InterSystems early adopter of Hira FHIR API

FEATURE - Industry Innovation Article

InterSystems, a creative data technology provider, has become an early user of the Hira Programme’s application programming interfaces (APIs) developed by Health New Zealand – Te Whatu Ora using the HL7^® FHIR^® health data sharing standard.

APIs enable two or more computer programs to communicate with each other using a set of definitions and protocols. The Hira Programme is driving the move to using FHIR-based APIs for interoperability to enable New Zealanders to access their health information securely wherever it is stored.

Patient administration
Brian Biggs, customer relations and sales director for InterSystems New Zealand, says the company found out that new API functionality was being developed by Te Whatu Ora when his team started the discovery phase of a major patient administration system project.

InterSystems is delivering the patient administration system for Te Toka Tumai Auckland, part of Te Whatu Ora. Serving multiple facilities, including Auckland City Hospital, Starship Children’s Hospital and several community organisations, the system is due to go live in mid-2024.

“Our long-term goal was always to use the National Health Index API, but in any project of this scale, it can be a risk relying on technology that doesn’t quite exist yet,” says Biggs.

“So, we started to work with Te Whatu Ora data and digital identity team, who were developing the NHI API, with a view to InterSystems being early adopters.

“Together, we took the theory and started to discuss how certain scenarios would be handled – for example, how we would work with patients – and put it in the real world.”

Biggs gives the example of managing the identity of a person only known by one name (a mononym) rather than a first name and a surname.

“Currently, the legacy NHI needs a first name and a last name. So, we needed to determine what would happen with the new service when someone had a mononym. The specification said to treat any single name as a mononym. Many systems, including ours, need at least a surname – but treating a single surname as a mononym may have impacts, including with patient identification, in downstream systems.

“These were the types of conversations we were having. We were very excited by the level of engagement we had with the Te Whatu Ora team – they were very pragmatic, open and collaborative.”

Benefits
Biggs says using the FHIR-based APIs has several benefits for Te Toka Tumai Auckland’s new patient administration system, including the ability to reconcile data within the wider information systems environment.

The FHIR (Fast Healthcare Interoperability Resources) standard is a set of rules and specifications for exchanging electronic healthcare data. It is designed to be flexible and adaptable for use in various settings and with different healthcare information systems.

“We will know when a patient’s data was last accessed from the NHI, for example, and FHIR enables us to access other relevant information,” he says. “As well as demographic information, data is retrieved from the National Enrolment Service on the individual GP and GP practice a patient is enrolled with. Data is shared using Health Provider Index identifiers for the individual (HPI-CPN) and the facility (HPI-Fac).

“FHIR enables us to do multiple things at the same time. Whereas historically, you could just do one thing and then another, now you can pull them together into a bundle. Using FHIR resources, we can intuitively and seamlessly provide access to different services in the background without the user having to be aware of the complexities involved.”

The increased reliability and consistency of data will make a big difference to hospital administrators, says Biggs. And, because the patient administration system is the backbone of Te Toka Tumai Auckland’s healthcare information systems, there will be other benefits.

“The system will also benefit patients because the data that other healthcare information systems hold about them will be more up-to-date and reliable.”

Working with Te Whatu Ora
Biggs says the InterSystems team appreciates the opportunity to work with Te Whatu Ora and run the NHI API through real-life scenarios.

“The team at Te Whatu Ora has been genuinely wanting our feedback, and being able to be an early adopter will pay longer-term dividends. It is great for the project, but more importantly, great for the sector.”

Te Whatu Ora Hira Programme industry engagement director Russell Craig says the programme is very pleased with the outcomes of the partnership.

“InterSystems is in the vanguard of those adopting modern FHIR APIs as part of the digital transformation of our health system – transformation being enabled by Hira and other strategic initiatives such as the National Data Platform.

“As Hira continues to build Te Whatu Ora API-management capabilities and releases more FHIR APIs into production, we are looking forward to many more health digital service suppliers following in InterSystems’ footsteps.”

This feature appeared in the Hira Programme update in December 2023.

Picture 2: Brian Biggs, customer relations and sales director for InterSystems New Zealand
Picture 3: Te Whatu Ora Hira Programme industry engagement director Russell Craig

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