SME Session 7: Scaling Requirements for FHIR RESTful Exchange Intermediaries 

This SME Panel Session will focus on the proposed solution to address barriers related to Scaling Architecture, developed by the FAST Directory, Versions and Scale Tiger Team. The group of SMEs invited to participate in this session will be asked to evaluate the team's proposed solution, "Scaling Requirements for FHIR RESTful Exchange Intermediaries",  and provide expert insight, feedback, and guidance.

Intermediaries will be needed to scale FHIR across a growing number of healthcare ecosystem participants in anticipation of future healthcare needs and increased transactions embedded in clinical workflows.  Yet there are no “rules of the road” for intermediaries to meet minimum requirements for performance, availability, or response times in support of synchronous end-to-end real-time data exchange.  The FAST team has proposed a solution intended to support:

  • The ability to utilize intermediaries to reduce the complexity of connecting with a large number of endpoints and managing authentication and authorization with each
  • Predictable intermediary performance to meet real-time exchanges


NameOrganization Participation Role 
Patrick MurtaHumanaMeeting Facilitator, ONC FAST Chief Architect 
Paul OatesCignaMeeting Facilitator, ONC FAST Chief Architect 
Alex KonturHHS | ONC Meeting Facilitator, ONC FAST Lead 
Alix GossImpradoMeeting Facilitator, ONC FAST Tiger Team Lead 
Bob Dieterle Enablecare Meeting Facilitator, ONC FAST Tiger Team Lead 
Arien MalecChange HealthcareSubject Matter Expert
Michael PrivatAvailitySubject Matter Expert
James AgnewSmile CDRSubject Matter Expert
Sasha VolkovOptumSubject Matter Expert
John KellyEdifecsSubject Matter Expert
Mike GouldBCBSASubject Matter Expert

Vijey Kris Sridharan

UnitedSubject Matter Expert
Patrick HarenCigna/ EvernorthSubject Matter Expert
Patrick Murta or designeeHumanaSubject Matter Expert
Hans BuitendijkCernerSubject Matter Expert
TBDAthenahealthSubject Matter Expert
Vassil PeytchevEpicSubject Matter Expert
Jeff DanfordAllscripts/ VeradigmSubject Matter Expert
Rohit ShindeeClinical Works/ HealowSubject Matter Expert
TBDMilitary/DoD/VASubject Matter Expert
Eric HeflineHealth ExchangeSubject Matter Expert
Alan SwensonCarequalitySubject Matter Expert
Jason VogtCommonWellSubject Matter Expert
Tim PletcherMIHINSubject Matter Expert
Brandon NeiswenderCRISPSubject Matter Expert
Cody JohansenUHINSubject Matter Expert
Matt SpielmanInterSystemsSubject Matter Expert
Bill GreggHCASubject Matter Expert
Verghese AbrahamSutter HealthSubject Matter Expert
Mike WestoverProvidence St. JosephSubject Matter Expert
Michael ShoemakerProvidence St. JosephSubject Matter Expert
Jon CopleyCenteneSubject Matter Expert
John LoonskAssociation of Public Health Laboratories (APHL) Subject Matter Expert
Walter SuarezDigital BridgeSubject Matter Expert
Paula BraunCDCSubject Matter Expert
Richard HawesCDCSubject Matter Expert
Jamie FergusonKaiser PermanenteSubject Matter Expert

*All SME participants with an asterisk by their name are invited, pending confirmation. 

Relevant Pre-meeting Reading Material 

SME Session Details

The nominated SME's will be asked to participate in two meetings in their area of expertise. 

Meeting #1 - SMEs Prep-session  (1 hour) (closed session, by invite only)

  • Date/time: 4-5PM ET
  • Scope and goals: This session is intended to orient SMEs to the work of FAST, the barriers this team is addressing and the proposed solution the team has developed. The goal is to provide SMEs with the foundational knowledge required to conduct an evaluation of the proposed solution prior to the SME Session.
  • Agenda
    • Introductions
    • FAST 101
    • SME Role and Expectations
    • Barriers & Proposed Solution
    • Setting the Stage for SME Session
  • Meeting Materials: FAST_SME PREP Session_Scaling Architecture_120221_FINAL.pdf

Meeting #2 -  SMEs Panel Session - An industry discussion around the FAST proposed solution for Scaling Requirements for FHIR RESTful Exchange Intermediaries  (3 hours) (closed session, by invite only)

  • Date/time:   3-6PM ET
  • Scope and goals: The goal of this session is to elicit SMEs expert insight into proposed solution(s), specifically:
    • Feasibility and effectiveness
    • Potential gaps
    • Unintended consequences
    • Alternate approaches to consider
    • Industry path forward (standard, regulation or policy)
  • Agenda
    • Welcome
    • Session Goals
    • Solution Review and Discussion
    • Implications of Solution
    • Industry Path Forward
    • Action Items
  • Meeting Materials: FAST_SME Session_Scaling Architecture_120621_FINAL.pdf

Learn More About FAST

FAST’s goal is to analyze and identify HL7® Fast Healthcare Interoperability Resources (FHIR®) scalability gaps and offer possible solutions that will address current barriers and will accelerate FHIR adoption at scale. 

To learn more, you can review the FAST Action Plan for a snapshot of the progress made by FAST so far.

Next Steps following SME Sessions

    • FAST Report-Out to summarize session discussion, decisions, and next steps
    • FAST Action Plan updates to define proposed solution path (standard, regulation and/or process)

Contact Us

If you have any further questions, comments or would like more information please contact ONC FAST Lead:

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