Wednesday, January 15, 2014

Excited about FHIR, but want it done right

I am a huge supporter of HL7 FHIR. I am involved in the development, the use by IHE, and promoting it inside of GE Healthcare. I am about as involved in the FHIR standard as I can be, given my day-job. I truly want and expect FHIR to succeed. It is far better in many ways than the existing HL7 v2 or v3. It will break Healthcare out of the dark ages, and into the modern world of Interoperability.

The best way to get to this vision is to make sure that it receives as much review as is possible, without going overboard. Too much review is a bad thing too, as many standards have died due to over analysis. However FHIR has received ONE formal ballot, while benefiting from many people experimenting with it at the various FHIR connectathons (hackathons). I encouraged everyone back in August to review and comment Time to kindle the FHIR - It needs ballot comments to grow. I provided 42 comments, mostly focused on DocumentReference (aka XDS),  during this one formal ballot. I worked with Grahame to resolve these. I am happy that they were given the best review by Grahame as they could.

I however want another chance to review the whole FHIR ballot, and even more so I want everyone that is now more excited than ever to have a chance to review and comment on the whole FHIR ballot. There were hundreds of comments that changed almost every part of FHIR. Most of these changes were done by a very small core team that I have total faith in. I am not concerned that the HL7 ballot process was not executed. I am interested in making sure I and all the newly excited people get a second chance. A second chance to make sure the content is consistently following the FHIR core principles and is reasonable quality.

The DSTU phase is a dynamic phase. There WILL be more changes during the DSTU phase. So I know that a second ballot is not necessary to get convergence, this could happen during DSTU. However the more changes we make during DSTU the less visibility these changes have and the more they will break.

I, on behalf of GE, sent the following message to the FHIR Management Group (FMG), FHIR Governance Board (FGB), and the FHIR mailing list.

GE Healthcare would like to express our complete support for FHIR. GE has provided comments and have seen these comments resolved to our satisfaction. However we would like to encourage the FMG and FGB to support another formal ballot before entering the DSTU phase. This reasoning is not that reconciliation of any specific votes is not satisfactory, but rather that the overall change by the total votes requires a renewed top-to-bottom examination. The most concerning is where a voter (A) was satisfied with a portion of the original ballot, where that section is changed by voter (B) to something that voter (A) would not agree with. It is simply too hard to watch the total ballot reconciliation and track all changes piecemeal.

The future for FHIR is very bright, and now is the time to make sure that it meets all the principles and uniformly applies them. GE realizes that this extra step is not minimally necessary according to the HL7 GOM. We accept the decision of the FMG and FGB, and will continue to support FHIR regardless of if another formal Ballot is executed or if FHIR enters DSTU directly.

Please give us a second chance to review and comment on the FHIR content before it enters DSTU.