Helios aims to keep public health needs at the forefront as FHIR standards evolve and are implemented nationwide.
2024 SUMMER AND FALL HIGHLIGHTS
Our teams have been hard at work since our last update. We continue to explore new FHIR capabilities and bring FHIR to the larger public health community. Here are just some of the things we are working on.
Retrieve patient health information from electronic health records (EHR) systems using FHIR Query and Response
Under the leadership of Angel Aponte (New York City), Bill Howard (eHealth Exchange), Jim Collins (Michigan Department of Health and Human Services), and Tina Hardin (JMC) this priority area is working to demonstrate how the FHIR Query and Response paradigm can help meet high-priority public health needs efficiently and effectively, while also returning valuable and actionable information to care providers.
The group met in Atlanta for the 37th FHIR Connectathon to test FHIR query capabilities across a variety of use cases. Attendance was so high that we not only filled our two assigned tables but overflowed into neighboring ones as well! For our Cancer Registry use case, our partners from the College of American Pathologists (CAP), Centers for Disease Control (CDC) and Topology Health, were able to query several EHRs and a TEFCA QHIN to pull supplemental initial pathology information. The response was refined to prioritize data elements from the mCODE profiles of interest. Several groups explored the use of FHIR for Sexually Transmitted Infection (STI) case follow up, including South Carolina, New York City, Michigan, Skylight, JMC and Altarum. Testers were able to use electronic laboratory report (ELR) v2 messages to trigger a series of FHIR queries to retrieve additional information on impacted patients. Special emphasis was placed on simulating the scenario where multiple data sources (FHIR servers) hold data of interest. We also investigated how public health can use an iterative approach to improve reference chasing to identify clinical information specific to the cases of interest, and to conform to the various clinical scenarios in which data may be available. Finally, our RESP-NET participants from Washington state were able to use the CDC’s open-source Data Integration Building Blocks (DIBBs) Version 2 to FHIR converter to convert ELR Version 2 messages into FHIR resources. They also sent FHIR queries through the DIBBs FHIR Query Connector tool and received supplemental patient data back from simulated EHRs. We would like to thank all of the HL7 FHIR Connectathon 37 participants for joining us in Atlanta. More opportunities to test with us will happen with the January 2025 virtual Connectathon. Reach out to us for more information on that event.
On our bi-weekly project team calls, we continue to explore topics related to FHIR queries. Please join us!
Make data in public health systems available in Bulk
Led by John Stamm (Epic) and Mary Beth Kurilo (American Immunization Registry Association), this priority area is exploring ways to enable authorized users of public health data to access complete, accurate, and timely information on their patient and member populations in bulk. As our first use case, we are exploring how Immunization Information Systems (IIS) can share immunization history in bulk with their trading partners.
The summer of 2024 saw the group capture almost two years of discussion and testing into the Helios Bulk Data for Immunization Guidance Document so that both public health programs and authorized users can better understand the methodology and implications of the Bulk Data Access approach. In this document we discuss:
- Policy considerations and implications of implementing Bulk Data Access using FHIR,
- Technical concepts and options for developing a supporting FHIR infrastructure,
- Trading partner expectations,
- Options for identifying and grouping individuals,
- And approaches for executing the bulk query itself.
We plan to ballot this document in the form of an informational HL7 white paper as part of the January 2025 ballot cycle. We encourage everyone to review and comment on material during the ballot period to ensure that Helios’ first HL7 published artifact is informative and practical for the interoperability community.
Exploring public health uses cases and educate the community
Helios would like to welcome our newest Operating Committee community leads, Danny Wise (Practice Fusion) and Steve Schultes (Oracle Health). Danny and Steve join our existing leads Gillian Haney (Council of State and Territorial Epidemiologists) and Michelle Barber (Oregon Health Authority) in helping this group explore public health use cases that could benefit from the use of FHIR. Over the summer and into the fall, the Operating Committee has explored use cases for Multi-Drug Resistant Organisms (MDRO), the FHIR International Patient Summary (IPS), and National Health Care Surveys (NHCS). We look forward to further discussions on these and other use cases. We encourage anyone with a topic they would like to explore with us to reach out!
In addition to our Operating Committee work, Helios also partnered with HL7 and the CDC to sponsor a special HL7 Connectathon Track aimed at educating members of the public health community about FHIR. With generous sponsorship from the CDC Foundation, over 50 public health representatives from local and state agencies from across the country were able to join us in person in Atlanta. The track not only included educational sessions on core HL7 and FHIR functions but also touched on issues of data modernization and the impact of policy on data sharing. Not only were participants able to see the Connectathon floor to better understand the mechanics of HL7 Connectathons but also talk to participants about their tracks and what they came to test and accomplish. Response to the track was overwhelmingly positive and we are already planning future events to better expose the public health community to the inner workings of HL7.
Get Involved in HELIOS!
Helios is currently recruiting organizations to actively participate in current discussions, future testing events and piloting efforts. There are no membership fees for participation in Helios, so there are ways for everyone to get involved!
Everyone can participate by:
- Bringing your public health interoperability pain points to our priority area team leads to learn what FHIR can do for you. FHIR offers new possibilities for public health, and we can help you understand how to address your current interoperability needs.
- Applying your FHIR tools to public health use cases at HL7 FHIR Connectathons and other Helios testing events. We need tool developers playing a wide range of roles in public health data exchange to help evaluate FHIR-based approaches and develop technical solutions.
- Talk to your colleagues and technical teams about how to take the next step towards piloting a real-world solution.
If you are ready, willing, and able to help drive forward public health interoperability in these areas, please reach out to us at helios@hl7.org to become part of our team!
