OpenMRS' FHIR Strategy

Why FHIR? 

• Integrations between systems in healthcare are critical for exchanging important health information - e.g. between the EMR and a Lab System, or Inventory System, or a National Identify System.
• HL7 FHIR is a standard for how information can be shared between systems. Over the last decade FHIR has been embraced by health system leaders and corporations world-wide as the standard-of-choice for health-related data sharing. 
• In recent years, the OpenMRS community - especially implementers and policy makers - has increasingly embraced FHIR as an efficient way of achieving cross-system interoperability. 

How can OpenMRS Members use FHIR today? 

• OpenMRS FHIR API: The community-created, community-maintained OpenMRS FHIR Module acts as a translation layer between the FHIR standard and OpenMRS' custom data model: it maps OpenMRS data model items to FHIR Resources, and provides a FHIR REST API developers can use to query data for purposes of client-side rendering (e.g. a frontend widget) or data exchange with another system. The FHIR Module allows both export and import of data in the form of FHIR Resources - a "two-way street". 
• OpenMRS FHIR IG: To see which FHIR resources are mapped to OpenMRS and what to query, see the OpenMRS FHIR IG documentation here. The OpenMRS FHIR Module does not (yet!) cover all possible FHIR resources nor all the data in OpenMRS, but we have aimed to cover the highest priority items. We have been building out the module with community implementers based on their pressing needs (e.g. see the Lab System, MPI, and SHR use cases below). 

Other Applications of FHIR

• Using FHIR for Data Storage. Some community members are interested in whether a FHIR Database (e.g. HAPI FHIR) could eventually be used to completely replace the custom OpenMRS backend altogether; however, there remains world-wide debate about whether FHIR should only be used for data transfer rather than data storage. For now, we are keenly watching the experience of other global goods like Ona who recently completed this switch to a FHIR database. In fact, we are watching community interest in and maintenance of the current FHIR Module to help us gauge the actual market demand for FHIR amidst OpenMRS implementers.
• Using FHIR for Data Analytics at scale. Google Health recently collaborated with the OpenMRS Analytics Squad on exactly this use case. The resulting tooling for performant fhir-based data analysis is the "fhir data pipes" project, a collection of tools for extracting FHIR resources and analytics services on top of that data. 

Last Updated: Mar 7 2023 by Grace Potma. Note: We are forever grateful to Brown University and ITECH for their dedication in co-founding the OpenMRS FHIR Module. 

Examples: Showing FHIR being used in real OpenMRS Implementations

For an exhaustive, more detailed list, please see Real-world OpenMRS FHIR Projects and Tutorials. These examples and videos should help inspire you: 

Tutorial Videos