DirectTrust recently released a white paper that proposes how FHIR and Direct communities and technical specifications for each standard should relate to each other to offer new value. FHIR is a standards framework created by HL7, an ANSI-accredited SDO in the health care arena. DirectTrust is a health care industry alliance created by and for participants in the Direct exchange network used for secure, interoperable exchange of personal health information (PHI) between provider organizations, and between provider and patients, for the purpose of improved coordination of care.
FHIR is a new standard that defines a web API and related specifications for health data exchange. Direct is an existing federal standard that is widely used in the USA for the exchange of health care data. There are differing views across the health care system as to the correct relationship between the two standards and communities.
Direct, DirectTrust, and FHIR: A Value Proposition, which is offered to the DirectTrust and FHIR communities for their consideration, does the following:
"The existing work in the FHIR eco-system does not standardize all aspects of establishing trust between systems," says Grahame Grieve. Grieve, FHIR's original architect, is director of HL7's FHIR international programs and principal at Health Intersections, a Melbourne, Australia-based consultancy. "While FHIR offers SMART-on-FHIR as a way to delegate authorization, underlying trust frameworks are needed to provide a framework in which these are managed. Working with DirectTrust could potentially save the FHIR community from the costs of building a new trust framework by using one already proven to scale high identity assurance," Grieve concludes.
"Collaboration is key to getting the best out of standards," says DirectTrust President and CEO David C. Kibbe, MD, MBA. "We should take every opportunity to combine the strengths of different interoperability standards, so that they enrich and support each other. No single standard, either for transport, or for content, or for trust in identity, can do everything that is needed by providers and patients wanting to securely share and exchange health information using various tools and technologies. At DirectTrust, we're delighted to share insights and innovations with the HL7 FHIR implementation community this way."