FHIR Dev Days Amsterdam 2017-11-17

All our FHIR developments are in the open on github https://github.com/nhsconnect

we have had to create our own tools, as well as using Forge for FHIR - we have open sourced the tools

we were guilty of creating our own version of v3, but we arenot going to do that with FHIR, we aren't going to fork it

for profiling we use Forge from furore - for validation we use both .NET for Authoring and HAPI for Accreditation

our implementation guides are published in jekyll and our reference server is HAPI

In comparison to v3, the FHIR toolset is much better

Messaging is the unloved paradigm in FHIR as most people relate FHIR to REST

FHIR is about interoperability and it supports all modes, not just REST and databases

when we talk about messaging we have loosley coupled systems - I may not know how to reach a source

Messaging is always trigger event based, and each message is acknowledged by a response

when we do exchanges, they have to support both synchronous and asynchronous messages

the most common category of messaging exchange is notification

the other 10% of reasons for messaging are queries or commands

the list of trigger events in the standard is very small

a trigger event could be 'here is a list of all known allergies' - if you change the list you need to send it again

messaging does not define the transport model -

the FHIR Subscription mechanism lets you subscribe to changes on all types

a message is a contract - when I send a message I expect you to act on it

Message as defined in https://www.hl7.org/fhir/messagedefinition.html

NHS England uses messaging

There is more messaging in healthcare than REST

is there any initiative for blockchain in messages? If you have messages that cross domains

there are people interested in blockchain in FHIR on https://chat.fhir.org, though they are moving away from documents on the blockchain. they haven't talked about messaging

I'm from the Open API Foundation

there are 17,000+ APIs available

developers are bad at keeping their api documentation up to date - or writing it at all

the Open API Initiative is a set of specificatons for REST APIs

in 2010 Tony Tam @wordnick came up with Swagger and Open API Initiative became part of linux foundation

the docs are built by processing the API spec

if you start with the framework at the beginning it will generate code for you

a big problem is that custom APIs are seen as a competitive edge

we're at openapis.org and the spec is at github.com/oai

some of you know that json schema is not our friend - Mo and I are planning to get them in a room and fix things

I love Dev Days - I'm going to comment on the keynotes - I'm going to start with tinkering

looking at @jamesagnew's plot of HAPI calls by latlong there is a huge circle around India, so we should ramp up the Indian community

I got Simone to bring an old bit of tinkering back to life

this dates back to 2015 at the Atlanta connectathon -look at the twitter stream and create a patient resource when anyone tweets #fhir

if you go to the R2 endpoint of grahame's server you can find your patient record for your tweets

it's running on my laptop, so it will vanish when I close it.

from @rolfhut's presentation I wanted to repeat that APIs are interfaces to people

Then we heard from Eyal about Google Brain, and have heard a lot of commentary about it

we talk about paradigms of exchange in FHIR - REST, Document, Messaging paradigms we need to add a Database paradigm too

It was great seeing Eyal doing live SQL queries against a FHIR backed - we want to get that up for other people to use too

a few people commented about Dev Days being a technical thing, but it is more a community

I wanted to thank Morita for organising and all the @fhir_furore team

There are Dev Days in Boston next year in the spring and back in Amsterdam in the Autumn

our current focus is on finishing off and publishing release 4, which will be the first Normative release of FHIR, where parts go normative

we need to get this done in the next 2 weeks before the ballot in December. Things can get dropped from normative, but they can't get made normative after that

I want you to go to the coverage resource on my server and fill out info about what coverage is in your country

The FHIR foundation www.fhir.org is a partner to HL7 - they publish highly reviewed documents - the FHIR foundation is for the other things that make the community

I'd like to thank Google for support for all FHIR foundations cloud computing requirements -

you can now become an individual member of fhir.org you get a badge, a newsletter and access to a marketplace - I post contracts there

It's $250 US a year to be an individual member of the FHIR Foundation - we are looking for corporate sponsorship for specific things

I do want to talk about certification - you can go to https://www.hl7.org/implement/certification.cfm and pass a test and become certified FHIR proficient

another thing we run is the FHIR registry https://registry.fhir.org/ which lists resources for FHIR, we are nailing down the data in it

whenever I talk about FHIR to communities around the world - people focus on FHIR as a technical spec, but it is a community first

all of us, not just those here but those who follow along online too. We believe that getting involved with FHIR is a worthy endeavour

when people find problems with FHIR they come to us, and it isn't whining, it is showing that they care

The next HL7 meeting is in New Orleans, and we're holding a connectathon http://wiki.hl7.org/index.php?title=FHIR_Connectathon_17

here are the connectathon proposals: http://wiki.hl7.org/index.php?title=Category:201801_FHIR_Connectathon_Track_Proposals

we currently support old version of the code, and it is up to 6 versions now - have a look at the http://wiki.hl7.org/index.php?title=201801_Versioned_API track

I want you all to be aware ofr the FHIR code of conduct - do read it and make sure you comply http://wiki.hl7.org/index.php?title=FHIR_Code_of_Conduct

I wrote a post on my blog about "why participate in the FHIR community?" do read it http://www.healthintersections.com.au/?p=2665

you give us your treasure. you all give to us your time, your energy and your passion and we share that treasure with everyone

we live in a world where zero sum thinking seems to dominate - that's not how we work.

You're going to see, I fear, zero sum thinking in the healthcare data industry in the next year.

We went for a very strong open source license - the creative commons licence we use is there to protect the treasure of the community

it's always important to pay attention to the provenance of information - how many people have written or created a FHIR Provenance resource?

when we set up FHIR we realised If we did FHIR well it would lead to outcomes in Health, not just Health IT

the implementation process for FHIR went much faster than we expected - we are building onthose to make the formal standard

implementation first for FHIR has worked well— learning how to do things before you bake them in stone is a good idea

we can't control the hype part of the hype cycle - we don't want inflated expectations

obviously I believe in FHIR, but we know that healthcare is hard. interoperability helps but it is still hard

I think we have now transformed the expectations - people now see there is a workable health data ecosystem to use if they want to

in the last few weeks I have felt that we are reaching the tipping point where we start to change health too

I will keep doing what I am doing until the care provider to my family changes

as a community we need to focus on how to transform health