R4 Ballot #1 (Mixed Normative/Trial use) Current Build
This is the FHIR R4 Mixed Normative/Trial Use Ballot #1, and the version for the Cologne Connectathon in May 2018. The current version is R3 . See the ballot introduction for details about the ballot. For a full list of available versions, see the Directory of published versions and Timelines for an explanation of STU and other statuses.
FHIR Infrastructure Work Group Maturity Level : N/A Ballot Standards Status : Informative

FHIR is a platform specification that defines a set of capabilities use across the healthcare process, in all jurisdictions, and in lots of different context. contexts. While the basics of the FHIR specification are relatively straight-forward (see the Overviews: General , Developers , Clinical , and Architects ), it can still be difficult to know where to start when implementing a solution based on FHIR.

This page provides some guidance to help get new implementers started on their path to successful implementation. Beyond reading the overviews (previous paragraph), where should an implementer start? Generally, an implementer needs to resolve:

The remaining sections provide guidance on specific areas (Foundation, Implementer Support, Security and Privacy, Conformance, Terminology, Linked Data, Administration, Clinical, Diagnostics, Medications, Workflow, Financial and Clinical Reasoning).

All implementers should be aware of how versioning works in the FHIR specification. See both:

In order to help implementers find their way around the specification and answer these questions, it is organized into a set of "modules". Each module represents a different functional area of the specification, and contains:

  • Scope and Index :A : A description of the content covered by the module, and an index of the important content
  • Use cases : guidance Guidance for common uses of the module, and how to approach them. This is a key resource for implementers familiarizing themselves with the FHIR specification
  • Security / Privacy : information Information
  • Roadmap : Where the content covered by the module is in terms of overall progress (see also, for general information: FHIR Timelines )

Broadly, the modules are organized into 3 groups:

  • Infrastructure (bottom rung, and bottom row of boxes)
  • Content (middle rung, and top row of boxes)
  • Reasoning (top rung)

Level 1 Basic framework on which the specification is built

Level 2 Supporting implementation and binding to external specifications

Level 3 Linking to real world concepts in the healthcare system

Level 4 Record-keeping and Data Exchange for the healthcare process

Level 5 Providing the ability to reason about the healthcare process

Dependencies between the modules are mainly downwards, with some horizontal dependencies. Implementers should choose the content modules to engage with based on their requirements, and should only engage with the reasoning module if they need to do clinical decision support, and/or Quality Measures.

In addition to the use case based assistance in the modules, these additional documentation pages may be useful:

  • Common Use Cases : Personal Health Record, Document Sharing (XDS) and Decision Support
  • Resource Guide : Further information about the resources and the relationship between them

Finally, one important place to look is the registry of implementation guides , to see whether similar (or identical) requirements have been met.