One of the risks for FHIR as mentioned by Dr. Stan Huff (CMIO of Intermountain Healthcare) during an interview at the HL7 Working Group Meeting in Orlando lies in “Profiling”. Profiling is the mechanism of adapting FHIR Resources in a certain use-case. (Read Michel Rutten’s blog about profiling if you want to know more about the key concepts.) His concern is this: if everyone is building his or her own profiles and these profiles do not correspond, even in similar cases, this would not contribute to interoperability.
I imagine this was a calculated risk in the minds of those who started FHIR. But Dr. Huff mentiones a way to diminish the risk of getting lost in this jungle of profiles: a central catalogue of profiles from which to choose or derive. We should even be willing to pay vendors for publishing their profiles in this catalogue, he says, in stead of hosting their own catalogues.
We are following a similar route at Firely. Our registry Simplifier.net is a central catalogue, where everyone can find and publish profiles for free. On top of that, or rather next to it, we provide proprietary FHIR registries for e.g. standardization organizations, associations and governments; not as silos though, but interconnected with each other in order to maintain references between profiles. This will enhance interoperability, but not completely annihilate the differentiation. Don’t pursue total interoperability, says the spirit of FHIR. It is too expensive a journey, leading nowhere.
Here is the interview with Dr. Huff, where I ask him about the risks of FHIR.