HLN participated in the HL7 FHIR Connectathon in Las Vegas on January 14-15, 2023 representing the Rhode Island Child and Adult Immunization Registry (RICAIR) in the Helios Accelerator Bulk Data Track. Connectathons are an opportunity for developers from different organizations to work in-person with each other and with standards development teams to exchange test data using new FHIR interoperability standards. FHIR bulk data offers a way for physicians and other providers to efficiently access up-to-date immunization data from Immunization Information Systems (IIS) using modern tools and protocols. It is particularly useful for use cases in which providers need to be kept up-to-date on the immunization status of large groups of patients.
HLN/RICAIR, American Immunization Registry Association (AIRA)/National Institute of Standards and Technology (NIST), Amazon Web Services (AWS), Envision, Intersystems, and Scientific Technologies Corporation (STC) had FHIR servers at the Connectathon; and Epic, AIRA/NIST, Mitre Corporation, and Deloitte had FHIR clients. HLN brought a FHIR client as well, for the purpose of querying the other teams and learning from their responses.
Over the two-day event, we successfully exchanged FHIR bulk data using groups of test patients ranging from 10 to 100,000 in size; and served bulk “ImmunizationEvaluation” and “ImmunizationRecommendation” FHIR resources, fed by ICE forecasts, in addition to the typical “Patient” and “Immunization” resources.
RICAIR handled queries for the 100,000 patient group easily, and in a small fraction of the time it would take to respond to 100,000 individual queries using the current HL7 version 2 standards for IIS data exchange. The predefined groups of test patients were intended to simulate the use case of a provider, payer, or school performing a bulk query on its complete patient roster as currently known by the IIS. At the Connectathon we also discussed strategies for submitting bulk FHIR queries for newly-defined groups based on FHIR search criteria, as opposed to predefined groups. There are ways of doing this with the standards as they exist today, but methods for doing it more efficiently have been proposed.
Building on the successes at the Connectathon, HLN plans to continue to work with the Helios team to demonstrate bulk data exchange and help IIS and their partners adopt this new standard.
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