What is FHIR? A plain-language guide for doctors in Senegal
What is FHIR? A plain-language guide to the health data standard: resources, codes, API, SMART on FHIR, who uses it and what it changes for clinics in Senegal.
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The standard
Imagine every clinic in Dakar writing prescriptions in its own private shorthand. Each one makes sense inside its own walls and nowhere else. FHIR, pronounced “fire”, is the international answer: a shared way to write, label and exchange health information, published by HL7, the global health-standards organisation, and free for anyone to use.
No IT background needed. FHIR rests on four simple ideas; together they let a prescription written in Plateau be read correctly in a pharmacy in Medina, a lab in Parcelles or an insurer’s office.
1
Standard forms
Every piece of health information has an agreed shape, called a resource: a patient, an appointment, a prescription, a blood-pressure reading. Like an official form, everyone fills in the same boxes in the same way, so any system can read it.
2
Shared codes
Diseases, lab tests and medicines carry international codes. Whether a doctor writes paludisme, malaria or palu, the record carries the same code, 1F40, and every system understands it the same way.
3
A common way to ask
Systems talk over the internet using the same simple requests, a bit like ordering from the same menu everywhere: “give me this patient’s prescriptions”. Any FHIR system understands the question and answers in the same format.
4
The patient holds the key
Nothing is shared by default. An app or a pharmacy only sees what it has been allowed to see, with the patient’s consent, and every access is recorded.
Try it: one disease, one code
However the diagnosis is written, the record carries the same international code. Pick a word.
ICD-11 · WHO1F40Malaria due to Plasmodium falciparum
Sources: ICD-11 1F40.
Under the app, every booking or prescription is a small structured document called a resource. Pick one and point at a line: the note on the right says what it means.
1{2"resourceType": "Patient",13"id": "awa-diop",24"name": [{ "family": "Diop", "given": ["Awa"] }],35"gender": "female",6"birthDate": "1990-04-12",47"telecom": [{ "system": "phone", "value": "+221 77 000 00 00" }],58"communication": [{ "language": { "text": "Wolof" } }]69}
Who the care is for.
- 1The type of form. Every FHIR system knows what a Patient contains.
- 2A stable identifier, so other records can point to Awa.
- 3Names in agreed boxes: family name, given names.
- 4Dates always written the same way (year-month-day).
- 5How to reach her: the phone number used for SMS reminders.
- 6The language she prefers for her care.
Written once by a doctor in Dakar, read by everyone who is allowed to. No one retypes it and no paper travels. The national figure arrives without the patient’s name.
Swipe to follow the prescription →
Without
- Each app invents its own format
- Data retyped, lost or duplicated
- Every new connection is a costly custom project
- Patients start from zero at each clinic
With
- One shared format, published and free to use
- Written once, read wherever it is allowed
- New partners plug into the standard
- The history follows the patient
“FHIR is to health data what the shipping container was to trade: the box is standard, so everything else can move.”
01US health software
Required by federal rulesCertified health software must offer standard FHIR access.
02Epic
Hospital softwareOne of the largest hospital record systems, with FHIR interfaces.
03Apple Health
On millions of phonesHealth Records on iPhone are retrieved in FHIR.
04WHO
SMART GuidelinesPublishes its guidelines as FHIR implementation guides.
05DHIS2
Senegal’s national systemWorks with FHIR through its integration tools.
06India
National digital health missionIts national health records are exchanged in FHIR.
Four words worth knowing
Resource
One standard building block: a patient, an appointment, a prescription. FHIR R4 defines about 145 of them.
Code
An international label for a disease, a test or a medicine, from lists such as ICD-11, LOINC or ATC.
API
The common door through which systems ask for information and send it back.
SMART on FHIR
The rules for signing in and giving consent, so each app only sees what it is allowed to see.