By: Amos (Kippi) Bordowitz
FHIR Server or a Façade?
“What is a FHIR® server?”
“What is a FHIR® Façade?”
“Which one is right for our business?”
“Is one better than the other?”
We have been asked these questions, and more like them, many times as time has gone by. It seems like
suddenly every healthcare company is wrestling with these questions.
We know there is not enough clear information out there regarding FHIR® servers and Façades, and which one might be right for you. So… Let’s talk about it!
Server:
A FHIR® server consolidates information from operational systems and creates a repository of all clinical information in the organization, organized in a way that allows retrieval in REST. Here are
a few properties and characteristics of FHIR® servers:
- All the information is kept in the organization
-
Any organization can access and view information as standard (provided they support FHIR®) without the need for conversion or integration
-
Enables enrichment of standard (international) terminologies
-
Requires duplication of all information in the organization
-
Operating systems must constantly maintain the information. Sync is required between all operating systems. In the future this will be resolved when all clinical systems speak FHIR®
-
Requires conversion of and establishment of interfaces from the source systems for the purpose of populating the server
A FHIR® server is necessary if the organization receives data from diverse sources and / or on a large scale, and when support for a variety of Clients is required that require complex search
capabilities. The FHIR® server should be the ultimate endeavor as an enterprise-wide solution. Eventually. Any company using FHIR® will require a server, especially as we move towards a FHIR®-fluent business world.
However, this is not the right solution for everyone right out the gate. If your enterprise is just now making its first steps in the world of FHIR®, especially if you already have a legacy system, going straight for a FHIR® server might not be right for you, as migrating your system to a server could be a long and expensive process. Is there an intermediate solution?
Enter the FHIR® façade.
Façade:
A façade is server-side product whose function is to perform OnDemand conversion between FHIR® commands and generic commands according to the capabilities of enterprise systems. In fact, it is an
ESB fully compliant with FHIR®. A Façade has different implications for incoming and outgoing data. Here are a few properties and characteristics of FHIR® façades:
Inbound:
-
Conversion process from FHIR® to the structure of the operating system. Depends on the capabilities of the source system.
-
It is necessary to build conversions from FHIR® to the source system-supported interface. Conversion construction is required for each type of resource / information system / business process
-
Information may be lost during conversion (FHIR® hierarchical structure versus source system FLAT structure)
-
High overhead - economic and time.
Outbound:
- The client is limited to only simple search requests that are restricted by the source systems
- Requires querying of several systems in order to populate all the necessary information
Advantages of facade - Suitable as a first step in implementing FHIR® in the organization if the needs are
specific and well defined and the expected volume of movements is small. No information duplication. Less suitable as an enterprise-wide solution.
Conclusions:
So, to conclude, here is a birds-eye comparison between the two solutions - which is best for you - FHIR Server or a Façade:
|
FHIR® |
FHIR® |
|
Data is |
ESB fully optimized for FHIR® |
|
There is no need to address source systems |
Direct referral to 1 or more source systems in each query |
|
Maximum flexibility in accessing external data |
Complexity and duration of resource and ID construction – high overhead |
|
Requires an orderly policy of updating |
May overload and compromise the availability of source systems |
|
Necessary if the organization receives |
Suitable as a first step in implementing FHIR® in the organization if the needs are specific and well defined and the expected volume of movements is small |
Products:
There are several products on the market that you should look at and analyze the differences between them according to your business needs (click on any link to go to their website):
- InterSystems HealthShare Health Connect
- Firely
Here at Outburn Ltd., we will be happy to help you figure out which is best for you - FHIR Server or a Façade - and implement the right solution for your needs. Contact us at info@outburn.co.il
Did you know we give courses on al things FHIR? Want to know more? Check out our Academy page
Follow us on LinkedIn
